Nutrition News

ADHD & Disordered Eating

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our fifth of many videos! This video is on ADHD and disordered eating!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We will be sending out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

We will only send out one video per month and you can unsubscribe at any time!

Within the next year you can look forward to the following topics being covered:

Trauma and Eating Disorders
Impulsivity and Decision Making
Night Eating Syndrome
Food Politics

View last month’s video on Social Media and Body Image

Monthly Newsletter

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

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Nutrition for Opioid Overdose

Nutrition for Opioid Overdose

On September 15, 2017 The Academy of Nutrition and Dietetics issued a statement to the CDC regarding Nutrition Interventions and Drug Overdose Response Investigation (DORI) Data Collections. The statement was written by Registered Dietitian Nutritionist David Wiss and essentially advocates the role of nutrition for opioid overdose.

The official statement which is reproduced below can be viewed HERE

Re: Drug Overdose Response Investigation (DORI) Data Collections (Docket No. CDC-2017-0055)

The Academy of Nutrition and Dietetics (the “Academy”) appreciates the opportunity to submit comments to the Centers for Disease Control and Prevention (CDC) in response to the data collection published in the July 17, 2017 Federal Register regarding the Drug Overdose Response Investigation (DORI) Data Collections (Docket No. CDC-2017-0055). The Academy is the world’s largest organization of food and nutrition professionals, with more than 100,000 members comprised of registered dietitian nutritionists (RDNs), nutrition and dietetic technicians, registered (NDTRs), and advanced-degree nutritionists. We are committed to improving the nation’s health through food and nutrition and providing medical nutrition therapy (MNT) and other nutrition counseling services to meet the health needs of all citizens, including those with eating disorders (EDs) or substance use disorders (SUD).

The Academy supports the proposed data collection as necessary for the proper performance of the functions of the agency, particularly given the practical utility resulting from the collections. We respectfully offer recommendations below from Academy member David A. Wiss, MS, RDN, on behalf of our Behavioral Health Nutrition Dietetic Practice Group for potential improvements to the data collections and as support for the claim that nutrition can play a very important role in promoting wellness during the recovery process, thereby helping to reduce relapse and accidental overdose or death.

Eating Patterns and Substance Use Disorders

There are several studies that document substandard eating patterns during drug use, including inadequate intake leading to micronutrient deficiencies [1-6] and malnutrition [7-11]. Abnormal preference for sweetened foods and beverages have been documented in alcoholics [12-14] and other SUDs [15, 16] particularly opioids [17-25]. While micronutrient deficiencies and malnutrition are often corrected by abstinence and recovery, dysfunctional eating patterns such as bingeing and night-eating are often exacerbated during sobriety. Early recovery should be considered a critical time to get nutritional support (e.g. dietary counseling) by a qualified professional such as an RDN.

The overlap between SUDs and EDs has received significant attention in the scientific literature [26-41]. Authors have recently begun to suggest that these disorders be treated concurrently rather than separately. In members’ personal experience working in both fields, patients will oscillate between treatments and are seldom treated concurrently. While it is true that RDNs are a requirement for ED treatment, there is no present requirement for RDNs in SUD treatment settings. Based on members’ experience working with SUD treatment centers, the use of RDNs is rare most likely because nutrition services are not covered by insurance for SUD. We note that the failure to address food and body image issues in SUD treatment is likely contributing to poor outcomes.

It is predictable that individuals entering treatment for SUD will find other substances to abuse, including food [42-45], caffeine [46, 47], and nicotine [46, 47]. While some would argue that it makes sense to allow unlimited access to such substances during early recovery, others believe that the lack of nutrition and health standards are contributing to poor treatment outcomes. Evidence suggests that gastrointestinal health is linked to mental health [48-51] with strong implications for anxiety and depression. Given what is known about the importance of gut health, it seems that improved health and nutrition should be considered a prime intervention for SUD recovery. RDNs in treatment settings are highly qualified to discuss health habits including caffeine and nicotine in the context of nutrition and gastrointestinal health.

Nutrition Education and Interventions During Treatment

Several studies have demonstrated links between nutrition education and positive outcomes in SUD treatment settings [52-57]. Some of the studies have suggested that nutrition education has led to reduced rates of relapse, but higher quality research with greater sample sizes are needed to confirm these findings. Given the opioid epidemic and alarming number of overdose and deaths, however, it seems unwise to wait for more data before using nutrition as an intervention strategy.

Nutrition interventions during recovery may promote abstinence and prevent or minimize the onset of chronic illness, improving resource allocation. A review article from the United Kingdom on the role of healthy eating advice as part of drug treatment in prisons concluded that “substance-misuse is a major factor in recidivism and if this could be reduced through improvement of nutritional status, it could be a cost effective means of helping to tackle this problem” [58]. Given the opioid epidemic, public health measures necessitating nutrition standards in treatment settings should be considered critical. There is a timely need for specialized nutrition expertise in SUD treatment centers, and RDNs are highly qualified for the job.

References

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  7. Baptiste, F., Drugs and diet among women street sex workers and injection drugs user in Quebec City. Candian Journal of Urban Research, 2009. 18(2): p. 78-95.
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  15. Janowsky, D.S., O. Pucilowski, and M. Buyinza, Preference for higher sucrose concentrations in cocaine abusing-dependent patients. J Psychiatr Res, 2003. 37(1): p. 35-41.
  16. Hamamoto, D.T. and N.L. Rhodus, Methamphetamine abuse and dentistry. Oral Dis, 2009. 15(1): p. 27-37.
  17. Alves, D., et al., Housing and employment situation, body mass index and dietary habits of heroin addicts in methadone maintenance treatment. Heroin Addict Relat Clin Probl, 2011. 13(1): p. 11-14.
  18. Canan, F., et al., Eating disorders and food addiction in men with heroin use disorder: a controlled study. Eat Weight Disord, 2017.
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  21. Neale, J., et al., Eating patterns among heroin users: a qualitative study with implications for nutritional interventions. Addiction, 2012. 107(3): p. 635-41.
  22. Nolan, L.J. and L.M. Scagnelli, Preference for sweet foods and higher body mass index in patients being treated in long-term methadone maintenance. Subst Use Misuse, 2007. 42(10): p. 1555-66.
  23. Richardson, R.A. and K. Wiest, A Preliminary Study Examining Nutritional Risk Factors, Body Mass Index, and Treatment Retention in Opioid-Dependent Patients. J Behav Health Serv Res, 2015. 42(3): p. 401-8.
  24. Waddington, F., et al., Nutritional intake of opioid replacement therapy patients in community pharmacies: A pilot study. Nutrition & Dietetics, 2015. 72(3): p. 276-283.
  25. Zador, D., P.M. Lyons Wall, and I. Webster, High sugar intake in a group of women on methadone maintenance in South Western Sydney, Australia. Addiction, 1996. 91(7): p. 1053-1061.
  26. Baker, J.H., et al., Eating disorder symptomatology and substance use disorders: prevalence and shared risk in a population based twin sample. Int J Eat Disord, 2010. 43(7): p. 648-58.
  27. Buckholdt, K.E., et al., Emotion regulation difficultes and maladaptive behaviors: Examination of deliberate self-harm, disordered eating, and substance misuse in two samples. Cognitive Therapy and Research, 2015. 39: p. 140-152.
  28. Bulik, C.M., M. Slof, and P. Sullivan, Comorbidity of eating disorders and substance-related disorders. Medical Psychiatry, 2004. 27: p. 317-348.
  29. Calero-Elvira, A., et al., Meta-analysis on drugs in people with eating disorders. Eur Eat Disord Rev, 2009. 17(4): p. 243-59.
  30. Cohen, L.R., et al., Survey of eating disorder symptoms among women in treatment for substance abuse. Am J Addict, 2010. 19(3): p. 245-51.
  31. Courbasson, C.M., C. Rizea, and N. Weiskopf, Emotional Eating among Individuals with Concurrent Eating and Substance Use Disorders. International Journal of Mental Health and Addiction, 2008. 6(3): p. 378-388.
  32. Czarlinski, J.A., D.M. Aase, and L.A. Jason, Eating disorders, normative eating self-efficacy and body image self-efficacy: women in recovery homes. Eur Eat Disord Rev, 2012. 20(3): p. 190-5.
  33. Dennis, A.B., T. Pryor, and T.D. Brewerton, Integrated Treatment Principles and Strategies for Patients with Eating Disorders, Substance Use Disorder, and Addictions. 2014: p. 461-489.
  34. Eichen, D.M., et al., Weight perception, substance use, and disordered eating behaviors: comparing normal weight and overweight high-school students. J Youth Adolesc, 2012. 41(1): p. 1-13.
  35. Gadalla, T. and N. Piran, Eating disorders and substance abuse in Canadian men and women: a national study. Eat Disord, 2007. 15(3): p. 189-203.
  36. Grilo, C.M., et al., Eating disorders in female inpatients with versus without substance use disorders. Addict Behav, 1995. 20(2): p. 255-260.
  37. Ho, V., S. Arbour, and J.M. Hambley, Eating Disorders and Addiction: Comparing Eating Disorder Treatment Outcomes Among Clients With and Without Comorbid Substance Use Disorder. Journal of Addictions Nursing, 2011. 22(3): p. 130-137.
  38. Luce, K.H., P.A. Engler, and J.H. Crowther, Eating disorders and alcohol use: Group differences in consumpion rates and drinking motives. Eating Behaviors 2007. 8: p. 177-184.
  39. Root, T.L., et al., Substance use disorders in women with anorexia nervosa. Int J Eat Disord, 2010. 43(1): p. 14-21.
  40. Root, T.L., et al., Patterns of co-morbidity of eating disorders and substance use in Swedish females. Psychol Med, 2010. 40(1): p. 105-15.
  41. Specter, S.E. and D.A. Wiss, Muscle Dysmorphia: Where Body Image Obsession, Compulsive Exercise, Disordered Eating, and Substance Abuse Intersect in Susceptible Males. 2014: p. 439-457.
  42. Michaelides, M., et al., Translational neuroimaging in drug addiction and obesity. ILAR Journal, 2012. 53(1): p. 59-68.
  43. Muele, A., T. Hermann, and A. Kubler, Food addiction in overweight and obese adolescents seeking weight-loss treatment. European Eating Disorders Review, 2015. 23: p. 193-198.
  44. Nair, S.G., et al., The neuropharmacology of relapse to food seeking: methodology, main findings, and comparison with relapse to drug seeking. Prog Neurobiol, 2009. 89(1): p. 18-45.
  45. Volkow, N.D. and R.A. Wise, How can drug addiction help us understand obesity? Nat Neurosci, 2005. 8(5): p. 555-60.
  46. Junghanns, K., et al., The consumption of cigarettes, coffee and sweets in detoxified alcoholics and its association with relapse and a family history of alcoholism. Eur Psychiatry, 2005. 20(5-6): p. 451-5.
  47. Yudko, E. and S.I. McNiece, Relationship between coffee use and depression and anxiety in a population of adult polysubstance abusers. J Addict Med, 2014. 8(6): p. 438-42.
  48. Huang, R., K. Wang, and J. Hu, Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 2016. 8(8).
  49. Rieder, R., et al., Microbes and mental health: A review. Brain Behav Immun, 2017.
  50. Singh, R.K., et al., Influence of diet on the gut microbiome and implications for human health. J Transl Med, 2017. 15(1): p. 73.
  51. Skosnik, P.D. and J.A. Cortes-Briones, Targeting the ecology within: The role of the gut-brain axis and human microbiota in drug addiction. Med Hypotheses, 2016. 93: p. 77-80.
  52. Barbadoro, P., et al., The effects of educational intervention on nutritional behaviour in alcohol-dependent patients. Alcohol and Alcoholism, 2011. 46(1): p. 77-9.
  53. Grant, L.P., B. Haughton, and D.S. Sachan, Nutrition education is positively associated with substance abuse treatment program outcomes. J Am Diet Assoc, 2004. 104(4): p. 604-10.
  54. Curd, P., K. Ohlmann, and H. Bush, Effectiveness of a voluntary nutrition education workshop in a state prison. J Correct Health Care, 2013. 19(2): p. 144-50.
  55. Cowan, J.A. and C.M. Devine, Process evaluation of an environmental and educational nutrition intervention in residential drug-treatment facilities. Public Health Nutr, 2012. 15(7): p. 1159-67.
  56. Cowan, J.A. and C.M. Devine, Diet and Body Composition Outcomes of an Environmental and Educational Intervention among Men in Treatment for Substance Addiction. Journal of Nutrition Education and Behavior, 2013. 45(2): p. 154-158.
  57. Lindsay, A.R., et al., A gender-specific approach to improving substance abuse treatment for women: The Healthy Steps to Freedom program. J Subst Abuse Treat, 2012. 43(1): p. 61-9.
  58. Sandwell, H. and M. Wheatley, Healthy eating advice as part of drug treatment in prisons. Prison Service Journal, 2009.
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FNCE 2017 Reflection

FNCE 2017 Thoughts and Recap

I have attended the Food and Nutrition Conference and Expo for the past several years. Traditionally I have attended as a representative of Dietitians for Professional Integrity, which is an advocacy group we formed back in 2013, to promote responsible and ethical sponsorship within the Academy of Nutrition and Dietetics. In 2016 I wrote a recap which highlights concerns around industry-sponsored continuing professional education (CPE) units for registered dietitian nutritionists (RDNs).  FNCE 2017 was a celebration of 100 years and this theme was certainly central at the event.

I was not planning to attend this year but was alerted that I had won an award, so felt an obligation to show up! My award was for “Excellence in Practice” for Addictions and was presented by the Behavioral Health Nutrition Dietetic Practice Group. The award was presented at a breakfast at 6:30am Monday morning. There was also awards given to an RDN for excellence in practice in eating disorders, mental health, and intellectual and developmental disabilities. We all had a few minutes to give a speech and received little plaques. It’s always great to be recognized for accomplishments.

On Monday I went to a session called “Food Fraud” which was about deception in our food supply. Fake honey, mislabeled seafood etc. The focus was on seafood since there is much fraud happening globally. There is a website with more info. On Monday I spent an hour wondering the expo floor. It has improved from previous years, but of course Monsanto and The Sugar Association were present. It didn’t upset me like it has in the past, and I did not take photos since it is no surprise to anyone that these companies are here. Monday afternoon I attended a talk called “Intolerance vs. Avoidance” which discussed the intersection between food allergies and eating disorders. A certified eating disorder registered dietitian discussed common concerns around food allergies with restrictive patients and those with “orthorexia nervosa” while an MD gave some background on testing for food allergies.

Tuesday I went to talk on “Nutritional Genomics” where the speakers summarized the latest advances in the intersection between genetics and nutrition. They discussed a website called 23 and Me where one can send in a spit sample to get personalized nutrition information. Unfortunately, the recommendations are pretty generic, but I am still curious and will request a kit! The closing keynote was a physicist (Dr. Michio Kaku) who discussed “The Future of the Mind” where he outlined current advances that could revolutionize healthcare. I was most impressed by the contact lens with a screen on it. Digitized healthcare definitely sounds intriguing, but much of what he described seems like a potential disaster for mental and spiritual health. Overall, my experience for FNCE 2017 was different this year. I was at the event as an undercover journalist. Just another RDN trying to make a difference in people’s lives…

 

FNCE 2017

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Social Media and Body Image Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our fourth of many videos! This video is on social media and body image!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We will be sending out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

We will only send out one video per month and you can unsubscribe at any time!

Within the next year you can look forward to the following topics being covered:

ADHD and Disordered Eating
Trauma and Eating Disorders
Impulsivity and Decision Making
Night Eating Syndrome
Food Politics

View last month’s video on the Microbiome and Mental Health

Monthly Newsletter

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Read more

Healthy Food Festival

Healthy Food Festival 2017 in Josephine County, Oregon

David Wiss MS RDN founder of Nutrition in Recovery will be the keynote speaker this year at the Healthy Food Festival in Josephine County, Oregon.

The hope is to translate David’s research into new and innovative addiction treatment techniques amidst the heroin crisis.

Event WebsiteHealthy Food Festival

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Microbiome and Mental Health Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our third of many videos! This video is on the microbiome and mental heath!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We will be sending out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

We will only send out one video per month and you can unsubscribe at any time!

Within the next year you can look forward to the following topics being covered:

Social Media and Body Image
ADHD and Disordered Eating
Trauma and Eating Disorders
Impulsivity and Decision Making
Night Eating Syndrome
Food Politics

Monthly Newsletter

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Read more

Food Addiction Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our second of many videos! This video is on food addiction.

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We will be sending out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

We will only send out one video per month and you can unsubscribe at any time!

Within the next year you can look forward to the following topics being covered

Microbiome and Mental Health
Social Media and Body Image
ADHD and Disordered Eating
Trauma and Eating Disorders
Impulsivity and Decision Making
Night Eating Syndrome
Food Politics

Monthly Newsletter

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Learn more about Food Addiction

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Nutrition for Addiction Recovery Video

Nutrition for Addiction Recovery Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our first of many videos!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We will be sending out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

We will only send out one video per month and you can unsubscribe at any time!

Within the next year you can look forward to the following topics being covered

  • The Controversies of Food Addiction
  • Microbiome and Mental Health
  • Social Media and Body Image
  • ADHD and Disordered Eating
  • Trauma and Eating Disorders
  • Impulsivity and Decision Making
  • Night Eating Syndrome
  • Food Politics

 

Monthly Newsletter

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Learn more about Nutrition for Addiction Recovery

 

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DEFANG Video

DEFANG Video by David Wiss MS RDN

The Disordered Eating Food Addiction Nutrition Guide (DEFANG) was published in November 2016 in the Journal of Eating and Weight Disorders. The paper was designed to help sort out some of the confusion around food addiction, as it relates to eating disorder treatment. This video is a very brief summary of the paper. The paper has been published with open access to feel free to download it HERE.

DEFANG Abstract

Although not formally recognized by the DSM- 5, food addiction (FA) has been well described in the sci- entific literature. FA has emerged as a clinical entity that is recognized within the spectrum of disordered eating, par- ticularly in patients with bulimia nervosa, binge-eating disorder and/or co-occurring addictive disorders and obe- sity. Integrating the concept of FA into the scope of dis- ordered eating has been challenging for ED treatment professionals, since there is no well-accepted treatment model. The confusion surrounding the implications of FA, as well as the impact of the contemporary Westernized diet, may contribute to poor treatment outcomes. The purpose of this review is twofold. The first is to briefly explore the relationships between EDs and addictions, and the second is to propose a new model of conceptualizing and treating EDs that incorporates recent data on FA. Since treatment for EDs should vary based on individual assessment and diagnosis, the Disordered Eating Food Addiction Nutrition Guide (DEFANG) is presented as a tool for framing treatment goals and helping patients achieve sustainable recovery.

DEFANG Fig. 1 Download

Do you have thoughts about food addiction that you want to share with David Wiss?

Do you think the food addiction framework is not valid?

Do you believe that this information conflicts with eating disorder treatment?

What do you think are the next steps in establishing the addiction framework around food?

Email your thoughts to: DavidAWiss@NutritionInRecovery.com

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PhD Public Health

David Wiss is in the Process of Earning his PhD Public Health from UCLA in the Department of Community Health Sciences!

His Personal Statement has been included here:

I am a working Registered Dietitian Nutritionist (RDN) with an academically focused private practice specializing in patients with challenging eating and substance use disorders. In addition, I supervise several educational groups at various addiction treatment centers throughout the Los Angeles area. My interest in this unique patient population led me to develop specialized dietary curriculum for people in early recovery. Currently, there are no “best practice” protocols. To this end, I am pursuing a PhD in Community Health Sciences in order to improve the impact of nutrition interventions in patients with various addictions, as well as develop curriculum for clinical practices on a larger scale. My overall aim is to reduce disordered eating in early recovery and to improve the quality of life for patients with disabling addictive disorders.

Introducing the concept of food and nutrition into an addiction treatment program is not an easy task. Many patients in early recovery are not ready for multiple health behavior changes, since most are simply trying to get past the immediate crisis of addiction and the associated life adjustments of abstinence. In fact, sobriety can magnify pre-existing dysfunctional eating behavior. Many patients began using drugs and alcohol in their early teens, and never developed a healthy relationship to food, and may have damaged their gut microbiota through the use of alcohol, pills, opiates, and other substances, creating significant barriers to nutrition interventions. Most are unaware of the links between nutrition and recovery. Meanwhile, an increasing number of people in recovery have reported that the inclusion of healthful food as a healing modality has been beneficial for their overall mood and mental acuity. In several of the treatment centers where I work, patients are surprised when they discover that making small nutritional changes (such as drinking water or eating breakfast) can impact energy levels, overall sense of wellness, and optimism about being sober.

Unfortunately, traditional medical insurance plans do not cover nutrition services for addiction recovery. This is in part due to a lack of objective evidence about the efficacy of nutrition interventions in addiction recovery. My goal is to develop evidence-based guidelines for nutrition interventions in substance use disorders, which will hopefully lead to new policies and protocols for nutrition standards. Specifically, I am proposing an investigation of various measurable outcomes such as weight changes, nutritional status, inflammatory markers, length of abstinence, quality of life, and self-efficacy, in individuals receiving nutrition education and life skills training (shopping, cooking) compared to individuals who do not (control group).

My Master’s Thesis “Nutrition and Substance Abuse” was a multidisciplinary (psychologists and dietitians) investigation into the special needs of patients with addiction/alcoholism in the Veterans Affairs healthcare system. The survey study examined differences between veterans (who were engaged in recovery) with a history of alcohol or drug abuse and those with no history, all of who were enrolled in a weight management program. One of the significant findings in the study was that individuals with a history of substance abuse reported more difficulty controlling their eating when they were depressed. This research was published internally and awarded the Carrie Latt Wiatt Scholarship by the Family & Consumer Sciences (Nutrition) department at California State University, Northridge (CSUN).

During my dietetic internship year, I spent four transformative months at UCLA Medical Center where I worked with the eating disorders unit. During this time, I also began to teach nutrition classes at local addiction treatment settings. It quickly became apparent that patients in most treatment centers do not receive targeted nutrition education. After graduation from CSUN in 2013, I opened a private practice to treat patients with addictions, eating disorders, and those struggling with weight management, body image, and mental health issues. I founded Nutrition in Recovery to offer a range of nutrition and wellness services to private sector addiction treatment centers. At this time I was also on staff at Breathe Life Healing Centers, developing their binge eating disorder program as Director of Nutrition. After years of working in the field, I feel ready to pursue a PhD degree at UCLA.

Since becoming a registered dietitian, I have continued to be involved in research and education. I have published two book chapters and two peer-reviewed journal articles on eating disorders and addictions. In the past three years I have chaired five webinars sponsored by the Academy of Nutrition and Dietetics on topics related to my area of expertise.  Additionally, I serve as a consultant reviewer for the Journal of The Academy of Nutrition and Dietetics. From 2012-2014 I was a member of the executive committee of the Behavioral Health Nutrition Dietetic Practice Group where I gained insight into the role of nutrition in the treatment of mental illness. As the Research and Grants Committee Chair for the Los Angeles District (California Dietetic Association) I created a video series about the importance (and lack) of research in dietetics. Since that time I have felt a strong determination to “be the change I wish to see” in the nutrition field, which means conducting original studies using validated research methodology. I am seeking the training and support from the UCLA School of Public Health to achieve these goals.

Personal career highlights of mine have included teaching opportunities at conferences, hospitals, and at local universities. In my private practice I am a preceptor for numerous dietetic interns, where I can “give back” as well influence the future of my field. For several years I have volunteered at the United States District Court in downtown Los Angeles teaching nutrition courses to post-guilty-plea defendants in the conviction and sentence alternatives (CASA) program. This work with underserved populations in the criminal justice system has created a sense of purpose and duty that I would like to develop further. This experience has led me to believe that an academic career would complement and fulfill my life’s mission: to use nutrition to help people.

I am also proud to be a co-founder of an organization called Dietitians for Professional Integrity. We are a group of concerned dietetic professionals looking to advance our profession and credential through advocacy for greater financial transparency and ethical sponsorships within the Academy of Nutrition and Dietetics. Our efforts and dialogues with other dietitians and our Academy leadership have spurred policy changes regarding industry-sponsored educational sessions at our annual Food and Nutrition Conference and Expo. We believe the American public deserves nutrition information that is not tainted by the questionable interests of the food industry, who funds most of the nutrition research in the United States. With publication bias and ways of spinning conclusions in favor of their agenda (profit), the food industry has succeeded in undermining public health initiatives to reduce intake of high-energy foods with very little nutritional value. There is more advocacy work to be done and I am highly motivated to conduct innovative research within the emerging framework of food addiction. From my perspective, the Community Health Sciences Program at UCLA offers me an excellent pathway to advance these goals.

Another goal in obtaining a doctorate from the UCLA Department of Community Health Sciences is to broaden my knowledge and skill set in order to evaluate and interpret complex data using statistical analysis. Advanced graduate training will improve my ability to think in a formal, logical, and structured way, and to assess needs on a population level. In recent years, research that demonstrates a connection between food and addiction has gained momentum and increased public attention. I have been called to contribute to our understanding of how brain chemistry, hormones, and gut microbes influence human behavior. My aim is to bridge this gap and establish a better scientific basis for nutrition in recovery. Traditionally, we have looked at eating disorders as individual (and family) issues, but now is the opportunity to further understand them as public health issues.

Addiction and eating disorders are both major public health problems worldwide. There are numerous questions that relate to food, addiction, eating disorders, and recovery that remain unanswered. Can nutrition be used to improve addiction outcomes? What is the best practice for treating co-occurring eating and substance use disorders? How can dietitians help with recovery from mental health disorders? What policy implications can address food addiction on a societal level? What new programs can be developed for underserved populations that struggle with addiction and nutrition-related challenges?

The UCLA School of Public Health will provide an opportunity to investigate some of these questions, which will hopefully translate into more effective health policies that could impact the way we treat addiction and eating disorders. In order for nutrition in addiction treatment to improve, we need strong leadership and unbiased data. My goal in pursuing a doctorate in public health is to produce data that guides treatment. I am confident that my work in this area will create strong evidence to improve funding for nutrition services, creating opportunities for dietitians to work in publicly-funded as well as underserved addiction treatment centers. Dietitians desperately need more evidence of effectiveness in order to advance our profession. With new information it may be possible to change the way we approach addiction treatment, but more importantly to improve the recovery process amidst the current addiction crisis.

PhD Public Health

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