Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

The connection between a healthy lifestyle and a healthy mood state is often overlooked; however it is well known that exercise and other natural methods are effective at alleviating depression symptoms.  My natural protocol for depression has helped many sufferers of depression and seasonal affective disorder (SAD) improve their symptoms without the risks and side effects associated with antidepressant medications. Even for those of us who do not suffer a mood disorder, it is common to experience some decline in mood during the winter. Fortunately, there are natural methods that help to alleviate the winter blues.

Exercise

Exercise is known to be as effective as antidepressant drugs or cognitive behavioral therapy for improving the symptoms of depression.  Exercise works by increasing the production of serotonin, a mood-elevating neurotransmitter, which is often low in those with depression. The combination of aerobic exercise plus strength training is better than aerobic exercise alone, and yoga has also been shown to improve symptoms.^1-4

Light exposure

In the winter, we tend to spend most the day’s sunlit hours indoors, at work or just staying warm at home. Exposure of the retina to morning light helps the brain to properly regulate its production of melatonin and therefore our sleep-wake cycle; inadequate light exposure during the winter can disrupt this cycle. During the winter, if getting natural sunlight isn’t possible, a therapeutic light is an effective substitute; it corrects the body’s clock, restores normal melatonin production, and stimulates production of serotonin.⁵  SAD has been successfully treated with light therapy for nearly thirty years, and light therapy is also highly effective for depression, comparable to the effects of anti-depressant drugs, so it is effective even for non-seasonal depression.⁶ Light therapy is an excellent tool for anyone who experiences sadness, fatigue, or disrupted sleep patterns, and especially if you note this associated with winter.  

Omega-3 fatty acids

Omega-3 fatty acids play an important role in brain health; DHA is primarily associated with cognitive function, and EPA with mood.⁷ A recent meta-analysis of 28 trials determined that EPA supplementation is effective for improving depression symptoms.^7,8  EPA and DHA are considered long-chain omega-3 fatty acids, in contrast to the shorter ALA found in plant foods, such as flax, hemp, and chia seeds, walnuts and leafy greens. The primary source of EPA is fish, although a small amount ALA from plant foods can be converted to DHA and EPA in the body. Since conversion efficiency is low for many people, in addition to eating ALA-rich foods daily, I recommend a DHA + EPA supplement for everyone, and additional EPA for those with depression.^9-11

High-nutrient diet

Two recent studies compared mood scores in subjects eating vegetarian or omnivorous diets.  In an observational study, vegetarian Seventh Day Adventists reported more positive mood and lower levels of depression and anxiety compared to omnivore Adventists.¹²  In a second study by the same research team, subjects were assigned to different diets for two weeks. The subjects in the vegetarian group increased their mood scores after the two weeks, but those on the omnivorous diet did not.¹³  These results suggest that plant foods contain substances that positively affect mood. One possibility is the high antioxidant content of plant foods; the brain is highly susceptible to oxidative stress, and markers of oxidative stress are indeed associated with a higher incidence of depression.¹⁴

In October 2012, another study found a connection between fruit and vegetable consumption and healthy mood.  The authors collected data on the diets of 80,000 people, and analyzed scores on a life satisfaction questionnaire relative to the amount of fruit and vegetables consumed daily. Even after adjusting for many other parameters such as employment status, marital status, income, illness, education, and other dietary variables, greater fruit and vegetable consumption was strongly correlated with greater life satisfaction scores.¹⁵

In addition to antioxidants, vitamins and minerals may factor into the positive effects of fruits and vegetables on mood. Several B vitamins contribute to the production of mood-enhancing neurotransmitters, folate for example.^16,17 Folate deficiency is known to increase the risk of depression; about one-third of people with depression are folate-deficient.^17-20 Also, a low-sodium, high-potassium diet has been shown to have a positive effect on mood.²¹ Green vegetables and legumes are rich in folate, and all whole plant foods are naturally rich in potassium and low in sodium.

Vitamin D

Reduced exposure to sunlight during the winter means less natural vitamin D production by the skin. Scientists don’t know exactly how vitamin D works in the brain, but it is thought to affect the production of neurotransmitters, including serotonin.²²  Low blood vitamin D levels are associated with SAD and depression, and there is evidence that supplementing with vitamin D helps to maintain a healthy mood state.^{23, 24} For example, a 4000 IU/day dose of vitamin D for six months starting in the summer improved wellbeing scores in February compared to a lower (600 IU) dose.²⁵ Vitamin D is active in essentially every cell and tissue in the human body, and contributes to many facets of health.  It is crucial for everyone to maintain adequate blood vitamin D levels (a 25(OH)D of 35-50 ng/ml) with supplements.

The natural brain-healthy properties of a high-nutrient diet, regular exercise, adequate vitamin D and omega-3 stores, and light exposure combine to promote a positive mood, even in the cold, gray days of winter.

Image credit: Flickr - SashaW 

References:
1. Gill A, Womack R, Safranek S. Clinical Inquiries: Does exercise alleviate symptoms of depression? J Fam Pract 2010;59:530-531.
2. Uebelacker LA, Epstein-Lubow G, Gaudiano BA, et al. Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract 2010;16:22-33.
3. Saeed SA, Antonacci DJ, Bloch RM. Exercise, yoga, and meditation for depressive and anxiety disorders. Am Fam Physician 2010;81:981-986.
4. Ma Q. Beneficial effects of moderate voluntary physical exercise and its biological mechanisms on brain health. Neurosci Bull 2008;24:265-270.
5. Miller AL. Epidemiology, etiology, and natural treatment of seasonal affective disorder. Altern Med Rev 2005;10:5-13.
6. Golden RN, Gaynes BN, Ekstrom RD, et al. The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry 2005;162:656-662.
7. Kidd PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev 2007;12:207-227.
8. Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr 2009;28:525-542.
9. Harnack K, Andersen G, Somoza V. Quantitation of alpha-linolenic acid elongation to eicosapentaenoic and docosahexaenoic acid as affected by the ratio of n6/n3 fatty acids. Nutr Metab 2009;6:8.
10. Davis BC, Kris-Etherton PM. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr 2003;78:640S-646S.
11. Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr 2006;83:1467S-1476S.
12. Beezhold BL, Johnston CS, Daigle DR. Vegetarian diets are associated with healthy mood states: a cross-sectional study in Seventh Day Adventist adults. Nutrition Journal 2010;9:26.
13. Beezhold BL, Johnston CS. Restriction of meat, fish, and poultry in omnivores improves mood: A pilot randomized controlled trial. Nutr J 2012;11:9.
14. Tsuboi H, Shimoi K, Kinae N, et al. Depressive symptoms are independently correlated with lipid peroxidation in a female population: comparison with vitamins and carotenoids. J Psychosom Res 2004;56:53-58.
15. Blanchflower DG, Oswald AJ, Stewart-Brown S. Is Psychological Well-Being Linked to the Consumption of Fruit and Vegetables? Social Indicators Research 2012.
16. Coppen A, Bolander-Gouaille C. Treatment of depression: time to consider folic acid and vitamin B12. J Psychopharmacol 2005;19:59-65.
17. Miller AL. The methylation, neurotransmitter, and antioxidant connections between folate and depression. Altern Med Rev 2008;13:216-226.
18. Ng TP, Feng L, Niti M, et al. Folate, vitamin B12, homocysteine, and depressive symptoms in a population sample of older Chinese adults. J Am Geriatr Soc 2009;57:871-876.
19. Sachdev PS, Parslow RA, Lux O, et al. Relationship of homocysteine, folic acid and vitamin B12 with depression in a middle-aged community sample. Psychol Med 2005;35:529-538.
20. Watanabe H, Ishida S, Konno Y, et al. Impact of dietary folate intake on depressive symptoms in young women of reproductive age. J Midwifery Womens Health 2012;57:43-48.
21. Torres SJ, Nowson CA, Worsley A. Dietary electrolytes are related to mood. Br J Nutr 2008;100:1038-1045.
22. Bertone-Johnson ER. Vitamin D and the occurrence of depression: causal association or circumstantial evidence? Nutr Rev 2009;67:481-492.
23. Murphy PK, Wagner CL. Vitamin D and mood disorders among women: an integrative review. J Midwifery Womens Health 2008;53:440-446.
24. Lee DM, Tajar A, O'Neill TW, et al. Lower vitamin D levels are associated with depression among community-dwelling European men. J Psychopharmacol 2011;25:1320-1328.
25. Vieth R, Kimball S, Hu A, et al. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J 2004;3:8.

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A recent study published in the Nutrition Journal reports that eschewing animal products in favor of plant-based foods helps improve mood in just a few weeks.  This short-term study incorporated thirty-nine omnivores.  Each participant was randomly assigned to a control group consuming meat, fish and poultry daily, a group consuming fish 3-4 times per week but avoiding meat and poultry or a vegetarian group avoiding meat, fish and poultry.  At the outset of the study and after two weeks of making assigned dietary transitions, participants were asked to complete a Food Frequency Questionnaire, the Profile of Mood States questionnaire and the Depression Anxiety and Stress scales.  By the conclusion of the study, mood scores remained constant for the omnivore and fish eating group but several mood scores for vegetarian participants improved significantly.¹  These findings might be surprising given that people who eat fish regularly increase their intake of healthy eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) fatty acids, fats that are critical for optimal brain health.  This is what makes the study’s results so surprising.

Research evidence has frequently linked long-chain omega-3 fatty acids, EPA and DHA, to mood- a substance primarily found in fish and shellfish.  Conversely, meat and poultry are high in arachidonic acid (AA), a potentially neuroinflammatory long-chain omega-6 fatty acid.  Omnivores who consume large amounts of meat and poultry and low amounts of fish, with their elevated AA to EPA/DHA ratio, have been known to be at increased risk of depression.² Omnivorous diets rich in fish and low in meat and poultry have been linked to a lower risk of depression.3 Vegetarian and vegan diets tend to be low in both long-chain omega-3 and long-chain omega-6 fatty acids, but prior to this study, there has been limited research examining the effects of a vegetarian diet on mental well-being. 

Potential confounding variables such as a prior history of mental disorder, alcohol or substance abuse, BMI, age, gender and exercise frequency were accounted for and a general health history was completed at baseline.  After two-weeks, the vegetarian group’s levels of EPA, DHA and AA dropped to negligible amounts while the fish eating group exhibited a 95-100 percent rise in dietary EPA/DHA.  This evidence is indicative that manipulation of fatty acid concentrations in each of the participants was successful.  In every individual on the vegetarian plan, stress and anxiety scores decreased after the two weeks, indicative that those who eliminate meat, fish and poultry may be better able to cope with mental stress than omnivores.  The results of this study support another cross-sectional study which found that vegetarians report significantly better moods than non-vegetarians.⁴

While warranting further investigation, the results may be due to increased antioxidant consumption on the vegetarian plan leading to a reduction in oxidative stress on the brain.⁵ These findings are fascinating and while we might not completely understand the mechanisms involved in why a vegetarian diet likely leads to enhanced mood, the results are certainly worth pondering.  I know I feel good as I finish off my huge salad or green smoothie!   

I know my father gets excellent results with those suffering with depression by combining his nutritarian diet with added EPA and morning light therapy.  He always uses nutrition and lifestyle medicine as the primary intervention, not drugs, which can lead to dependency, side effects and long-term health problems.  It is good to know that the scientific literature is slowly catching up to Dr. Fuhrman (my dad).   Who knows, maybe next year some other study will show that combining green vegetables, onions and mushrooms prevent cancer (Ha Ha)!

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Thirty years ago this Valentines Day my husband and I became officially engaged. We were young, naïve, and deeply in love. Little did we know about the dark prison that lie just ahead for both of us with my budding food addiction and resulting binge eating disorder and obesity. While we were dating, I had confided that I had a “food problem,” but neither of us had any clue whatsoever how powerful it was, or how severely food addiction would take over and practically destroy my life. [Back in 1981 food addiction was not openly discussed or understood like it is today.] Since today is a special day for sweethearts, I want to focus on those who are supporting a spouse or significant other through food addiction by inviting my husband, Kurt, to share his thoughts on the topic. Welcome to Disease Proof, Kurt.  

What was your initial reaction when I first told you that I had a “food problem” when we were dating?

 I thought it was no big deal.  After all, in my mind I thought, “Who doesn’t have an extra piece of cake once in awhile?”  Besides, you were so special to me that I couldn’t believe there was anything that was a problem.

From your perspective, what was it like to discover and see first-hand the seriousness of my food addiction / binge eating disorder after we were married?

It was hard, especially when it seemed like you were out of control.  I could see that you wanted out of the addiction, yet seemed helpless to help yourself.  My first reaction was to try to control things, and being a typical guy, I thought it was something that I needed to fix. Unfortunately as I tried unsuccessfully to “fix” it, usually in an unproductive way, it only made the addiction worse.

How did it make you feel?

I felt disappointed and cheated. I realize now that I had very unrealistic expectations and views on life, but unfortunately, my perception was my reality at the time.

What was the turning point for you?

I don’t think there was one point as much as a series of turns.  I was so frustrated and disappointed that I got honest with God about how I felt.  Then I just didn’t care anymore.  For awhile I did my own thing, and found ways to detach myself and emotionally escape.  It was just easier to give up and not care or try to help anymore.  Eventually God pointed out my own “stuff” that I needed to deal with; and even though the food addiction was a terrible situation, He used it to burn up some of my own crud that was an issue as well.   We went to a professional counselor, and I learned the only person that I could change was me.  That was a huge turning point in the process because I finally stopped trying to change you.  I worked on dealing with my own garbage, and then I started to believe you when you’d say, “Someday I’m going to get free.”  

What has it been like to see me get free from food addiction and get my health back?

 

It was like a light came on and good things started happening immediately when you committed to Eat to Live ~ beyond anything either one of us had ever dreamed.  It was amazing.  To see someone go from getting beat up mentally, emotionally and physically with food addiction to being healthy, confident, and free; and helping others to do the same is indescribable.  It’s like watching the movie “Rocky” for the first time; witnessing someone that you love and want the best for finally winning in a war they’ve been fighting for years. 

 

 

What are your thoughts to share with others who are supporting a loved one through food addiction and resulting eating disorders and diseases? 

 

• Be honest with yourself and acknowledge your feelings.  Stuffing your frustrations and anger only makes it worse.

• Be committed to the relationship.  Everyone needs someone solid and a good influence in their life.

• Realize you can’t change them.  The only person that you can change is yourself. 

• There may be times when you’ll need to pull back so your “boat” doesn’t sink.  A person drowning in addiction can pull others down with them so maintain your own mental, spiritual, emotional, and physical health; just don’t abandon them.

• Seek professional counseling for the person as well as yourself.  Not all counselors are equal.  If a counselor doesn’t help, then keep looking. The key is being willing to be totally honest about the underlying root problems and cut out the destructive issues that psychologically fuel addiction.

• Don’t quit.  Never give up.  Never give in.  Never, Never, Never.  Like the old adage goes, “When you reach the end of your rope, tie a knot and hang on!”

   

   

Related posts:

Are you a food addict?  by Dr. Fuhrman

A Valentine’s love story;  an interview with Peggy Valentine, wife of Ronnie who suffered for years from food, alcohol and cigarette addiction, and today is completely free

Freedom is for everyone!  by Emily Boller

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• Mom is tired so she stops by Dairy Queen on the way home from the late afternoon soccer game. She orders a Blizzard for herself and dipped cones for the children. There are some chips and leftover slices of pizza at home if anyone gets hungry before bed.   Lately she’s been too wiped out to care.

• Junior is sitting in front of the computer munching on Doritos for supper. Dad and Mom don’t mind because they are lounging in their lazy boys watching the news while eating cheddar melts and curly fries. Later on they plan to dig into the two quarts of fudge ripple and butter pecan ice cream that’s in the freezer. Cooking and setting-the-table for dinner are obsolete words in their household. 

• Baby is teething and cranky but the frazzled Mom has discovered that McDonald’s salted fries do the trick to quiet him down every time. Her two-year-old is also a happy camper when eating a Happy Meal in Playland. Mom has found the perfect place of serenity to escape to while eating Big Macs and chocolate sundaes at the golden arches.  

• When the new parents held their twins for the first time, they had ideals for excellent nutrition. However, one by one, those ideals were tossed by the wayside in the flood of social events and birthday parties. Hotdogs, donuts, cake and ice-cream took over the best of logic and common sense. The pressure to fit in overcame the desire to be healthy. Today their teens eat chicken nuggets, cheeseburgers, or pizza pockets most nights of the week.                  

In a study conducted by RAND Corporation, alcoholism increases the risk of chronic illnesses by 12%; cigarette smoking increases the risk of chronic illnesses by 25%; and obesity increases the risk of chronic illnesses by 67%.¹

We have laws established to govern and prohibit the sale of both cigarettes and alcohol to minors, yet gluttonous eating that leads to obesity and poor health is practiced everywhere; especially by adults who are setting the example and leading the way by promoting the dangerous lifestyle. 

An infant is encouraged to eat French fries that develops into an addiction for salty, high fat, processed foods in the preschool years; which snowballs into craving bags of chips and slices of pizza during the pre-teen / teen years. Chronic fatigue from malnutrition is replaced by Pepsi, coffee and energy drinks that become the drugs of choice through college and beyond. Over time, hypertension, heart disease, diabetes, fatigue, and depression become the accepted and expected, All-American diseases; stimulating the economy by keeping drug reps employed, pharmaceutical companies in business, and surgical suites well staffed. 

When a faulty crib or playpen is recalled a wise parent returns the product. 

When crossing a busy street a careful guardian holds a child’s hand.

When danger lies ahead a prudent caregiver changes paths.

A victim is one that is [intentionally or unintentionally] injured, harmed, or destroyed by another.

 

Are children the innocent victims of our vices?

¹ RAND Corporation; “The Health Risks of Obesity”; © 2002

 image credits - Flickr: babies by paparutzi; Pepsi Max by Lord Biro

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Depression is a growing problem in our society, and diabetes has reached epidemic proportions.
Major depressive disorder affects nearly 15 million American adults – that’s almost 7% of the adult population, and it is the leading cause of disability in the U.S. for individuals aged 15-44. [1] Type 2 diabetes affects almost 10% of Americans, about 24 million people, and is the 7th leading cause of death in the U.S. [2]

In women, it has been shown that those with depression are more likely to develop diabetes, and those with diabetes are more likely to develop clinical depression.[3] Diabetes doubles the risk of heart attack and stroke, and depression is also an independent risk factor for heart disease, increasing risk by 64%. [2, 4] A new study has found that the coexistence of depression and diabetes imposes additive detrimental effects, especially with regard to death from cardiovascular disease. As a part of the Nurses’ Health Study, 78,000 women were followed for 6 years, and diagnoses of depression and type 2 diabetes were recorded.

Compared to subjects with neither diabetes nor depression:

• Depression alone increased risk of all-cause mortality by 53%, and cardiovascular mortality by 56%
• Diabetes alone increased risk of all-cause mortality by 52%, and cardiovascular mortality by 146%
• The risk of death from all causes climbed in those with both conditions to more than double, and risk of cardiovascular mortality almost quadruple that of individuals with neither condition.
• Those who had lived with diabetes for more than ten years combined with depression more than tripled their risk of death from cardiovascular disease.
• Depressed individuals who were also on insulin therapy had almost 5 times the risk of death from cardiovascular disease.[5, 6]

This is a reminder not only of the substantial health hazards associated with diabetes, but also the significance of the mind-body connection – in this study, depression increased the risk of death from all causes by 53%. Psychological conditions profoundly affect physical health. The potential physiological effects of depression on the cardiovascular system include increased platelet aggregation and inflammation, sympathetic nervous system hyperactivity, and impaired endothelial function. [7] Living healthfully, with the right lifestyle and diet-style in conjunction with judicious use of supplements to assure comprehensive nutritional adequacy can go a long way to making sure you and your loved ones avoid both diabetes and depression.

No one needs to resign to becoming a victim of these common American conditions.

Even if you have or have had depression, there are effective natural methods for getting well. Dr. Fuhrman uses a treatment regimen that includes morning light therapy and exercise combined with a high nutrient diet and supplementation with vitamin D and omega-3 fatty acids for patients with depression. Type 2 diabetes is a disease of poor lifestyle choices. As such, health-promoting lifestyle habits – a plant-based diet and exercise – are established in the medical literature as effective treatments for diabetes. [8-13] Furthermore, Dr. Fuhrman’s high-nutrient, vegetable-based diet offers dramatic results as it unlocks the body’s enormous healing potential, enabling many people to completely reverse their diabetes. Living a healthy lifestyle allows you to take control of your own health – both physical and mental health.

References:

1. The Numbers Count: Mental Disorders in America.
2. American Diabetes Association: Diabetes statistics. Available from: http://www.diabetes.org/diabetes-basics/diabetes-statistics/.
3. Pan, A., et al., Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med, 2010. 170(21): p. 1884-91.
4. Wulsin, L.R. and B.M. Singal, Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med, 2003. 65(2): p. 201-10.
5. Pan, A., et al., Increased mortality risk in women with depression and diabetes mellitus. Arch Gen Psychiatry, 2011. 68(1): p. 42-50.
6. Walsh, N. Depression Plus Diabetes Raises CV Death Risk. Medpage Today, 2011.
7. Huffman, J.C., C.M. Celano, and J.L. Januzzi, The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes. Neuropsychiatr Dis Treat, 2010. 6: p. 123-36.
8. Barnard, N.D., et al., A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr, 2009. 89(5): p. 1588S-1596S.
9. Barnard, N.D., et al., A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care, 2006. 29(8): p. 1777-83.
10. Barnard, N.D., et al., Vegetarian and vegan diets in type 2 diabetes management. Nutr Rev, 2009. 67(5): p. 255-63.
11. Trapp, C.B. and N.D. Barnard, Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Curr Diab Rep, 2010. 10(2): p. 152-8.
12. Thomas, D.E., E.J. Elliott, and G.A. Naughton, Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev, 2006. 3: p. CD002968.
13. Conn, V.S., et al., Metabolic effects of interventions to increase exercise in adults with type 2 diabetes. Diabetologia, 2007. 50(5): p. 913-21.

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Exercise is so much more than just burning calories. The calories burned during exercise, unless you’re a professional athlete, make up quite a small portion of our total calories burned for the day; what we eat has a much greater influence on our body weight. So why should we bother to exercise? Because burning a few calories is just the tip of the iceberg – exercise is an indispensible component of a healthy lifestyle, and has profound beneficial effects, especially on the heart and brain. So if you’ve committed to 6 weeks of healthy eating during the holiday challenge, why not add some exercise?

Here are just a few of the many benefits of daily exercise:

Protects against chronic diseases.

Regular physical activity reduces the risk of coronary heart disease and diabetes by 30-50%. [1] There are clear associations between physical activity and decreased risk of colon, breast, and prostate cancers, and this is thought to be in part due to effects on the insulin-like growth factor 1 (IGF-1) system. [2] Exercise also protects against osteoporosis, as muscle strength is the best predictor of bone strength.

Less time spent sitting. 

There has been an 83% increase in sedentary jobs since 1950 – most of us are inactive for most of the day.[3] But the human body was meant to move – our ancestors probably walked up to 12 miles each day, every day.[4] Getting out to the gym for one hour is one hour you don’t spend sitting in a chair or on your couch – significant because prolonged sitting is associated with increased risk of diabetes and overall mortality.[5]

Makes the brain happy.

Exercise truly is nature’s mood elevator. [4, 6] In fact, exercise has such a powerful positive effect on our mental state that it is prescribed as a treatment for major depression. Meta-analyses of clinical studies have shown that exercise alone works just as well as anti-depressant drugs or cognitive behavioral therapy for depression. Aerobic exercise plus strength training works better than aerobic exercise alone, and hatha yoga (physical yoga) is also effective at reducing depression symptoms. [7-9] Exercise affects the levels of several neurotransmitters in the brain, including increasing the production of serotonin, which is associated with feelings of well-being. [10] Anti-depressant drugs are often in the class of selective serotonin reuptake inhibitors (SSRIs), drugs that increase the amount of serotonin in the brain – but it turns out we can elevate serotonin naturally with exercise.

Keeps the brain thinking. 

Physical activity has been consistently linked to cognitive abilities and mental alertness.[4] In older adults, regular walking was shown to decrease the risk of cognitive impairment and contribute to maintenance of brain volume [11], and strength training also produces cognitive benefits.[12] Physical activity may exert these effects in part by enhancing blood flow to the brain, which accelerates detoxification of free radicals – important since the brain is especially susceptible to oxidative damage.[4]

Keeps the mind focused and present.

Exercise helps to bring the human mind into the present moment, becoming intensely aware of sensations in the body, rather than daydreaming. A study published last month in Science found that the human mind is daydreaming (not thinking about its current task) about 47% of the time, and also that people rated their mood as happier when they were focused on their present activity rather than engaging in other thoughts. Certain activities were better correlated to focus on the present than others - the top two were sex and exercise. [13, 14] Certain types of exercise generate more presence than others – for example, it’s more likely that you’d daydream while running on a treadmill than in a yoga class. Mindfulness practices are known to be effective for reducing depression symptoms, and breathing exercises can reduce blood pressure, stress, and anxiety. [7, 15, 16] The incorporation of these two factors into physical activity results in a greater improvement in health outcomes than physical activity alone, according to a recent meta-analysis of comparisons between hatha yoga and other forms of exercise. [17]

Makes the heart work smarter, not harder

Exercise necessitates a huge increase in cardiac output (amount of blood pumped by the heart over a given amount of time), because of huge increases in oxygen demands. The muscle of the left ventricle is getting a workout, and that muscle can grow stronger with regular exercise. Endurance athletes may increase their left ventricular muscle mass by up to 30%! Essentially, the heart can do less work to pump the same amount of blood. This means that resting heart rate decreases. [18] This is desirable, since a high resting heart rate is an independent risk factor for cardiac mortality.[19]

Natural vasodilation. Bigger, better vessels

As blood flow increases during exercise, mechanical stresses placed on the vessel walls are altered, and these mechanical stimuli prompt changes in the endothelial cells that line the vessels. Coronary artery disease and congestive heart failure patients who exercise increase their expression of eNOS (endothelial nitric oxide synthase), a key regulator of blood pressure. In healthy individuals, the eNOS effect is not as pronounced and is transient, but it stimulates angiogenesis and vascular remodeling, increasing both the number and diameter of arterial vessels in skeletal and cardiac muscle, which results in improved blood flow to these organs. [20, 21]

A few more favors exercise does for us:

Builds our antioxidant defenses. [20]
Enhances sleep. [22, 23]
Protects against chronic inflammation. [24]
 

Here’s the best part: if you exercise regularly, you will get better at it and start to like it. 

Anything you practice on a regular basis will get easier over time, and the same is true for exercise. At first, it may feel cumbersome and very uncomfortable, but over time exercise will become enjoyable. Eventually, it becomes so routine and so enjoyable that if you don’t exercise for a few days, you will miss it terribly. (Really. I promise.)

 

So…what are you waiting for? Get out there and get moving! Your body and mind will both thank you.

 

And tell us:

• Who wants to commit to exercising every day throughout the rest of the Six Week Holiday Challenge? 

• What type(s) of exercise do you enjoy most?

   

image credits: flickr; tennis balls by aechempati; runner by lululemon athletica

References:
1. Bassuk, S.S. and J.E. Manson, Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol, 2005. 99(3): p. 1193-204.
2. American Institute for Cancer Research: The Exercise Factor. [cited 2010 September 1, 2010]; Newsletter 85, Fall 2004:[Available from: http://www.aicr.org/site/News2?page=NewsArticle&id=7651&news_iv_ctrl=0&abbr=pub_.
3. The Price of Inactivity. American Heart Association.
4. Medina, J., brain rules. 2008, Seattle, WA: Pear Press.
5. van Uffelen, J.G., et al., Occupational sitting and health risks: a systematic review. Am J Prev Med, 2010. 39(4): p. 379-88.
6. Hyman, M., The UltraMind Solution2009, New York, NY: Scribner.
7. Gill, A., R. Womack, and S. Safranek, Clinical Inquiries: Does exercise alleviate symptoms of depression? J Fam Pract, 2010. 59(9): p. 530-1.
8. Uebelacker, L.A., et al., Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract, 2010. 16(1): p. 22-33.
9. Saeed, S.A., D.J. Antonacci, and R.M. Bloch, Exercise, yoga, and meditation for depressive and anxiety disorders. Am Fam Physician, 2010. 81(8): p. 981-6.
10. Ma, Q., Beneficial effects of moderate voluntary physical exercise and its biological mechanisms on brain health. Neurosci Bull, 2008. 24(4): p. 265-70.
11. Erickson, K.I., et al., Physical activity predicts gray matter volume in late adulthood: the Cardiovascular Health Study. Neurology, 2010. 75(16): p. 1415-22.
12. Davis, J.C., et al., Sustained Cognitive and Economic Benefits of Resistance Training Among Community- Dwelling Senior Women: A 1-Year Follow-up Study of the Brain Power Study. Arch Intern Med, 2010. 170(22): p. 2036-8.
13. Killingsworth, M.A. and D.T. Gilbert, A wandering mind is an unhappy mind. Science, 2010. 330(6006): p. 932.
14. Tierney, J. When the Mind Wanders, Happiness Also Strays. The New York Times, 2010.
15. Anderson, D.E., J.D. McNeely, and B.G. Windham, Regular slow-breathing exercise effects on blood pressure and breathing patterns at rest. J Hum Hypertens, 2010. 24(12): p. 807-13.
16. Brown, R.P. and P.L. Gerbarg, Yoga breathing, meditation, and longevity. Ann N Y Acad Sci, 2009. 1172: p. 54-62.
17. Ross, A. and S. Thomas, The health benefits of yoga and exercise: a review of comparison studies. J Altern Complement Med, 2010. 16(1): p. 3-12.
18. Duncker, D.J. and R.J. Bache, Regulation of coronary blood flow during exercise. Physiol Rev, 2008. 88(3): p. 1009-86.
19. Verrier, R.L. and A. Tan, Heart rate, autonomic markers, and cardiac mortality. Heart Rhythm, 2009. 6(11 Suppl): p. S68-75.
20. Kojda, G. and R. Hambrecht, Molecular mechanisms of vascular adaptations to exercise. Physical activity as an effective antioxidant therapy? Cardiovasc Res, 2005. 67(2): p. 187-97.
21. Brown, M.D., Exercise and coronary vascular remodelling in the healthy heart. Exp Physiol, 2003. 88(5): p. 645-58.
22. Atkinson, G. and D. Davenne, Relationships between sleep, physical activity and human health. Physiol Behav, 2007. 90(2-3): p. 229-35.
23. Montgomery, P. and J. Dennis, Physical exercise for sleep problems in adults aged 60+. Cochrane Database Syst Rev, 2002(4): p. CD003404.
24. Mathur, N. and B.K. Pedersen, Exercise as a mean to control low-grade systemic inflammation. Mediators Inflamm, 2008. 2008: p. 109502.

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The days are beginning to get shorter and we’re spending more time indoors as most of the day’s sunlit hours are occurring during the work day. For our bodies, this is a significant change to adjust to, especially for those of us who live in cooler climates. It’s common to experience some decline in mood during the winter – feelings of anxiety and depression are known to be more prevalent throughout the colder months. For some individuals, these seasonal mood changes along with fatigue, irritability, and appetite changes are especially pronounced, and this is called Seasonal Affective Disorder (SAD).[1] Incidence of SAD increases with distance from the equator, and light therapy is an effective treatment for many individuals with SAD. Reduced sunlight exposure, resulting in shifts in circadian rhythms and alterations in serotonin metabolism, is thought to underlie this condition.[2]

Timing of exposure of the retina to light affects the sleep-wake cycle, and inadequate light exposure during the winter disrupts this cycle. Light therapy independent of vitamin D production (ultraviolet light is filtered out), especially in the morning hours, is known to be effective for treating SAD and major depression. SAD has been successfully treated with light therapy since the early 1980s. For depression, a meta-analysis in 2005 revealed that the effectiveness of light therapy was comparable to that reported in many trials of anti-depressant drugs.[3] Light entry into the retina inhibits production of melatonin, a hormone that promotes sleep. Light therapy helps to restore melatonin, the neurotransmitter serotonin, and other mood-regulating molecules to their normal time cycles and levels of production; consequently depressive symptoms are reduced.[4]

Reduced exposure to sunlight during the winter also means less natural vitamin D production by the skin, , and vitamin D itself may also regulate mood. There is still much unknown about how vitamin D works in the brain, but there are plenty of vitamin D receptors in the brain, and it is thought to affect daily biorhythms and production of neurotransmitters, including serotonin.[1] Also, low circulating vitamin D is associated with SAD and major depression.[5] So far, only a handful trials of vitamin D supplementation for seasonal depressive symptoms have been performed, and some of these used doses that were likely too low to have any measurable effect (400 IU; currently many experts believe that 2000 IU/day or more may be necessary for most people to maintain adequate blood 25(OH)D levels [6]). A dose of 800 IU improved mood of healthy subjects during winter in one trial [7], but had no effect in another trial.[8] A third trial used a dose of 4000 IU/day for six months starting in the summer, and then evaluated feelings of wellbeing during the December-February time period. The 4000 IU dose of vitamin D produced an average 25(OH)D level of 45 ng/ml and improved wellbeing scores compared to a 600 IU dose (average 25(OH)D level of 32 ng/ml). [9]

Current research is investigating the connection between depression and diabetes with a focus on vitamin D. Because depression is associated with insulin resistance, and vitamin D is thought to affect insulin secretion by the pancreas, ongoing studies are evaluating whether vitamin D supplementation can help to prevent diabetes. [10] In fact, healthy adults with low vitamin D levels were more likely to develop diabetes within 10 years compared those with adequate levels, according to a recent study. [11]

Vitamin D is active in essentially every cell and tissue in the human body. It is crucial (for everyone, not just sufferers of SAD ) to maintain adequate 25(OH)D levels (Dr. Fuhrman recommends 35-55 ng/ml) with supplementation. Especially if you note mood or sleep issues during the winter, be sure to accompany vitamin D supplementation with plenty of morning light.

References:

1. Bertone-Johnson, E.R., Vitamin D and the occurrence of depression: causal association or circumstantial evidence? Nutr Rev, 2009. 67(8): p. 481-92.
2. Lurie, S.J., et al., Seasonal affective disorder. Am Fam Physician, 2006. 74(9): p. 1521-4.
3. Golden, R.N., et al., The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry, 2005. 162(4): p. 656-62.
4. Miller, A.L., Epidemiology, etiology, and natural treatment of seasonal affective disorder. Altern Med Rev, 2005. 10(1): p. 5-13.
5. Murphy, P.K. and C.L. Wagner, Vitamin D and mood disorders among women: an integrative review. J Midwifery Womens Health, 2008. 53(5): p. 440-6.
6. University of California - Riverside (2010, July 19). More than half the world's population gets insufficient vitamin D, says biochemist. ScienceDaily July 28, 2010]; Available from: http://www.sciencedaily.com/releases/2010/07/100715172042.htm.
7. Lansdowne, A.T. and S.C. Provost, Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl), 1998. 135(4): p. 319-23.
8. Dumville, J.C., et al., Can vitamin D supplementation prevent winter-time blues? A randomised trial among older women. J Nutr Health Aging, 2006. 10(2): p. 151-3.
9. Vieth, R., et al., Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J, 2004. 3: p. 8.
10. Loyola University Health System (2010, March 8). Vitamin D lifts mood during cold weather months, researchers say. ScienceDaily. . November 9, 2010]; Available from: http://www.sciencedaily.com/releases/2010/03/100303162854.htm.
11. Valencia, W., Abstract 125: Prospective risk of hyperglycemia in a South Florida population with low levels of vitamin D, in World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease 2010.

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(Image credit: Fakeelvis @Flickr)

Three recent studies document that consumption of processed foods increase odds of depression, and not only that, but those high protein, high fat diets (high in animal products) are also linked with more depression. The diet to protect against depression – that is simple, a high nutrient, plant-based diet outlined in my books, Eat for Health and Eat to Live. 

In one study, middle-aged subjects were categorized by their dietary patterns based on how much “whole” or “processed” food they consumed. The high processed foods group was characterized by high intake of sweetened desserts, fried food, processed meat, refined grains, and high-fat dairy products. Five years later, the researchers evaluated how many of the subjects had reported depression symptoms.

Subjects who ate the most whole foods had the lowest odds of depression, and those who ate the most processed foods had the highest odds of depression – 60% increased odds compared to those who ate the least amount of processed foods.¹

Another study compared the effects of low-fat plant-based diet and low-carbohydrate animal-product-rich diet on mood in overweight women. Although both groups lost similar amounts of weight over one year, measures of mental health and mood only improved in the low-fat group. The low-carb dieters eating more fat and animal products had higher depression scores. The authors also cited previous human studies in which high protein, low-carbohydrate diets have resulted in cognitive impairment.²

A third study measured scores of depression before and after removing meat, poultry, and fish from subjects normally eating a typical American diet. Indicators of depression significantly decreased after removing all the animal products and shifting to a plant-based diet for 2 weeks. ³

Nutrition is crucial for regulating mood – high oxidative stress in the brain and low levels of several micronutrients have also been linked to depression.⁴  

These studies are a reminder that what we eat affects not only our physical health but our mental health as well. Combine great diet with light therapy, exercise, sufficient Vitamin D and the right fatty acid balance for the brain, and you have my protocol to beat depression. 

References:

1. Akbaraly TN et al. Dietary pattern and depressive symptoms in middle age. Br J Psychiatry. 2009 Nov;195(5):408-13.

2. Brinkworth et al. Long-term Effects of a Very Low-Carbohydrate Diet

and a Low-Fat Diet on Mood and Cognitive Function. Arch Intern Med. 2009;169(20):1873-1880

3. Beezhold BL et al. Preliminary evidence that vegetarian diet improves mood. American Public Health Association 2009 National Meeting, Abstract 206464. 

4. Leung BM, Kaplan BJ. Perinatal depression: prevalence, risks, and the nutrition link--a review of the literature. J Am Diet Assoc. 2009 Sep;109(9):1566-75.

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Preface:  Over the next year or two, I'll be following the weight loss journey of Stephanie, age 39, who is 200% committed to getting her health back.  Her husband died recently and she’s currently raising four young children under the ages of nine, plus attending nursing school.  Stephanie has courageously volunteered to share her thoughts and medical stats with DiseaseProof readers as she undertakes the journey to optimal health.  Welcome Stephanie!

Why have you chosen to commit to nutritarian eating?  I currently weigh 398 lbs (5’10”) and I’m tired all the time.  I cry a lot and get easily irritated and aggravated.  My knees hurt, I have constant headaches and acid reflux.  My local doctor feels that I’m unable to lose weight on my own and is urging me to have gastric bypass surgery.  I want to play at the park, ride bikes and be a fit and healthy mother for my children.  Most importantly, I want to BE HERE for them.

What are some of the events in your life that have led you to this point?  I’ve been overweight my entire life, but have steadily added more pounds each year; especially after having babies.  Last year my husband died after a battle with congestive heart failure and a failed heart transplant.  In an instant, I became a 38-year-old widowed mother of four children ages eight to three, and the stress has been overwhelming.  During this past year I have been diagnosed with premature osteoarthritis in both knees, high blood pressure, ADHD, and major depression. 

Describe a typical day for you:  My alarm goes off at 6:45 am, but I hit the snooze button four times before I drag myself out of bed.  I struggle to pull myself together and prepare the kids’ breakfasts and get them off to school.  I plan my day by prioritizing how much energy and/or steps it will take to do an activity.  It’s difficult to do much with my children, because I’m unable to move fast due to my size. 

                                           I feel like I’m a prisoner in my own body. 

• Weight  398 lbs.
• BMI  57.1
• Blood pressure  140/100
• Waist measurement  58”
• Cholesterol  180
• Triglycerides  98
• HDL  48
• LDL  112
• Fasting blood sugar  87
• currently taking anti-depressants, amphetamines for ADHD, and medication for urinary incontinence

Stephanie’s “official” starting date is November 1,  2009, and I’ll be posting her progress updates the first week of every month.  We are cheering for Stephanie and wish her all the best as she takes this courageous step to get her health and life back!    

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Here’s more depressing vitamin D news. Writing in the Journal of Clinical Lipidology, scientists have determined insufficient vitamin D is associated with a 31% prevalence of metabolic syndrome, compared to only 10% for people with higher levels. I got Dr. Fuhrman's thoughts on this vitamin D mess.

What nobody considers in the metabolic syndrome (and overeating) issue is my overall message and mantra and that is that low-nutrient eating in general creates metabolic derangements leading to discomforts relievable by overeating.

This I have labeled toxic hunger. Toxic hunger or food addition has at its basis, low micronutrient intake. We have an exciting study we just completed documenting the changing perception of hunger with high-nutrient density diet and it is compelling.

In related news, lack of vitamin D has been linked to depression, difficulty thinking, high blood pressure and back pain. Luckily, Dr. Fuhrman’s Osteo–Sun can help keep your Vitamin D level within ideal range.

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