Eat your way to better mental health?

October 10 has been designated by the World Health Organization (WHO) as World Mental Health Day 2018, and I must confess to being somewhat less enthusiastic about this particular ‘awareness day’ than I was about last week’s Sleep Awareness Week.

It’s not that I’m unconcerned about people’s psychological well being; quite the opposite. That’s why I followed up my naturopathic studies with a Graduate Diploma of Counselling, and why I spend a great deal more of my consultation time working on clients’ thinking patterns, emotional and relationship difficulties, and psychological barriers to change than on telling them what to eat.

My concerns with the modern mental health movement are firstly that the notion of ‘mental health’ has been warped into a paradigm that pathologises and medicalises human experience; and secondly, that it almost entirely ignores the rapidly mounting evidence on the impact of diet and lifestyle behaviours on people’s thought patterns and emotional states, while clinging to long-disproven theories of ‘chemical imbalance’ (described by eminent professor of psychiatry David Healy as “pure bio-babble”) as the ’cause’ of psychological suffering.

I’ve written about both issues extensively in previous blog posts – see my previous articles:

• ‘Depressed’ or just going through a rough patch – have you been misdiagnosed?
• Who says you’re depressed or anxious? Pfizer does
• Dying to feel better?
• 5 reasons to think twice before taking antidepressants
• Beat the holiday season blues – with broccoli and blueberries
• Of bugs and brains – how your gut microbiome affects mental health
• Depression – bringing your black dog to heel
• Good mood food
• Hormonal contraception and women’s mental health
• Inflammation: Why you’re fat, sick, tired, depressed and in pain… and what to do about it
• Rumination inflammation
• Want to feel happier? Change what’s on your plate!

WHO very appropriately stresses the importance of cultivating mental resilience in children and adolescents to prevent so-called mental illness, and psychological interventions that focus on changing thinking patterns in overcoming it. But there’s nary a mention of diet, nutrition or exercise in their Mental Health Action Plan 2013-2020.

Fortunately, some in the mental health research community are way ahead of WHO when it comes to taking the link between diet and mental health seriously.

A team of Chinese researchers published a paper titled Dietary patterns and depression risk: A meta-analysis in the journal Psychiatry Research, in which they sought to make sense of inconsistent findings about the relationship between intake of individual foods and nutrients and the risk of developing depression, by examining dietary patterns.

Their rationale for analysing dietary patterns is that people eat meals comprised of many different foods, rather than consuming individual nutrients or foods. As I am continually pointing out to clients who have been taken in by marketing hype around superfoods and nutritional supplements, it is the total dietary pattern that determines a person’s health outcome, not their intake of a particular vitamin, mineral or food.

As the authors of the meta-analysis pointed out,

“It is well-known that diet is related to inflammation, oxidative stress and brain plasticity and function; all of these physiological factors are potentially involved in depression.”

The researchers characterised a healthy dietary pattern as high in fruits, vegetables, whole grains, soy, fish, olive oil, low-fat dairy and antioxidants (e.g. vitamin C, vitamin E, flavonoids, and carotenoids – all of which are abundant in plant foods and either entirely absent from, or extremely low, in animal derived foods).

By contrast, the unhealthy or Western-style dietary pattern was characterised as high in red and/or processed meat, refined grains, sweets, desserts, fast food, butter, high-fat dairy products and carbonated drinks, and low in fruits and vegetables.

When the 21 articles that met the researchers’ criteria – involving a total of 117 229 participants from Europe, the US, Asia, the Middle East and Australia – were meta-analysed, they found that the odds of developing depression were 36% lower in those who adhered most closely to the healthy dietary pattern compared to those whose dietary intake most closely resembled the Western dietary pattern.

• High antioxidant content in fruits and vegetables, which may protect against depression by reducing oxidative stress which damages neurons (brain cells), particularly those in the hippocampus, a brain region which is thought to be centrally involved in depression.
• High folate intake from vegetables and fruits, which reduces homocysteine concentrations and increases the availability of S-adenosylmethionine, (SaME), a compound which has been suggested to play a critical role in the pathophysiology of depression.
• High intake of long-chain omega-3 polyunsaturated fatty acids, which have anti-inflammatory properties, make the cell membranes of neurons more fluid, which contributes to brain functioning and serotonin neurotransmission.
• Anti-inflammatory properties in the healthy dietary pattern influence concentrations of monoamines, which are thought to play an important role in the regulation of emotions and cognition (although it must be said that the monoamine hypothesis of depression is not supported by evidence, as discussed above). On the other hand, highconsumption of refined grains, sugar, fat and processed meat is associated with increased levels of low grade inflammation which results in atrophy of brain regions linked with depression. Furthermore, this low grade inflammation is also associated with the development of cardiovascular diseases, which share similar pathogenic pathways with depression.
• High sugar intake from sweets and soft drinks is associated with an increased risk of depression because it alters endorphin levels and generates oxidative stress.
• High caffeine intake from coffee and energy drinks may be associated with an increased risk of depressive symptoms.

While the mechanisms by which dietary patterns affect mood are nowhere near fully elucidated (and perhaps never will be), one thing is clear: the food you eat on a daily basis has a profound effect on your state of mind, and any health professional who does not incorporate dietary counselling in their mental health treatment plan is derelict in their duty to provide the best, most evidence based care to people who are experiencing psychological distress.

Improving your diet can be challenging when you’re already struggling with low mood. However, a step-by-step plan that gives you the opportunity to create small daily wins not only accretes into significant mood-enhancing dietary change, it also builds the sense of self-efficacy that is fundamental to lasting recovery from depression.

Need help with designing and implementing a dietary change plan to help you overcome depression? Apply for a Roadmap to Optimal Health Consultation today!