By Carla Gerryts, Registered Dietitian (RD SA)
Mental health conversations have become more open and widespread than ever before. As our understanding evolves, research is increasingly pointing to nutrition as a critical factor influencing mental wellbeing.
Mental health is shaped by a complex interaction of biological, psychological, and social factors. Optimising nutrition may be the missing link that supports both prevention and treatment outcomes.
Nutrition: the missing piece to the mental health puzzle
From soft whispers behind closed doors and “keeping problems private and in the family” to Gen Z’s proudly discussing their insights after a therapy session during break, the conversation around mental health has become louder and bolder than ever before.
As we grow in our understanding of mental health conditions, an evolving body of research look towards the intricate relationship between nutrition and mental health as a crucial point of intervention for improved outcomes. It is currently understood that mental health is influenced by a complex interplay of genetic, psychological, and social factors. Optimising nutrition as a preventative and treatment strategy is gaining traction and might be the missing piece in your mental health puzzle that connects every intervention seamlessly.
Why do people that experience mental health struggles often have difficulty with their nutrition?
For the person struggling with mental health, nutrition can become a contentious issue. It takes energy to buy and prepare food, physically and mentally. For someone in the thick of a depressive episode, the thought of meal prep and following a recipe is close to impossible. The ability to plan and prepare balanced meals is self-actualisation, on top of Maslow’s hierarchy of needs, and an unrealistic expectation for someone in survival mode. This often leads to a catch-22 situation: nutritional status decrease, decreasing mental health, decreasing nutritional status…The cycle can be broken by providing support and providing practical, realistic strategies to provide the body with the nutrients that it needs.
The research speak for itself
One of the most interesting studies on the subject is the SMILES trial. The SMILES trial, a landmark randomised controlled study, demonstrated that a Mediterranean-style diet significantly reduced depressive symptoms in people with major depressive disorder compared to a control group only receiving social support. Post-intervention, a third of the participants in the dietary support group met the criteria for remission compared to 8% of the control group.
This guides us towards exploring the Mediterranean diet as an excellent starting point in dietary modification. The typical Mediterranean diet consists of whole grains, plenty of vegetables and fruits, lean proteins and high in Omega 3 fatty acids. On the flipside, the SAD (Standard American Diet) that is high in refined carbohydrates, trans and saturated fats, sugar as well as ultra-processed foods are associated with an increased risk of mood disorders.
Specific nutrients that is worth having a look at
There are specific micronutrients that are worth incorporating to support your mood and cognitive function:
- Omega-3 fatty acids (EPA and DHA) support neuronal membrane fluidity and reduce inflammation. Supplementation is worth considering and vegan options is also available in the form of microalgae as an example.
- B vitamins, particularly folate, B6, and B12, are crucial for one-carbon metabolism and neurotransmitter synthesis. Deficiencies exacerbate poor energy levels and have been associated with mood disturbances.
- Vitamin D receptors are widespread in the brain, and low vitamin D status has been associated with depressive symptoms. It is tempting to think that, living in South Africa, it is impossible to be deficient in Vitamin D. However, from clinical practice, I can assure you that it is not the case and exposure/consumption does not always guarantee absorption/utilization by the body.
- Minerals such as zinc, magnesium, and iron are essential cofactors in neurotransmitter function, with deficiencies correlated with increased risk of anxiety and depression.
- Polyphenols from plant foods exhibit antioxidant and anti-inflammatory effects, with emerging evidence for cognitive and mood benefits.
I have heard about the gut-brain connection: can you tell me more about it?
The gut-brain axis is a complex system and central to the nutrition–mental health connection. This bidirectional communication system connects the gastrointestinal tract and the central nervous system. The gut microbiota contributes to the production (such as serotonin, dopamine, and gamma-aminobutyric acid) and influences immune function, stress reactivity, and inflammation. Here is where fermented foods such as kombucha, kefir and as more commonly consumed sources yoghurt and pickles is encouraged to be included in the diet. Dysbiosis, or an imbalance of gut bacteria, has been associated with anxiety, depression, and cognitive decline.
Final observations and key takeaways
All points of intervention can be summarised in a singe word: anti-inflammatory. Lots of research even describes depressive disorders as an inflammatory disease of the brain. Pro-inflammatory diets (high in trans fats and refined sugars) can exacerbate oxidative stress, impair neuroplasticity, and contribute to depressive symptoms. Anti-inflammatory diets, on the other hand, help support resilience against stress and promote overall brain health.
If you don’t know where to start: optimize hydration, prioritize protein and protein distribution, don’t shy away from foods rich in Omega 3 fatty acids, include complex carbohydrates high in fibre, fruits and vegetables and keep it simple.
Small changes, big impact!