Food for Anxiety and Depression

8/2/2019 Food for Anxiety and Depression

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Food for Anxiousand Depressed

Mind

Clinical Dietitian

Bee See Wei


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Sneak Preview

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Facts and Statistics of anxiety

and depressionSymptoms and Causes

Foods for anxious and depressedmind: Myths and facts, Whatworks?

Special topic: Eating Disorder andCase Study

Q& A

Food foranxious and

depressedmind


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Facts and Statistics

1. Depression is the leading cause of disability

among Malaysian female (12.7%), compared to7.2 % in men; known as 4th leadingcontributor to global burden of disease.

2. Occurs more in women than men (ratio 2:1);This could be due to hormonal changes that

women experience during menstruation,pregnancy, postnatal phase and menopause

3. Women between age of 25-44 are mostaffected group

4. Anxiety Disorders are the most commonpsychiatric condition, affecting 25% of adults atsome point in their lives & 5%+/- of hospital pts.

Source: Malaysian Burden of Disease and Injury Study, 2000


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Symptoms of anxiety and depression

Headache Nervous stomach Change in appetite Rapid breathing Rapid heart rate Sweaty palms Irritability Fatigue Insomnia

Dissatisfaction Anger Inability to concentrate


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Causes

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Major life events such asdivorce, financialdifficulties, job loss

People with low selfesteem

Genetics predisposition

Serious orchronicphysical illness

Stressful environment

Lack of supportiverelationship


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http://rds.yahoo.com/_ylt=A0S0204G1CFIgh4BRr6JzbkF;_ylu=X3oDMTByc2R0bHV1BHBvcwMxNjIEc2VjA3NyBHZ0aWQDSTk5OV83Mw--/SIG=1jt5g8gp3/EXP=1210262918/**http%3A//images.search.yahoo.com/images/view%3Fback=http%253A%252F%252Fimages.search.yahoo.com%252Fsearch%252Fimages%253Fp%253Dcouch%252Bpotato%2526ni%253D18%2526ei%253DUTF-8%2526fr%253Dyfp-t-120%2526xargs%253D0%2526pstart%253D1%2526b%253D145%26w=375%26h=500%26imgurl=static.flickr.com%252F2023%252F1561603147_1cf14ff8c2.jpg%26rurl=http%253A%252F%252Fwww.flickr.com%252Fphotos%252Fstovak%252F1561603147%252F%26size=151.1kB%26name=33/365%20-%20Couch%20potatoing%26p=couch%20potato%26type=JPG%26oid=22e61536262692b6%26fusr=stovak%26tit=33/365%20-%20Couch%20potatoing%26hurl=http%3A//www.flickr.com/photos/stovak/%26no=162&tt=28250


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Maintain Healthy Weight

According to Journal of Clinical Psychology: Science and

Practice, showed a link between obesity and depression,indicating people who are obese are more likely to becomedepressed.

Obesity and depression may result from physiological changesin immune system and hormones with depression.


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Diseases and Co-morbidities Associated WithObesity

Psychological: Low

self-esteem,depression, anxiety

Neurological: Nerve entrapment,

sciatica

Respiratory :Breathlessness, obstructivesleep apnoea

Cardiovascular: stroke,hypertension, coronary heartdisease, deep venousthrombosis

Breast: Breast cancer,gynoecomastia

Metabolic : Type 2 diabetes,dyslipidemia, insulinresistance, polycystic ovarysyndrome (PCOS)

Gastro-intestinal: Hiatushernia, gallstones, colorectalcancer, fatty liver

Orthopaedic:Osteoarthritis (of weight-bearing joints)

Genito-urinary: Stress incontinence,reduced fertility, pregnancycomplications

*World Health Organization Steering committee. The Asia-Pacific perspective: Redefining obesity and its treatment.1-56 2000. Health Communication Australia


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MALAYSIA BOLEH!!!

Prevalence of Obesity in

Malaysia 20.1% of males are

overweight and 4% are obese.

For females, 21.4% are

overweight and 7.6% are obese

In Malaysia, 25% - 30% of

adolescents are overweight

(UKM, MOH 2004) )

Latest statistic : 48% are overweight and 90% of them likely are

pre diabetic and diabetic )


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Current status : Prevalence of Obesity in MalaysianAdult

Prevalence of Obesity

29

4

14

17

0

5

10

15

20

25

30

35

NHMS 1996 NHMS 2006

Percentage

Overweight

Obesity


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Body Mass Index = Weight (kg)Height(m2)

If YOUR BMI IS YOU ARE

18.4 or less Underweight

18.5 to 24.9 Desired body weight

25.0 to 29.9 Overweight ( Pre-obese)

30 to 34.9 Obese grade I

35 to 39.9 Obese grade II

40 and above Obese grade III

Desired BMI is 23 kg/m2 * BMI only for ages 18 to 64 years old only


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Know Your Needs in A Day

Quick MethodActivitylevel

BMI > 23 kg/m2 BMI 18.5 22.9kg/m2

Sedentary 20 25 kcal/kg 30 kcal/kg

Moderate 25 30 kcal/kg 35 kcal/kg

Active 30 35 kcal/kg 40 kcal/kg


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1 TEASPOON OF SUGAR IS 20 KCALS

1 TEASPOON OF RICE IS 6 KCALS

1 TEASPOON OF FAT/OIL IS 45 KCALS

1 gram of carbohydrate = 4 kcals

1 gram of protein = 4 kcals

1 gram of fat = 9 kcals

500 additional calories can increaseyour weight by kg in one week

1 gram alcohol = 7 kcals

Calories


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Regular Eating PatternLunch

Breakfast

Dinner

AfternoonSnack

MorningSnack


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Small Serving

Largeserving

Medium

serving

The smaller the portion, the lesser the calories

Watch your portion


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Modify Recipes and Food Preparations


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Ways to minimize fat in cooking..

Roasting BarbecueMicrowave

Stir fryingSteaming Shallow fat frying


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Tips to Enhance Taste In Cooking

Usenatural spices and herbs in cooking


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Eating Out and About

49g Fat, 702 kcal 14g Fat, 355 kcal

*Atlas of Food Exchanges and Portion Sizes. UKM 2002


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40g Fat, 687 kcal 7g Fat, 153 kcal



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19.4g Fat, 553 kcal 23g Fat, 762 kcal



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9g Fat, 300 kcal13g Fat, 356 kcal



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21g Fat, 340 kcal6g Fat, 154 kcal




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How can Diet Affect Depression?

1. Neurotransmitters relay nerve impulsesthroughout body and make up

communication system in brain.

2. Neurotransmitters seem to have mostimpact on your mood are:

Serotonin Dopamine Noradrenalin Glutamine Endorphins

3. A diet that is low in amino acidtryptophan has been found to increasedepression.

4. Consumption inadequate amounts ofomega fatty acid, antioxidantvitamins, folate, and vitamin B 12

have also found to relate to depression


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Nutrients in foodssupport bodys repair,growth, and wellness.

Including vitamins,minerals,

carbohydrates, proteinand sufficient amountsof fat

A deficiency in any ofthese nutrients lead to

bodies not working atfull capacity

Eat a Diet High in Nutrients


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Food Pyramid Your Guide to Eat Well


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Damaging molecules called free radicals contribute to aging and dysfunction

Antioxidants such as beta carotene, vitamin C and vitamin E combatseffects of free radicals

Get Essential Antioxidants

Beta Carotene Vitamin C Vitamin E

Apricots, Brocolli,Carrot, Peaches,Pumpkin, Spinach,Sweet potato

Blueberries, Grapefruit,Kiwi, Orange, Peppers,Potatoes,Strawberries, tomato

Margarine, nuts andseeds, vegetable oil,wheat germ

600-800 ug 65-70 mg 7.5-10 mg


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Get Adequate B Complex Vitamin

B complex vitamins involved in cell metablism. Vitamin B6,B12 are essential for making chemical messengers in brainthat regulate mood

In Spanish study, found that rates of depression increased

in men, especially smoker- as Folate, B12 intake reduced.

Folate Vitamin B12

Legumes, nuts, dark leafyvegetables and fruits

All lean and low fat animalproducts, like fish, low-fat dairyproducts


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Include Omega- Fatty Acid

3 types of omega 3 fatty acid: EPA, DHA, and Alpha-linolenic.

In study featured in Archives of General Psychiatry, 2002showed that 1 gram of fish oil/ day helps to decreasesymptoms of anxiety, sleep disorder or unexplained feeling ofsadness

Recommended 2-3 servings fatty fish /week or 1 handfulwalnut/ 1 tablespoon flaxseed oil daily

EPA/ DHA Alpha-linolenic

Fatty fish (anchovy -900mg,mackerel- 1400mg, salmon-800mg, sardines-1000mg, tuna-900mg)

Flaxseed, canola oil, soybean oil,walnuts


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Eat Smart Carbs for CalmingEffect

Connection between carbohydrates and mood is linked to be themood-boosting brain chemical, serotonin. It helps us to feelcalm and less anxiety

Limit sugary foods and opt for smart carbohydrate, such aswhole grain, fruits and vegetables, legumes

A low glycemic carbohydrate releases glucose intobloodstream gradually, preventing sugar low and mood swing


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Eat Protein- Rich foods to BoostAlertness

Tryptophan is an essential amino acid which is convertedinto serotonin in body.

Foods rich in protein like tuna, chicken, fish, low fat dairyproducts boost levels of brain chemical serotonin in happy

zone, this helps you feel good and alert.

Good sources of healthy proteins: beans and peas, lean meat,low fat cheese, fish, milk, soy products, yogurt


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What to avoid? False Pick-me-ups

Alcohol consumption has been found to be common in depressedpeople, and it affect production of serotonin, this is associated withworse outcomes.

Caffeine, in tea, coffee, or fizzy drink might give us energy boost

but can causes a crash as the effect wear off. Drinking too muchmake you shaky or anxious. A few studies have found high caffeineintake (= 6-9 cups of 5 ounce coffee per day) was linked todepression.

A morning cuppa, chocolate bar or candy give us a quick fix of

happy feeling (by releasing neurotransmitter beta endorphin) and aspike of energy, but it doesnt last long. Spending your life on arollercoaster of sugar highs and lows is bad for brain.


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Active Lifestyle Habits

Exercise increases your overall health and sense of well

being:

1) It helps to pump up endorphins (brains feel goodneurotransmitter).

2) Its meditation in motion, results you remain calm andoptimism.

3) It improve mood because regular exercise increaseconfidence, improve sleep and ease your stress level.


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How to Maintain Active Lifestyle

Exercise 3 times a day for 10 minuteseach time e.g. in the morning, afternoonor late evening

At workplace, do desk exercises or walkto your colleagues desk instead ofcalling.

Use the stairs than elevator orescalator.

If the destination is short, walk instead

of driving.

If you drive, park further away fromyour destination and walk!


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Increase Physical Activity Level

Exercise/ Daily Activities Calories burnt in 30 min(if you are 65kg)

Dancing/ Aerobic Dance 204

Yoga 117

Running, 8 mph 462

Football 321

Sitting 60

Climbing up stairs 273

Standing, light work 69

Walking, quick pace, 3 mph 120

hi i id f i


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Hope this is not your idea of exercise


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Myths about Foods for Depression

Myth: Coffee helps get relief from stress?

Caffeine injects adrenaline into your system, giving you a temporary boost. Butpossibly making you fatigued and depressed later. If you take more caffeine tocounteract these effect, you end up spending a day in agitated state.

Myth: Carbohydrates cause weight gainCarb do not cause weight gain and neither does protein or fat. In fact, carb should

comprise 50-55% of daily intake for cells functions, especially brain cells. A low

carb diet can cause depression due to lack of serotonin regulation.If carb is too restricted, likely will lead to binge eating and cause weight gain

Myth: Sweet improves our mood?When you are tired and also in bad mood, we look for something sweet like

chocolate. And indeed sweets give us a quick energy, but it also causesfluctuation in sugar level. This results mood swing.

Myth: Skip breakfast is recommended to lose weightNo, study shown that people who skip breakfast gain more weights and perform not

as good in courses that require mental concentration and alertness.


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Special Topic:Eating Disorder (Anorexia/ Bulimia Nervosa) Anorexia nervosa is disease marked by pathological fear of weight gain leading

to rapid or extreme weight loss.

Bulimia nervosa is psychologically stirred eating disorder whereby a personexperiences regular phases of binge eating (overeating) which followed by acompensatory act like purging, fasting, exercise.

Prevalence of eating disorder in Asian is 1-4% girls aged between 14-18 havean eating disorder

1 in 10 urban female college students tend to eating disorder. 70% ofthem are no satisfied with the shape/size of body.

Anorexia is curable in 80% cases that are detected early and treatedeffectively.

3 distinct aspects of eating dysfunction for your child to qualify as clinical eatingdisorder:

1) Physical aspect: weight loss, amenorrhea, fainting, cold intolerance2) Behavioral aspect: strict eating, secretive eating, binge eating, compulsive

exercise, laxative, diet pill..3) Emotional aspect: Depression, anxiety, low self esteem, fear of weight gain,

body image distortion


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Case Study


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Case Study

Journey in Managing Patient with


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Journey in Managing Patient withAnorexia Nervosa

Identify Problem:

1. Eating disorder with anorexia nervosa2. Severe underweight (< 5th percentile of

growth chart)3. Behavioral, physical, and emotional disorder

Journey in Managing Patient with


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Journey in Managing Patient withAnorexia Nervosa

Strategies and Goals :

1) Establish a good rapport or relationship with patient2) Restore the weight to level between ideal weight and

patients ideal weight3) Negotiate an adequate food intake with patient4) The provision of a balanced diet, build up extra 500 kcal

per day in 3-4 meals per day. Expected weight gain0.5kg in a week

5) Teach patient how to keep a food journal, including typeof food eaten, eating frequency, and feeling associated

with eating/exercise6) Encourage patient to recognize and express her feeling

freely


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1) Token of appreciation

2) Parents education

Role model Ways of dealing with their child


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3) attractiveness of the presentation of food

4) More variety of food: Bring food from home


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5) Group therapy

6) Increase outdoor activities

A team approach to care- combining aggressive medicalmanagement, nutritional counseling, group/ family psychotherapy or

behavioral modification therapy the most effective treatment ofanorexia nervosa.

I N t h ll H lth H bit T P t A i t d


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In Nutshell: Healthy Habits To Prevent Anxiety andDepression

Base your food around 3 main

meals each day To check the fat and calories

content on food label

Do not skip meal. Have small lightmeals between if you have a busyschedule

Prepare snacks that are high incomplex carbohydrate andprotein

Select foods that are high inomega fatty acids, vitamin Bcomplexes, vitamin C andantioxidants are proven help to

reduce depression

Drink 2-3litres of water per day.

Avoid excessive intake of caffeine

Exercise and rest


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Thank You for

Your Attention

Any Questions?

Further Contact:

Sime Darby Medical Centre, Subang JayaDietetic Department

Tel: 03 5639 1212 Ext: 1624

Direct line: 03 5639 1627

[email protected]
mailto:[email protected]:[email protected]

Food for Anxiety and Depression

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