Anxiety Screening for All?

Earlier this week, the U.S. Preventive Services Task Force (an arm of the Dept of Health & Human Services) recommended that (because of the extreme stress levels we’re all under), ALL ADULTS should be screened for ANXIETY (by their primary healthcare providers).

This is a BIG deal!

Over the last couple of years, national surveys have shown that negative moods (stress, depression, anxiety, tension, fatigue, pain, etc) are at an all-time high, while positive moods (happiness, wellness, well-being, energy, focus, etc) are at an all-time low – so these recommendations certainly come at a good time.

The GOOD = hopefully more people will start feeling better and become aware of the importance of attending to their mental wellness (it’s AS important as your physical wellness).

The BAD = a lot of people are going to get prescription anti-depressants and anti-anxiety drugs – which come with a long list of side effects.

BUT WHAT IF… people learned about the wide variety of safe and effective NATURAL options for improving mood, reducing stress, and calming tension?

There are SO MANY OPTIONS – from specific strains of probiotic bacteria, or prebiotic fibers, or a wide range of phytonutrients (plant-extracts) that have excellent scientific evidence for helping people feel better.

The New York Times ran and article on Tuesday (Sept 20, 2022) that announced the new anxiety screening recommendation – so I have some highlights below and a link to the original article HERE

Health Panel Recommends Anxiety Screening for All Adults Under 65

The guidance comes as Americans are coping with illness, isolation and loss from the pandemic, as well as other stressors like inflation and rising crime.

By Emily Baumgaertner

Published Sept. 20, 2022

A panel of medical experts on Tuesday recommended for the first time that doctors screen all adult patients under 65 for anxiety, guidance that highlights the extraordinary stress levels that have plagued the United States since the start of the pandemic.

The advisory group, called the U.S. Preventive Services Task Force, said the guidance was intended to help prevent mental health disorders from going undetected and untreated for years or even decades. It made a similar recommendation for children and teenagers earlier this year.  

The panel, appointed by an arm of the federal Department of Health and Human Services, has been preparing the guidance since before the pandemic. The recommendations come at a time of “critical need,” said Lori Pbert, a clinical psychologist and professor at the University of Massachusetts Chan Medical School, who serves on the task force. Americans have been reporting outsize anxiety levels in response to a confluence of stressors, including inflation and crime rates, fear of illness and loss of loved ones from Covid-19.

“It’s a crisis in this country,” Dr. Pbert said. “Our only hope is that our recommendations throw a spotlight on the need to create greater access to mental health care — and urgently.”

From August 2020 to February 2021, the percentage of adults with recent symptoms of an anxiety or a depressive disorder increased to 41.5 percent from 36.4 percent, according to one study cited by the task force.

The guidance was issued in draft form. The panel will finalize it in the coming months after reviewing public comments. While the panel’s recommendations are not compulsory, they heavily influence the standard of care among primary care physicians across the country.

In response to the recommendations, mental health care providers emphasized that screening programs are useful only if they lead patients to effective solutions. At a time when the country is “short on mental health resources on all levels — psychiatrists, psychologists, and therapists — that’s a real concern,” said Dr. Jeffrey Staab, a psychiatrist and chair of the department of psychiatry and psychology at Mayo Clinic in Rochester, Minn.

“We can screen lots of people, but if that’s all that happens, it’s a waste of time,” said Dr. Staab, who is not on the task force.

Psychiatrists, while pleased with the attention on mental health, also underscored that a standardized screening is only the first step toward a diagnosis, and that providers will need to guard against assuming that a positive screening result indicates a clinical disorder.

For many Americans, the screening could simply reveal a temporary period of distress and a need for extra support.

“When providers say, ‘You must have a disorder, here, take this,’ we could face an overprescribing problem,” Dr. Staab said. “But the opposite scenario is that we have lots of people suffering who shouldn’t be. Both outcomes are possible.”

Rising mental health issues are not unique to the United States. Anxiety and depression increased by 25 percent globally during the first year of the pandemic, according to the World Health Organization, and has only partially improved since.

About a quarter of men and about 40 percent of women in the United States face an anxiety disorder in their lifetimes, according to the task force, though much of the data is outdated. Women have nearly double the risk of depression compared with men, studies show, and the recommendation paid special attention to screenings for pregnant and postpartum patients.

Physicians typically use questionnaires and scales to survey for mental health disorders. According to the recommendations, positive screening results would lead to additional assessments at the provider’s discretion, depending on underlying health conditions and other life events.

Some primary care physicians expressed concern that adding an additional responsibility to their wide-ranging checklist for brief patient appointments is implausible.

Dr. Pbert of the task force said that those providers should “do what they already do on a daily basis: Juggle and prioritize.”

She also said the task force’s rigorous review of available studies revealed that people of color are often underrepresented in mental health research, which, if not addressed, could contribute to a cycle of inequity.

Mental health disparities are rampant in the United States, where Black patients are less likely to be treated for mental health conditions than are white patients, and Black and Hispanic patients are both more frequently misdiagnosed. From 2014 to 2019, the suicide rate among Black Americans increased by 30 percent, data shows.

Standardizing screening for all patients could help combat the effects of racism, implicit bias and other systemic issues in the medical field, Dr. Pbert said.

The task force panel did not extend its screening recommendations to patients 65 and older. It said there was no clear evidence regarding the effectiveness of screening tools in older adults because anxiety symptoms are similar to normal signs of aging, such as fatigue and generalized pain. The panel also said it lacked evidence on whether depression screening among adults who do not show clear signs of the disorder would ultimately prevent suicides.

The task force will accept public comments on the draft recommendation through Oct. 17.

What is the Best Supplement for Mental Focus?

Short video explainer is HERE

Hands down, the best supplement for memory is pomegranate extract – and I think the “Pomma+” extract is probably the best because it is concentrated in compounds called “punicalagins” that have been studied to show improved memory in cases of dementia/Alzheimer’s but also in cases of “regular” memory deficits that come with aging.

Most pomegranate extracts are either not standardized at all (making them low potency and not very effective), or standardized to ellagic acid – which is great for “blood flow” benefits, but not specific to memory effects.

I often recommend to combine pomegranate extract for memory with New Zealand pine bark extract for focus and calming of the “monkey mind” – this combination is miraculous for alleviating what a lot of people refer to as “brain fog” (and so many people don’t even realize that they have brain fog until it goes away)…

Other very effective supplements for memory and focus can be Theanine (also improves relaxation and alertness), Saffron (also improves focus and mood), Guayusa (also improves mental awareness) and Mango Leaf (also improves cognition and sports performance) – so if you would like me to elaborate on any of those, please let me know?

Happy Juice Mixology

One of our most popular “stacks” of Amare products is the “Happy Juice” pack – a combination of MentaBiotics, Edge, and Energy+

This unique combo delivers an unmatched feeling of holistic Mental Wellness – abundant energy, sharp focus, and all-day motivation and resilience.

Check out THIS 5-min video to see what it’s all about and THIS 1-hour webinar to hear all the science behind the products.

The “Secret” to Mental Energy?

UPDATE = here is the video from the webinar last night = https://youtu.be/mXq5Oqq8jaA (slides can be downloaded below)…

Join me tonight at 7pm ET for a discussion about “Mental Energy”

Zoom link = https://us02web.zoom.us/j/89065682766

Facebook Live = https://www.facebook.com/groups/1bewell/

I’ll be covering how to NATURALLY promote the different types of “energy”…

Physical Energy – natural plant-derived stimulants (Goldilocks principle)

Mental Energy – focus, clarity, creativity, problem solving

Mental Awareness – engagement, connection, flow/zone

Motivation – actionable combination of mind/body synchronicity

And also discussing how to fight back against the main “energy drains”…

•Monkey Mind?

•Sleep Deprived?

•Dehydrated?

•Leaky Gut?

Here are the slides that I’ll be using…

Psychobiotics – Natural Mental Wellness Enhancers

There was a very nice article on the LiveScience website a couple days ago about “Psychobiotics” – the specific probiotics and prebiotics that can naturally improve mental wellness (mood, energy, stress, focus, etc)…

I have a link to the original article below – as well as an edited/highlighted version of the article with some of my favorite bullet points…

What are Psychobiotics?

By Lou Mudge (original article at https://www.livescience.com/what-are-psychobiotics)

Live bacteria known as psychobiotics could have an impact on our mental state. 

Psychobiotics may bring to mind images of a music festival or a Beatles song, but they are not as psychedelic as they sound. Psychobiotics are probiotics and prebiotics that have an impact on our mental state due to their interaction with our gut microbiome. This interaction is known as the gut-brain axis and is a growing area of research in the management of conditions that involve the brain, such as depression, anxiety and dementia.

Digestive conditions like irritable bowel syndrome (IBS) are often found in tandem with mental health conditions, such as depression and anxiety, but what exactly is the link between IBS and anxiety? Plus, would an improvement in gut health lead to a correlating improvement in mental health conditions?

We spoke to the experts to unpack the science behind psychobiotics.

WHAT ARE PSYCHOBIOTICS?

Professor Glenn Gibson, who works in food microbiology at the University of Reading, U.K, explains that psychobiotics is the name given to probiotics that can affect cognitive state. “Probiotics are live microbes with benefits,” he says. “I think prebiotics have also come into the psychobiotic category – these are growth promoters for beneficial microbes.”

A review in the Journal of Food and Drug Analysis defines psychobiotics as “a group of probiotics that affect central-nervous-system-related functions and behaviors mediated by the gut-brain-axis via immune, humoral, neural and metabolic pathways.” Another review, in the Journal of Trends in Neuroscience, also includes prebiotics within the definition of psychobiotics, as these also impact the health of the gut microbiome. 

Dr Deborah Lee, a medical doctor and writer for Dr Fox Online Pharmacy, explains that the concept of psychobiotics originated from the observation that mental health and gastrointestinal conditions frequently coexist.

“In recent years, researchers have become aware of the importance of the gut-brain axis: this is the way the gut and the brain communicate with each other,” she says. “They realized that the cognitive and emotional centers of the brain are intimately connected with the gut, such that thoughts and emotions directly affect gut reflexes, the permeability of the intestines, the gut immune responses, and the hormonal signaling within the gut wall. We now know that this relationship is bidirectional – meaning that gut health also affects mental functioning.”

A review in the journal Biological Psychiatry found that psychobiotics show promise in treating IBS, depression and chronic fatigue syndrome, possibly due to the anti-inflammatory properties of psychobiotics, or their ability to reduce hypothalamic-pituitary-adrenal axis activity, which is associated with many mental health conditions.

WHAT DOES THE SCIENCE SAY ABOUT PSYCHOBIOTICS?

According to Gibson, research into psychobiotics is ongoing. “This is looking at how diet can influence psychobiotics to make neurotransmitters (chemicals like gamma amino-butyric acid – GABA) that are manufactured in the gut but get to the brain via the bloodstream. The vagus nerve is also involved,” he says. 

A 2021 review in the journal Progress in Neuro-Psychopharmacology & Biological Psychiatry suggests that as the gut microbiome develops alongside the central nervous system, psychobiotics may be helpful in treating the effects of early life stress, which can cause developmental issues. This could help mitigate the impacts of childhood adversity and lead to a healthier adult life.

“Gut bacteria affect the hypo-thalamo-pituitary axis (HPA axis), reducing the stress response, and hence reducing inflammation,” says Lee. 

Chronic stress leads to raised levels of the stress hormone cortisol, which switches off the local immune response and increases intestinal permeability (also known as ‘leaky gut’). However, restoring the gut microbiota to a healthy flora, down-regulates the HPA axis, lowers cortisol production and restores the normal environment. 

“The range and diversity of the bacteria that make up the gut microbiome affects the production of cytokines: cell-signaling molecules that summon white blood cells and inflammatory mediators to the gut wall,” adds Lee. “In normal circumstances, the gut wall is protected by an intact epithelium (cell layer), which prevents infecting organisms and other foreign substances from breaching the gut wall and entering the bloodstream. However, certain bacteria produce metabolites that damage host defenses and allow these foreign organisms, and other substances to enter. Research has shown that people with depression have higher levels of inflammatory cytokines, such as interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α). Higher levels of interleukin-1α and interferon-γ – substances that regulate the immune response – are also more common in those diagnosed with depression.”

A 2021 review in the Nutrients journal indicates that there is a link between abnormalities in the intestinal barrier and depression, with psychobiotics showing potential in helping with immune system processes, proper immune functionality and overall intestinal barrier health.

Lee says that neurotransmitters related to mood are made in the gut. “A range of neurotransmitters are produced in the gut, including dopamine, serotonin, noradrenaline, acetylcholine and GABA,” she says. “Certain bacteria also produce long- and short-chain fatty acids, which can stimulate nerve function.”

THE FUTURE OF PSYCHOBIOTICS

When it comes to psychobiotic research, Gibson says “all sorts of cognitive issues are on the agenda”, ranging from anxiety and depression to dementia. “One project I’m involved with is using MRI scanning images of the brain and gut to look at chemical signaling in response to probiotics,” he says.

A 2021 review in the journal Modern Trends in Psychiatry indicates that encouraging patients with depression to eat a varied, plant-based diet rich in fermented foods may help, due to the impact such a diet would have on the gut microbiota. 

“There is still much to learn about the gut-brain-axis and the future role of psychobiotics,” adds Lee. “The fact that we could potentially prevent or cure many mental health conditions through diet, and perhaps without the need for such heavy reliance on antidepressants, is an exciting prospect. More research needs to be conducted to identify specific strains of bacteria that could benefit specific conditions and their exact mechanism of action. We need to understand how probiotics – and prebiotics – could benefit a range of medical conditions, and affect different parts of the body, including the skin, the mouth and the vagina.”

HRV is the Secret to Sports Performance?

Nice quick article in Trail Runner Magazine about HRV – Heart Rate Variability – and how it is a good measure of recovery and resilience (which we can ALL use more of – whether or not we consider ourselves to be “athletes”).

Original article is here = and an edited/highlighted version is below…

Wouldn’t it be super cool to have a nutritional supplement that can increase HRV by 11-19%? Of course – and that is exactly what our MentaHeart can do – the world’s first combination of phytonutrients to improve HRV, physical performance, and mental wellness – by optimizing the entire Heart-Brain-Axis.

I measure my own HRV using a variety of tools – Oura ring, Whoop band, Apple Watch, Wahoo Element Watch…

Using Heart Rate Variability to Get the Most From Your Training

HRV can help you decide when to push—and when to hold back—for optimal fitness and recovery.

AUGUST 29, 2022

EMMA-KATE LIDBURY, MACKENZIE HAVEY

It’s no secret that rest is one of the most important parts of training, but learning to listen to your body is also one of the greatest challenges triathletes face. “Should I hit that hard workout today, even though I’m tired, or should I sleep in?” It’s a thought we’ve all had, and it’s sometimes an impossible question to answer, especially when our zeal for training clouds our ability to read subtle warning signs. But heart rate variability (HRV) is a metric that helps give you the objective data you need to make a more informed decision on whether to push it or save the tough workout for another day. Many top professionals have been using it for some time now—and with great results—and an increasing number of age-group athletes are training with it too, especially as it is a function now built into so many smart watches, such as the Apple Watch and the WHOOP.

Alan Couzens, an exercise physiologist and coach who’s been in the multisport game for more than 25 years, predicated several years ago that HRV would help drive a “significant paradigm shift” when it comes to tri training. So what is HRV and why is it important?

“Heart rate variability reflects how strong your recovery system—the parasympathetic nervous system—is currently,” he said. “When it is low, it will take the body longer to recover from hard sessions and it indicates to the athlete (and the coach) that they need to spend more time recovering. Conversely, when it is high, an athlete will bounce back from intense work much more quickly.”

When it first appeared on the endurance scene, HRV could only be tracked via a lab-grade EKG assessment, but now it is a standard feature on many tri watches. “It’s a huge step forward over traditional metrics, like resting heart rate,” Couzens said. “It is a far more sensitive measure of the status of the autonomic nervous system.”

A HRV device measures the interval between each of your heart beats, in milliseconds (m/s), over a specific period of time, e.g., the Elite HRV app asks you to record for 2.5 minutes upon waking each morning. It then crunches the numbers to assign a HRV score for that day. If the intervals between beats are about the same, your HRV score will be low, indicating you need to take it easy. If there is more variation between beats, your score will be higher—and you’re ready to rock.

Couzens likened HRV to a group ride: When you’re feeling fresh, there will be a good amount of variability in your power file as you move around the group and maybe sprint certain sections. When you’re tired, however, you’re more likely to sit on the back of the group and steadily grind at an even pace. He also warned that the accuracy of the data can vary from app to app, but apps that use heart rate chest straps tend to be most accurate.

While the latest technology will crunch the numbers and give you the most vital data, you must first get baseline HRV numbers before you can effectively implement those values. This means tracking your HRV for at least a month (during a regular training cycle) to establish what your “normal” HRV range should be. As with so many data points from training and performance, your HRV score is unique to you and highly individualized. Your HRV score will be dependent on a number of factors, such as gender, fitness, lifestyle, sleep, and genetics. Couzens said that, typically speaking, highly-conditioned athletes tend to see lower drops in HRV (when fatigued) than those who are less well-trained. So what is a “good” HRV score? WHOOP data shows that the average HRV score for WHOOP users is 65 for men and 62 for women, but this varies a lot among different age brackets (e.g., the average HRV score for 25-year-olds is 78 compared to a HRV score of 44 for a 55-year-old). Experts agree, though, that the most important point of comparison is you: Track your own HRV scores over time and with improvements in health and fitness should also come an overall rise in your HRV scores.

This article first appeared in Triathlete Magazine