Dr. David Koehn is a psychologist practicing in Fort Myers, FL. Dr. Koehn specializes in the treatment of mental health problems and helps people to cope with their mental illnesses. As a psychologist, Dr. Koehn evaluates and treats patients through a variety of methods, most typically being psychotherapy or talk therapy.... more
Nutrition and Mental Heath
Dr. David J. Koehn
Taken from several sources on the internet, here is a synopsis of nutrition and mental health. Being a systems mental health professional, I look for interconnecting elements that play well together for improving mental well-being. Nutrition and natural supplements are part of the equation and need to be taken seriously.
Nutritional Mental Health: Your Brain on Food
Think about it. Your brain is always “on.” It takes care of your thoughts and movements, your breathing and heartbeat, your senses — it works hard 24/7, even while you’re asleep. This means your brain requires a constant supply of fuel. That “fuel” comes from the foods you eat — and what’s in that fuel makes all the difference. Put simply, what you eat directly affects the structure and function of your brain and, ultimately, your mood.
Like an expensive car, your brain functions best when it gets only premium fuel. Eating high-quality foods that contain lots of vitamins, minerals, and antioxidants nourishes the brain and protects it from oxidative stress — the “waste” (free radicals) produced when the body uses oxygen, which can damage cells.
Unfortunately, just like an expensive car, your brain can be damaged if you ingest anything other than premium fuel. If substances from “low-premium” fuel (such as what you get from processed or refined foods) get to the brain, it has little ability to get rid of them. Diets high in refined sugars, for example, are harmful to the brain. In addition to worsening your body’s regulation of insulin, they also promote inflammation and oxidative stress. Multiple studies have found a correlation between a diet high in refined sugars and impaired brain function — and even a worsening of symptoms of mood disorders, such as depression.
It makes sense. If your brain is deprived of good-quality nutrition, or if free radicals or damaging inflammatory cells are circulating within the brain’s enclosed space, further contributing to brain tissue injury, consequences are to be expected. What’s interesting is that for many years, the medical field did not fully acknowledge the connection between mood and food.
Today, fortunately, the burgeoning field of nutritional psychiatry is finding there are many consequences and correlations between not only what you eat, how you feel, and how you ultimately behave, but also the kinds of bacteria that live in your gut.
How the Foods you Eat Affect How you Feel
Serotonin is a neurotransmitter that helps regulate sleep and appetite, mediate moods, and inhibit pain. Since about 95% of your serotonin is produced in your gastrointestinal tract, and your gastrointestinal tract is lined with a hundred million nerve cells, or neurons, it makes sense that the inner workings of your digestive system don’t just help you digest food, but also guide your emotions. What’s more, the function of these neurons — and the production of neurotransmitters like serotonin — is highly influenced by the billions of “good” bacteria that make up your intestinal microbiome. These bacteria play an essential role in your health. They protect the lining of your intestines and ensure they provide a strong barrier against toxins and “bad” bacteria; they limit inflammation; they improve how well you absorb nutrients from your food, and they activate neural pathways that travel directly between the gut and the brain.
Studies have compared “traditional” diets, like the Mediterranean diet and the traditional Japanese diet, to a typical “Western” diet and have shown that the risk of depression is 25% to 35% lower in those who eat a diet that builds and supports healthy mitochondria – the energizer bunny for every organ in the human body. Scientists account for this difference because these “mitochondria” diets tend to be high in vegetables, fruits, unprocessed grains, and fish and seafood. They: (1) contain only modest amounts of lean meats and dairy as well as eliminate sugar and minimize salt; and (2) avoid processed and refined foods which are staples of the “Western” dietary pattern. In addition, many of these unprocessed foods are fermented, and therefore act as natural probiotics. In my practice, I recommend the mitochondria plan to my patients. This may sound implausible to you, but the notion that good bacteria not only influence what your gut digests and absorbs but that they also affect the degree of inflammation throughout your body, as well as your mood and energy level, is gaining traction among researchers.
Nutritional Mental Health: What Does it Mean for you?
Start paying attention to how eating different foods make you feel. Not just in the moment, but the next day. Try eating a “clean” diet for two to three weeks — that means cutting out all processed foods and sugar. See how you feel. Then slowly introduce foods back into your diet, one by one, and see how you feel. When some people “go clean,” they cannot believe how much better they feel both physically and emotionally, and how much worse they then feel when they reintroduce the foods that are known to enhance inflammation.
Why Nutritional Mental Health is the Future of Mental Health Treatment
A lack of essential nutrients is known to contribute to the onset of poor mental health in people suffering from anxiety and depression, bipolar disorder, schizophrenia, and ADHD. Nutritional Mental Health is a growing discipline that focuses on the use of food and supplements to provide these essential nutrients as part of an integrated or alternative treatment for mental health disorders. Nutritional approaches for these debilitating conditions are not widely accepted by mainstream medicine. Treatment options tend to be limited to official National Institute for Care Excellence (NICE) guidelines which recommend talking therapies and antidepressants.
Use of Antidepressants
Antidepressant use has more than doubled in recent years. In England, 64.7m prescriptions were issued for antidepressants in 2016 at a cost of £266.6m. This is an increase of 3.7m on the number of items prescribed in 2015 and more than double the 31m issued in 2006. In the USA, during 2015–2018, 13.2% of adults used antidepressants in the past 30 days Use was higher among women (17.7%) than men (8.4%). The percentage of antidepressant use increased with age, from 7.9% among adults aged 18–39 to 14.4% for those aged 40–59 to 19.0% for those aged 60 and over.
A recent Oxford University study found that antidepressants were more effective in treating depression than placebos. The study was led by Dr. Andrea Cipriani who claimed that depression is under-treated. Cipriani maintains that antidepressants are effective and a further 1m prescriptions should be issued to people in the UK. This approach suggests that poor mental health caused by social conditions is viewed as easily treated by simply dispensing drugs. But antidepressants are shunned by people whom they could help because of the social stigma associated with mental ill-health which leads to discrimination and exclusion.
Prescriptions for 64.7m items of antidepressants were dispensed in England in 2016, the highest level recorded by the National Health Service (NHS). The data in the USA is also staggering. More worrying is the increase in the use of antidepressants by children and young people. In Scotland, 5,572 children under 18 were prescribed antidepressants for anxiety and depression in 2016. This figure has more than doubled since 2009/2010. According to British psycho-pharmacologist, Professor David Healy, 29 clinical trials of antidepressant use in young people found no benefits at all. These trials revealed that instead of relieving symptoms of anxiety and depression, antidepressants caused children and young people to feel suicidal. Healy also challenges their safety and effectiveness in adults. He believes that antidepressants are over-prescribed and that there is little evidence that they are safe for long-term use. Antidepressants are said to create dependency, have unpleasant side effects, and cannot be relied upon to always relieve symptoms.
Nutrition and Poor Mental Health
In developed countries such as the UK, people eat a greater variety of foodstuffs than ever before – but it doesn’t follow that they are well-nourished. In fact, many people do not eat enough nutrients that are essential for good brain health, opting for a diet of heavily processed food containing artificial additives and sugar.
The link between poor mental health and nutritional deficiencies has long been recognized by nutritionists working in the complementary health sector. However, psychiatrists are only now becoming increasingly aware of the benefits of using nutritional approaches to mental health, calling for their peers to support and research this new field of treatment.
It is now known that many mental health conditions are caused by inflammation in the brain which ultimately causes our brain cells to die. This inflammatory response starts in our gut and is associated with a lack of nutrients from our food such as magnesium, omega-3 fatty acids, probiotics, vitamins, and minerals that are all essential for the optimum functioning of our bodies.
Recent research has shown that food supplements such as zinc, magnesium, omega 3, and vitamins B and D3 can help improve people’s mood, relieve anxiety and depression, and improve the mental capacity of people with Alzheimer’s. Magnesium is one of the most important minerals for optimal health, yet many people are lacking in it. One study found that a daily magnesium citrate supplement led to a significant improvement in depression and anxiety, regardless of age, gender, or severity of depression. Improvement did not continue when the supplement was stopped. Omega-3 fatty acids are another nutrient that is critical for the development and function of the central nervous system – and a lack has been associated with low mood, cognitive decline, and poor comprehension.
Research has shown that supplements like zinc, magnesium, and vitamins B and D can improve the mental capacity of people with Alzheimer’s. The role of probiotics – the beneficial live bacteria in your digestive system – in improving mental health has also been explored by psychiatrists and nutritionists, who found that taking them daily was associated with a significant reduction in depression and anxiety. Vitamin B complex and zinc are other supplements found to reduce the symptoms of anxiety and depression.
Hope for the Future?
These over-the-counter" supplements are widely available in supermarkets, chemists, and online health food stores, although the cost and quality may vary. For people who have not responded to prescription drugs or who cannot tolerate the side effects, nutritional intervention can offer hope for the future.
There is currently much debate over the effectiveness of antidepressants. The use of food supplements offers an alternative approach that has the potential to make a significant difference to the mental health of all age groups. The emerging scientific evidence suggests that there should be a bigger role for nutritional psychiatry in mental health within conventional health services. If the burden of mental ill-health is to be reduced, GPs and psychiatrists need to be aware of the connection between food, inflammation, and mental illness.
Medical education has traditionally excluded nutritional knowledge and its association with disease. This has led to a situation where very few doctors in the UK have a proper understanding of the importance of nutrition. Nutritional interventions are thought to have little evidence to support their use to prevent or maintain well-being and so are left to dietitians, rather than doctors, to advise on. But as the evidence mounts up, it is time for medical and mental health education to take nutrition seriously so that medical and mental health professionals of the future know as much about its role in good health as they do about anatomy, physiology, and psychological wellness. The state of our mental health could depend on it. While in its infancy, the idea of including nutrition into the curricula of mental health and medical doctors is changing. My daughter, Dr. Deborah Koehn, for example, who is an internist and specializes in diabetes and lipids, heads up a nutrition center and teaches classes at Virginia Medical College on nutrition and eating healthy.
In my practice, I often have patients take Dr. Amen’s Brain Fit Assessment. A video explaining the results is sent to the patient as well as a Brain Type Report. Part of the recommendations that we data mind together deal with nutrition and the use of natural supplements. Launched in 2009, BrainMD is founded and run by Dr. Amen with a mission to help the world feel better, brain first. Daniel G. Amen, MD is a renowned psychiatrist, clinical neuroscientist, New York Times bestselling author, and to his patients, he is the man who has helped hundreds of thousands of people feel healthier, clearer, and more alive with a 360-approach to brain health. He and his clinical research team are backed by decades of experience and incorporate the latest science and medical data into every BrainMD product, from cutting-edge brain-directed supplements to online courses that help illuminate the real-life actions that you can take for a better brain and better life.