Paper
Nutrition and Mental Health
Published Nov 1, 2016 · J. Rucklidge, B. Kaplan
Clinical Psychological Science
14
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Abstract
This series is intended to showcase the diversity of studies being conducted in a new, rapidly emerging field of nutrition and mental health, coined by leaders in the field as nutritional psychiatry (Sarris, Logan, et al., 2015). The series begins with an article by Sánchez-Villegas, Ruiź-Canela, Gea, Lahortiga, and Martínez-González (2016) that fits into the field of nutritional epidemiology but expands it significantly. Over the past decade, there has been a steady increase in epidemiological studies investigating the relationships between dietary patterns and mental states. Both cross-sectional and longitudinal studies have shown that the more one eats a Western or highly processed diet, the more one is at risk for developing psychiatric symptoms such as depression and anxiety. Conversely, the more one eats a diet rich in fruits and vegetables, high in healthy fats, nuts, and fish, and low in processed food (a Mediterranean-style diet), the more one is protected from developing a mental disorder (Akbaraly et al., 2009; Jacka et al., 2010; Jacka et al., 2011; Sánchez-Villegas et al., 2009; Sánchez-Villegas et al., 2012). In several studies, the dietary pattern has been shown to precede the onset of psychiatric symptoms, clearly supporting the direction of causality (dietary pattern does influence mental health, although we tend to attribute poor dietary patterns to being carbohydrate craving induced by low mood). Sánchez-Villegas and colleagues broaden their analyses beyond the Mediterranean diet to Mediterranean lifestyle variables. What they report is of great relevance to our understanding of how lifestyle variables fit together: Dietary pattern, physical activity, and social activities were all independently and inversely associated with risk of depression. Taken together, the reduction in risk for those at the highest levels on all three variables was about 50%. If a drug with no side effects were to be associated with that significant a reduction in risk, it would be prescribed often. Is it time for our health professionals to prescribe Mediterranean diet, physical activity, and social activities? Although some of the research in clinical patients involves intervention (changing dietary habits and examining associated changes in cognitive function and mental symptoms), other studies, such as the article by Chang, Jingling, Huang, Lu, and Su (2016) in the current series, evaluate correlations between some aspect of dietary intake in relation to mental health. In a small group of 21 children diagnosed with attention-deficit/ hyperactivity disorder (ADHD) and 21 non-ADHD controls, three types of variables were compared: n-3 fatty acid intake based on a food frequency questionnaire for the prior 3 months, the physical signs and symptoms known to indicate a deficiency in essential fatty acids (e.g., dry skin or hair, dandruff, brittle nails), and performance on some laboratory tasks of cognitive function and inhibition. One intriguing finding was that although there were no group differences in omega 3 intake, there were group differences in signs of essential fatty acid (EFA) deficiency. Does this finding mean that children with ADHD might require more EFA intake than normal children to prevent signs of deficiency? This possibility does require further exploration but may tie into Bruce Ames’s hypothesis that some people may inherit an inborn error of metabolism that results in the need for a greater intake of the nutrient(s) not being well metabolized (Ames, 2004; Ames, Elson-Schwab, & Silver, 2002). The study by Chang et al. also found that greater ADHD symptoms were correlated with lower n-3 fatty acid intake and higher severity of symptoms indicative of EFA deficiency. EFA deficiency was also correlated with higher delay aversion in the laboratory tasks of inhibitory control. The series includes two articles that explore micronutrient treatment, one looking at a single nutrient (Sarris, Oliver, Camfield, & Dean, 2016) and one exploring the potential of multinutrient treatment (Lothian, Blampied, & Rucklidge, 2016). When examining the potential of any new therapy, a question often emerges: Who might be most likely to benefit from this approach? Using data 641050 CPXXXX10.1177/2167702616641050Rucklidge, KaplanNutrition and Mental Health research-article2016
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