Don’t Settle For Just “Getting By”

understanding and addressing depression

Now that spring is well on its way, is your mood picking up? If you’re still feeling the “blahs” – low energy, persistent sadness, changes in appetite or sleep patterns, and a loss of interest in activities you once enjoyed – this might be more than the winter blues.

While Seasonal Affective Disorder (SAD) is a well-known culprit for winter blues, it’s crucial not to overlook other underlying issues that may contribute to depressive symptoms. Booking an appointment with your ND can provide valuable insights into your mental and physical well-being. During your visit, we can explore various factors contributing to depression, including hormonal imbalances, nutritional deficiencies, lifestyle habits, and environmental stressors.

By taking a comprehensive approach, we can tailor a treatment plan to address your unique needs. This may include a combination of dietary adjustments, supplementation, herbal remedies, lifestyle modifications, and acupuncture. Additionally, we will work collaboratively with you to uncover any potential root causes and develop strategies for long-term wellness.

Here a few tips to consider as we hop into spring…

Protein

Foods that are rich in protein contain amino acids that help produce neurotransmitters like dopamine and serotonin. If your protein intake is low, you may experience low mood. Most adults require 1g of protein per kilogram of body weight. Fortunately, it is easy to increase your protein intake – here are some easy ideas to snack on:

• A handful of unsalted almonds, walnuts, and/or pecans

• A hard-boiled egg

• No-bake energy balls

• An apple with 2 tbsp nut butter of your choice

• Sausage sticks or jerky (aim for ones with no fillers)

• Edamame

Mediterranean Diet

The Mediterranean Diet is a diet high in fish, legumes, whole grains, vegetables, fruits, seeds, and olive oil. It is low in high fat meats and dairy products. Following the Mediterranean Diet has been shown to be protective against depression at all ages throughout a person’s lifespan. For more information, check out our past blog post.

Exercise

Adults (including seniors) should get at least 150 minutes of moderate to vigorous physical activity per week[i]. Think that’s a stretch? Here are some ways to incorporate more movement into your day:

• Do squats or lunges while you brush your teeth

• Park farther away from stores or work

• Take the stairs

• Spontaneous dancing (at home OR in public 😊)

• Deep clean something

• Get up and move your body during commercial breaks – marching in place, jumping jacks, walking lunges across the room…be creative!

Sunshine

Exposure to sunlight increases serotonin levels in the brain. While you may be taking a Vitamin D supplement to keep your levels up, being in the sunshine is the best source of natural Vitamin D[ii]. In order to optimize your exposure, we recommend spending anywhere between 5-30 minutes each day outside[iii] – and while you’re out there, why don’t you get in that little extra bit of exercise and take a walk around the block?

Did you know that Vitamin D is not typically tested when you have bloodwork completed by your physician? Many people may be deficient in this important vitamin and not even know it. If this is something you are concerned about or would like to know more, bring it up with your naturopathic doctor - it may be worth investigating!

Don’t forget…

You don’t have to navigate depression alone. Your mental health matters every day and every season of the year.

[i] https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html

[ii] Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023 May 5;15(5):e38578. doi: 10.7759/cureus.38578. PMID: 37284402; PMCID: PMC10239563.

[iii] Srivastava SB. Vitamin D: Do We Need More Than Sunshine? Am J Lifestyle Med. 2021 Apr 3;15(4):397-401. doi: 10.1177/15598276211005689. PMID: 34366736; PMCID: PMC8299926.

Probiotics, Your Microbiome and Your Mood

Have you ever noticed that what you eat impacts your mood? Have you felt worse after binging on junk food or after a night of drinking? There is compelling research suggesting that it may not be just the guilt talking - your microbiome may be contributing in a large way to the conversation.  

What is the microbiome?  

There are 10- to 100-trillion symbiotic microbes of various species existing in and around the human body, collectively referred to as the microbiome [1]. These friendly microbes outnumber your own human cells and have recently become popularized for the growing body of evidence detailing the vast impacts they have on human physiology and behaviour. 

The microbes in your intestines make vitamins, amino acids, hormones, neurotransmitters and other signaling molecules that impact the way your brain and body function [2], [3]. They also produce short-chain fatty acids as byproducts that your intestinal cells use for energy, which contributes to healthy gut function [3].  

These microbes live in our digestive tract and survive off the foods that we eat. Just like any other living organism, their health (and therefore ours) depends on consuming a healthy diet. It has been shown that dietary changes (e.g. from animal-based to plant-based), as well as any significant systemic stress and inflammation can alter the composition (i.e. diversity and abundance of species) of your microbiome within just 24 hours [3].  

Altered microbiome composition has been associated with many conditions, such as inflammatory bowel disease (IBD), psoriasis, atopic dermatitis, autoimmune arthritis, type 2 diabetes, obesity, and atherosclerosis [3]. This is not surprising given the significant role these organisms have in regulating metabolism and immunity. In fact, researchers are finding that the microbiome composition in a given disease seem to have a different complement of microbes associated with it. For example, an IBD microbiome has less diversity (fewer species of healthy microbes), and lower numbers of good bacterial species. Therefore, it has lower short-chain fatty acid production [3]. Short-chain fatty acids (SCFAs) are essential to the health of your intestinal cells and are also thought to be anti-inflammatory in the gut [3]. 

The Microbiome’s Effect on Mood & Behaviour  

Gut microbes relay messages to the brain via various direct and indirect mechanisms - bacterial metabolites, metabolic precursors, immune signalling, vagus nerve signalling, and Hypothalamic Pituitary-Adrenal axis activation [4], [5]. It is through these mechanisms that neurodevelopment or neurodegeneration are influenced [5]. A significant portion of the microbiome influence on the brain comes via the gut-brain axis: a bi-directional pathway connecting the nervous system in your digestive tract to the central nervous system (your brain) [4], [5]. As shown in the graphic below, your gut and your brain communicate directly via nerves that transmit different signals and molecules, which can have a profound effect both ways to both systems [6].

Photo credit: https://fhs.mcmaster.ca/forsythe-lab/microbiota_gut_brain_axis.html 

Considering the gut-brain axis and the physical manifestations that different microbiome composition can produce, it should be no surprise that there are mental/emotional implications as well. Many psychiatric and neurological pathologies have gastrointestinal co-morbidities, including schizophrenia, autism, neurodegenerative diseases, anxiety, and depression [7]. As noted above, different pathologies have different microbiome composition. This extends to mood and neurodegenerative disorders, such as major depressive disorder, schizophrenia, Parkinson’s disease, and autism spectrum disorder [2], [5], [8]. There is also data suggesting that alterations in the microbiome from addictions (e.g. alcohol, cocaine) may be associated with substance cravings and increased risk of developing associated psychiatric disorders, such as anxiety and depression [9], [10]. 

Probiotics & Your Mood 

Probiotics are supplements that contain healthy microbes that ,when ingested, influence the health of your microbiome. Probiotics used to benefit mood and cognition have been coined “psychobiotics,” and are a burgeoning new area of interest in research. A study by Tillisch et al. used brain scans (functional magnetic resonance imaging) to demonstrate the ability of probiotics to alter brain activity in areas associated with processing emotion and sensation, and to reduce negative thinking associated with sad mood [4], [7], [11], [12]. While most studies indicate that further research in this area is needed, associations between specific strains of microbial species and their benefits on various conditions are rapidly emerging [7], [13][14]. A recent human clinical trial of adjunctive probiotic intervention for Major Depressive Disorder (MDD) showed that compared with placebo, probiotic intervention exhibited greater improvement in depressive symptoms [15]. Participants who received the probiotic intervention experienced reductions in both depression and anxiety, and the probiotics were well-tolerated, prompting the authors to suggest probiotics as an acceptable adjunctive intervention for adults with MDD [15]. 

How Can I Support My Microbiome? 

Lifestyle 

A healthy lifestyle goes a long way in supporting your microbiome, and healthy eating is just one part of it. As mentioned earlier, dietary changes, significant systemic stress, and inflammation can alter your microbiome within just 24 hours. There are many different types of stress - physical, mental and emotional - that can lead to physiologic changes that can alter the microbiome. Practicing stress management through self-care, meditation, social connection, thoughtful schedule planning, getting adequate sleep, and setting appropriate boundaries with people and responsibilities will help you be more resilient in dealing with stress. The better you are at managing stress, the less likely it will spill over into added physical or mood-related symptoms.  

Digestive Supports 

Probiotics are a great start to improving your gut health and mood, though quality and potency matter!  Our naturopathic doctors are here to assess if and which type of probiotics are most suitable for you, as well as to review if any further testing or treatments are indicated to optimize your digestive and mental health.  

We are here to help, so reach out if you are looking for professional guidance! 

In Health,  

Dr. Jacalyn Sieben, ND 

[1] Ursell, L.K. et al. (2012). Defining the human microbiome. Nutrition Reviews. Vol. 70 (Suppl. 1):S38- S44. doi:10.1111/j.1753-4887.2012.00493.x

[2] Dinan, T.G. & Cryan, J.F. Mood by microbe: Towards clinical translation. Genome Medicine. 8:36. DOI  10.1186/s13073-016-0292-1

[3] Corfe, B.M. et al. (2015). The multifactorial interplay of diet, the microbiome, and appetite control:  current knowledge and future challenges. Proceedings of the Nutrition Society. 74, 235-244.  doi:10.1017/S0029665114001670

[4] Dinan, T.G., Stilling, R.M., Stanton, C., Cryan, J.F. (2015). Collective unconscious: How gut microbes shape human behavior. Journal of Psychiatric Research. 63:1-9. http://dx.doi.org/10.1016/ j.jpsychires.2015.02.021

[5] Sharon, G. et al. (2016). The central nervous system and the gut microbiome. Cell. 167. http:// dx.doi.org/10.1016/j.cell.2016.10.027

[6] McMaster University. (2019). The microbiota-gut-brain axis. [Digital Image] Retrieved from: https:// fhs.mcmaster.ca/forsythe-lab/microbiota_gut_brain_axis.html

[7] Sampson, T.R. & Mazmanian, S.K. (2015). Control of brain development, function, and behavior by the microbiome. Cell Host & Microbe. http://dx.doi.org/10.1016/j.chom.2015.04.011

[8] Jiang, H. et al. (2015). Altered fecal microbiota composition in patients with major depressive disorder. Brain, Behavior, and Immunity. 48:186-194. http://dx.doi.org/10.1016/j.bbi.2015.03.016

[9] Hillemacher, T., et al. (2018). Alcohol, microbiome, and their effect on psychiatric disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry. Volume 85, Pages 105-115. https://doi.org/ 10.1016/j.pnpbp.2018.04.015

[10] Kiraly, D.D. et al. (2016). Alterations of the host microbiome affect behavioral responses to cocaine. Scientific Reports. 6:35455. DOI: 10.1038/srep35455

[11] Rea, K., Dinan, T.G., Cryan, J.F. (2016). The microbiome: A key regulator of stress and neuroinflammation. Neurobiology of Stress. 23-33. http://dx.doi.org/10.1016/j.ynstr.2016.03.001

[12] Tillisch, K., Labus, J., Kilpatrick, L., Jiang, Z., Stains, J., Ebrat, B., Guyonnet, D., Legrain-Raspaud, S., Trotin, B., Naliboff, B., et al. (2013). Consumption of fermented milk product with probiotic modulates brain activity. Gastroenter- ology 144, 1394–1401. DOI: https://doi.org/10.1053/j.gastro.2013.02.043

[13] Foster, J.A., Rinaman, L., & Cryan, J.F. (2017). Stress & the gut-brain axis: Regulation by the microbiome. Neurobiology of Stress. 124-136. http://dx.doi.org/10.1016/j.ynstr.2017.03.0 01

[14] Sarkar, A. et al. (2016). Psychobiotics and the manipulation of bacteria-gut-brain signals. Trends in Neurosciences. Vol 39, No. 11. http://dx.doi.org/10.1016/j.tins.2016.09.002

[15] Nikolova VL, Cleare AJ, Young AH, Stone JM. (2023). Acceptability, Tolerability, and Estimates of Putative Treatment Effects of Probiotics as Adjunctive Treatment in Patients with Depression: A Randomized Clinical Trial. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2023.1817

Eating to Prevent Chronic Disease: The Mediterranean Diet

Eating to Prevent Chronic Disease

What is a Mediterranean Diet?

The Mediterranean diet is a diet high in fish, legumes, whole grains, vegetables, fruits, nuts, seeds, and olive oil. It is low in high fat meats and dairy products.

If you want to be on a healthy Mediterranean diet you should try eliminating cream, butter, margarine, carbonated and/or sugared beverages, and processed foods such as pastries, industrial bakery products, industrial desserts (puddings, custard), French fries, potato chips, cakes and sweets.

It is a good idea to limit your consumption of cured meats, red meats, and cured and fatty cheeses. When choosing animal products, choose healthy sources (Grass fed, Free range, wild etc) that have minimal contaminates and a good balance of omega-3 and omega 6 fatty acids.

The Mediterranean diet is also characterized by a high intake of b-carotene, B vitamins, vitamin C, vitamin E, folic acid, polyphenols and a wide variety of phytochemicals that are found in the various plant foods frequently consumed (1).

Research shows adherence to Mediterranean diet is effective in prevention of cardiovascular disease, depression, metabolic syndrome and Type 2 Diabetes. The information to follow summarizes a bit of the research.

Supporting Research

Cardiovascular Disease

The Mediterranean diet has been ranked as the most likely dietary model to provide protection against coronary heart disease. (2)

 In a 2018 study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet (Med Diet) supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet. (3)

• 3 groups studied

o   Low-fat diet

o   Mediterranean Diet with added nuts

o   Mediterranean Diet with added olive oil

• Risk of combined heart attack, stroke and death from cardiovascular disease compared to low-fat diet was reduced by 30% in the Med Diet + Olive Oil and 28% in the Med Diet + Nuts.

Good adherence to a Mediterranean diet resulted in a more favorable health status as reflected by improved cardio vascular disease risk factors, such as lipid profile, blood pressure, and glucose, especially in persons with diabetes and compared with a low-carbohydrate diet. (4)

Higher adherence to a Mediterranean diet was associated with lower mean levels of blood pressure after 6 years of follow-up. (4)

Diabetes

Mediterranean diet supplemented with extra virgin olive oil (EVOO) or mixed nuts has shown to reduce the incidence of type 2 diabetes by 40% and 18%, respectively, compared with a low-fat control diet. (5)

Depression

High adherence to a Mediterranean diet high in whole grains, fruits, vegetables, nuts, lean meats and olive oil was protective for depression at all ages throughout the lifespan. Even moderate adherence to a Mediterranean diet was protective in younger individuals. For older individuals, the research showed that the benefit to mental well-being and depression prevention was only associated with those individuals who adhered to a more strict Mediterranean diet. (6)

A 2017 study examined 56 men and women with major depression who all had a very poor diet containing lots of highly refined foods, very few fruits and vegetables, and few lean types of meats. Implementing a Mediterranean diet that was high in whole grains, fruits, vegetables, nuts, lean meats and 3 TBSP of olive oil per day led to 32% of participants no longer meeting the criteria for depression after only 12 weeks! (7)

Metabolic Syndrome

Metabolic syndrome is a cluster of 3 or more related cardiometabolic risk factors:

• Central obesity (determined by waist circumference)

• Hypertension

• Hypertriglyceridemia

• Low HDL cholesterol levels

• Hyperglycemia.

Research has shown that olive oil supplementation can decrease central obesity and elevated fasting glucose levels. Supplementation with nuts (rather than olive oil) has also been shown to reduce central obesity. (8)

Interested in changing your diet to a Mediterranean Diet? Below is some good information to help you get started!

References

Welcome Nicole Loran

Meet Nicole Loran! She is a 4th year student finishing her training in Naturopathic Medicine at the Southwest College of Naturopathic Medicine (SCNM) in Tempe, Arizona. Nicole is a dedicated and hard working student who currently holds a Bachelor of Science degree in Physiology and Pharmacology as well as a Arts and Science degree in Religion and Culture from the University of Saskatchewan. Nicole is involved in ongoing research through SCNM for psoriasis and is currently class Treasurer and Vice President of the Aesthetics Club at SCNM.

Education is extremely important to Nicole and she continually strives to further her knowledge in many areas including anti-aging, integrative, and functional medicine. She incorporates what she learns into her daily practice and strives to empower the patients with knowledge on how to improve their health.

Nicole has 2 years of clinic experience with a focus on general, naturopathic community and internal medicine, women and men’s health, endocrinology, botanical medicine, nutrition, nature cure, acupuncture, IV therapy, heavy metal toxicity and addictions.

Her interests include: endocrinology, women’s health, nutrition, weight loss, gastrointestinal health, metabolic disorders, stress, chronic fatigue and acupuncture.

Nicole is originally from Saskatoon. She is looking forward to spending one of her final months as an intern under the supervision of Dr. Velichka ND. Once her schooling is complete, she plans on moving back to Saskatoon to start her practice as a Naturopathic Doctor.

You can book in to see Nicole at our clinic ever Monday, Wednesday and Friday during the month of May. Nicole has experience in creating diet plans for patients with diabetes or PCOS and those who require FODMAP, anti-SIBO or ketogenic diets. Nicole will be assisting Dr. Velichka ND in her acupuncture services.

We are excited to have Nicole be a part of our clinic over the next month. We hope you get to enjoy the benefits from having her involved in your care!

MIGRAINE PRESENTATION

WEDNESDAY JULY 17, 2019 @ 7 pm

“The Highly Sensitive Brain”

An Update on Migraines from a Functional Medicine Perspective

Dr. Reid-Ahenakew will discuss:

• What is happening in the brain when you get a migraine?

• Common (and not so common) food triggers

• The role of estrogen and progesterone in migraines

• Nutrient deficiencies that can be a factor

• Natural medicines to improve your resilience to stress

• The role of gut health in prevention of migraines

A registration fee of $25 will reserve your spot. All profits will be donated to LDAS

(The Learning Disability Association of Saskatchewan)

Dr. Reid-Ahenakew, ND

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Join us from 7:00-8:00 pm on July 17th at our clinic.

To Register, or to learn more about this presentation:

Call the clinic at: (306) 664-2150

Or email us at: info@saskatoonnaturopathic.com

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HEALTHY LIVING PRESENTATION

Interested in learning more about Healthy Living in today’s world? Feeling that you could be more vibrant both physically and emotionally? Confused by information overload?

You’ll want to attend Dr. Reid-Ahenakew’s presentation:

Lifestyle Habits to Feel Vibrant in 2019: An Update on Healthy Living Habits Supported by Research

When: Wednesday, April 17 & Thursday, April 25

Time: 7:00-8:30 pm

Where: Saskatoon Naturopathic Medicine 14-118 Cope Crescent, Saskatoon

Dr. Reid-Ahenakew will discuss:

• Changes to the Canada Food Guide

• The top 3 supplements for prevention

• The most important strain of probiotic to take

• The microbiome - sleep connection

• Who will most benefit from a ketogenic diet

• Which fish are the healthiest to eat

To Register or to learn more about this FREE presentation:

Call the clinic at: (306) 664-2150

Or email us at: info@saskatoonnaturopathic.com

Dr. Darlene Reid-Ahenakew, ND is a licensed Naturopathic Doctor in Saskatchewan. Her premedical training was at Queen’s University, graduating with a Bachelor of Physical and Health Education, as well as a Bachelor of Life Sciences. She spent 4 more years at CCNM in Toronto and graduated with her ND in 2001. Dr. Reid-Ahenakew, ND is passionate about helping patients regain their health which enables their ability to enjoy life to its fullest. She strives for clinical excellence, which means continuous research and ongoing education to be able to give patients the best possible advice.