Food and mood for healthcare providers

Key points about food and mood

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  • Find information on the latest research on this topic and recommendations for patients.
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The authors of a meta-analysis of 41 previous studies into mental health and diet found such strong associations, including a likely causal link between diet and depression, that they recommend GPs discuss diet with patients. There was a robust association between both higher adherence to a Mediterranean diet and lower adherence to a pro-inflammatory diet and a lower risk of depression. Also they found that an extensive body of evidence now points to the microbiome-gut-brain axis as playing a key role in neuropsychiatry, and to the primacy of diet as a factor modulating this axis Lassale C, Batty GD, Baghdadli A et al. Healthy dietary indices and risk of depressive outcomes – a systematic review and meta-analysis of observational studies(external link) 

People with some kind of mental health problem eat fewer healthy foods (such as fresh fruit and vegetables, organic foods and meals made from scratch) and more unhealthy foods (chips and crisps, chocolate, ready meals and takeaways). Diet and mental health(external link) Mental Health Foundation, UK 

A diet high in refined sugars is related to poorer brain functioning and worsening mood disorders, such as depression. The risk of depression is 25% to 35% lower in those who eat a traditional diet high in vegetables, fruits, unprocessed grains, and fish and seafood, and only modest amounts of lean meats and dairy, an little or no processed and refined foods and sugars.  Nutritional psychiatry – your brain on food(external link) Harvard Health, US, 2015

Long-term exposure to unhealthy dietary habits independently predisposes someone to depression over the life course, regardless of socioeconomic circumstances and other health behaviours. Jacka FN, Cherbuin N, Anstey KJ, Butterworth P. Dietary patterns and depressive symptoms over time: examining the relationships with socioeconomic position, health behaviours and cardiovascular risk(external link) PLoS One. 2014 Jan 29;9(1):e87657

People with better quality diets are less likely to be depressed, whereas a higher intake of processed and unhealthy foods is associated with increased anxiety. Jacka FN, Mykletun A, Berk M, Bjelland I, Tell GS. The association between habitual diet quality and the common mental disorders in community-dwelling adults – the Hordaland Health study(external link) Psychosom Med. 2011 Jul-Aug;73(6):483–490.

Researchers into the relationship between unhealthy dietary patterns and poorer mental health in children and adolescents observed a consistent trend for the relationship between good-quality diet and better mental health. O’Neil A, Quirk SE, Housden S, et al. Relationship between diet and mental health in children and adolescents – a systematic review(external link) Am J Public Health. 2014 October; 104(10): e31–e42.

Further, appropriate diet helps reduce depression in older adults. Reynolds CF, Thomas SB, Morse JQ.  Early intervention to preempt major depression in older black and white adults(external link) Psychiatr Serv. 2014 Jun 1; 65(6): 765–773.

A Mediterranean diet has consistently been found to reduce the risk of getting depression and helping those with it. See, eg, Sánchez-Villegas A, Martínez-González MA, Estruch R, et al. Mediterranean dietary pattern and depression – the PREDIMED randomized trial(external link) BMC Med. 2013; 11: 208; Psaltopoulou T1, Sergentanis TN, Panagiotakos DB, Sergentanis IN, Kosti R, Scarmeas N. Mediterranean diet, stroke, cognitive impairment, and depression – a meta-analysis(external link) Ann Neurol. 2013 Oct;74(4):580–591; Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults(external link) Am J Clin Nut. 2014 Jan;99(1):181–197.

In the Australian SMILES (Supporting the Modification of lifestyle in Lowered Emotional States) Trial, randomised controlled trial, Australian researchers found that after 12 weeks a third of those in the dietary support group had significantly improved mood and symptoms, compared with only 8% of those in the group receiving social support. The diet was a modified Mediterranean diet (ModiMedDiet) to include some low fat dairy and lean red meat SMILES trial(external link) Food & Mood Centre, Australia, 2016; Opis RS, O’Neil A, Jacka FN, Pizzinga J & Itsiopoulos C. A modified Mediterranean dietary intervention for adults with major depression – dietary protocol and feasibility data from the SMILES trial(external link) J Nut Neurosci. 2017 Apr; 21(7):487–501. 

In New Zealand, in a University of Otago study, young adults who ate more fruit and vegetables for just two weeks reported a University of Otago study 24% increase in feelings of vitality and wellbeing. The top 10 raw foods recommended to boost mental health are carrots, bananas, apples, dark leafy greens like spinach, grapefruit, lettuce, citrus fruits, fresh berries, cucumber and kiwifruit. Conner TS, Brookie KL, Carr AC, Mainvil LA, Vissers MCM. Let them eat fruit! The effect of fruit and vegetable consumption on psychological well-being in young adults – a randomized controlled trial(external link) PlosOne, February 3, 2017; Brookie KL, Best GI, Conner TS. Intake of raw fruits and vegetables is associated with better mental health than intake of processed fruits and vegetables(external link) Front. Psychol. 2018 Apr 10.

A notable feature of the diets of patients suffering from mental disorders is the severity of deficiency in nutrients. Studies have indicated that daily supplements of vital nutrients are often effective in reducing patients' symptoms. Sathyanarayana Rao TS, Rao, Asha MR, Ramesh BN, Jagannatha Rao KS. Understanding nutrition, depression and mental illnesses(external link) Indian J Psychiatry. 2008 Apr-Jun; 50(2): 77–82. 

Because of its anti-inflammatory properties and effects on dopamine and serotonin transmission, omega 3 has a role in brain development and functioning, with deficiencies linked to mental health problems. The link between food and mental health(external link) American Psychological Association, 2017.

Food and Mood: Improving Mental Health Through Diet and Nutrition(external link) Future Learn NZ (paid course) 3 hours a week for 3 weeks 
This is an introductory course which might be of interest to healthcare practitioners working with people with mental and brain health issues or in roles related to diet, nutrition and mental and brain health education.

Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

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