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From personal experience, empirical data or folklore, familiarity with the peculiar eating habits of pregnant women is well known. Alcoholics in recovery are strongly drawn to coffee, sugar, breads and pastas. Women suffering from PMS and the associated emotional swings may strongly crave sweets, especially chocolate or “salty” things. In the late 1970’s, Mayor Mosconi of San Francisco and his associate, Harvey Milk, were murdered at gunpoint by an irate appointee. The murderer pleaded insanity and was adjudicated on the following premise: given the individual’s past history and current, seriously depressed state of mind, his then over-consumption of enormous quantities of sugar, prior to his egregious act, drove him into a psychotic state, culminating in the violent deaths of the two elected officials. This came to be known as “The Twinkie Defense”.

These seemingly unrelated scenarios share a mutual bond: the influence between diet, emotions and behavior. At times, everyone has used food to ease tension, suppress unpleasant feelings or create a quick burst of energy. At other moments, certain foods make us drowsy or sleepy. For hyperactive children and those with learning disorders, carbohydrate and specific food sensitivities are intimately linked. Those who have a tendency to blood sugar fluctuations (and the numbers are rapidly growing every year), moodiness, anger, rage and possible blackouts, or in the very extreme case, hallucinations may transpire. The mind, the body and food can no longer be viewed separately.


The brain is 60% fat, dried weight. It warrants tremendous nutritional attention, especially during infancy. Breast milk is not genetically programmed to guarantee healthy maturation. It’s ratio of peptides (protein molecules), fatty acids and carbohydrates are dependent upon the mother’s diet. (ersatz mother’s milk i.e. Similac are inefficient). The most critical of these nutrients to assure healthy brain development are the fats. The primary fats are the essential fatty acids (EFA) and phospholipids, with strong emphasis on arachidonic acid (AA) and decosohexanoic acid (DHA). Doctors in Great Britain discovered infants receiving bottle-feeding had lower IQs than those breast fed. Not only does recent research reveal that in the first few months of pregnancy, the nutrient choline is essential for increasing the infant’s potential intelligence but other research indicates imbalances in the aforementioned critical fats may lead to mood disorders, seizures, developmental delays, behavioral problems and autism.

As the brain reaches maturation, it weighs only three pounds, approximately 2% of body weight, yet it receives 15% of the blood supply, utilizes 25% of the available oxygen and consumes 7-10 times more glucose than any other body tissue equivalents. And whereas these other tissues may utilize protein, fat and glucose as an energy source, the brain exclusively requires glucose. This explains why people become cranky, irritable and moody when they become hungry (hunger is the signal that indicates our blood sugar levels are low).

Eventually, the brain’s structure consists upwards of 100 billion neurons, the functional cellular unit of the brain, with each nerve cell capable of making thousands of connections. This staggering number of interconnections transfers information from cell to cell via chemical messengers classified as neurotransmitters. These messengers are directly involved with our moods, emotions, hunger and sleep cycles, perceptions and behavior.

The previous two paragraphs emphasize three critical factors with tremendous influence on our emotional well being: Glucose regulation, healthy fat consumption and neurotransmitter function (derived from protein).


Hunger is one of the strongest drives in nature. When we experience this sensation, it is a signal that our blood sugar (glucose) level is low and serves as the impetus to “search for food”. In response to our food intake, the blood sugar level rises and stimulates the production of insulin by the pancreas. Insulin attaches itself to the carbohydrate molecule and then carries it to the cells in the body. The cells receive the glucose and utilize it for energy production. During this time, the blood sugar levels return to normal, hunger is satiated and the cells function normally.

If we don’t eat at regular intervals, the body has built-in mechanisms to assure that the brain will always have glucose to function. It has the capacity to store sugar in the liver, in the form of glycogen, which the body may retrieve and convert to glucose as needed. It can also break down protein from muscle tissue (and organ tissue if necessary) and convert it to the necessary fuel. If this happens occasionally, the body has no difficulty adapting in the short term and then re-supplying its stores. However, if one has the habit of going all day with minimal to no food intake and then eats a large meal at night or chooses to live on protein bars and shakes, with the belief this is an appropriate substitute for food, there is a metabolic cost that can lead to serious consequences in the long run.

The other major negative influence on glucose regulation is the consumption of refined carbohydrates (trans-fats also effect insulin regulation but it will discussed in the insulin section). Because refined carbohydrates are processed in a manner that alters their basic biochemical makeup, their consumption forces an overproduction of insulin. The body will translate this abnormal increase in insulin as low blood sugar and stimulate the individual to eat more. If refined foods are continually eaten, this will again trigger more insulin production, and the potential for the seesaw effect continues. Eventually it subsides, but again there is a metabolic cost.

There are numerous, major ramifications of this glucose-insulin fluctuation (other chemicals, i.e. cortisol, are also involved. See the review on stress). One such problem from this skewed glucose regulation is tryptophan metabolism in the brain is negatively affected, leading to a decrease in serotonin production, resulting in depression (Note: many of today’s antidepressants are specifically manufactured to maintain higher levels of serotonin, i.e., Prozac, Paxil, Zoloft). Quite often, as imbalances in blood sugar regulation are corrected, depression lessens or may totally disappear. Blood glucose regulation is also implicated in other neurological conditions including anxiety, mood swings, ADHD and ADD, cerebral allergies, lethargy, fogginess and loss of memory.


There is so much misleading information in regards to the influence of fats on our health, it has become quite difficult to decipher the truth (for information specific to cholesterol, please see our review on cholesterol). Without fat, we could not survive. Fats are utilized for energy, insulation, shock absorption, skin integrity and is incorporated in every cell membrane of the body. And it is this last area that influences neurotransmitter function and our sense of mental well-being.

If we were to examine a cell membrane under a microscope, we would notice its composition is made up of fats and proteins arranged in a precise manner. This arrangement guarantees that all chemical messengers that approach the cell will be received and transmitted into the cell to carry out their function. In order for these messengers to work, they must link up with the cell at a specific area on the membrane, similarly to a boat pulling into a dock, termed a receptor site. Only at this designated receptor site can a messenger have any impact.

What does this have to do with fats? Though the receptor sites are protein based, their ability to carry out their function is predicated on the integrity of the rest of the cell membrane, which is made up of fats. Since there are numerous classifications and types of fats in every cell mebrane, any imbalance in their relative ratios impacts the membranes fluidity and in turn affects the capability of the receptor sites.

The analysis of cell membrane fatty acid composition is a relatively new field. However, research has conclusively proven a few critical factors that influence membrane integrity. First and most important is to abstain from “trans fats”, which are unhealthy, aberrant forms of fat resulting from using high levels of heat to cook i.e. frying, and the manufacturing process that yields hydrogenated or partially hydrogenated oils and fats, artificial fats i.e. margarine, olestra, and vegetable oils and shortening. When the body consumes these products, they will replace the healthy fats in the cell membrane, alter the natural fluidity of the membrane and negatively impact its relationship with its messengers. The research has also revealed that long term consumption of this products are directly linked to cancer, cardiovascular disease, immune problems, diabetes and create free radical production which is involved in memory loss and dysfunctions such as Alzheimers and Parkinsons disease.

Secondly, our western diet has a tremendous imbalance in essential fatty acid consumption. Many fats we consume can be converted to different types of fats in the body for various needs. Essential fats can not be manufactured by the body and can only be derived from our diet. These fats are classified as omega 6 and omega 3 fats and have a tremendous influence not only on messenger function but are involved with many inflammatory conditions. Experts vary on the most beneficial ratio of these fats but the range is anywhere from 4:1 to 1:1, omega 6 to omega 3. But because our present day diet consists of predominantly refined foods, processed grains, animals fed on these same foods so the omega 6 fats in these foods remain tin their tissues when we consume them, and is devoid of quality fish i.e. salmon, herring, sardines, mackerel, trout, and the right nuts and seeds i.e. walnuts, flax seeds, pumpkin seeds, chia seeds, our current omega 6 to omega 3 ratio has been estimated to be anywhere from 25:1 to upwards of 50:1. Again, this directly effects cell communication by varying the proper balance of omega 6 to omega 3 ratio in the cell membrane and concomitantly leads to many inflammatory conditions i.e. arthritis, allergies and asthma.

A good starting point is the elimination of refined and processed foods, the inclusion of healthy fish, organic nuts and seeds, increasing vegetable and fruit intake upwards of 7-9 servings a day and possible supplementation of omega 3 oils such as flax seed oil and fish oil (earlier we stated the need for DHA for infant brain development. This is derived from fish oil) can help reverse this trend and improve cell and neurotransmitter function.


With a recorded 40 million Americans suffering from some form of mental and/or emotional condition, altering the serum levels through chemical intervention, though important in certain short term situations and critical in specific circumstances, has not decreased the swelling numbers of people on medications. Actually, in a large percentage of the population, numerous medications are given simultaneously either to counter the side effects of the initial drugs or to amplify its initial mediocre effect (approximately 50% of the people on anti-depressants do not experience relief). In children, they are given all too frequently for behavior control as a first resort without any investigation into the individual’s biochemical makeup and eating habits. But whatever medications are given, their purpose is to balance out the levels of neurotransmitters deemed in need of assistance i.e. Zoloft, Paxil and Prozac are used to maintain the proper level of serotonin.

The neurotransmitters (NT) are protein-based and are dependent upon certain vitamins, minerals and enzymes for their production (the exception is acetylcholine which is manufactured from choline, not protein, as mentioned earlier). These messengers influence our behaviors, i.e. pleasure and reward signal, response to daily life, cycles of the body i.e. sleep and wake, moods, movement, memory and learning abilities.

The breakdown of each of the NT (categorized as monamines, amino acids and neuropeptides) is beyond the scope of this article. But it is important to understand that since dietary protein plays an important role in NT production, the ability to break down these foods efficiently, absorb the appropriate nutrients and eliminate the toxins is critical (see the review on digestion). For those following a strict vegetarian regimen, please combine your foods properly to assure you get the full array of amino acids for protein synthesis, along with supplementing with Vitamin B12 and possibly omega 3 fish oil (flax seed oil is not always effective because of enzyme deficiencies, that exist in a certain percentage of people, that convert flax seed oil to EPA)


As we look at other factors that influence NT production, we must examine is stress (see article on stress for details). Most of us use the term rather loosely to define any from of ongoing aggravation we may incur, but for any stress we encounter there is a biochemical equivalent that transpires in our bodies to compensate for these aggravating circumstances. And if over time, these stressors remain in our lives, the internal chemical changes eventually have a deleterious affect on our well-being (see the article on stress for details). Suffice it to say, there are three main areas of stress in each of our lives to evaluate: physical (exercise, sleep, postural habits, play, rest, work), emotional (relationships, play and rest, work, finances, personal loss, major changes in life) and chemical (diet, water, environmental exposures, recreational drugs, alcohol and medication). The more accurate the assessment of each of these areas and the accompanying changes can be made, the more powerful impact one will have on their mental state of well-being.

One other arena impacting NT synthesis is toxicity (see review on toxicity). Though this term is vague and covers a large territory of possibilities, its influences can never be underestimated. Toxicity, in simple terms, is the relative balance between one’s ability to efficiently eliminate toxins at a rate that is equal to or quicker than the rate at which one consumes and produces them. This is dependent upon an individual’s genetic make-up, lifestyle (diet, mental outlook, exercise, rest and work habits etc.), and environmental influences.

Finally, even with the proper corrections to all these areas, there can still be individual imbalances that require supplementation to deal with issues of depression, hyperactivity, memory etc.

Since there are numerous NT and they all have multiple actions and interactions, we will elaborate on the most commonly discussed NT in today’s culture. As stated previously, today’s pharmaceutical market is focusing heavily on drugs capable of maintaining an adequate level of serotonin in the brain to eliminate or at least to minimize depression.

What is serotonin? It is a chemical involved in modulating a wide variety of behaviors and non-behavioral functions including mood, sleep (it is converted to melatonin which relaxes the body to allow the induction of sleep), carbohydrate and protein selection (earlier we stated the role of glucose regulation and tryptophan metabolism), and aggressive behavior. It works conjointly with other NT, dopamine (its deficiency is involved with Parkinsons disease) and noradrenaline (“fight or flight”) to modulate cognitive function, moods and emotion.

Serotonin is a protein compound derived from the amino acid tryptophan, which is converted to 5-hydroxytryptophan (5-HT) and utilizes pyridoxal-5-phosphate (active form of B6), folinic acid (a form of folic acid), NADPH (an active from of B3) and iron to make this conversion occur. Oxygen is also necessary and any decrease in its level may be reflective of a low level of iron and/or B12, specifically in the form of adenosylcobalamin. The next step requires zinc, magnesium, B1 in the form of thiamine pyrophosphate and again pyridoxal-5-phosphate, to convert 5-HT to serotonin.

Obviously, deficiencies in any of the aforementioned nutrients resulting from digestive imbalances, stress or poor diet selection, can have a noticeable impact on this one NT, depending on the degree of nutrient inadequacy. What is so important about this equation to talk about it in detail? Basically to understand that the chemistry of NT is complicated, but to also recognize that to take some pro-active measures, one does not have to have be a chemist. By following some of the suggestions in this review as well as the recommendations found in the associated articles, positive changes in ones sense of well-being can be made. Also, certain individuals may need to supplement their die with 5HT, a good B complex with emphasis on B1, B6, B12 and folic acid, a sound multi-mineral and nutrients to help regulate glucose metabolism. This will them the additional vital nutrients for serotonin production (many people struggling with depression will improve with proper dietary changes, correcting glucose and fatty acid imbalances and stress reduction.This is a more sound approach than starting with 5-HTP.)

One important note that must not be overlooked is women have a greater proclivity to depression because they produce only about two-thirds as much serotonin as men. Since serotonin is involved in many functions as previously stated, i.e. sleep, and is correlated with obesity (again this is glucose regulated related too), tending to ones diet and stress levels is even more critical.

Before starting on any program, please inform your practitioner of your changes. If you start to feel improvement, never wean yourself off of any medication on your own because here can be tremendous, negative rebound effect. Again, please consult with your doctor first.

Dr. Mitchhell Peritz, Chiropractor, is certified in Clinical Nutrition (C.C.N.) and Chiropractic Sports Medicine (C.C.S.P.). He practices in Manhattan and in Bridgewater, N.J. at Natural Medicine & Rehabilitation (NM&R). For further questions, please contact Dr. Peritz at (212) 995-5525