Table Of Content,STNEIRTUN ,SSERTS DNA LACIDEM SREDROSID
NUTRITION 0 AND 0 HEALTH
Adrianne Bendich, Series Editor
Nutrients, Stress, and Medical Disorders, edited by Shlomo Yehuda and David I.
Mostofsky, 2006
Calcium in Human Health, edited by Connie M. Weaver and Robert P. Heaney, 2006
Preventive Nutrition: ehT Comprehensive Guide for Health Professionals, Third
,noitidE edited by Adrianne Bendich and Richard J. Deckelbaum, 2005
The Management of Eating Disorders and Obesity, Second Edition, edited by David J.
Goldstein, 5002
Nutrition and Oral Medicine, edited by Riva Touger-Decker, David A. Sirois, and
Connie .C Mobley, 5002
IGF and Nutrition in Health and Disease, edited by M. Sue Houston, Jeffrey M. P.
Holly, and Eva L. Feldman, 5002
Epilepsy and the Ketogenic Diet, edited by Carl E. Stafstrom and Jong M. Rho, 2004
Handbook of Drug-Nutrient Interactions, edited by Joseph I. Boullata and Vincent .T
Armenti, 2004
Nutrition and Bone Health, edited by Michael F. Holick and Bess Dawson-Hughes,
4002
Diet and Human Immune Function, edited by David A. Hughes, L. Gail Darlington,
and Adrianne Bendich, 2004
segareveB in Nutrition and Health, edited yb Ted Wilson and Norman J. Temple, 4002
Handbook of Clinical Nutrition andAging, edited by Connie Watkins Bales and
Christine Seel Ritchie, 2004
Fatty Acids: Physiological and Behavioral Functions, edited by David I. Mostofsky,
Shlomo Yehuda, and Norman Salem, Jr., 1002
Nutrition and Health in Developing Countries, edited by Richard .D Semba and
Martin W. Bloem, 1002
Preventive Nutrition: ehT Comprehensive Guide for Health Professionals, Second
,noitidE edited by Adrianne Bendich and Richard J. Deckelbaum, 1002
Nutritional Health: Strategies for Disease Prevention, edited by Ted Wilson
and Norman J. Temple, 1002
Clinical Nutrition of the Essential Trace Elements and Minerals: ehT Guide for
Health Professionals, edited by John .D Bogden and Leslie M. Klevey, 2000
Primary and Secondary Preventive Nutrition, edited by Adrianne Bendich
and Richard J. Deckelbaum, 2000
The Management of Eating Disorders and Obesity, edited by David J. Goldstein, 9991
Vitamin D: Physiology, Molecular Biology, and Clinical Applications, edited by
Michael F. Holick, 1999
Preventive Nutrition: ehT Comprehensive Guide for Health Professionals,
edited by Adrianne Bendich and Richard J. Deckelbaum, 1997
~ S T N E I R T U N ~ S S E R T S
D N A L A C I D E M S R E D R O S I D
Edited yb
SHLOMO YEHUDA,
PhD
ygolocamrahpohcysP ,yrotarobaL Department of ,ygolohcysP
and ehT Gonda hcraeseR ,retneC Bar Ilan ,ytisrevinU
Ramat Gan, Israel
and
DAVID I. ,YKSFOTSOM DhP
Department of ,ygolohcysP Boston ,ytisrevinU ,notsoB MA
_ (cid:127)
ANAMUH SSERP
, A W O T O T WEN Y E S R E J
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dosages set forth in this text are accurate and in accord with the standards accepted at the time of publication. Notwithstanding, as
new research, changes in government regulations, and knowledge from clinical experience relating to drug therapy and drug reactions
constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change
in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a
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Library of Congress Cataloging-in-Publication Data
I. Mostofsky.
p. cm. -- (Nutrition and health)
Includes bibliographical references and index.
ISBN 1-58829-432-3 (alk. paper) -- ISBN 1-59259-952-4 (e-isbn)
1. Stress (Physiology) 2. Stress (Physiology)--Nutritional aspects. 3.
Chronic diseases--Nutritional aspects. 4. Inflammation--Nutritional
aspects. I. Yehuda, Shlomo. II. Mostofsky, David I. III. Series: Nutrition
and health (Totowa, N.J.)
QP82.2.S8N88 2005
616.9'8--dc22
2005003216
Series Editor's Introduction
The Nutrition andHealth Series of books have had great success because each volume
has the consistent overriding mission of providing health professionals with texts that are
essential because each includes (1) a synthesis of the state of the science; (2) timely, in-
depth reviews by the leading researchers in their respective fields; (3) extensive, up-to-
date fully annotated reference lists; (4) a detailed index; (5) relevant tables and figures;
(6) identification of paradigm shifts and the consequences; (7) virtually no overlap of
information between chapters, but targeted, interchapter referrals; (8) suggestions of
areas for future research; and (9) balanced, data-driven answers to patient/health profes-
sionals' questions that are based on the totality of evidence rather than the findings of any
single study.
The series volumes are not the outcome of a symposium. Rather, each editor has the
potential to examine a chosen area with a broad perspective, both in subject matter as well
as in the choice of chapter authors. The international perspective, especially with regard
to public health initiatives, is emphasized where appropriate. The editors, whose trainings
are both research- and practice-oriented, have the opportunity to develop a primary
objective for their book, define the scope and focus, and then invite the leading authorities
from around the world to be part of their initiative. The authors are encouraged to provide
an overview of the field, discuss their own research, and relate the research findings to
potential human health consequences. Because each book is developed de novo, the
chapters are coordinated so that the resulting volume imparts greater knowledge than the
sum of the information contained in the individual chapters.
Nutrients, Stress, and Medical Disorders, edited by Shlomo Yehuda and David I.
Mostofsky, is a critical addition to the Nutrition and Health Series and fully exemplifies
the goals of the series. Stress, health, and illness are well accepted as intimately linked.
However, the critical influence of nutritional status (and/or specific dietary components
that can affect the brain) on mental functions affected by stress has often been a neglected
area of research focus. This volume has been developed to examine the current clinical
findings and put these into historic perspective as well as point the way to future research
opportunities. Both editors are internationally recognized leaders in the field of nutrition
and neurological function. Both are excellent communicators and they have worked
tirelessly to develop a book that is destined to be the benchmark in the field because of
its extensive, in-depth chapters covering the most important aspects of the complex
interactions between diet and its nutrient components, mental health, stress, and its
impact on disease states. The introductory chapters provide readers with the basics so that
the more clinically related chapters can be easily understood. The editors have chosen 40
of the most well-recognized and respected authors from around the world to contribute
the 25 informative chapters in the volume.
The chapters of Nutrients, Stress, andMedical Disorders are logically organized to
provide the reader with a basic understanding as well as an appreciation of the develop-
V
vi Series Editor's Introduction
ment of the field of stress research, its relationship to brain function, and the potential for
nutrients to affect these variables. The first section reviews the history, methodologies,
and basic scientific information that is essential to understanding the following sections.
In Chapter ,1 the reader is introduced to the leading investigators who developed the area
of clinical stress research. Three scientific disciplines are compared: biology--exemplified
by the work of Walter B. Cannon and Hans Selye; psychology--Kurt Lewin and Richard
Lazarus; and psychobiology--John W. Mason and coworkers. In every experimental
field of research, the animal models used have been crucial in understanding the com-
plexities of the disease states as well as the development of drugs to treat the disease.
Equally important is the understanding of the potential for nutrients to affect responses
to stress and/or its treatment. Chapter 2 provides an in-depth look at the animal models
used in stress research, effects of food and its deprivation, and also critiques the model's
value in predicting human responses. Chapter 3 introduces the reader to the complexities
of the physiological responses to stress in the brain, nervous, and endocrine systems, and
also includes detailed information about the differences in responses between males and
females. Chapter 4 begins the integration of nutrition, stress, and disease. The chapter
includes a summary of the extensive literature that is finding a strong association between
diets containing fruits and vegetables that are rich in polyphenolic compounds with
antioxidant functions and reduced risks of diseases often associated with aging that affect
the brain such as Alzheimer's and Parkinson's diseases. The importance of the blood-
brain barrier and its role in stressful situations is discussed in-depth in Chapter 5. This
chapter also includes an analysis of the roles of neuroactive amino acids and their inter-
actions with the blood-brain barrier.
The second section of the volume includes chapters addressing the interactions
between specific nutrients, effects of food, and stress. The editors and their colleagues
have included an extensive chapter on the effects of fatty acids on stress responses. Both
editors of this volume and Dr. Norman Salem have collaborated on another book in this
series, Fatty Acids, and consequently, these dietary components are of special interest to
the chapter authors. Chapter 6 provides relevant information on the mechanisms of
actions of the major polyunsaturated long-chain fatty acids, their availability in the food
supply, and their actions on the nervous system, with emphasis on their effects during
stress. Chapter 7 examines the interactions between stress, glucocorticoids, and the brain.
This chapter spans the research from the cellular to the behavioral levels, as well as
providing information on genetic influences on stress responses that are organized in a
comprehensive table. Herbal product use has increased dramatically over the last decade
and in the United States, these products are classified as dietary supplements. The chapter
on herbal products, stress, and the mind critically reviews the clinical literature and
provides guidance to health professionals concerning the efficacy and safety of St. John' s
Wort, Kavakava, valerian, ginkgo and several other plant products associated with stress
reduction. Chapter 9 compares and contrasts the stress reactions to drug cravings vs food
cravings. Chapter 10 specifically examines the effects of alcohol and alcoholism on stress
to the individual, family members, the fetus, and the neonate. Of interest are the interac-
tions between environmental influences other than diet and the effects on stress and
central nervous system (CNS) functions. These influences include the effects of temporal
(rise in obesity incidence, increase in the number of women in the workforce) and space
Series Editor's Introduction vii
(neighborhood, city, state, and the medical benefits available) on the interactions
between diet and stress.
The chapters in the third section of Nutrients, Stress, and Medical Disorders examine
the health, mental health, and cognitive functions influenced by stress. Beginning with
the discussion of the developing fetus in Chapter 12, there is an extensive review of the
literature that points to the critical effects of maternal nutritional status as well as stress
level on fetal physical and mental development. Certain components of the diet have
specific function in the CNS and are critical for mental health. Chapter 31 examines the
role of lipids in the development and treatment of depression. The exciting preliminary
data indicate that eicosapentaenoic acid has beneficial effects in depressive patients as
well as having virtually none of the serious side effects seen with current drug therapies.
To further examine depression, Chapter 14 reviews the role of nicotine in depression as
well as sleep. Chapter 51 looks at the clinical data that point to a role of fish oils, rather
than any specific long-chain fatty acid, on neurological responses that may lead to the
development of aggressive behaviors. Another area given a great deal of public interest
is obesity. The next chapter reviews the studies that have looked at the consequences of
obesity on stress and the development of eating disorders. This chapter examines the
effects of eating on reducing anxiety and its potential to further increase the obesity
epidemic.
The fourth and final section of Nutrients, Stress, and MedicaI Disorders reviews the
effects of stress on chronic disorders and the influence of inflammation on diet, dietary
components, neurological functions, disease incidence, and cognitive functions. Several
of these chapters review novel findings, such as those seen in Chapter 17, which examines
the adverse effects of hypercholesteremia on immune cells and their functions. To assure
that readers understand the effects of high- circulating cholesterol levels on disease, there
is an extensive review of the role of cholesterol in immune cell membranes and cytokines.
Huntington's disease is an inherited neurodegenerative disease that progresses fairly
rapidly, leaving the patient with many physical as well as behavioral abnormalities. Until
fairly recently, there were no treatments available; however, as described in the Chapter
18, it appears that there are preliminary findings that eicosapentaenoic acid may slow the
progression of this disease. Another critical area that has been included in this unique
volume is the effects of and major causes of stress in women. The major diseases that
affect women at significantly higher rates than men include several autoimmune
diseases, depression, and osteoporosis. All of these medical conditions are discussed in
detail in Chapter 19. Also included in this chapter are discussions of stressors associated
with menstruation, including polycystic ovarian syndrome and premenstrual syndrome.
Type 2 diabetes is a major chronic disease and is preceded by a syndrome that is linked
to insulin resistance, syndrome X. The next chapter looks at the role of fatty acids in the
development of insulin resistance as well as syndrome X and the stress this metabolic
syndrome places on the individual. Another chapter with novel findings deals with the
roles of specific amino acids on mental functions. Chapter 21 reviews the effects of amino
acids on sleep, mood, and responses to stress. Cardiac function is acutely as well as
chronically affected by stress. Less well known is the importance of certain nutrients
(such as carnitine, coenzyme Q, and thiamine) on cardiac muscle and nerve responses.
The new data on the nutritional requirements that may be increased in the injured or
iiiv seireS Editor's Introduction
stressed heart are described in Chapter 21. Chapter 22 describes how brain functions are
also often adversely affected by stress and the resulting inflammation of brain cells.
Long-chain fatty acids are abundant in brain tissue and their dietary intake level has been
associated with modulating complex inflammatory responses of specific cytokines in
distinct areas in the brain. The next chapter continues to examine the effects of inflam-
mation in the brain and its effects on memory functions. This chapter describes the
development of memory, distinct areas of the brain and cytokines that are associated with
memory, and the balance between the importance of inflammatory molecules for the
development of some memories and the adverse effects of certain inflammatory mediators
on memory, especially with stress and aging. The final chapter examines the complex
interactions between inflammation and diet throughout the life cycle. This full-circle
analysis of the major consequences of stress, dietary deficiencies, and genetic predispo-
sition reminds us of the critical role of nutrition in modulating responses to stress-induced
inflammation.
Hallmarks of all of the chapters include complete definitions of terms with the abbre-
viations fully defined for the reader and consistent use of terms between chapters. There
are more than 20 relevant tables, and 55 useful figures, as well as more than 2000 up-to-
date references; all chapters begin with a Key Points section, and close with a conclusion
that provides the highlights of major findings. The volume contains a highly annotated
index and within chapters, readers are referred to relevant information in other chapters.
This important reference text provides practical, data-driven integrated resources based
on the totality of the evidence to help the reader evaluate the critical role of nutrition,
especially in at-risk populations, in optimizing health and preventing stress-related
chronic illnesses. The overarching goal of the editors is to provide fully referenced
information to health professionals so they may have a balanced perspective on the value
of foods and nutrients that are routinely consumed and how these help to maintain mental
as well as physical health.
In conclusion, Nutrients, Stress, and Medical Disorders, edited by Drs. Yehuda and
Mostofsky, provides health professionals in many areas of research and practice with the
most up-to-date, well-referenced, and easy-to-understand volume on the importance of
nutrition in reducing stress-related chronic diseases and optimizing health. This volume
will serve the reader as the benchmark in this complex area of interrelationships between
diet, specific nutrients, CNS function, immune responses, and mental health. The editors
are applauded for their efforts to develop the most authoritative resource in the field to
date and this excellent text is a very welcome addition to the Nutrition and Health Series.
Adrianne Bendich, PhO, FACN
Series Editor
Preface
The entry of the 21st century has been accompanied by a continuing surge of interest
in brain science that began with the "Decade of the Brain" initiative. The laboratory
research and clinical practice that followed have contributed to a realignment of perspectives,
an integration of theory and thought, and the establishment of numerous multidisciplinary
collaborations. Nutrition has begun to be recognized for its pharmacological relevance
and stress phenomena are no longer viewed simply as mental health constructs. The study
and treatment of health and illness has become the province of a broad segment of
scientists and clinicians that includes psychologists, immunologists, biochemists, and
public health professionals along with physician specialists from medicine. Even a
cursory scanning of the published literature reveals the vast terrain that such
enterprises represent. Journals, edited volumes, and monograph publications from
almost all related disciplines can be expected to report on developments that cross the
once familiar disciplinary boundaries. Investigations of nutrition, behavior, and health--
in all their combinations--are now more the rule than the exception. For whatever reasons
this has come to be, it has taken hold. The implications for research direction inherent in
such activities, and especially the potential for interventions and treatments of many
serious health conditions, are profound and are attracting the attention of the entire
community of health science and delivery.
In Nutrients, Stress, and Medical Disorders we have assembled a sampling of the
issues and findings that are representative of much of the current theoretical and laboratory
activity. The volume is addressed to professionals and graduate students from
diverse areas, for whom the need to become better informed about concepts and
methodologies from neighboring disciplines is not readily solved by the specialized
scientific literature. We have attempted to provide a wide-ranging collection of chapters
by established experts that will provide a useful introduction to the literature of each of
the areas of stress, nutrition, and medical disorders. In doing so, we have left it to the
individual reader to attempt the global integration of the various messages that are
presented, and to extract the salient features that will allow extensions for future scientific
investigations or clinical applications. We are most appreciative of the valuable support
of Humana Press in bringing this work to publication. We are especially grateful to Paul
Dolgert, Editorial Director and to Andrianne Bendich, Series Editor for their expertise
and patience in working with us on this project, as well as the earlier volumes that we have
prepared. Although we were not able to include all of the relevant topics nor include chapters
by all of the available experts, it is our hope that the efforts of the respective authors will merit
a favorable reception by the audience of those who are advancing our knowledge in each of
these areas--nutrition, stress, and health so that our boundaries of scientific knowledge will
be extended and that the quality of human life will be improved.
Shlomo Yehuda, eho
David L Mostofsky, eho
ix
