Nutrition and Mental Health

As a nutrition and dietetics student I developed an interest in the field of behavioral health nutrition. The idea that nutritional deficiencies or a variety of medical disorders could produce symptoms that mimicked psychiatric abnormalities [1] resonated with me early in my academic exploratations. The links between nutrition and mental health appeared to be a promising new area of investigation. In the past decade, research on the gut microbiome has documented compelling evidence that the bacteria flora in our intestines have a direct link to our brain and that these pathways are bidirectional [2]. As a registered dietitian nutritionist (RDN) working with patients with co-existing mental health conditions, I have observed an association between diet and depression. Practice experience has shown that dietary improvement can reduce some depressive symptoms [3]. Given that mental illness is a major public health problem, an emerging field known as nutritional psychiatry has received increased attention [4].
There are established links between depression and chronic diseases such as obesity [5], metabolic syndrome [6], and type 2 diabetes [7]. There are also associations between depressive symptoms and inflammatory bowel disease [8], as well as disordered eating [9]. Recent evidence suggests that altering the composition of the gut microbiome can lead to depressive-like behavior in animal models [10]. Because the human microbiome is highly influenced by foods that we eat, there may be an opportunity to improve depressive-like symptoms through dietary interventions. Randomized controlled human trials have shown that nutrition interventions can provide alternative or adjunct treatment for depression in common conditions such as obesity and type 2 diabetes [11]. The most common dietary recommendation is a Mediterranean-style diet with early trials showing a reduction in depressive symptoms [12,13]. Given the likelihood that nutrition can improve some depression-related symptoms, targeted dietary interventions should be considered a public health priority.

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  2. Evrensel, A., and Ceylan, M.E., The gut-brain axis: the missing link in depression. Clinical Psychopharmacology and Neuroscience, 2015. 13(3): p. 239-244.
  3. Li, Y., et al., Dietary patterns and depression risk: a meta-analysis. Psychiatry Research, 2017. 253: p. 373-382.
  4. Marx, W., et al., Nutritional psychiatry: the present state of the evidence. Proceedings of the Nutrition Society, 2017. doi:10.1017/S0029665117002026
  5. Garcia-Toro, M., et al., Obesity, metabolic syndrome and Mediterranean diet: impact on depression outcome. Journal of Affective Disorders, 2016. 194: p. 105-108.
  6. Ohmori, Y, et al., Associations between depression and unhealthy behaviors related to metabolic syndrome: a cross sectional study. Asia Pacific Journal of Clinical Nutrition, 2017. 26(1): p. 130-140.
  7. Dipnall, J.F., et al., The association between dietary patterns, diabetes and depression. Journal of Affective Disorders, 2015. 174: p. 215-224.
  8. Bhandari, S., et al., Association of inflammatory bowel disease (IBD) and depressive symptoms in the Unites States population and independent predictors of depressive symptoms in an IBD population: a NHANES study. Gut and Liver, 2017.
  9. Kim, O. et al., Binge eating disorder and depressive symptoms among females of child-bearing age: the Korea Nurses Health Study. BMC Psychiatry, 2018. 18:13.
  10. Wong, M-L., et al., Inflammasome signaling affects anxiety- and depressive-like behavior and gut microbiome composition. Molecular Psychiatry, 2016. 21: p. 797-805.
  11. O’Neil, A., et al., A randomized, controlled trial of a dietary intervention for adults with major depression (the “SMILES” trial): study protocol. BMC Psychiatry, 2013. 13:114.
  12. Parletta, N., et al., A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: a randomized controlled trial (HELFIMED). Nutritional Neuroscience, 2017. doi:10.1080/1028415X.2017.1411320
  13. Sanchez-Villegas, A., et al., Mediterranean dietary pattern and depression: the PREDIMED randomized trial. BMC Medicine, 2013. 11:208

Nutrition and Mental Health

Dr. David Wiss became a Registered Dietitian Nutritionist (RDN) in 2013 and founded Nutrition in Recovery, a group practice of RDNs specializing in treating eating and substance use disorders. In 2017, David received the “Excellence in Practice” award at the National Food and Nutrition Conference and Expo. The California Academy of Nutrition and Dietetics awarded him the “Emerging Dietetic Leader Award” in 2020. He earned his Ph.D. from UCLA’s Fielding School of Public Health in the Community Health Sciences department (with a minor in Health Psychology) by investigating the links between adverse childhood experiences and various mental health outcomes among socially disadvantaged men. His treatment philosophy is based on a biopsychosocial model which incorporates an understanding of biological mechanisms, psychological underpinnings, and contextual factors that integrate the social determinants of health. Wise Mind Nutrition is an app-based interactive treatment program available for download now -

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