Nutritional Psychiatry and its role in mental health
Mental health conditions are becoming more prevalent. They are a leading cause of worldwide disability.
The common treatments are medications, such as antidepressants, and psychotherapy, like cognitive behavioural therapy. These therapies can be helpful for many. However, not all. The gaps in mental health solutions leave many more without relief from their symptoms.
Nutritional psychiatry is an emerging field that examines these treatment gaps, studying the relationship between what we eat and how we feel mentally and emotionally.
Once thought to be caused by a brain imbalance resulting in low serotonin levels, there are several proposed mechanisms for the cause of mental health disorders that research shows may be treated with diet.
Those who suffer from depression, schizophrenia, and bipolar disorder have been shown to exhibit chronic low-grade inflammation in their brains.
Inflammation has many causes: an imbalance in the microbiota of the gut, psychosocial stress, physical illness, and also, an imbalance in nutrients in the diet. Research shows the anti-inflammatory effect of a Mediterranean Diet, which has the effect of reducing inflammatory cytokines and other inflammatory molecules, through its anti-inflammatory fats (omega 3 PUFA, MUFA), antioxidants from fruits and vegetables, and fibre from whole grains, nuts and seeds.
An elevated amount of oxidative stress and decreased production of the antioxidant glutathione is found in the brains of those who suffer from schizophrenia.
A meta-analysis of 115 studies found a relationship between major depressive disorder and low antioxidant status.
Oxidative stress can possibly be reduced in those who suffer from mental health conditions by increasing the consumption of antioxidant-rich fruits and vegetables.
The Gut Microbiome
There are trillions of bacteria living in and on us, most of which reside in the large bowel. These bacteria help us digest our food, make neurochemicals that can support mood, and support gut health, through the chemicals they produce.
There are many pathways through which the bacteria in the gut can influence mental health: serotonin signalling, immune regulation, and supporting the stress response, to name a few.
Studies have found a relationship between gut microbial diversity and reduced incidence of depression.
Microbial diversity in the gut can be improved through consuming a diet high in fibre, antioxidants, and fermented foods.
In bipolar disorder, depression and schizophrenia, there is often an impaired ability to make energy in the brain, due to a decrease in mitochondrial size, function, and abundance in brain cells.
Mitochondrial dysfunction can go hand-in-hand with oxidative stress and can be a significant cause of chronic low-grade inflammation in the brain.
Diet and Mood
There are many biochemical pathways in which a whole foods diet rich in fruits and vegetables, antioxidants, whole grains, nuts, seeds and PUFA-rich fish, can improve symptoms of depression.
Recent studies, (like this one, and this one, and also this one), have shown a relationship between consuming a whole foods diet low in processed foods and an inverse risk of developing major depressive disorder.
A high intake of fruits and vegetables can also improve brain neuroplasticity through production of Brain Derived Neurotrophic Factor, which is of much interest in its benefit to mental health conditions.
Diet and lifestyle may be important factors to look at to modify the many factors that can influence mental and emotional health, as well as cognitive health.
Knowing what we know now, should nutrition be the first-line treatment in the management of mental health conditions such as depression, schizophrenia and bipolar disorder?