The Emerging Field of Nutrition and Mental Health
From the time of the ancients until the 17th century everyone recognized the interconnectedness of the mind and body. The idea of viewing the mind and body as separate was a result of a philosophical argument (Cartesian Dualism) to understand thinking and what and how we can know. It was also the dividing line between science and religion. Mind, body and soul were no longer connected, so the body could be examined. It was not until Merleau-Ponty introduced the philosophical argument of the “living body” in Primacy of Perception that we begin to return to a union of mind/body in western thought. Western medicine still tends to view the body as something to be measured and explored, but Integrative Medicine is returning to the view that mind and body are aspects of a whole, like heads and tails of coins. The emerging field of Nutritional Psychiatry is conducting broad and extensive research in the area of diet, brain function, gut health and the risk of mental disorders.
In this article we will look at some common mental health conditions and focus on what foods and dietary changes may impact health. Please note we are not suggesting that anyone stop their current medications and begin a specific regiment or diet. Nor are we saying that mental health challenges are a result of eating or not eating specific foods. It is important and imperative that one consults with their appropriate medical and mental health professionals. Some of the recommended foods may not be right for you, depending on allergies or dietary restrictions, either biological or by choice.
The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders – Fifth edition) describes anxiety disorders as sharing features of excessive fear and anxiety. Fear is the emotional response to real or perceived imminent threat. Anxiety is anticipation of future threat. Anxiety disorders differ from one another in the types of objects or situations that induce fear, anxiety or avoidance behavior and the associated cognitive ideation. The basic principle underlying nutritional support in anxiety, is to; 1. Eliminate all stimulants such as coffee, tobacco, tea, colas, soft drinks, alcohol, refined foods, food additives and coloring, and avoid processed foods especially hot dogs. 2. Provide crucial nutrients for proper neuronal function.
Foods that help with controlling anxiety are:
1. Complex carbs that increase serotonin: whole grain breads and cereals, brown rice; chocolate
2. Folate and foods rich in B vitamins: beef, pork, chicken, leafy greens, legumes, oranges and other citrus fruits, nuts, rice and eggs
3. Low-glycemic foods
5. Foods rich in Omega-3 fatty acids: fatty fish like salmon, lake trout, herring, mackerel, anchovies and sardines
6. Foods high in zinc: oysters, cashews, liver, beef and egg yolks
7. Foods rich in tryptophan: turkey, chicken, bananas, milk, oats, cheese, soy, nuts, peanut butter and sesame seeds
8. Probiotic foods: such as pickles, sauerkraut, kefir and kimchi
9. Protein helps stimulate production of norepinephrine and dopamine: Greek yogurt, fish, meats, cheese, eggs, nuts, beans, soy and lentils. It is best to combine carbohydrates and protein throughout the day
Nutrients which are beneficial in the management of anxiety include:
1. Inositol: a supplement which is also found in legumes and whole grains has been shown through research to be as effective as SSRIs for anxiety
2. EPA and DHA: found in fish oil and flax oil have also been shown to improve anxiety, and it has been shown that people who suffer from anxiety have lower levels of EPA and DHA
3. Vitamin B6: abundant in whole grains, wheat germ, brown and red rice and oatmeal has been shown to increase serotonin level in people with anxiety
4. Iron: found in dark green vegetables, beets, and black strap molasses, has also been shown to be statistically lower in people with anxiety. Iron increases serotonin levels so a diet high in iron is recommended for the management of anxiety.
Other beneficial supplements which have been shown to help in the treatment of anxiety, and for which you need to consult your health care practitioner for correct dosing include; Niacinamide, Magnesium, GABA, Glycine, and Vitamin C.
In the DSM 5, Depressive Disorders share the common feature of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the person’s capacity to function. What differ among the disorders are issues of duration, timing or presumed etiology.
There have been several studies linking some forms of depression with inflammation in the body. Foods that work as anti-inflammatories are; blueberries, raw oats, ginger, green tea, dark chocolate, wild salmon, turmeric, beets, broccoli, black beans, extra virgin olive oil, tomatoes, chia seeds, pineapple, spinach, whole grains, eggs, garlic, oysters and probiotic foods. The general principles underlying nutritional support for depression are: 1. Eat a lot of vegetables, whole grains, legumes, cold water fish, raw nuts and seeds. 2. Avoid caffeine, nicotine, alcohol, sugar and artificial sweeteners. 3. Identify and eliminate food sensitivities.
Foods such as bananas, plums, and figs are high in serotonin and should be eaten on a regular basis to increase the natural pool of serotonin. Folic acid has been shown to help with depression. Folic acid is abundant in all green leafy vegetables so eating a lot of dark green vegetables is not only good for your overall health because of all the phytochemicals they contain but also because of the folate content. Vitamin B6 which can be found in whole grains, oatmeal, wheat germ, red rice, and brown rice has also been shown to be beneficial in the management of depression. Studies have confirmed that people with depression and anxiety have lower levels of DHA and EPA, the omega 3 fatty acids. Thus, increasing the consumption of omega 3 can improve depression. Omega 3 fatty acids can be found in Flax oil or fish oil.
Other nutrients beneficial in depression include:
1. SAMe: which has been shown in clinical trials to be comparable to tricyclic antidepressants (TCA) for the management of mild-moderate depression.
2.5HTP: which has been shown to be comparable to Prozac (fluoxetine) in the management of mild to moderate depression.
3. Chromium: which help functions in the metabolism of glucose, has been shown to improve mood in persons with depression.
Risks for depression include processed foods, high fat dairy, sugar and sweet deserts. Remember that alcohol is a central nervous depressant and can induce and/or exacerbate depression.
Dietary interventions for ADHD and ADD have not been successfully replicated. The typical western fast food diet high in sugars, additives and simple carbs is not particularly good for anyone, especially young people, with these conditions. There appears to be a connection for children with ADHD to develop Type 2 diabetes later in life. Therefore, limiting sugar intake is a good idea. In some studies children seemed to be deficient in Omega-3 and Omega -6 fatty acids. Implementing a balanced healthy diet including fish or seafood twice a week, eliminating excess sugar products and dairy would be beneficial. 64% of children diagnosed with ADHD may be experiencing a hypersensitivity to food. Exploring whether children or adults have food allergies or sensitivities may be beneficial as an intervention. Some studies suggest that heavy metal toxicity may have a relationship with some cases of ADD. Testing for heavy metals, especially Mercury, may be helpful and chelation for detoxification may be indicated. Food sources to help the conditions include salmon and trout; kiwis, papaya, pineapple and cilantro. DHA is an excellent supplement to add to the diet as is magnesium.
Autism is a developmental disorder and is not caused or cured by diet. Dietary intervention may help the individual live a more manageable life. A GF/CF (gluten free/casein free) diet has been suggested by the ARI (Autism Research Institute) based on 30 years of dietary interventions. They also recommend mercury detoxification. There are doctors specializing in the treatment of autism known as “DAN! Doctors” (Defeat-Autism-Now!). You may wish to visit the website: www.autism.com for further information. Children with autism often have poor nutrition due to their unwilling-ness to accept many types of food. All milk and cheese products should be eliminated. Eggs, asparagus and cilantro are beneficial foods. Supplements such as Zeolite, monolaurin and DHA may prove helpful along with B complex vitamins depending on the individual’s ability to absorb nutrients.
An anti-inflammatory diet is the best initial approach. We suggest Dr. Dale Bredesen’s dietary consideration in his book The End of Alzheimer’s. He introduces his ReCODE program which is individualized based on laboratory results and values. The diet is referred to as Ketoflex 12/3. It is a largely plant based diet with an emphasis on non-starchy vegetables. The 12/3 refers to fasting times – at least 12 hours between the end of the last meal and the first meal of the following day with at least 3 hours minimum between the end of the last meal of the day and going to bed. The diet stresses eating whole foods and avoiding processed foods. Probiotics and prebiotics are included to support good gut health.
Diets – Mediterranean, Plant-Based, Intermittent Fasting
The Mediterranean Diet consists primarily of vegetables, fruits, nuts, seeds, legumes, potatoes, whole grain breads, herbs, spices, fish, seafood and extra virgin olive oil. One can eat in moderation poultry, eggs, cheese and yogurt. Red meats are rarely eaten. Sugar-sweetened drinks, sugar added products, processed meat, refined grains, refined oils and highly processed foods (anything labeled diet or low fat) are never consumed. The diet helps reduce inflammation and supports positive gut health.
Plant based diets, avoiding all meats and dairy products, have shown reductions in anxiety, stress and depression, along with lower cholesterol and heart disease. For many maintaining a vegetarian or vegan diet may be difficult. Increasing the amounts of fruits and vegetables we eat daily, especially cruciferous vegetables (broccoli, cauliflower, kale, brussels sprouts, and other green leafy vegetables) will make a huge difference in our general and mental health.
Intermittent fasting (Monk’s Diet) is not a diet in the usual sense of the word. It is merely allowing at least 12 -14 hours (16 hours is even better) between your last meal of the day and your morning meal with at least 3 hours between your last meal and going to bed. This length of time allows your body to enter a state of ketosis and promotes autophagy, a state in which the cells of the body including the brain recycle components and destroy damaged proteins and mitochondria. Intermittent fasting combined with a Mediterranean, Keto or Plant based diet will greatly improve physical and mental health.
There are other factors for maintaining and improving our overall mental health. These include regular exercise; maintaining a healthy weight; positive self-care including meditation, relaxation or prayer; being aware (mindful) and having a sense of gratitude; social contact and maintaining friendships. All these factors play an important part in maintaining and improving our mental health and positive attitudes.
Dr. Martin Opoku Gyamfi is a Medical Doctor and Naturopathic Physician. He is a wellness expert and educator with clinical and research experience from Argentina, Canada, Mexico and the USA. Dr. Opoku Gyamfi is the Director of the Diabetes Reversal Clinic at ProNatural Physicians Group, 120 Webster Square Rd. Berlin. Please call 860-829-0707 to book an appointment with Dr. Opoku.
James W. Osborne, MS, LPC, BCPC is a Licensed Professional Counselor, Board Certified Professional Counselor, Board Certified PTSD Clinician with over 40 years of clinical experience. He employs Mindfulness, Jungian Psychology, Gestalt Psychology, EMDR and value-based techniques unique to the individual to support positive health changes. He can be contacted at ProNatural Physicians Group in Berlin, CT at (860) 829-0707.