Since May is Mental Health Awareness Month, I devote every article this month to a different mental health topic and links to nutrition. I will preface this by saying that not all mental health diagnoses can be treated or prevented with nutrition. However, research shows that nutrition plays a vital role. My main focus will look at nutrition as a preventative factor, especially in children and adolescents. I will also look at nutrition as a factor for improvement or an adjunct to treatment. In some cases, nutritional deficiencies can impede the benefits of medication.
May is Mental Health Awareness Month
I want to emphasize that mental health issues are multifactorial and that diet is not the complete answer. More and more research is showing us that there is a vital link between our minds and our gut.
I will outline in this first article some of the research that supports the link between the brain and the gut and the significant relationships between an unhealthy diet and poorer mental health. I want to emphasize that a healthy diet should start early in life as a preventative measure. Dietary interventions should begin once a problem is recognized. The mental health disorders most commonly diagnosed in children are attention deficit hyperactivity disorder (ADHD/ADD), anxiety, depression, and behavior problems. These will be topics for the following four weeks. Some of these commonly occur together and have increased over time.
A new medical field is nutritional psychiatry which integrates food and supplements as alternatives or adjuncts to medical treatment. Think about it, your brain never shuts down, and food is what fuels the brain. By feeding our brain optimal nutrition, we can help to keep it functioning optimally. For example, diets high in refined sugars create inflammation and oxidative stress in the brain and can worsen depression.
Nutritional Psychiatry uses food to help treat mental health disorders
Research is unraveling the connection between what you eat and how you feel. This link also ties into what is in our gut - the mind-gut connection. For example, serotonin, a hormone considered to be a mood regulator, is primarily (90%) produced in our intestines from tryptophan, which is in many foods that we eat. The gastrointestinal tract contains millions of nerve cells, which help to guide emotions, which, in turn, is influenced by the gut microbiome (see article 11/9/22 on The Importance of the Microbiome).
Studies show that the risk for certain mood disorders, such as depression, is 25-35% lower in individuals who consume a more traditional diet, like Mediterranean or Japanese diets. This is compared with those who consume a typical Western diet.
Why is this? The more traditional diets are high in vegetables, fruit, seafood, and unrefined grains and naturally low in processed foods and sugar. They also have low amounts of meat and dairy. Traditional diets are beneficial for the gut microbiome.
People often report feeling better physically and mentally when they clean up their diet and aim for less sugar, fewer refined grains, and more natural, plant-based foods. This can decrease inflammation in your body and influence your brain’s function. A poor diet high in processed foods is associated with a greater risk for anxiety and depression.
Healthy dietary patterns started early in life can have a bearing on the quality of mental health later. One of the most notable changes I observed in my thirty years of pediatric practice was the dramatic increase in mental health disorders in children and adolescents. Some of this paralleled the childhood obesity epidemic, which we know is related to increased consumption of sugar and ultra-processed foods. I suspect these are interrelated.
There are numerous ways in which diet quality can impact mental health. A diet low in nutrient-dense foods can lead to specific nutritional deficiencies such as folate, zinc, and magnesium, which have been linked to depression, the most common mental health condition. Depression affects people of all ages and backgrounds. A diet rich in omega-3 fatty acids helps lower the risk of anxiety.
Diet can also affect signaling factors in the brain, such as brain-derived neurotrophic factor or BDNF. This factor is often lower in patients with depression. Diets high in fat and sugar can reduce these levels.
It is difficult to discern the initial causes since a poor diet can lead to increased mental health issues while mental health issues can lead to poor eating habits. People who are depressed often tend to overeat.
Research has also found a link between alterations in the gut microbiome and disorders such as schizophrenia and psychoses. In other words, changes in the gut microbiome can increase one’s risk for certain psychiatric disorders.
The International Society for Nutritional Psychiatry Research (ISNPR) has made recommendations to clinicians for nutritional guidelines in treating mental health disorders. Many of these recommendations center on promoting a healthy gut microbiome through diet. The gut microbiome can be manipulated with fermented foods, prebiotics, probiotics, and fiber. Thus far, their recommendations have promoted Mediterranean and Japanese diets with fresh fruits and vegetables, whole grains, seafood, and very limited processed foods. Other advice includes specific vitamin supplements such as B vitamins and vitamin D.
Prioritize your mental health with a healthy diet
Research and evidence for nutrition to treat mental health disorders are ever-evolving. Just as in medicine, we are learning that diet plays a substantial role in keeping our bodies and brains healthy. Changing diet is accessible, affordable, and without side effects, unlike traditional treatments. Nutritional therapy can improve both physical and mental health. Definitely something to consider and discuss with your healthcare professional.