Dietary and lifestyle support to mental health outcomes

Mental wellbeing is crucial for both societal prosperity and individual functioning. Recent statistics state that roughly 3 million Australians are living with either anxiety or depression. Given the current state of the world right now, it is unfortunately no surprise that many of us are feeling this way. According to the Australian Journal of General Practice, mental illness is the single most common reason for patients to visit a general practitioner (GP). Severe mental illness has shown to shorten life span by 10-20 years when compared to the general population, mostly due to the physical impacts of chronic disease. Poor mental health is associated with low income earning potential, unemployment, deprivation, poor education, poor physical health and engaging in behaviour that has a negative effect on health.

So what does the term ‘mental health’ really mean?

Mental Health is usually a blanket term for mental health conditions like depression, anxiety, schizophrenia, bipolar disorders and dysthymia (pervasive low mood).

The World Health Organization frames mental health as a state of wellbeing rather than illness, referring to it as, “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to the community".

Dietary and lifestyle impacts

Evidence suggests that dietary and lifestyle interventions have a significant impact on physical and mental health, quality of life and life expectancy when suffering from mental illness. Of course there are a number of other key influences that play crucial roles in the support and treatment of people suffering from mental illness. Here we explore the impacts of nutrition and lifestyle on mental health outcomes.

Research has demonstrated an association between the quality of diet and the risk of developing depression. For example, pro-inflammatory diet patterns have been shown to have a significantly higher incidence of symptoms of depression, even in people who have not previously been diagnosed with Major Depressive Disorder.

Dietary changes have also been shown to have a positive impact on multiple pathways in the body including reduced oxidative stress, inflammation and dysfunction of the mitochondria; and the promotion of the expression of Brain Derived Neurotropic Factor (BDNF) which in turn influences neuroplasticity.

The gut microbiome plays an important role in the modulation of the stress response, immune function, mood regulation and cognition. Consumption of dietary fibre can not only assist as a prebiotic (assists probiotic bacteria to thrive) but can also influence the composition of the microbiota itself.

Traditional whole foods dietary patterns

The Mediterranean Diet has been recommended in a number of nutritional guidelines for the treatment and prevention of disorders of the brain. However, the Mediterranean diet is just one example of a dietary pattern shown to confer health benefits. In general, diets that include lean meats, seafood, green leafy vegetables, legumes, nuts and fresh seasonal fruit are likely to be beneficial for mental health. Consistent dietary consumption of traditional whole foods that are rich nutrients and contain lower amounts of highly processed food have been shown to be of greatest benefit for both physical and mental health.

OMEGA-3 (EPA/DHA)

EPA and DHA fatty acids have been found to be effective in reducing symptoms of depression due to their anti-inflammatory activity and involvement in maintaining membrane integrity and fluidity.

IRON

Iron has been shown to play an important role in neurological development and function. Iron deficiency anaemia can results in impairment of monoamine metabolism and myelination in the brain. This can influence neurotransmitter homeostasis that causes emotional and psychological problems as well as deficits in behaviour, memory and learning.

MAGNESIUM

Magnesium is an essential nutrient involved in multiple functions of the central nervous system, including brain function and mood. There is some suggestion that magnesium may play a role in the physiopathology of depression. Magnesium affects glutamatergic transmission of the limbic system and cerebral cortex, HPA axis regulation, oxidative stress and inflammation, BDFN expression, modulation of serotonin, dopamine and noradrenaline and modulation of the sleep-wake cycle.

VITAMIN C

Vitamin C plays an important role in modulating neurotransmitter synthesis and release in the brain. Vitamin C is a cofactor in the conversion of dopamine to noradrenaline, and is involved in the modulation of dopaminergic and glutamatergic neurotransmission and exhibits antioxidant properties in the brain.

VITAMIN D

Vitamin D plays an integral role in cognitive functions and mental health. Vitamin D receptors are present within the brain, including the amygdala. The amygdala is directly associated with regulating emotions and behaviours. Deficiency in vitamin D has been linked with mood disorders and neuropsychiatric conditions. The factors contributing to vitamin D deficiency include low dietary intake, reduce exposure to sunshine, lack of physical activity and smoking.

B VITAMINS

Deficiencies in certain micronutrients like B12 or folate are associated with an increased risk of depression. Serotonergic and dopaminergic neurotransmitter synthesis and regulation require B vitamins as cofactors due to their role in one-carbon metabolism. B vitamins may play a role in the modulation of neurotransmitter function that can influence mood.

ZINC

Low intake of zinc has been associated with depression, altered cognition and behaviour and the reduced ability to learn. Similar to magnesium, zinc intake affects production of brain-derived neurotropic factor (BDNF).

Physical activity improves mental health outcomes

Physical activity and exercise has also been used as a fundamental management option for depressive disorders and those suffering from schizophrenia. Evidence has shown that physical activity can be just as effective as medication and psychotherapy in improving quality of life and symptoms of depression and anxiety, as well as assisting to reduce tension, headaches, phobias, and dysfunctional and psychotic behaviours.

Physical exercise may enhance neuroplasticity. Neuroplasticity is an important feature of the nervous system that has been shown to respond to exercise. Exercise has been shown to facilitate the increase in blood flow improving cerebrovascular health, releasing neurotropic factors like peripheral BDNF and can metabolise glucose and lipids to carry “food” to the brain. In relation to cognitive functioning, exercise can lead to improvements in attentional processing, memory and executive-control processes.

References:

1. Beyond Blue – What is mental health

https://www.beyondblue.org.au/the-facts/what-is-mental-health

2. Botturi, A., Ciappolino, V., Delvecchio, G., Boscutti, A., Viscardi, B., & Brambilla, P. (2020). The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients, 12(6), 1661. https://doi.org/10.3390/nu12061661

3. Cuomo, A., Maina, G., Bolognesi, S., Rosso, G., Crescenzi, B., Zanobini, F., GOracci, A., Facchi, E., Favaretto, E., Baldini, I., Santucci, A., Fagiolini, A. (2019). Prevalence and Correlates of Vitamin D Deficiency in a Sample of 290 Inpatients with Mental Illness. Frontier in Psychiatry. https://www.frontiersin.org/articles/

4. Firth, J., Marx, W., Dash, S., Carney, R., Teasdale, S. B., Solmi, M., Stubbs, B., Schuch, F. B., Carvalho, A. F., Jacka, F., & Sarris, J. (2019). The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials. Psychosomatic medicine, 81(3), 265–280. https://doi.org/10.1097/PSY.0000000000000673

5. Manger, S. (2019). Lifestyle interventions for mental health. Australian Journal of General Practitioners, 48(10). https://www1.racgp.org.au/ajgp/2019/october/lifestyle-interventions-for-mental-health

6. LaChance, L. R., & Ramsey, D. (2018). Antidepressant foods: An evidence-based nutrient profiling system for depression. World journal of psychiatry, 8(3), 97–104. https://doi.org/10.5498/wjp.v8.i3.97

7. Lee, HS., Chao, HH., Huang, WT. et al. Psychiatric disorders risk in patients with iron deficiency anemia and association with iron supplementation medications: a nationwide database analysis. BMC Psychiatry 20, 216 (2020). https://doi.org/10.1186/s12888-020-02621-0

8. Liao, Y., Xie, B., Zhang, H. et al. Efficacy of omega-3 PUFAs in depression: A meta-analysis. Transl Psychiatry 9, 190 (2019). https://doi.org/10.1038/s41398-019-0515-5

9. Mandolesi, L., Polverino, A., Montuori, S., Foti, F., Ferraioli, G., Sorrentino, P., & Sorrentino, G. (2018). Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits. Frontiers in psychology, 9, 509. https://doi.org/10.3389/fpsyg.2018.00509

10. Petrilli, M. A., Kranz, T. M., Kleinhaus, K., Joe, P., Getz, M., Johnson, P., Chao, M. V., & Malaspina, D. (2017). The Emerging Role for Zinc in Depression and Psychosis. Frontiers in pharmacology, 8, 414. https://doi.org/10.3389/fphar.2017.00414

11. Plevin, D., Galletly, C. The neuropsychiatric effects of vitamin C deficiency: a systematic review. BMC Psychiatry 20, 315 (2020). https://doi.org/10.1186/s12888-020-02730-w

12. Young, L. M., Pipingas, A., White, D. J., Gauci, S., & Scholey, A. (2019). A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and 'At-Risk' Individuals. Nutrients, 11(9), 2232. https://doi.org/10.3390/nu11092232

Dietary and lifestyle support to mental health outcomes

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