1 MIND What You Eat Workshop 2Action Against Alzheimer’s Programme © Cytoplan

2 Content of Workshop Recap Workshop 1 and Self Care Journey homeworkFats to avoid and fats to enjoy The importance of essential fatty acids for brain health The benefits of vegetable and fruit consumption for brain health How to eat for your MIND Understanding your eating behaviours and how you can change Self Care Journey home study Action Against Alzheimer’s Programme © Cytoplan

3 MIND What You Eat – Workshop 2Explain the functions of fat Describe which fats are crucial for excellent brain health List the fats to enjoy and incorporate into your diet Describe the benefits of vegetables for excellent brain health Define nutrient rich foods and give examples Summarise what constitutes a healthy diet for the mind Explain the principles of the Mediterranean and Paleo dietary approaches Understand how unhealthy eating behaviours can sabotage our intentions Implement strategies designed to help change your approach to eating Action Against Alzheimer’s Programme © Cytoplan

4 Recap of Workshop 1 Evidence our current diet and lifestyle is making us sick The nutrition gap Sugar & carbohydrates (refined & starchy) Self Care Journey home study Action Against Alzheimer’s Programme © Cytoplan

5 In a nutshell Reduce or preferably avoid sugary and refined foods as they are nutrient poor and have a significant effect on blood sugar Eat starchy carbohydrates in moderation for example; oats, rice, potatoes as they too are broken down into sugar Choose NUTRIENT DENSE foods, foods rich with vitamins, minerals, healthy fats and fibre Action Against Alzheimer’s Programme © Cytoplan

6 Self Care Journey Home StudyHow did you get on? What did you think about the Whole Person Approach to health? Discuss in pairs the Well Formed Outcome exercise and your learnings Action Against Alzheimer’s Programme © Cytoplan

7 Fats Action Against Alzheimer’s Programme © Cytoplan

8 Low Fat Diets 1970s high fat diets linked to heart disease – new studies contradict this 1980s – low fat diets Fat-phobia THE BRAIN IS 60% FAT !! Action Against Alzheimer’s Programme © Cytoplan

9 Functions of fat Energy All cell membranes are made up of fatHormone synthesis e.g. stress hormone, sex hormones Absorption of fat soluble vitamins A, D, E and K Prostaglandin synthesis (hormone like substances) Omega-6 fatty acids are in general inflammatory Omega-3 fatty acids are anti-inflammatory Action Against Alzheimer’s Programme © Cytoplan

10 Which symptoms do you have?Poor memory / concentration Depression / tingling in arms and legs due to nerve deterioration / vision problems Decreased ability to cope with stress Dry / itchy skin / eczema / hair loss / poor nail growth Joint pains / inflammation / allergies / autoimmune conditions / digestive problems / constipation Low energy levels Poor immunity Action Against Alzheimer’s Programme © Cytoplan

11 Nutritional value of fatsThe nutritional value of a fat depends on Its fatty acid composition; Monounsaturated Polyunsaturated (omega 6, omega-3) Saturated Trans The degree of processing / refining / storage and other nutrients present Action Against Alzheimer’s Programme © Cytoplan

12 What fats are we eating? In 1970s and 80s government advised against eating animal fats (saturated fats) and to eat more polyunsaturated fats (vegetable oils) – to swap from butter to margarine. Polyunsaturated: We now eat large quantities of polyunsaturated omega-6 fatty acids found in sunflower, corn, and other oils. Omega-6 are inflammatory. Action Against Alzheimer’s Programme © Cytoplan

13 What fats are we eating? TRANS fats – found in processed foods, margarines. They are created when vegetable oils are heated to high temperatures. They are TOXIC and should be avoided. Normal structure is CIS. Retrieved from: https://qph.is.quoracdn.net/main-qimg-a5e067decfb245bc722e8872ce58be94?convert_to_webp=true Source: https://upload.wikimedia.org/wikipedia/commons/3/37/Difference_DNA_RNA-EN.svg Action Against Alzheimer’s Programme © Cytoplan

14 Essential fatty acids Omega-6 AND omega-3 fats (polyunsaturated)Omega-6 and Omega-3 are families of fats – within each family there are a number of fatty acids. Within omega-6 some are pro-inflammatory; omega-3 are anti-inflammatory Western diet ratio of 10:1 (omega-6 : omega-3) Optimal health ratio is between 4:1 and 2:1 Action Against Alzheimer’s Programme © Cytoplan

15 Brain Health - Fats to Avoid or LimitFried food Sunflower / Corn oil Processed Foods Margarine Action Against Alzheimer’s Programme © Cytoplan

16 Brain Health - Fats to EnjoyCold water fatty fish eg wild salmon Olives and olive oil Avocado Nuts and Seeds Coconuts / coconut oil Action Against Alzheimer’s Programme © Cytoplan

17 Activity 1: Healthy or Unhealthy Fats?Sort the photographs into two piles one for healthy fats, the other for unhealthy fats Discuss the similarities and differences between doughnuts and nuts Action Against Alzheimer’s Programme © Cytoplan

18 Answer Activity 1 Healthy fats Unhealthy fatsAction Against Alzheimer’s Programme © Cytoplan

19 Answer Activity 1 Similarities nuts and doughnuts: High in fat, high in calories Differences nuts and doughnuts: Nuts are high in healthy monounsaturated fats Nuts are nutrient dense – source of vitamins, minerals, fibre, phytonutrients Doughnuts are high in ‘empty calories’, lack nutrients, high in sugar, carbohydrates and unhealthy fats Action Against Alzheimer’s Programme © Cytoplan

20 Nutrition Labels High total fat > 20 g per 100 gLow fat < 3 g per 100 g High saturated fat > 5 g / 100 g Low saturated fat < 1.5 g / 100g Traffic lights: Red (high), Amber, Green MANY LOW FAT FOODS ARE VERY HIGH SUGAR Action Against Alzheimer’s Programme © Cytoplan

21 Vegetables Action Against Alzheimer’s Programme © Cytoplan

22 How Many Portions of Vegetables and Fruit?Recent research suggested 7-10 per day for good health UK – 5 Denmark – 6 France – 10 Canada – 5 to 10 Japan – 13 vegetables plus 4 fruit Portions of vegetables / fruit in linear relationship with health Action Against Alzheimer’s Programme © Cytoplan

23 UK Fruit and Vegetable consumptionNo age category in the UK is achieving the government recommendation of five-a-day. The average is 3 portions per day Age Portions MEN WOMEN 4-10 2.5 2.1 11-18 2.2 2.6 19-64 3.5 3.6 Over 64 4 Average 3 NB: Victorians 10 Action Against Alzheimer’s Programme © Cytoplan

24 The Benefits of Vegetables for Brain HealthLow in carbohydrates - AD has been described as type 3 diabetes High in anti-inflammatory phytonutrients – inflammation part of pathology of AD High in folate for homocysteine metabolism - raised homocysteine is linked to AD High in fibre Encourages growth of beneficial gut bacteria Aids proper elimination through the bowel Poor gut health = poor brain health – Workshop 4 Action Against Alzheimer’s Programme © Cytoplan

25 What is Eating for Your Mind?Action Against Alzheimer’s Programme © Cytoplan

26 High in NUTRIENT DENSE foodsAction Against Alzheimer’s Programme © Cytoplan

27 Diet for Brain Health - SummaryVery low in sugar Moderate in ‘starchy’ carbohydrates (oats, rice, quinoa, buckwheat, sweet potatoes). Maximum ¼ plate. High in non-starchy vegetables 6+ portions per day Moderate in fruit 2 portions per day Adequate protein including plant protein Right types of fats – olives, avocado, oily fish, nuts, seeds, coconut Action Against Alzheimer’s Programme © Cytoplan

28 Half Plate Rule Vegetables Broccoli, Cabbage Spinach, Kale,Runner/French/Green Beans, Peas, Courgettes, Mange tout, Sugar snaps, Carrots, Brussels Sprouts, Cauliflower, Peppers Onions, Garlic, Celery, Tomatoes, Lettuce, Watercress, Avocado, Cucumber, Fennel, the list is endless! Turkey, Chicken, Fish, Eggs Nuts, Seeds, Beans, Lentils, or lean red meat Protein Carbohydrate Rice, Oats, Quinoa, Sweet potato, Potato, Buckwheat, Swede, Squash, Parsnip, Broad beans, Beetroot or Pumpkin. Action Against Alzheimer’s Programme © Cytoplan

29 Heavy alcohol consumption is detrimental to brain healthAlcohol contents Government recommendation – women maximum 2-3 units per day; men 3-4 units. 14 units per week maximum for both men and women Heavy alcohol consumption is detrimental to brain health Action Against Alzheimer’s Programme © Cytoplan

30 Are you adequately hydrated?Amount of fluids needed is individual and dependent on a person’s weight, the weather conditions, activity levels etc Water and herbal teas all help to hydrate Caffeine is a diuretic Listen to your body – drink according to thirst, you can also be guided by urine colour It is possible to over-hydrate as well – water intoxication Action Against Alzheimer’s Programme © Cytoplan

31 Popular Eating RegimesThe Mediterranean diet The Paleo diet Action Against Alzheimer’s Programme © Cytoplan

32 Mediterranean Diet Lots of vegetables and fruitMeat / fish / eggs / dairy Healthy fats – olive oil, nuts/seeds, oily fish, avocado Wholegrains (watch portion sizes, small amounts only) Lots of research on the benefits of the Mediterranean diet Action Against Alzheimer’s Programme © Cytoplan

33 The Paleo Diet (or Stone Age)Meat, fish, eggs Lots of vegetables (incl sweet potatoes) Fruit Nuts / seeds / coconut oil / avocado / olive oil No grains (rice, oats, bread, pasta, quinoa) No dairy Low sugar Large following in US Action Against Alzheimer’s Programme © Cytoplan

34 Activity 2: Food diary activityWrite down what you ate and drank yesterday – breakfast, lunch, supper, snacks, drinks Use a pink highlighter to identify sugary foods Use a yellow highlighter to identify unhealthy fats Use a green highlighter to identify portions of vegetables How many portions of vegetables did you eat? How many healthy fats? Action Against Alzheimer’s Programme © Cytoplan

35 Homework – food & mood diaryComplete the food and mood diary and bring next week Time Food / drink Where? Hunger level 1 to 10 Mood / state of mind before and after eating How did you feel afterwards? Comment Action Against Alzheimer’s Programme © Cytoplan

36 Next week – MIND What You EatRecap on how our ancestors ate Increasing nutrient density Basic & Advanced Dietary Programme Smoothies Action Against Alzheimer’s Programme © Cytoplan

37 Eating Behaviour Action Against Alzheimer’s Programme © Cytoplan

38 “Diet and exercise programs routinely fail not for lack of willpower but because the society in which we live favours unhealthy behaviours.” Willett & Underwood (2010) Action Against Alzheimer’s Programme © Cytoplan

39 How many food related decisions do we make per day?Hands-up for 15? 130? Or 250? Action Against Alzheimer’s Programme © Cytoplan

40 How many food related decisions per day?Answer: 250 Every time we see food we make an unconscious decision about whether to eat it or not Brian Wansink (2009) – Mindless Eating Action Against Alzheimer’s Programme © Cytoplan

41 What is the most influential factor that determines how much adults and children eat?Hunger or Mood or Portion size or Time of day ? Action Against Alzheimer’s Programme © Cytoplan

42 What is the most influential factor that determines how much adults and children eat?Answer: Portion Size Wansink (2009) found that when he increased the size of bowls, plates, serving items – his study subjects increased how much they served themselves by up to 57% and they ate it! Action Against Alzheimer’s Programme © Cytoplan

43 Eating behaviour People think they eat according to hungerIn fact how much we eat is determined by Portion size Family Friends Packaging Plates Lighting Shapes Smells …… distractions and other things Action Against Alzheimer’s Programme © Cytoplan

44 Help yourself ! Engineer your home and work environment! Make overeating a hassle Don’t buy the junk to avoid mindless eating If it must be in the house – have it all out of sight / hard to get at Eat until you are 80% full – serve smaller portions especially starchy carbohydrates Be aware – high sugar, fat and salt foods stimulate release of dopamine in brain (associated with reward). Eating can be a pleasure but avoid Eating FOR pleasure! Action Against Alzheimer’s Programme © Cytoplan

45 Help yourself ! Mental rehearsalDevelop “If … then …” scenarios. E.g. “if I go to the supermarket …. then I will ...” Develop a meal plan for the week. If necessary also plan when you will make each meal. Avoid allowing yourself to get to stage of being ravenous and having no food easily available PLANNING – if you fail to plan you plan to fail Action Against Alzheimer’s Programme © Cytoplan

46 © Cytoplan

47 Your Self Care Journey Prepare for Change                                                                               Prepare for Change 360° Whole Person Needs Assessment Design a realistic Self Care Plan with goals that you can achieve Identify areas where you need more support. Create time in your schedule for self-care activities e.g. exercise, food preparation, relaxation techniques and sleep Organise your life to enable success Action Against Alzheimer’s Programme © Cytoplan

48 Home Study Module Week 2 Prepare for Change Self Care Questionnaire360° Self Care Assessment Complete a Food Diary Explore your Eating Behaviour Action Against Alzheimer’s Programme © Cytoplan

49 Summary of today Fats to avoid Fats to enjoy VegetablesNutrient dense foods Eating behaviour Action Against Alzheimer’s Programme © Cytoplan

50 Nothing tastes as good as brain health and vitality feels!A final thought ….. Nothing tastes as good as brain health and vitality feels! Action Against Alzheimer’s Programme © Cytoplan

51 Feedback questionnairesFeedback is welcome – please complete now and hand-in on your way out. Thank you ! Action Against Alzheimer’s Programme © Cytoplan