Coffee, tea, soda, and energy drinks. These are some of the everyday beverages we consume. Especially when we have long nights and early mornings, or a never-ending workday. Maybe even kids that wake you up in the middle of the night, or exams and homework that just need to get done. Sometimes we just need that boost that coffee gives us, a little pick-me-up to start the day or to just keep going.

All those drinks have caffeine in them, something that most of us are very familiar with. On average, Americans consume 179 mg of caffeine a day. But what does caffeine even do? How does it impact our brain and mental health?

Caffeine is a stimulant. It plays a role in reducing drowsiness (which is why the morning cup of coffee is a go-to for many people). It has also been shown to increase concentration, motor coordination, and alertness. There is also an effect on learning and memory. Depending on genetics, people react to and breakdown caffeine differently. Some people are more sensitive to caffeine, so it takes longer to metabolize and its effects will last longer.

On average, caffeine will reach its peak effectiveness 30-60 minutes after consumption. Half of the caffeine consumed will break down within 2-10 hours—this wide range is a testament to how differently each person experiences caffeine!

Be wary—stimulants such as caffeine can be addictive. People also build up a tolerance, so they’ll consume more and more caffeine to feel the same effects that they did before. The problem is that your body is taking in a lot more caffeine. This can lead to sleep problems, jitters, increased heart rate, and overstimulation.

So, what does caffeine do to our brain? How does it impact different neurological disorders? Does it affect men and women differently in these disorders? We’re going to talk about caffeine and how it impacts our brain and mental health over two parts. In this first part, we will focus on neurological disorders. The second part will discuss caffeine’s impact on mental health.

There are theories that coffee plays a protective role when it comes to some neurological diseases, including stroke, dementia, and Parkinson’s disease. Looking at research studies, people who drank at least 3 cups of coffee a day had a reduced risk of stroke. With dementia, women (more so than men) had a reduced risk of developing dementia. In Parkinson’s disease, high caffeine intake has been associated with having a protective effect, including decreased rates of Parkinson’s disease in men. (In women the correlation is a lot smaller).

It’s also important to note that caffeine may help reduce the risk of developing these disorders, but once the disorder is present there is not a lot of research to suggest that caffeine will reduce the severity of the disorder.

What does this mean for us? More research needs to be done in further understanding and interpreting these connections. According to the USDA guidelines, the recommendation for a safe level of caffeine intake is less than 400 mg per day (or about four 8-oz cups of coffee). If you’re curious how much caffeine you are consuming every day, check out this chart with a wide variety of common food and beverages and their caffeine amount.

We’ve seen that some benefits of regular caffeine intake include protection against dementia and stroke more strongly in women, and protection against Parkinson’s disease in men.

Based on these research findings, caffeine intake seems to help decrease the risk of the development of neurological disorders such as dementia, stroke, and Parkinson’s disease for some people. This doesn’t mean that it is wise to drink a ton of caffeine every day, but—good news for coffee-lovers—a moderate amount daily might be helpful in maintaining good brain health.

If you’re interested in finding out how caffeine impacts risk of mental health disorders, stay tuned for part 2!
​
Main research article for more information: https://www.mdpi.com/851178
Chart for caffeine intake in foods/beverages: https://www.cspinet.org/caffeine-chart

If you’re interested in learning more about how your dietary choices influence your mental and neurological health, reach out or schedule a virtual telehealth appointment with Erica Golden, RDN, LD, IFNCP. She specializes in nutrition for mental and cognitive health.

Autism spectrum disorder, or ASD, is a neurodevelopmental disorder that leads to challenges with social interactions and communication, as well as repetitive behaviors. While these are the three core symptoms that lead to the diagnosis of ASD in children, there is also a very strong association between autism and gut symptoms (especially diarrhea, constipation, and acid reflux, or heartburn).

More and better research studies are still needed to tease out the impact of diet on autism, and what gut symptoms are related to the disease itself versus the dietary patterns and preferences of people with ASD. However, there has already been some fascinating research on ASD and the gut microbiota, as well as the potential impact of dietary changes on neurological symptoms.

Autism and the Microbiome

Altered levels of gut bacteria have been strongly associated with ASD. The average healthy child’s microbiome becomes fairly diverse as they eat an increasing variety of solid foods. However, kids with autism tend to have a much less diverse diet, which seems to lead to a sub-optimal gut microbiome.

Though actual gut microbiome composition varies widely, some bacterial families, like Clostridium (known for C. difficile, a common gut infection, but actually a common and generally harmless bacterial family in the gut), Firmicutes, and Proteobacteria tend to be increased in kids with ASD. The types of bacteria of which these kids have an abundance seem to produce too much of a type of short-chain fatty acid called propionic acid, and they have less of the beneficial bacteria that produce butyrate, a short-chain fatty acid with lots of positive effects on mental health and inflammation.

There are a few case reports of treatments with antibiotics have sometimes helped to reduce anxiety and improve some behavioral measures in kids with autism, which is another fascinating sign that the gut microbiome is involved in their neurological symptoms. However, treatment with antibiotics is (and should only be) short-term – and even short-term use can have negative consequences – so this seems unlikely to become a universal solution.

But probiotics and prebiotics – essentially live bacteria and their food – have a strong potential as a much safer treatment with far fewer side effects or risks.

Prebiotics and Probiotics

For example, a study combining an autism exclusion diet with the prebiotic supplement GOS, a type of prebiotic fiber found in dairy products, beans, and root vegetables, found significant improvements in abdominal pain and bowel habits with the exclusion diet, and additional improvements in anti-social behavior with 6 weeks of supplementation with GOS.

Other studies have looked at a variety of probiotics, including single, highly specialized strains such as L. Plantarum WCSF1, or broad-spectrum probiotic supplements containing multiple different strains (mostly in the Bifidobacterium and Lactobacillus families).

While a person with ASD may see benefits from a standard probiotic, strains and combinations of strains specifically studied for the particular condition you’re looking to treat are much more likely to be effective. Some significant improvements in both gut health and behavioral symptoms were seen with the probiotic blend delPRO in one study (though the study did not have a control group with which to compare the experimental group’s results) and with a blend of L. acidophilus, L. rhamnosus, and B. longum in a different study.

Restrictive and Elimination Diets
Lots of different restrictive diets have been proposed for people with autism, and in some cases they may be very helpful. Artificial colors have been linked to behavior disturbances in kids, and there are also concerns about contamination with toxins and heavy metals (though the FDA does require that all artificial colors be tested for lead, mercury, and arsenic).

Gluten-free and casein-free diets are commonly tried. While there are theories about how and why they work, there isn’t enough evidence to say whether they’re generally useful for people with ASD. Proponents feel that the studies that have been done on the GF-CF diet are too short-term to show much impact.

Some people with ASD may have other issues with gluten- and casein-containing foods, such as lactose intolerance, Celiac disease, or non-Celiac wheat sensitivity contributing to their GI symptoms. Others may have IBS, and may see improvements from a low-FODMAP diet (always followed by a re-introduction phase).

However, the more complex the diet, and the more difficult it is for the whole family to follow, the less likely it is to be feasible. Plus, for those with texture issues or those who have more difficulty eating enough variety as it is, it can be difficult to plan a diet that will give enough nutrition to meet their needs. It’s always a good idea to seek the guidance of your pediatrician, neurologist, or dietitian to discuss the pros and cons of restrictive and elimination-style diets, and how to plan them in a way that makes them nutritionally adequate and feasible for the whole family.

Adding to the Diet Instead of Taking Away?

For people with ASD, the diet is often already quite restricted based on personal preferences and aversions. Difficulties with food based on texture, color, and taste are common. Kids may also recognize that certain foods cause tummy pain, and refuse to eat these foods, even if they can’t verbalize this.

It’s important not to make mealtime a fight. Try to stay calm and don’t allow a power struggle to arise over certain foods. We all deserve the right to choose what foods to eat and what foods not to eat, and a person with autism is no exception. However, it may be helpful to try new foods in combination (such as finely chopped mushrooms sautéed and added to spaghetti sauce) or in different forms to make the texture easier to tolerate (such as peeled and crushed tomatoes in a salsa).

As much as possible, involve your child in the food preparation, and try to make it fun. Get your hands dirty together and allow your kids to acclimate to new foods outside of mealtimes to help decrease anxiety during mealtimes.

Very often, it’s more about what we add to the diet than what we take away. Eating more fruits, vegetables, beans and legumes, and whole grains can increase intake of those healthy, gut-nourishing prebiotic fibers that can then feed the gut microbiome, promote more butyrate production, and improve bowel health and GI symptoms.

Eating fermented foods when possible, such as yogurt with live and active cultures, can introduce probiotic “travelers” which can have a positive impact on the gut microbiome, as well.

Eating a greater variety of foods makes it more likely that the diet will have enough protein, vitamins, minerals, essential fats, and polyphenols to promote a healthy brain, gut, skin, immune system, etc.
And besides all that, focusing on food as the hero rather than the enemy can help to foster a healthier relationship with food, less fear of food, and possibly even less reactivity to it. We are all heavily influenced by our expectations, and people with autism are no exception to this, either.

Take-aways

The subject of neurological and developmental disorders and diet is a hotly debated topic, and one that is quite difficult to study. It’s also essential that it be individualized to the needs of the person with autism and their community or family.

If you’re interested in developing a supportive relationship with a dietitian who can assist with making some of these difficult decisions in a non-judgmental environment, and with helping make some of these recommendations more feasible for your family, please reach out to me or schedule an appointment.

​I provide virtual nutrition care services to caregivers and parents living with people with autism, as well as directly to adults with ASD, throughout Colorado, California, Michigan, Arizona, Alaska, and Virginia. 

IBS is incredibly common in the US – somewhere between 10-20% of people suffer from it. But it’s incredibly more common in people with mood and anxiety disorders such as generalized anxiety disorder, schizophrenia, major depression, and panic disorder.

Let’s be clear: IBS is not always IBS. Sometimes there are other issues going on that medical professionals can miss, especially since IBS is often a “diagnosis of exclusion” (meaning, “we’ve ruled out everything else we can think of, so it must be IBS”). It’s always important to see a provider with a specialty in gut disorders to make sure that you get the correct diagnosis.

But let’s assume that the diagnosis is correct. What is going on in the gut that makes things so wonky in the brain? Or what’s going on in the brain that makes things so wonky in the gut?

Since the connection between the gut and the brain goes both ways (primarily via the vagus nerve, hormones, and the immune system), problems with either one can affect the other. And that means that there is a long list of factors that can impact the gut-brain axis and trigger mood disturbances, anxiety disorders, and IBS.

Dietary changes are often needed to calm an “irritated” gut, improve the composition and health of the gut microbiome, heal an intestinal barrier that has become too permeable (or “leaky”), provide adequate vitamins and minerals and amino acids to produce neurotransmitters necessary for mood stability, and more. Dietary changes sometimes include increasing fiber intake, eating more probiotic foods, eating a greater variety of foods, or, on the other hand, restricting certain foods that are common triggers (and then re-introducing them in a planned and careful way).

Lifestyle changes are often needed to calm an over-worked or over-stressed mind. We all have stress, and stress is not inherently bad or harmful, but often can be when we are dealing with it in an unhealthy way or when the stress is chronic and when we aren’t good at resting and relaxing in a healing way. CBT (cognitive behavioral therapy) has been helpful for many people with IBS, which is testament to the importance of managing this disorder from both a gut and a brain perspective. Yoga, stretching, and other forms of gentle movement are also helpful for some people.

Probiotic supplements, fiber supplements, and herbal supplements such as natural anti-microbials, demulcents, digestive bitters, and peppermint can be helpful for some people, but I would always recommend getting advice from a trained professional such as a gastroenterologist or dietitian before starting such supplements, as they need to be carefully selected and tailored to your needs.

Managing disorders of the gut-brain axis, like IBS, can be very challenging. You don’t have to go it alone. If you’re interested in working with a gut health dietitian, schedule a virtual telehealth nutritionist appointment with me or send me a message today.

PS - I was recently interviewed about this topic for DeliveryRank. You can read the interview here.

Move over smoothies, this is my new favorite way to eat kefir. 

I preach about fermented foods all the time, but I know it can sometimes be hard to find practical ways to fit them into your day. I home-make my own kefir (not as hard as it sounds), so I always have lots on hand and I love to experiment with new ways to eat and love it. This one is too good not to share! So here you go, friends. Enjoy!


Ingredients:

• ½ cup rolled oats
• 1 cup liquid (start with ¼ cup kefir + ¾ cup milk of choice; gradually increase kefir each time you make it until you reach your preferred flavor)
• ½ large banana
• 1 pitted date, chopped (optional)
• 1 tsp cinnamon
• 1 ½ Tbsp ground flaxseed
• ½ cup blueberries
• 2 Tbsp chopped pecans or walnuts

 
Instructions:

1. Mash the ½ banana in a bowl. Add oats, kefir, milk, and chopped prune or date. Mix the ingredients, cover, and place in the refrigerator at least 4 hours or (preferably) overnight.
2. Top with cinnamon, flaxseed, berries, and nuts. Stir to mix and enjoy!

 
Variations:

• Apple cinnamon overnight oats: replace berries with ½ chopped apple and increase cinnamon to 2 tsp.
• Strawberry chia overnight oats: replace blueberries with ½ cup chopped strawberries and flaxseed with chia seeds. Add the chia seeds with the oats the night before.
• Peanut butter chocolate overnight oats: a great dessert! Warm 1-2 Tbsp peanut butter for a few seconds in the microwave and drizzle over the fermented oats. Top with shaved dark chocolate. Yummmmmmm.
• Carrot cake overnight oats: replace berries with shredded carrot and use extra walnuts if desired. Add a sprinkle of brown sugar if needed. 

***Note: If you're wondering, "What's the deal with kefir anyway?" --let me tell you about it. Kefir is an amazing source of probiotics that, like yogurt, has been around for a very, very long time. It's sometimes called the "champagne of dairy" because of the bubbly, drinkable texture. It's a great source of Lactobacillus bacteria, which are one of the best-studied probiotics for gut health and mental health, as well as Saccharomyces cerevisiae, which is a probiotic yeast. Kefir has been shown in some studies to have benefits such as reducing constipation, reducing bloating, and improving mood--just to name a few. 

Got a favorite way to eat or drink your kefir? Share it with us below!

Interested in scheduling an appointment with a gut health dietitian? I'm a virtual telehealth dietitian, and I love to make my clients amazing meal plans with recipes like this one! Reach out to me or schedule a 15-minute discovery call to learn more.