Nutritional Psychiatry: Better Food, Better Mood

Nutritional psychiatry simply means foods can influence your mental well being. Your food choices may be one of the reason why you are feeling extra anxious, snappy or depressed.

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It might not be as bizarre as you think; you are what you eat. Eating junk foods will turn your body into a junkyard; wholesome foods will make your body, well, whole.

What is nutritional psychiatry?

Nutritional psychiatry is a therapeutic approach that focuses on the role of diet and nutrition in mental ill-health. Evidence are showing that our diet and our gut microbiota can protect (or harm) our mental health. In other words, what you eat will directly affect your mood and behaviour.

Think of your body as a car. It will run smoother and perform better with a high-end, premium fuel. The car might be able to run anyway on cheap fuel, but it might suffer on performance and break down a lot quicker.

Diet quality can be a modifiable risk factor for mental illness.

Now, think of your organs in your body as car parts. the wires that connect these car parts enable the car to run smoothly (please pardon the simplification of an automobile system). Similarly, our nerves connect the organs in our body. This enable effective interaction between, for example, our digestive tract and the brain.

This gut-brain highway is complex; it does more than maintaining our gut homeostasis. It also influences our feelings, motivations, and higher cognitive functions. Our gut-brain highway has a two-way system; the gut can send information to the brain and likewise, the brain can send information to the gut.

Your gut and your brain has a bidirectional relationship (the brain-gut axis)

Just as your brain can send butterflies to your stomach before going for that math exam, your gut can also send its state of calm (or tense) to the nervous system.

The brain-gut axis involve the interaction between the central nervous system (CNS) (brain and spinal cord) and the enteric nervous system (ENS) (a network of neurons within the walls of the gastrointestinal tract that can control GI behaviour independent of CNS input).

The brain-gut axis

Other than CNS and ENS, the brain gut axis also involves:

The autonomic nervous system (ANS)

  • A component of the peripheral nervous system that regulates involuntary physiologic processes eg. heart rate, respiration, digestion;

and the hypothalamic pituitary adrenal (HPA) axis

  • The central stress response system that coordinates the adaptive responses of the organism to stressors of any kind.

What is gut microbiota?

Gut microbiota is the collection of bacteria, archaea, and eukarya colonising the GI tract. It includes both the good and the bad microbes.

Our gut microbiota is quite attuned to our moods and feelings. Psychological stressors can modify our enteric microbiota in as little as 2 hours.

Our gut microbiota can be modulated by our diet, among other things. A change in your diet may therefore, result in a change of mood. Our brain, gut, and microbiome work as a single synergistic system. This system is often referred to as the brain gut microbiome axis.

How is our gut and mental health connected?

How does microbes that live in the colon can influence such a remote organ like the brain? The ‘wiring’ that connects our brain and gut microbiota is our vagus nerve.

Bacterial products from the gut can directly influence our nervous system

Bacterial products such as short chain fatty acids (SCFA) are absorbed into the blood stream, affecting remote organs such as your brain. SCFA is the fermentation product of undigested carbohydrates such as cereals, vegetables, and fruits. Studies have shown that SCFA may have an influence in our behaviour12.

Our gut bacteria can modify our neurotransmitters

Gut bacteria in rats and humans has been shown to stimulate the production of the happy hormone, serotonin, and tryptophan (precursor of serotonin). Bifidobacterium infantis, a strain of friendly bacteria that is naturally found in our gut, can increase the concentration of tryptophan.

How well do you know your happy hormone?

Well done if you know the answer!

People with depressive symptoms are often prescribed with selective serotonin reuptake inhibitor or SSRI. As you may have have predicted, SSRIs common side effects are gut-related. SSRIs such as fluoxetine and fluvoxamine are commonly prescribed anti-depressants. It blocks the reuptake of serotonin, making more serotonin to be available in the body. Common adverse reactions to SSRIs such as loss of appetite, nausea, upset stomach, bloating, vomiting, or diarrhoea may persist in the first 1 to 2 weeks of taking an SSRI.

Serotonin deficiency has been associated with major depressive disorder (MDD), although there are still a lot to discover with regards to serotonin and the neuropsychology of depression.

A dysregulation of the ‘good’ and the ‘bad bacteria’ is a common cause of functional bowel disorders (eg. irritable bowel syndrome), and it is also implicated in many psychiatric disorders such as anxiety, depression, and schizophrenia. A diet with adequate amount of amino acids, minerals and B vitamins is also crucial in production of neurotransmitters.

Your diet contributes to the health of your brain gut axis.

An imbalance of the ‘good’ and the ‘bad bacteria’ can cause functional bowel disorders (eg. irritable bowel syndrome). It is also implicated in many psychiatric disorders such as anxiety, depression, and schizophrenia.

Why are scientists looking at foods that are affecting our mental health?

Despite the wider use and wider availability of psychotropics and psychotherapies, the burden of depression has not reduced, and potentially on the rise. Unfortunately, non-invasive disease prevention alternatives such as social support, dietary modifications and exercise receive much less attention as opposed to the bold and seeming heroism of pharmaceutical-based interventions. 

Depression is a common disorder, but difficult to treat effectively because:

  • A third of all depressive patients shows resistance to therapy read more
  • Combination therapy of antidepressants and psychotherapy for severe depression shows only moderate effects read more
  • Psychiatric patients often prematurely  discontinue their psychopharmacological treatment due to side effects of antidepressants read more
  • Pharmacotherapy treatment addresses only half of the disease burden read more
  • The risk of relapse among people with depression is high and is often recurrent read more
  • The social stigma that is associated with mental health disorders leads to discrimination and exclusion

Recently, high quality trials have produced promising findings. Nutrition modification perhaps offers the least risk in rehabilitating people with mental health disorders. Keep tabs on your diet, keep your emotions in check, and surprise yourself with how good you can feel.

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