Nutrition Addiction

Nutrition & Addiction Helen Sandwell MSc Nut Med helen@goodfoodandhealth.co.uk About me • • • • Masters in Nutritional Medicine Associate Registered Nutritionist Freelance nutritionist Worked with NGOs – The Food Commission, Sustain, FDAP • Interest in effects of nutrition on mood & behaviour How poor nutrition is likely to have impacted on your clients’ health by the time they present for treatment • Poor Nutrition (malnutrition) is inevitable for people entering treatment, resulting from: – Chaotic lifestyle – Money used on drink or drugs in preference to food • Nutrition is last thing you are likely to think about when a client presents with a drug or alcohol problem But be aware! • Poor nutrition compounds the problems people have on entering treatment How poor nutrition is likely to have impacted on your clients’ health by the time they present for treatment • Nutritional status – assess through dietary history, signs of deficiency diseases & blood tests • Body weight & appearance – overweight, underweight, loss of muscle mass • Bone loss • Liver health • Immune functioning • Chronic illness progression e.g HIV, Hepatitis C • Oral health • Mood • Cognitive functioning • Alertness/ fatigue • Response to treatment & prevention of relapse What the professional bodies say: American Dietetic Association: Attention to food and nutrition intake behaviors will aid the overall goal of quality sobriety and relapse prevention. Nutrition, which includes physiological and psychosocial disciplines, is involved in every aspect of recovery. It is imperative that a qualified nutrition professional be a part of each individual's recovery and foundation for relapse prevention. 1990 What the professional bodies say: American Dietetic Association: • Chronic nutrition impairment causes serious damage to the liver and brain, which reinforces the craving for more drugs and alcohol, and perpetuates the psychological aspect of addiction. • During treatment, efforts are concentrated on the physical recovery - providing adequate nutrition to replete and heal the brain, liver, and digestive system. • Nutrition makes a difference in the rate and quality of physical recovery, which prepares individuals to function at a higher level in treatment-cognitively, mentally, and socially. • Improved nutritional status can make treatment more effective, while reducing drug and alcohol craving, thereby preventing relapse. 1990 What the professional bodies say British Dietetic Association: No information published and no guidelines on nutrition in drug and alcohol treatment programmes. Nutrition concerns in drug and alcohol treatment and relapse prevention Malnutrition resulting from: • Low calorie diet • High calorie diet • Poor diet – eg. Low vitamins, minerals, essential fatty acids, protein • Altered taste - affects food choices • Malabsorption esp. with alcohol misuse/HIV • Poor metabolism of nutrients by damaged liver • Accelerated nutrient metabolism Nutrition concerns in drug and alcohol treatment and relapse prevention Typical diet of a drug of alcohol user: • Refined/junk food diet • Low protein intake • High saturated fat intake • High refined carbohydrate intake • Low fruit and vegetable intake • Low fibre intake • High caffeine intake • Low non-caffeinated fluid intake • Erratic eating pattern Nutrition concerns in drug and alcohol treatment and relapse prevention • Protein energy malnutrition • Vitamin and mineral deficiencies • Low levels of important fatty acids e.g omega 3s • Blood sugar imbalance Leading to: • Muscle wasting • Obesity • Metabolic syndrome • Compromised immune system • Disease progression – liver disease, hepatitis, HIV • Neurotransmitter exhaustion • Mood disorders • Cognitive dysfunction • Insomnia • Low pain threshold • Increased likelihood of relapse A diet for recovery & relapse prevention What do we want out of the diet? • Need to keep the blood sugar balanced to prevent mood highs and lows • Nutrient rich food to replenish the body – especially with chronic disease where there is a high nutrient turnover • Foods especially important for mood & cognitive functioning i.e.those which are good sources of omega 3 fatty acids, B vitamins, selenium, magnesium, potassium, iron. • Low or no caffeine – help prevent anxiety and insomnia • Plenty of fluids to keep hydrated A diet for recovery & relapse prevention What types of food? • High in complex carbohydrates • Medium levels of protein = two 4oz portions • Low fat especially saturated fats • Low caffeine • Low refined sugar and starch • Lots of non-caffeinated, sugar-free fluids A diet for recovery & relapse prevention What does this translate as? • 5 portions fruit & veg/day = 400g raw prepared fruit & veg – but can be cooked, dried etc. • Wholegrains, pulses, nuts, seeds – complex carbohydrates & full of nutrients • Meat, fish, eggs, milk, yoghurt, beans, pulses – good quality protein • Oily fish - 2 portions – young women, 4 portions – men & older women • Water, herbal teas, limited juices & smoothies, decaf tea & coffee What’s being served up in treatment today What’s being served up in treatment today • Caffeine, caffeine, caffeine • 24 hour coffee access in residential treatment • NA parties – Red Bull on sale! • Red Bull - 80mg caffeine, taurine, glucuronolactone – may give you wings but as yet the effects on the body are unknown and it is banned in France. Dietary Supplements? • Initially B vitamins for alchohol users - WernickeKorsakoff syndrome & other brain damage • General vitamin & mineral supplement – short term use • Beware damaged livers! – supplements could further damage • Fish oil – ongoing can help with depression & anxiety • Supplements can enhance a good diet but should not be used to substitute a good diet What can you do with your clients? • Assess clients upon entering treatment for nutritional status, attitudes to food, and knowledge of healthy eating • Reassess menus if you are responsible for your clients’ meals • Discourage the use caffeinated drinks – especially at night! • Give clients advice for eating healthily – Motivational techniques are necessary – Consider their lifestyle, skills & values! • Ideally – use a nutritionist to work with clients & audit menus And remember…… Nutrition goes hand in hand with exercise & relaxation. Exercise & relaxation: • Improve mood • Increase self image • Improve sleep patterns • Reduce stress • Increase alertness Helen Sandwell helen@goodfoodandhealth.co.uk www.goodfoodandhealth.co.uk 01273 236324 07833 678980