{"id":4427,"date":"2017-12-22T18:04:00","date_gmt":"2017-12-22T16:04:00","guid":{"rendered":"http:\/\/www.easistent.ro\/?p=4427"},"modified":"2018-03-05T12:37:08","modified_gmt":"2018-03-05T10:37:08","slug":"psihiatria-nutritionala-rolul-alimentatiei-in-dezvoltarea-tulburarilor-psihiatrice","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=4427","title":{"rendered":"Psihiatria nutri\u021bional\u0103 \u2013 rolul alimenta\u021biei \u00een dezvoltarea tulbur\u0103rilor psihiatrice"},"content":{"rendered":"<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2017\/12\/psihiatrianutritionala.png\"><img class=\"alignleft size-full wp-image-4409\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2017\/12\/psihiatrianutritionala.png\" alt=\"psihiatrianutritionala\" width=\"219\" height=\"174\" \/><\/a>\u00cenc\u0103 din anii 1990, au ap\u0103rut studii care ar\u0103tau rolul important pe care alimenta\u0163ia \u00eel poate juca \u00een prevenirea unui al doilea infarct. De asemenea, exist\u0103 studii care arat\u0103 c\u0103 diabetul poate fi \u0163inut sub control cu interven\u0163ii nutri\u0163ionale (precum o diet\u0103 de 700 de calorii pe zi, \u0163inut\u0103 timp de 8 s\u0103pt\u0103m\u00e2ni). \u00cen ultimii ani s-a \u00eenregistrat, de asemenea, \u015fi o aten\u0163ie sporit\u0103 din partea cercet\u0103torilor asupra leg\u0103turii dintre calitatea nutritiv\u0103 a alimenta\u0163iei \u015fi tulbur\u0103rile psiho-mintale.<\/p>\n<p>Astfel, studiul SMILES care a durat\u00a012 s\u0103pt\u0103m\u00e2ni \u015fi s-a\u00a0desf\u0103\u015furat \u00een Australia, acum aproximativ 5 ani (\u015fi al c\u0103rui rezultate au fost publicate \u00een 2014), a urm\u0103rit s\u0103 g\u0103seasc\u0103 corela\u0163ia dintre alimenta\u0163ie \u015fi depresie. Participan\u0163ii, ale\u015fi dintre cei care avuseser\u0103 un episod depresiv major, au fost repartiza\u0163i aleatoriu \u00een dou\u0103 grupe \u2013 una care a primit sprijin nutri\u0163ional \u015fi una care a primit sprijin social. Ace\u015ftia au trebuit s\u0103 raporteze c\u00e2nd au avut aport sc\u0103zut de alimente cu valoare nutritiv\u0103 ridicat\u0103 (fibre, proteine slabe, fructe, legume) \u015fi c\u00e2nd au avut un aport ridicat de dulciuri, carne procesat\u0103 \u015fi snack-uri s\u0103rate. Dup\u0103 12 s\u0103pt\u0103m\u00e2ni, 32% din grupul care a primit sprijin nutri\u0163ional a \u00eenregistrat remisie, comparativ cu 8% din grupul care a primit sprijin social, dup\u0103 cum s-a constatat \u00een urma administr\u0103rii unui test standard pentru depresie.<\/p>\n<p>Rezultatele studiului SMILES au fost \u00een concordan\u0163\u0103 cu cele ale studiului legat de Alzheimer, desf\u0103\u015furat de University of California din Los Angeles (SUA), care a ar\u0103tat c\u0103 interven\u0163ia nutri\u0163ional\u0103 a p\u0103rut a fi eficace \u00een cazul pacien\u0163ilor cu Alzheimer \u015fi probleme cognitive moderate. Important de notat, \u00een cadrul studiului SMILES, rezultatele ob\u0163inute de subiec\u0163ii din grupul de sprijin nutri\u0163ional ar fi putut fi afectate de efectul placebo, deoarece ace\u015ftia au \u015ftiut din ce grup fac parte.<\/p>\n<p>Au existat mai multe studii care au ar\u0103tat c\u0103 interven\u0163ia nutri\u0163ional\u0103 este corelat\u0103 cu dispozi\u0163ia clinic\u0103 \u015fi tulbur\u0103rile depresive sau de anxietate. Astfel, \u00eentr-un studiu condus de cercet\u0103torul japonez Nanri, s-a observat c\u0103 alimenta\u0163ia japonez\u0103 tradi\u0163ional\u0103, cuprinz\u00e2nd cantit\u0103\u0163i mari de legume, fructe, ciuperci \u015fi soia, era corelat\u0103 negativ cu simptomele depresive \u00eenregistrate la func\u0163ionarii publici japonezi. \u00a0Un alt studiu (al echipei de cercet\u0103tori condus\u0103 de Akbaraly) a ar\u0103tat \u015fi c\u0103 o alimenta\u0163ie bazat\u0103 pe preparate procesate (caracterizat\u0103 de deserturi \u00eendulcite artificial, alimente pr\u0103jite, carne procesat\u0103 \u015fi carbohidra\u0163i procesa\u0163i) a fost corelat\u0103 pozitiv cu riscul de apari\u0163ie a depresiei, m\u0103surat de indicele de auto-raportare a depresiei cinci ani mai t\u00e2rziu.<\/p>\n<p>\u00cen general, studiile desf\u0103\u015furate p\u00e2n\u0103 acum pe aceast\u0103 tem\u0103 au ar\u0103tat c\u0103 impactul cel mai mare al consumului sc\u0103zut de alimente s\u0103n\u0103toase \u015fi\/sau crescut de alimente nes\u0103n\u0103toase asupra riscului de apari\u0163ie a depresiei \u00een timp se \u00eenregistreaz\u0103 \u00een cazul v\u00e2rstnicilor, fa\u0163\u0103 de celelalte grupe de v\u00e2rst\u0103. O posibil\u0103 explica\u0163ie e legat\u0103 de mecanismele biologice care afecteaz\u0103 riscul de depresie, precum procesele inflamatorii cronice (de exemplu, obezitatea visceral\u0103) \u015fi patologia vascular\u0103 (ateroscleroza). Consecin\u0163ele acestor procese \u015fi ale condi\u0163iilor medicale asociate evolueaz\u0103 \u00een timp \u015fi devin vizibile, inclusiv impactul asupra func\u0163iei creierului, mai t\u00e2rziu \u00een via\u0163\u0103, cel mai des dup\u0103 60 de ani. Acest fenomen apare \u015fi \u00een cazul general al func\u0163iilor cognitive, unde factorii de risc ap\u0103ru\u0163i \u00een perioada adult\u0103 influen\u0163eaz\u0103 riscul de apari\u0163ie a demen\u0163ei \u00een perioada v\u00e2rstnic\u0103.<\/p>\n<p>De\u015fi concluziile studilor desf\u0103\u015furate pe tema rolului alimenta\u0163iei \u00een apari\u0163ia tulbur\u0103rilor psiho-mintale\/psihiatrice sunt practic convergente, nu exist\u0103 \u00eenc\u0103 dovezi de nedisputat legate de mecanismul prin care se manifest\u0103 acest rol. \u00a0Ca urmare, deocamdat\u0103 nu se poate afirma c\u0103 exist\u0103 o leg\u0103tur\u0103 cauzal\u0103 \u00eentre alimenta\u0163ie \u015fi s\u0103n\u0103tatea mintal\u0103 \u015fi psihic\u0103. Este posibil ca al\u0163i factori, de exemplu statutul socio-economic al persoanei respective, s\u0103 afecteze at\u00e2t alegerile alimentare, c\u00e2t \u015fi riscul de depresie, caz \u00een care alimenta\u0163ia \u015fi riscul de depresie sunt corelate, dar nu cauzal, fiind am\u00e2ndou\u0103 influen\u0163ate de statutul socio-economic.<\/p>\n<p>Ca urmare, e nevoie de mai multe studii pentru a se putea explica mecanismele corela\u0163iei alimenta\u0163ie \u2013 s\u0103n\u0103tate psiho-mintal\u0103. Deocamdat\u0103, cercet\u0103torii cred c\u0103 acestea sunt inflama\u0163ia cronic\u0103 \u015fi stresul oxidativ. \u00a0Consumul unor alimente bogate \u00een zah\u0103r, proteine \u015fi lipide este pro-inflamator, inclusiv la nivel neuronal, dup\u0103 cum au ar\u0103tat studii cu \u015foareci de laborator. Aceast\u0103 inflama\u0163ie neuronal\u0103, precum \u015fi stresul oxidativ, pot duce la apoptoz\u0103 \u015fi atrofie cerebral\u0103, \u00een special \u00een hipocampus, aceasta din urm\u0103 fiind legat\u0103, cred cercet\u0103torii, de cre\u015fterea riscului de depresie. \u00cen contrast, un num\u0103r de alimente s\u0103n\u0103toase, \u00een special pe\u015ftele, fructele \u015fi legumele, au propriet\u0103\u0163i anti-inflamatorii \u015fi anti-oxidante, ceea ce, cel mai probabil, le face s\u0103 aib\u0103 un rol benefic asupra creierului. \u00cen acela\u015fi timp, aportul de lipide \u015fi alte alimente \u201cpro-inflamatorii\u201d \u00a0este \u015ftiut a fi asociat cu ateroscleroza, diabetul \u015fi bolile cardiovasculare. La r\u00e2ndul lor, aceste boli cronice au fost asociate cu depresia, boli cerebro-vasculare \u015fi atrofia cerebral\u0103, ceea ce ar putea reprezenta \u00eenc\u0103 o cale prin care alimenta\u0163ia poate modela s\u0103n\u0103tatea psiho-mintal\u0103.<\/p>\n<p>Pentru a valida aceste ipoteze, este nevoie de noi studii care s\u0103 analizeze dac\u0103 biologia oxidativ\u0103, plasticitatea creierului sau axul microbiom-intestin-creier pot reprezenta zone eficace de interven\u0163ie.<\/p>\n<p>Mesajul este oricum clar. Exist\u0103 o nevoie presant\u0103 s\u0103 acord\u0103m mai mult\u0103 aten\u0163ie calit\u0103\u0163ii alimenta\u0163iei \u015fi obiceiurilor asociate acesteia. S\u0103n\u0103tatea psiho-mintal\u0103 se contureaz\u0103 a fi \u00eenc\u0103 o zon\u0103 pe care alimenta\u0163ia o poate influen\u0163a major, mul\u0163i cercet\u0103tori \u00eentreb\u00e2ndu-se dac\u0103 explozia tulbur\u0103rilor psiho-mintale \u00eenregistrat\u0103 \u00een ultimii 50 de ani nu are leg\u0103tur\u0103 cu schimb\u0103rile \u00a0profunde de alimenta\u0163ie (at\u00e2t ce m\u00e2nc\u0103m, c\u00e2t \u015fi cum m\u00e2nc\u0103m) care au avut loc \u00een aceea\u015fi perioad\u0103 de timp.<\/p>\n<p>Domeniul recent ap\u0103rut al Psihiatriei Nutri\u0163ionale ofer\u0103 speran\u0163e pentru viitor. Majoritatea tulbur\u0103rilor psiho-mintale este tratat\u0103 acum cu medicamente, \u00een timp ce abordarea principal\u0103 a fost de tratare \u015fi nu preven\u0163ie. Ca urmare, provoc\u0103rile principale pe care aceast\u0103 sub-disciplin\u0103 nou ap\u0103rut\u0103 le are de adresat sunt s\u0103 \u00eembun\u0103t\u0103\u0163easc\u0103 studiile clinice cu privire la rolul alimenta\u0163iei \u00een s\u0103n\u0103tatea psiho-mintal\u0103, s\u0103 identifice un set clar de c\u0103i biologice prin care acest rol se manifest\u0103, s\u0103 testeze r\u0103spunsul pacien\u0163ilor la tratamente holistice bazate \u015fi pe noi abord\u0103ri, a\u015fa numitele abord\u0103ri nutraceutice \u00a0\u015fi psihobiotice, \u015fi s\u0103 promoveze la nivelul popula\u0163iei educa\u0163ia pentru s\u0103n\u0103tate legat\u0103 de ce m\u00e2nc\u0103m \u015fi cum m\u00e2nc\u0103m.<\/p>\n<p>&nbsp;<\/p>\n<p><em><i>Mirela Musta\u021b\u0103, Redactor Executiv E-Asistent<\/i><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>Surse de documentare:<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1371\/journal.pone.0087657.t002\">https:\/\/doi.org\/10.1371\/journal.pone.0087657.t002<\/a><\/p>\n<p><a href=\"http:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0087657\">http:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0087657<\/a><\/p>\n<p>International Health News, <em><i>William R. Ware, PhD \u2013 Editor, number 283, December 2017-January 2018<\/i><\/em><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5360575\/\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5360575\/<\/a><\/p>\n<p>Dietary Patterns and Depressive Symptoms over Time: Examining the Relationships with Socioeconomic Position, Health Behaviours and Cardiovascular Risk\u00a0&#8211; Felice N. Jacka , Nicolas Cherbuin,\u00a0Kaarin J. Anstey,\u00a0Peter Butterworth (2014)<\/p>\n<p>Dietary patterns and depressive symptoms among Japanese men and women. Eur J Clin Nutr 64: 832\u2013839, Nanri A, Kimura Y, Matsushita Y, Ohta M, Sato M, et al. (2010)<\/p>\n<p>Dietary pattern and depressive symptoms in middle age, Br J Psychiatry 195: 408\u2013413, Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, et al. (2009)<\/p>\n<p>Sursa foto: <a href=\"https:\/\/www.health.harvard.edu\/blog\/nutritional-psychiatry-your-brain-on-food-201511168626\"><em><i>https:\/\/www.health.harvard.edu\/blog\/nutritional-psychiatry-your-brain-on-food-201511168626<\/i><\/em><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00cenc\u0103 din anii 1990, au ap\u0103rut studii care ar\u0103tau rolul important pe care alimenta\u0163ia \u00eel poate juca \u00een prevenirea unui al doilea infarct. De asemenea, exist\u0103 studii care arat\u0103 c\u0103 diabetul poate fi \u0163inut sub control cu interven\u0163ii nutri\u0163ionale (precum o diet\u0103 de 700 de calorii pe zi, \u0163inut\u0103 timp de 8 s\u0103pt\u0103m\u00e2ni). \u00cen ultimii [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":4409,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,14],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4427"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4427"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4427\/revisions"}],"predecessor-version":[{"id":4428,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4427\/revisions\/4428"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/4409"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4427"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4427"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4427"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}