Food & Mood
Nutritional Psychiatry
is a very exciting new area of research that aims to identify how nutrition can be used to prevent and treat mental health conditions.
This is probably one of my favourite areas of nutrition science and one that I am really passionate about.
Mental health is a topic that is generally spoken about a lot less often than physical health. However, it is an essential component of our overall health.
What is mental health? The world health organisation defines mental health as
“a state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community, and socio-economic development”
In contrast, mental illness is defined as
“a clinically diagnosable disorder that significantly interferes with an individual’s cognitive, emotional, and social abilities”
Unfortunately, many of us will be impacted by poor mental health at one or more times during our lives. Whether that be struggling with our own mental health, supporting someone struggling with their mental health, or grieving the loss of someone who has died by suicide.
The Statistics
Australian Mental Health Statistics:
43.7% of people will experience a mental illness in their lifetime
One in five people ages 16-85 years will experience a mental illness in any year
Anxiety is one of the most common mental health disorders affecting 3.3 million people
Depression is one of the most common affective disorders
People with a serious mental illness have a life expectancy of up to 15-25 years less than the general population
At any one time, 1 million people will experience an eating disorder
Binge eating disorder is the most common eating disorder affecting 6% of the population
What Influences Mental Health?
There are many risk factors across our lives that can influence our mental health. COVID-19 is probably one that stands out for many people especially those of us living in Melbourne during the lockdowns.
Biological influences:
Gender - Genetics - Physical health - Disability - Neurochemistry - Stress Reactivity
Psychological influences:
Behaviour - Personality - Attitudes and beliefs - Learning - Memory - Coping skills - Social skills - Emotions - Self-esteem - Temperament
Social influences:
Life events - Family background - Education - Social support - Family and peer relationships - Socioeconomic status - COVID-19
Mental illness can happen to anyone at any time.
If you are struggling please reach out for support. We would like you to stay with us. Even if it doesn’t feel it now there are brighter days ahead.
Police and Ambulance: 000 (If life is in danger)
Lifeline: 13 11 14 (24-hour crisis support)
Suicide Call Back Service: 1300 659 467 (24/7 phone and online counselling)
Beyond Blue: 1300 244 636 (24/7 Qualified mental health counsellors)
MensLine Australia: 1300 789 978 (24/7 support for men)
Butterfly: 1800 ED HOPE (Support for eating disorders and body image issues)
Kids Helpline: 1800 551 800 (Anytime, any reason for kids 5-12, teens 13-17, young adults 18-25)
QLife: 1800 184 527 (Anonymous and free support for LGBTIQ+ people 3pm-midnight everyday)
1800 Respect: 1800 737 732 (Domestic, family, and sexual violence counselling service)
13YARN: 13 92 76 (24/7 support for Aboriginal and Torres Strait Islander people)
What Influences Food Choices?
Experiencing a mental health condition can add further complexities to the many influences involved in our food choices.
Medication-related side effects:
Appetite +/- Food intake +/- Excessive thirst Cravings Energy levels +/-
Dry mouth Weight +/- Blood lipid/glucose disturbances
Physical symptoms:
Nausea GI upset Appetite +/- Weight +/- Sleep +/- Concentration Fatigue
Environmental:
Access to food Cooking facilities Living arrangement Cost
Behavioural:
Not eating in public Motivation Alcohol and drug use Restricting Binge eating Self-induced vomiting Repetitive behaviours Calorie counting
You may recognise the effect that the current cost of living is having on your food choices. Whether that be eating out less, cooking at home more, missing out on certain foods, or being unable to afford to eat.
Food Affects Mood
Nutrition & Mental Health
While nutrition is not a miracle cure, it does play a significant role in the management of mental health conditions. Diet is one of the lifestyle factors that we can change. Considering that we all have to eat, if we can optimise diet to improve mental health then it is a relatively lost-cost treatment support.
Nutrients, The Brain & The Gut
The majority of Australians (91%) regardless of mental health status are not eating enough of the foods that provide our bodies with the essential nutrients they require. Food should always be the first place we get our nutrients from. Supplements can be useful however, they do not provide the beneficial health effects of those fabulous phytonutrients and fibres that are found in plants. Supplements unless indicated by analysis of your dietary pattern by a dietitian, clinically due to a health condition/surgery or blood test results are often just very expensive urine.
The brain like the other cells and organs in our body requires nutrients in order to function optimally.
The brain prefers to use glucose as its primary fuel source and it gobbles up a massive 20% of our total daily energy requirements
The brain is around 60% fat and essential fatty acids especially omega-3 fatty acids are crucial for brain integrity and performance
Amino acids from protein foods and vitamins and minerals are required to make neurotransmitters. These chemical messengers are involved in mental health. You may have heard of dopamine and norepinephrine they are often called the “feel-good” chemicals, and you may know serotonin as the “happy hormone”
Folate (B9) is well known for its importance pre-conception due to its role in fetal brain development. It is so important that in Australia we have mandatory fortification of all (*except organic) flour used for bread products to prevent neural tube defects such as spina bifida
Vitamin D, B vitamins, and zinc also play an important role in mental health
Vitamin and mineral deficiencies can result in headaches, migraine, fatigue, irritability, anxiety, sleep disturbance, and insomnia
There is a bidirectional (back and forth) relationship between the gut microbiota and our brain, known as the gut-brain axis. Strong evidence suggests that the gut microbiome influences our mood and behaviour. This is a very exciting area of research.
Observations studies have shown us that people who eat a diet higher in whole foods are less likely to experience anxiety and depressive symptoms. Whereas, people who eat a diet higher in refined and processed foods are more likely to experience anxiety and depressive symptoms.
Exciting Evidence
There have been a couple of exciting randomised controlled trials (RCTs) in Australia that address the question of whether food can make us happy. RCTs are the gold standard (highest level) in study design they tell us if a treatment (e.g. Mediterranean diet) works by comparing it to a control group (e.g. social support).
The SMILES trial was conducted over 12 weeks that compared a dietary intervention against a social support control group in the treatment of moderate to severe depression. The dietary intervention was a dietitian-led modified Mediterranean diet. It saw 32.3% of participants achieve remission from depressive symptoms in comparison to 8% of people in the social support group. This was independent of any changes in BMI, smoking, self-efficacy, and/or physical activity. They also estimated the weekly cost of the diet in comparison to participants’ baseline diet and it was ~$26 cheaper per week.
The HELFIMED trial compared a Mediterranean-style diet and fish oil supplementation intervention in comparison to a social support control group in adults suffering from depression. The Mediterranean-style diet and fish oil supplementation group saw a 45% improvement in depression scores with changes sustained at 6 months in comparison to 26.8% in the social support group.
Lifestyle Modifications
Diet is not the only modifiable risk factor we can change to improve our mental health.
What you can do today
Eat a handful of nuts - the PREDIMED study found that people who ate a handful of nuts every day had a 22% reduced chance of depression
Eat some avocado - avocados contain folate and higher levels of folate in the blood are associated with a lower risk of depression
Eat some fruit - on days people ate more fruit they felt calmer, happier, and more energetic
Eat some tomatoes - tomatoes contain beta-carotene and lycopene. They act as powerful antioxidants protecting the body from oxidative stress
How I Can Help
I can support you to implement a modified Mediterranean dietary pattern that fits into your lifestyle and food preferences
I will not overwhelm you with drastic changes as mental health benefits are seen even with small changes
I can support you to find a ‘normal’ eating pattern for you, where patterns of eating and choices of food are no longer influenced by an eating disorder
I can assess and respond to the unique nutritional challenges experienced by people with a mental illness
I can help with translating the evidence, helping you to make food swaps, shopping lists, label reading, meal ideas, recipes, tips, tricks, and budgeting.
I can help you to troubleshoot and find strategies to succeed. We can make plans for the days you cannot get out of bed or find it hard to prepare food, or the days when takeaway is the only option
