functional medicine and nutritional genomics - American Association ...

More documents

Recommendations

Info

AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS Stress, Reward Pathways and Eating It is well known that stress affects eating behaviors. Brain reward circuitry appears to play a key role in stress related food intake. A theoretical model of Reward Based Stress Eating has been proposed by researchers at the University of California, San Francisco Department of Psychiatry. xxxi According to this model, cortisol and the reward circuitry affect motivation for calorically dense food intake. The reward value of food may be influenced by cortisol via neuroendocrine/peptide mediators such as insulin, leptin, and neuropeptide Y (NPY). Hence, the model also emphasizes the relationship between stress, eating, and potential neuroendocrine mediators. xxxi Stress, in addition to highly palatable food, can stimulate endogenous release of opioids. Opioid release appears to be part of the organism’s defense mechanism designed to protect from detrimental stress effects. This is done by reducing hypothalamic-pituitary-adrenal (HPA) axis activity and thereby attenuating the stress response. Stimulation of the reward circuits via the intake of highly palatable foods, stress induced stimulation of the HPA axis, or both, may lead to neurobiological adaptations that encourage overeating. xxxi Treating Obesity by Changing the Brain Most weight loss programs are not successful long-term. One reason may be due to the lack of attention given to the brain’s very powerful reward pathways. To improve success, it may be necessary to change reward circuitry that trigger cravings and drives to overeat highly palatable foods. Behavioral interventions that enhance dopamine function hold potential in the treatment of obesity. Breakthroughs in neuroscience show us that we can change our brain’s circuitry. We can literally choose to increase certain neural networks and reduce others. A comprehensive behaviorally based program designed to ‚re-wire‛ the brain’s reward pathways can be an effective way to reduce food cravings and overeating. Although detailed program 62 design is beyond the scope of this article, a few suggestions will be made. � A variety of professionals might be involved (i.e., dietitian, physician, exercise physiologist, psychologist) and a variety of formats (online and phone support, individual consultations, group classes, etc.) might be incorporated. � Treatment should be individualized and incorporate a variety of cognitive and behavioral tools. These tools should help the individual: 1) decrease the reward value of the food or behavior; 2) increase the reward of the new positive behaviors; 3) reduce the power of triggers; and 4) strengthen new neural circuits by learning new habits. xxxii � Stress management tools should be incorporated daily to weaken neural circuits that promote stress. Increasing natural pleasures can help reduce stress and may improve dopamine function. Exercise is a well known natural pleasure, stress reducer, and mood enhancer. This may be due to changes in neurotransmitter concentrations and alterations in central neural activity. xxxiii Techniques such as mindfulness meditation have been found to increase activity in the left prefrontal cortex, which is associated with joy and peace. ix � Analysis of stimuli, situations, and cues that trigger out-of-control-eating is critical. This information can help the patient become aware of the unconscious cues or settings that drive overeating behaviors. xxxiv Avoidance of certain triggers or foods (i.e., refined sugar) may be necessary at least initially. Ingrained behaviors will not likely change without a significant amount of repetition. Cognitive and behavioral tools must be practiced repeatedly if they are going to weaken the strong neural circuits that favor overeating. It is clear that to better treat the obesity epidemic we must unravel the neural mechanisms that process the hedonic effects of highly palatable foods, but also those that govern reward-learning, 2012
AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS reward-value, and decision making in the context of our current economic and social climate. Thanks to Sarah Harding Laidlaw, MS, RD CDE, Newsletter Editor of the Dietitians and Integrative and Functional Medicine Practice Group of the Acadamey of Nutrition and Dietetics. Reprinted with permission: Vargas, M. Highly Palatable Foods: The Brain Rewards Pathways and Connections to Overeating. Dietitians in Integrative and Functional Medicine. 2010: 13:2: 35-37. Micheline Vargas is owner and CEO of Lifestyle Therapy Resource Inc., a health and wellness consulting company. She specializes in the prevention and treatment of chronic diseases including obesity. She is an advisor to the Center of Optimal Health in Buena Park California, a speaker, and an author. Dr. Vargas is an Instructor for UCLA Extensions where she will be teaching courses in Food, Mood, and Eating Behaviors and Exercise and Sports Nutrition. She is also a sports nutritionist. She has provided nutritional counseling to collegiate sports teams and professional athletes. She is currently working with two professional sports teams – Detroit Red Wings Hockey Team and AC Milan Soccer Team in Italy. Dr. Vargas was a Research Scientist in the Supplement Product Development Department at the Nutrilite Health Institute. Her research emphasized the development of botanical products with functional properties designed to maintain health and well-being. She supported many product lines including, sports supplements, weight management, heart health, women's health, and men's health. Prior to joining Nutrilite, Dr. Vargas was a professor at California State University, Fullerton. She taught courses in nutrition, clinical exercise physiology, and health. She was also an adjunct faculty member at Loma Linda University where she taught a course in electrocardiography 63 (ECG). Dr. Vargas worked as a Clinical Exercise Physiologist in Cardiac Rehabilitation. She also worked as a Preventive Care Specialist, where she provided lifestyle therapy to weight management patients. Dr. Vargas has authored manuscripts on weight management; atherosclerosis, functional foods, and nutritional genomics; and the relationship between CRP, metabolic syndrome, and exercise. Dr. Vargas is a Certified Nutrition Specialist (CNS), Registered Clinical Exercise Physiologist (RCEP), Certified Strength and Conditioning Specialist (CSCS), and an Emotional Brain Training (EBT) provider. She held a certification as a Group Exercise Instructor from the American Council on Exercise for 14 years. She holds professional memberships with the American College of Sports Medicine, the American College of Lifestyle Medicine, the Obesity Society, and the American Society for Nutrition. Aside from her scientific interests she is an avid runner, has participated in triathlon, and loves Pilates and yoga. Contact Micheline Vargas at micheline.vargas@yahoo.com or 818-383-4664. References: i National Health and Nutrition Examination survey (NHANES 2001-2004). Accessed online 6/1/10. ii National Center for Health Statistics survey (2005-2006). Accessed online 6/1/10. iii Stix G. A Question of Sustenance. Scientific American. September 2007. iv World Health Organization Media Centre. Obesity and Overweight. The World Health Organization. http:www.who.int/mediacentre/factsheets/fs311/en/in dex.html. Published September 2006. Accessed 6/1/10. v Yale Hosts Historic Conference on Food and Addiction. Yale Office of Public Affairs and Communications Web site. http://opa.yale.edu/news/article.aspx?id=1581. Published July 9, 2007. Accessed 6/1/10. vi DiLeone RJ. The influence of leptin on the dopamine system and implications for ingestive behavior. International Journal of Obesity. 2009;33:S25-S29. 2012
Page 1 and 2:
2012 AAPI’S NUTRITION GUIDE TO OP
Page 3 and 4:
AAPI’S NUTRITION GUIDE TO OPTIMAL
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18: AAPI’S NUTRITION GUIDE TO OPTIMAL
Page 67: AAPI’S NUTRITION GUIDE TO OPTIMAL
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
show all

functional medicine and nutritional genomics - American Association ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?