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Brain, Behavior and the Gut

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anna esparham

on 28 April 2014

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Transcript of Brain, Behavior and the Gut

Brain, Behavior, and the Gut
Microbiota's Influence on Brain and Behavior
Bug symbiosis
We are in symbiotic relationship with bugs
Bugs live in our gut to perform functions that we haven't evolved on our own
Disruption of this symbiotic relationship impacts the rest of our body-brain included
Gluten, Brain, and Behavior

Because gastrointestinal symptoms were dominant in patients with coeliac disease, and enteropathy was seen after enteroscopy and small bowel biopsy, it is not surprising that coeliac disease was thought to be exclusively a disease of the gut. In 1963–65, Shuster, Marks, and Watson4
observed that dermatitis
herpetiformis was a form of gluten-sensitive dermatopathy that shared the same small bowel pathology, but not the gastrointestinal symptoms seen in patients with coeliac disease. This was the fi rst reported evidence that coeliac dis ease might present with extraintestinal manifestations by Marios Hadjivassiliou et al. 2010
"Celiac disease
KU Integrative Medicine Team:

by Anna Esparham, MD
KU Integrative Medicine

Gut-Brain Axis
bidrectional highway
70% immune system is in gut
95% neurotransmitter, serotonin, is made in the gut
Dr. Michael Gershon, MD quoted the gut to be "The Second Brain"
Q: What is Gluten?
A: Gluten is a protein found in wheat, rye, oats, barley

Q: What are the major illnesses associated with gluten?
A: Celiac Disease and Gluten Sensitivity

Q: What is celiac disease?
A: Celiac Disease is a gluten enteropathy, which means that ingesting gluten can damage the intestinal lining.

Q: What is Gluten sensitivity?
A: Gluten sensitivity is a systemic immune and inflammatory disease with diverse manifestations

In coeliac disease patients with affective disorders psychological support seems to be able to reduce depression and to increase gluten-free diet compliance. Psychological support counselling improves gluten-free diet compliance in coeliac patients with affective disorders. ADDOLORATO, G et al. 2004
struggles with families ??? Cases?
Nutrient Power
Micronutrient Deficiencies:
Vitamin B6
Copper/Zinc Ratio -->psychiatric behavior
Amino Acids
Fatty Acids
Iron: depression
Vitamin D: plays a role in gut healing and inflammation
Gut = "ENS" - enteric nervous system
Primary barrier between outside world and body's internal environment
Performs many functions
1. Digestion
2. Absorption
3. Detoxification
4. Immune protection
5. Metabolism
In 1950s-60s, doctors found neuro conditions improved in some psychosis and celiac disease patients when gluten was removed from diet Kalaydjian AE. The gluten connection, 2006

A few research studies reported that children with ASDs often experience gastrointestinal disorders
Children with ASD have different microbial metabolites as compared to controls
clostridium species more prevalent in ASD children
lactobacillus improved behavior and bowel health in autistic subjects
major regulator of microbiota ecossytem
Antimicrobials (antibiotics, antifungals, antiviral)
Healthy stomach acid
Treatment Plan:

For structural and morphological development and Neurochemistry and neurotransmission
Dutch famine studies: negative effects on mental health
What are we eating now?
Convenient, pre-packaged foods containing extra sugar, damaged fats, refined carbs, processed meats
Food devoid of micronutrients with chemical additives, colourings, flavourings, preservatives
Schools and Breakfast
Enhanced cognitive performance
Meeting nutritional demands for certain micronutrients likely to have beneficial effects on cognitive development in school children
Pre-Conception and Infant Nutrition
Food Additives and Behavior 17/23 peer reviewed studies demonstrated worsening behavior of children with ADHD when exposed to food dyes.food chemicals (Diet, aDHD and behaviorMichael f. jacobson and David Schardt.)
Nutrients are vital to mental health

Research demonstrates a clear link between micronutrient deficiencies and mental health problems

The impact of poor nutrition on health is common knowledge.
Early 17th century: discovery of scurvy and lack of fruits/veggies. What is interesting, is that vitamin C deficiency is often preceded by irritability and general fatigue
Like obesity, mental health problems increasing. Globally, 25% of people are affected by mental illness at some point.
At current rates, depression may be the second highest cause of chronic disease burden by 2020
The economic burden of mental illness in the United States is substantial—about $300 billion in 2002 (CDC)
Mental health costs increased significantly
Research study published in Journal of Pediatrics 2013: Analyzed ~3000 subjects and linked soda consumption to aggression, attention problems and social withdrawal in 5-year-olds

Dietary Changes and Nutritional Modulation
A diet rich in folate, omega-3 fatty acids, olive oil, fish, fruits, nuts and vegetables may have protective effect against depression. However, processed foods containing refined grains, procesed meats, dairy, and fried foods were associated with higher risk of depression

Adams JB BMC gastro 2011.
Maenner MJ 2011
n engl j med 368;21 nejm.org may 23, 2013, Suzanne L. Bender, M.D., et al.
(Crawford et al. 2009)
Thomas 2007
gonzalez et al. 2011
Parracho et al. (probiotics autism)
(Anjos T et al. 2013)
Suglia SF, Solnick S, Hemenway D.J Pediatr. 2013 Aug 19.
Soft Drinks Consumption Is Associated with Behavior Problems in 5-Year-Olds.
Stephen M Collins and Premysl Bercik. 2009
Bondi et al. 2013
C. Senhueza et al. 2013
Emotions and the Gut:
Stress-induced ulcers
Anxiety causing frequent bowel movements
Children with stomach aches who are bullied
The Gut and Emotions:
A change in gut motility may increase anxiety and depression
Worsening of gastrointestinal function is frequently associated with a decline in cognitive and behavioral function
PANDAS - Obsessive Compulsive Disorder

Toxoplasmosis - Schizophrenia
Brucella suis - Cognitive and emotional disturbances
Leptospira - Manic and psychotic symptoms resistant to antipsychotics, but treatable with antibiotics
Nutrition influences development and behavior from conception to adulthood
Nutrients vital to brain development
Folate and neural tube defects
Depression and Micronutrient deficiencies
B-vitamins, vitamin C, zinc, fatty acids important in neurotrologic function and transmission
The Fertile Crescent

History: obtained from K. Rostami et al. 2004

The Neolithic Revolution:
After the ice age, about 10,000 years ago,
people discovered that they harvest crops of cereals like wheat.
Hunting animals and gathering wild berries were not as fruitful.
The origin of agriculture was in the 'Fertile Crescent' in the wide belt of Southeast Asia.

The major crop included wheat, known as the wild progenitors Triticum monococcum

This agricultural revolution led to appearance of celiac disease.

Conception and Beyond
Stool Analysis
Nutrition's Influence in School-Age Children
Sugar and Behavioral Problems
Nutrition and Conception
Nutrition and Adolescence
Omega Fatty Acid (FA) Imbalance linked to behavioral alterations in adolescents
Omega-3 FA deficiency
hyperactivity, anxiety, decreased motivation
Omega-3 FA influences dopamine neurotransmission
Nutrition in Adults
Deficiencies noted in child-bearing women
Iron and DHA-increased risk of postpartum depression and difficulties in learning, memory, concentration
Zinc - levels can correlate with severity of depression
Common Foods and nutrient intake
gliadomorphins, caseomorphins,

Microbiota and Psychiatric Disturbance
The Case in Autism
Nutrient Depletion
Dr. Bill Walsh's Book "Nutrient Power"
Case Study
Child with ADHD found to have gluten sensitivity
Strict elimination
When reintroduced into diet, emotional breakdown ensued until gluten removed

Child who was adopted with poor emotional
connection, dysphoric mood, and social communication
gluten sensitivity
two weeks post elimination with improved communication both at school and home, and increased
Discuss the role of enteric microbiota and its influence on brain and behavior
Discuss the role of gluten sensitivity and celiac disease on mental health

Understand the relationship between nutrients and mental wellness
Identified micronutrient imbalances specifically with copper:zinc ratio among children with behavior disorders including violent behavior
Neurotransmitter metabolism requires vitamins, minerals
If deficient in a cofactor, neurotransmission begins to fail
Neurotransmitter urine analysis
CH3, Zn
Vit C, Cu
Correct underlying nutrient insufficiencies
gliadomorphins and caseomorphins
Gluten and Opiates
Gluten sensitivity can manifest in psychiatric disorders

Removal of wheat, rye, barley, oats
Breakdown of gluten can create opiate like molecules called gliadomorphins that act like "morphine" in the brain
Step 3
The Problem
Gut Feelings
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