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.
References
- Pollak, J., Levy, S., and Breitholz, T., Screening for medical and neurodevelopmental disorders for the professional counselor. Journal of Counseling & Development, 1999. 77(3): p. 35-358.
- 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.
- Li, Y., et al., Dietary patterns and depression risk: a meta-analysis. Psychiatry Research, 2017. 253: p. 373-382.
- Marx, W., et al., Nutritional psychiatry: the present state of the evidence. Proceedings of the Nutrition Society, 2017. doi:10.1017/S0029665117002026
- Garcia-Toro, M., et al., Obesity, metabolic syndrome and Mediterranean diet: impact on depression outcome. Journal of Affective Disorders, 2016. 194: p. 105-108.
- 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.
- Dipnall, J.F., et al., The association between dietary patterns, diabetes and depression. Journal of Affective Disorders, 2015. 174: p. 215-224.
- 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. https://doi.org/10.5009/gnl16347
- 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.
- Wong, M-L., et al., Inflammasome signaling affects anxiety- and depressive-like behavior and gut microbiome composition. Molecular Psychiatry, 2016. 21: p. 797-805.
- 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.
- 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
- Sanchez-Villegas, A., et al., Mediterranean dietary pattern and depression: the PREDIMED randomized trial. BMC Medicine, 2013. 11:208