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Food for Your Mood

Rosie Martin, Registered Dietition

The month of May saw Mental Health Awareness Week (May 13th-19th 2019), with both health professionals and the public working to raise the profile of mental health disorders. We talked awareness, body image, mental health stigma, and ways to support your mental health, but did you see anyone talking about nutrition?

We all know that what we eat has a significant impact on our physical health; many of us are quick to relate our diets to our risk of cardiovascular disease, obesity, high blood pressure, bone health, diabetes, to name a few, but the equally significant impact of diet on another vital organ, our brain, remains largely unrecognised.

Observational evidence for the impact of diet on the improvement or deterioration of mood disorders is extensive. Although there are a wide variety of different conclusions on the healthiest diet, dependent on country and culture, the consensus shows this to be a diet based on whole plant foods.

A recent meta-analysis by Lai et al. (2013) confirmed that diets comprised of high intakes of fruit and vegetables, fish (or healthy fats), and wholegrains, were associated with a reduced likelihood of depression in adults (1). Another study showed adherence to a Mediterranean diet (characterised by high intake of whole foods including fresh fruit, vegetables, whole grains, and healthy fats) was associated with 30% reduction for depression (2). Interestingly, several cohort studies have also highlighted associations between diet during pregnancy and risk for emotional dysregulation in children (3-5), with potential mechanisms including brain plasticity (6), the gut microbiota (7), and inflammatory and oxidative stress pathways (8,9). Research in this area does not come without its limitations, and remains in its infancy relative to the data we have on diet and physical health. Despite this, a 2018 randomised control trial aimed to explicitly seek an answer to the question: If I improve my diet, will my mental health improve? Although a preliminary study, results suggest that dietary improvement, in this case guided by a clinical dietitian, may provide an efficacious treatment strategy for the management of mental health disorders(10).

So how can we improve our patients’ and our own mental health with food? Here are a dietitian’s top tips for how to eat good mood food.

1. Eat regularly

Aim for 3 meals and 2-3 snacks between meals if you are hungry, starting with breakfast. Regular meals support blood sugar control throughout the day and can reduce feelings of tiredness and irritability associated with low blood sugar levels.

2. Stay hydrated

Aim for 6-8 cups (1.5-2L) of fluid daily to support concentration, alertness, and bowel function. Choose non-fizzy, non-alcoholic drinks. Keep caffeinated drinks to <3/day and pure fruit juice to <150ml.

3. Take care of your gut

Your gut and brain are constantly communicating with each other. To promote a wide variety of good bacteria beneficial to physical health as well as mood, choose whole foods, cook from scratch, and avoid or reduce processed foods, particularly those high in fat, sugar, and/or salt.

4. Get your fibre

We are recommended to have 30g of fibre but, as a nation, we only manage a mere 18g. Choosing a wide variety of plant foods including wholegrains, fruit, vegetables, legumes, nuts, and seeds significantly increases this. Adding food rich in soluble fibre such as oats and linseeds (flaxseeds) may also help with gut function. If you are increasing your fibre, do so gradually and with plenty of fluids to reduce the risk of short-term bowel discomfort.

5. Regular starchy carbohydrates

Wholegrain carbohydrates are crucial for both energy and certain nutrients including calcium and B vitamins. Our brain requires carbohydrate as its main source of fuel. Base your meals on wholegrain carbohydrates such as granary bread, brown rice, or whole-wheat pasta.

6. Fruit and vegetable intake

Fruit and vegetables provide vitamins, minerals, fibre, and water. We suggest aiming for at least 5 portions (80g or a handful) daily, and more is better! A whole food plant-based diet will ensure you are regularly exceeding this.

7. Choose good fats and protein

By eating a plant-based diet you will have already significantly reduced your saturated fat intake. Get a good dose of healthy fats by including avocados, nuts (particularly walnuts), and seeds. You may also wish to include a regular plant-based omega 3 supplement. Plant-based proteins such as beans, pulses, nuts, seeds, tofu, and tempeh should be included with most meals.

8. Key vitamins and minerals

Certain vitamins and minerals have been associated with moods including iron, B vitamins, folate and selenium. These can be found in abundance as part of a healthy well-balanced diet, as illustrated by Public Health England’s Eat Well Guide (2016).

9. Reduce processed foods high in fat, sugar and salt

If you are choosing a whole food plant-based diet, you will naturally be avoiding sugary drinks, cakes, biscuits, and crisps; even highly processed plant-based/vegan alternatives can do detriment to both our daily mood and long-term mental health.

10. Combine with additional lifestyle changes

Alongside your dietary choices, getting outside, moving a little more, stopping to relax, spending time with loved ones, and being mindful, will all help to support your mental health.

Please note, if you or your patients are experiencing periods of low mood, depression, or anxiety, additional support may be required.

REFERENCES

  1. Lai, J.S., Hiles, S., Bisquera, A., Hure, A.J., McEvoy, M., Attia, J. 2013. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. Am J Clin Nutr. 99(1):181–97. doi:10.3945/ajcn.113.069880.
  2. Psaltopoulou, T., Sergentanis, T.N., Panagiotakos, D.B., Sergentanis, I.N., Kosti, R., Scarmeas, N. 2013. Mediterranean diet, stroke, cognitive impairment, and depression: a meta-analysis. Ann Neurol. 74(4):580–91.
  3. Jacka, F.N., Ystrom, E., Brantsaeter, A.L., Karevold, E., Roth, C., Haugen, M., et al. 2013. Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study. J Am Acad Child Adolesc Psychiatry. 52(10):1038–47. doi:10.1016/j.jaac.2013.07.002.
  4. Pina-Camacho, L., Jensen, S.K., Gaysina, D., Barker, E.D. 2015. Maternal depression symptoms, unhealthy diet and child emotional-behavioural dysregulation. Psychol Med.45(9):1851–60. doi:10.1017/S0033291714002955.
  5. Steenweg-de Graaff, J., Tiemeier, H., Steegers-Theunissen, R.P., Hofman, A., Jaddoe, V.W., Verhulst, F.C., et al. 2014. Maternal dietary patterns during pregnancy and child internalising and externalising problems. The Generation R Study. Clin Nutr. 33(1):115–21. doi:10.1016/j.clnu.2013.03.002.
  6. Jacka, F.N., Cherbuin, N., Anstey, K.J., Sachdev, P., Butterworth, P. 2015. Western diet is associated with a smaller hippocampus: a longitudinal investigation. BMC Med. 13:215.doi:10.1186/s12916-015-0461-x.
  7. Dash, S., Clarke, G., Berk, M., Jacka, F.N. 2015. The gut microbiome and diet in psychiatry: focus on depression. Curr Opin Psychiatry. 28(1):1–6. doi:10. 1097/YCO.0000000000000117.
  8. Berk, M., Williams, L.J., Jacka, F., O’Neil, A., Pasco, J.A., Moylan, S., et al. 2013. So depression is an inflammatory disease, but where does the inflammation come from? BMC Med.11:200.
  9. Moylan, S., Berk, M., Dean, O.M., Samuni, Y., Williams, L.J., O’Neil, A., et al. 2014. Oxidative & nitrosative stress in depression: why so much stress? Neurosci Biobehav Rev. 45:46–62. doi:10.1016/j.neubiorev.2014.05.007.
  10. Jacka, F.N., O’Neil, A., Itsiopoulos, C., Opie, R., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., Chatterton, M.L., Dean, O.M., Hodge, A., Berk, M., 2018.

The SMILES trial: an important first step. BMC Medicine. 16:237 DOI:
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1228-y

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