Tag Archives: diet and mental health

Diet and Mental Health – Part 2

Huge thanks for this guest blog post by Bethany Francois. MSc Eating Disorders and Clinical Nutrition. Find her on Instagram: bethany_laura_

As mentioned in Part 1 of this blog post, health is not just a physical concept but involves mental and social wellbeing too. Therefore, by definition it is impossible achieve a healthy status if one of these aspects is jeopardised for the other i.e. regardless of what you are eating, if your dietary choices are negatively affecting your mental wellbeing you cannot reach state of health. 

The mass of dietary information available from unreliable and unqualified individuals has made food choices complicated and confusing. We know that social media use is associated with an over-fixation on eating ‘the correct way’, which can have a profound impact on our mental health (2). It is unsurprising that what we eat can often have a psychological impact when words and phrases such as ‘bad’, ‘guilty pleasure’, ‘naughty’ and ‘clean’ are used to describe the food we eat. An overemphasis on our dietary choices as a measure of our self-worth is dangerous and likely to result in low self-esteem and can lead to eating disorders and other mental health conditions.

In a society where disordered eating behaviours have become normalised e.g. removal of food groups, calorie counting and earning the right to eat via exercise, it can be difficult to recognise (in ourselves or others) when our dietary habits may be having a detrimental effect on our mental health. Here are some signs to look out for:

  • Preoccupation with food
  • Anxiety at the thought of straying from your meal plan or last-minute changes to eating plans 
  • Avoidance of social eating and self-isolation 
  • Feelings of guilt or shame associated with food
  • Compensating by restricting/skipping meals 
  • Justification of eating with exercise
  • Basing self-worth on dietary choice
  • Chronic under-eating 

Take Home Messages 

  • Diet is an important part of our overall wellbeing and a poor diet can both be a contributing factor and consequence of mental illness. However, it’s important to recognise that mental illnesses have complex aetiologies and require multicomponent treatment strategies. Whilst diet may be a tool to improve symptoms, it is not a cure (note that in the SMILES study (1), all participants remained on their current treatment plan throughout).  
  • Nourishing yourself properly and eating regular meals are likely to have a positive impact on your mental health. Research suggests that the Mediterranean diet may be associated with a decreased risk of depressive symptoms. However, eating well when struggling mentally can be extremely difficult. Feeling guilt or shame due to being unable to prepare meals will only make things worse. It is so important to be kind and compassionate towards yourself-you are doing the best you can.
  • Our relationship with food should always allow us to be able to fully engage with other aspects of our lives. Being too anxious to attend a friend’s birthday meal will always be worse for your health than any food you would have eaten. 
  • Please remember you can have poor health as a result of your relationship with food without experiencing weight changes. Health is not just physical and weight should never be solely used as measure of our health. Feelings of anxiety, shame and guilt are never healthy, no matter what your weight and you deserve the support to overcome these feelings.
  • People often roll their eyes at the word ‘balanced’. It may sound boring and it’s not as eye-catching as celebrity endorsed dietary products but it’s the truth. Regular and healthy meals are likely to have a positive impact on our mental health. But equally, an obsessive and restrictive approach to our dietary choices will never result in happiness. 

Resources and Support 

Mind: https://www.mind.org.uk/

Young Minds: https://youngminds.org.uk/

Mental Health Foundation: https://www.mentalhealth.org.uk/

Rethink Mental Illness: https://www.rethink.org/

Samaritans: https://www.samaritans.org

Beat: www.b-eat.co.uk 

References 

1. Jacka, F., O’Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., Chatterton, M., Brazionis, L., Dean, O., Hodge, A. and Berk, M. (2017). A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Medicine, 15(1).

2. Turner, P. and Lefevre, C. (2017). Instagram use is linked to increased symptoms of orthorexia nervosa. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 22(2), pp.277-284.

Diet and Mental Health PART 1.

Huge thanks for this guest blog post by Bethany Francois. MSc Eating Disorders and Clinical Nutrition. Find her on Instagram: bethany_laura_

The 13th-19th May 2019 is Mental Health Awareness Week. In the UK, mental health problems affect 1 in 4 adults and 1 in 10 children and up to 18% of NHS expenditure on treating and managing long-term conditions is associated with poor mental health and wellbeing1. Furthermore, depression is a major contributor to global overall disease burden and is the leading cause of disability worldwide2.

In the media, the term ‘health’ is often represented by an image of a thin person, with a low body fat percentage and visible muscles, but this definition couldn’t be further from the truth. Health is far more complicated than aesthetics and although often not visible, mental illness can have a serious impact on the overall health of an individual. The true definition of health is a state of physical, mental and social wellbeing-all of which can be impacted by our dietary choices. 

We’ve probably all heard the term ‘food and mood’, but what does this really mean? This article will take a look at current research and what we know about how our diet can impact our mental state.

What we Know about Food and Mood 

The best evidence we have currently, in terms of diet and mental health, is the impact of the Mediterranean Diet (MD). This diet is generally high in fruit and vegetables, legumes, beans, nuts, cereals, grains, fish and unsaturated fat sources such as olive oil and lower in meat, saturated fats and added sugar. The first causal data showing improvements in depression whilst following the MD were seen with the publication of the SMILES trial3. This was a 12-week randomised control trial, where individuals with depression either implemented the MD or received social support (control) alongside their normal treatment programme (such as psychotherapy or medication). Results showed a significantly greater improvement in depressive symptoms in the dietary group compared to the control, with 1/3 reaching remission at 12 weeks. The specific mechanisms by which dietary patterns may impact depressive symptoms is unknown, however, hypotheses include via inflammatory and oxidative stress pathways as well as the gut microbiota and the gut-brain axis. What I think is important to note is, the improvements seen in the study were independent of weight change. Often weight is overly relied on as a measure of health and I think it’s worth making clear that improvements in mood were not a result of weight loss. 

Eating Well with Mental Illness 

Severe mental illness is associated with poorer health outcomes and a significantly reduced life expectancy4. Reasons for this may include decreased income due to an inability to work, self-neglect, poor diet, the effect of some psychotropic medications and the effect of stress and trauma on the immune system. As well as exclusion and stigma within healthcare services and a reduced likelihood of seeking medical help5. In other words, those suffering with mental illness face significant health inequalities.  

Research into diets that may improve mental health is incredibly important. However, for somebody in the depths of mental illness, being able to eat an adequate diet and look after themselves in general can feel impossible. Social media is inundated with art-worthy bowls of oats, influencers spending hours making the perfect ‘Buddha bowl’ and green smoothies containing 10+ ingredients. For individuals struggling with their mental health, getting out of bed and showered can be a difficult task, let alone recreating these meals. To be bombarded with images like this and the message that this is what it takes to be ‘healthy’ (not true by the way), can exacerbate feelings of low self-worth and inadequacy. Please know that if all you can manage to do is reach for a sachet of instant porridge or put a piece of toast in the toaster, then you are doing great. Do not let social media or the wellness movement make you feel guilty for this. 

Tips for Eating Well when Struggling

Don’t complicate things 

Meals do not need to be complicated and require lots of ingredients. Try to aim for a portion of carbohydrates (wholemeal if possible) e.g. bread, pasta, rice or potatoes, a portion of protein e.g. meat, fish or veggie sources (beans, tofu, soy, eggs), a portion of fruit or vegetables and a source of fat e.g. cheese, olive oil or nuts at each meal. It can also be a good idea to freeze meals so that on difficult days they can simply be re-heated. 

For example, a simple and balanced meal could be wholemeal pasta with tuna mayonnaise, sweetcorn and grated cheese. 

Fresh isn’t always best  

Convenience is often seen as a negative connotation when it comes to diet. However, contrary to what we are often told by wellness influencers, convenience doesn’t automatically mean food is unhealthy. For example, it can be really useful to use frozen or tinned vegetables rather than fresh. These are not only cheaper but require less preparation and also means you don’t have to worry about not managing to use something before it’s use by date. Jarred or packet sauces can also help to enhance a meals flavour without considerably adding to preparation time. 

Food, family and friends 

Often the thought of socialising can be difficult when struggling with mental illness, resulting in isolation and further adding to feelings of low mood.  Although it can be difficult to reach out to those around us, food can be a useful way to interact with others, whether that is seeing a friend for lunch or preparing and eating dinner with family members. Social eating is also a key concept of the MD discussed earlier. 

Comfort  

When we hear the term ‘comfort food’, we automatically associate this with an unhealthy habit. We are told that comfort eating is bad for us, that emotional eating is something that should be avoided. Using food as our only way of coping with our emotions is not ideal, however, eating or cooking your favourite meal in an attempt to boost your mood is not something that should be frowned upon. Nourishment is an act of self-care, something some people with mental health problems struggle with. Often individuals feel underserving of things that make them feel good. Spending time preparing a meal you enjoy or perhaps used to have as a child can be an important way to show yourself some compassion and kindness. 

Resources and Support 

Mind: https://www.mind.org.uk/

Young Minds: https://youngminds.org.uk/

Mental Health Foundation: https://www.mentalhealth.org.uk/

Rethink Mental Illness: https://www.rethink.org/

Samaritans: https://www.samaritans.org

Beat: www.b-eat.co.uk 

References 

1. The King’s Fund and Centre for Mental Health (2012). Long-Term Conditions and Mental Health. The Cost of Co-morbidities. London.

2. Who.int. (2018). Depression. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/depression [Accessed 12 May 2019].

3. Jacka, F., O’Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., Chatterton, M., Brazionis, L., Dean, O., Hodge, A. and Berk, M. (2017). A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Medicine, 15(1).

4. Chang, C., Hayes, R., Perera, G., Broadbent, M., Fernandes, A., Lee, W., Hotopf, M. and Stewart, R. (2011). Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London. PLoS ONE, 6(5), p.e19590.

5. Makurah, L. (2019). Health Matters: Reducing health inequalities in mental illness – Public health matters. [online] Publichealthmatters.blog.gov.uk. Available at: https://publichealthmatters.blog.gov.uk/2018/12/18/health-matters-reducing-health-inequalities-in-mental-illness/ [Accessed 12 May 2019].

6. Turner, P. and Lefevre, C. (2017). Instagram use is linked to increased symptoms of orthorexia nervosa. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 22(2), pp.277-284.

Diet and Depression

This is a topic I’ve been wanting to write about for ages and a media quote has spurred me on. I think we all know someone suffering from depression and the incidence seems to be on the rise. Depression is a multi-factorial disorder, something that was highlighted to me in a conversation to a journalist this week. I don’t believe that just changing one thing will be the cure. You can have the perfect diet but could still suffer, so instead it’s seeing diet as part of the picture and combining this with medication, therapy, sleep patterns, exercise and all round lifestyle.

Looking through some of the recent evidence on diet and depression an instant pattern emerges. Eating a balanced diet that relies less on processed convenience foods and more on eating from scratch is the answer. More fruit and veggies, wholegrains, olive oil, fish, low fat dairy is associated with a decreased risk of depression. 

An antidepressant food score was worked out by researchers, looking at the nutrient density of foods that have clinical evidence for helping in depression. The top foods were oyster, seafood, organ meats, leafy greens, lettuce, peppers and cruciferous vegetables. 

Top antidepressant nutrients (in no particular order):

Folate

Iron

Omega 3’s 

Magnesium

Potassium

Selenium

Thiamine

Vitamin A

Vitamin B6

Vitamin B12

Vitamin C

Zinc

Tryptophan

Fluid

Now it’s usually more helpful to think about nutrients in terms of foods, so here are some top ways you can boost your antidepressant nutrient intake.

  1. Eat regular meals – the brain needs glucose as fuel and eating regularly helps prevent blood sugars dropping too low which can give symptoms of fatigue, tiredness, lethargy.
  2. Include healthy fats in the diet  to nourish the brain. Oily fish, nuts, seeds, olive oil are all good ones. Aim for 2 portions of oily fish a week.
  3. Wholegrain foods are good sources of zinc, and B vitamins. Think wholegrain bread products, brown rice, brown pasta, grains.
  4. Ensure you eat protein regularly for tryptophan, iron and zinc. Tryptophan is thought to play a key role as it is a precursor for the neurotransmitter serotonin. Wholegrains, fish, poultry, eggs and seeds can help with this.
  5. Green leafy veggies contain folate, iron, potassium and magnesium plus vitamin C. Another reason to get crunching your veggies.
  6. Orange veggies such as sweet potatoes, orange peppers, carrots and apricots plus green leafy veggies are sources of vitamin A.
  7. Even slight dehydration can affect your mood. The brain is 78% water. Reducing caffeine and replacing with non caffeinated drinks, mainly water will help. Moderate intake of alcohol can be ok but watch the interactions with medications and too much alcohol can increase anxiety/depression.

Following a Mediterranean style of eating with a focus on fruit, vegetables, wholegrains, protein, oily fish and healthy fats is a great way to help combat depression. It may not be the cure but it is definitely a large part of the puzzle. 

Dietary patterns and depression risk: A meta-analysis. Psychiatry Research, July 2017

Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies. Journal of Affective Disorders, January 15, 2018

Antidepressant foods: An evidence-based nutrient profiling system for depression. World J Psychiatry. 2018 Sep 20;8(3):97-104