Tell me more about Nutrition in Recovery and the services you offer there.

I offer nutrition counseling for individuals in early recovery from addiction, alcoholism, or eating disorders. I specialize in their co-occurrence, also known as "dual diagnosis". After a comprehensive intake and assessment, I will figure out the best intervention for my patients. Some people need very close monitoring while others need basic guidance and meal planning. I will often meet some of my patients at the grocery store to do some hands-on work and put theory into practice. I meet my clients weekly and slowly make changes that will last a lifetime! I specialize in the nutritional management of: Food Addiction, Substance Abuse, Eating Disorders, and Weight Management, and I also have backgrounds in sports nutrition and general wellness. I also specialize in the male population and work with individuals who struggle with Muscle Dysmorphic Disorder and food-related dysfunction. Lastly, I run groups at various residential treatment centers and outpatient facilities. 

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Excerpt from "Lethal but Legal" by Nicholas Freudenberg

Excerpt from "Lethal but Legal" by Nicholas Freudenberg pg. 152

Core Beliefs and Values of Advocates for Healthy, Sustainable Consumption

1. Making a profit by sickening others is wrong.

2. Parents, families, teachers, and health professionals, not corporations, should educate people about health, nutrition, and moral values.

3. Nanny corporations that seek to exploit children's vulnerability and immaturity, not nanny states, are the real threats to health and freedom.

4. The goal of social policy should be to make healthy choices easy choices.

5. In a globalized world, economic activity anywhere affects people everywhere; shifting the harms of such activity to another region or country in order to protect one group is wrong.

6. Every generation has a responsibility to leave the world a better place for future generations. Knowingly bequeathing our children and grandchildren a burden of disease, damaged environments, or corrupted democracy violates most of the world's moral codes.

7. Science belongs to all humanity; appropriating it to profit at the expense of health or the environment is wrong.

Do your recommendations differ depending on what substance the individual is withdrawing from (i.e. alcohol, opiates, stimulants, etc.)?

Absolutely. I will often use laboratory data to warrant any aggressive nutrient interventions but there are some guiding principles that are important for each substance. For example, alcohol and opiates create the most gut dysfunction, whereas meth creates the most oral dysfunction. Cocaine use has been associated with essential fatty acid deficiency as well as neurohormonal alterations that can lead to rapid weight gain. All substances are associated with an increased preference for sugar and "comfort food". For more information about specific nutritional deficiencies associated with specific substances, refer to the slideshow at: http://www.nutritioninrecovery.com/food-addiction/nutrition-interventions-in-addiction-recovery-the-role-of-the-dietitian-in-substance-abuse-treatment-2/

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What are some Specific Dietary Recommendations you would make to Someone Recovering from Drug or Alcohol Addiction?

a.     Eliminate sugar-sweetened beverages. Drink only water, black coffee, unsweetened tea, organic milk, unsweetened milk alternatives, and chia seeds soaked in water. Do not drink fruit juices, Gatorade, and energy drinks. The occasional vegetable juice is OK but do not do juice cleanses.

b.     Avoid refined grains and aim to eat 100% whole grains.

c.     Keep caffeine intake limited to a maximum of 400 mg/day.

d.     Reduce exposure to highly palatable and highly processed foods with added sugars, salts, and fats. These foods light up the brain like drugs of abuse and can perpetuate the cycle of addiction.

e.     Increase protein intake and spread out over the course of the day. Instead of having one or two large protein-based meals in the day, make sure every meal/snack contains a minimum of 10-15 g protein.

f.      Eat smaller meals every 2-4 hours starting with breakfast within 30 minutes of waking up. The mantra I encourage is "never hungry, never full".

g.     Increase fiber intake gradually yet progressively over time. Many addicts have a fiber aversion due to compromised gut health but will need to be persistent about their intake, increasing by 2-4 g/daily each week until reaching 38 g/day for men, 25 g/day for women. 50% of vegetables should be raw, and increase intake of beans, nuts, and seeds.

h.     Increased need for antioxidant vitamins A, C, E, and selenium that should be obtained through food and not supplements. Emphasize fruits and vegetables!

i.      Increased need for omega-3 fatty acids that should be obtained through fatty fish, chia seeds, flax seeds, and walnuts.  

j.      Get small doses of sunlight for vitamin D. 20-30 min 2-3 times/week can make a big difference!

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How does the Neuroscience of Nutrition Impact those Recovering from Addiction?

Amino acids (building blocks of protein) are pre-cursors of neurotransmitters including serotonin, dopamine, and norepinephrine. Since dopamine is the key neurotransmitter involved with addiction (associated with "reward"), it is critical to restore depleted dopamine levels through a higher protein intake. Phenylalanine is an essential amino acid (which is widespread in food) that becomes tyrosine, which is converted to dopamine, which can then become norepinephrine. While there some professionals who believe in amino acid therapy, I believe that this approach fails to emphasize the importance of changing eating behavior, therefore I believe it is better to make dietary changes and get the amino acids from a consistent stream of high biological value protein throughout the day. I emphasize eating behavior first, supplements second.

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Why is Proper Nutrition so Important for Recovering Addicts?

At the most basic level, substance abuse is associated with both primary and secondary malnutrition. Primary malnourishment occurs when the substance reduces or displaces food intake. Secondary malnutrition occurs when there are alterations in the absorption, metabolism, utilization, and excretion of nutrients due to compromised oral, gastrointestinal, circulatory, metabolic, and neurological health. An example is thiamine deficiency common in alcoholics, which is both primary and secondary.

Other primary goals of nutrition therapy for addiction recovery includes: healing the gut function, disrupting the potential for cross-addiction into food, recovering compromised neurological function, and stabilizing the endocrine system (hormones). Other goals can include achieving a healthy body weight and avoiding excessive and persistent weight gain, although concerns about weight should be secondary to concerns about overall health. Individuals with a history of addiction are at higher risk for developing disordered eating behavior (and vice versa), therefore it is important that nutrition behavior be monitored by a qualified professional such as a Registered Dietitian Nutritionist specializing in behavioral health.

For more info, visit Nutrition In Recovery