Nutritional psychiatry

Karen Davis, RDH, states dental hygienists can help promote healthy eating habits in their patients, preventing mental illnesses.

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Hygienists can help the emerging science by pointing out the brain food.

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We’ve all heard the saying, “You are what you eat.” But can our mental health and moods really be influenced by our choices of ice cream versus a bowl of blueberries? The idea that good nutrition or the lack thereof can substantially affect brain function and mood is intriguing, and frankly, something everyone with a brain should take time to think about.

Since many diseases globally are mental disorders such as depression, Alzheimer’s disease, and schizophrenia, understanding and using nutrition as a therapy makes sense financially and healthwise. In many countries, some people are overfed yet undernourished. The emerging science of understanding how nutrition has an influence on general mental well-being is called nutritional psychiatry.

The human brain operates at a very high metabolic rate and depends on amino acids, fats, vitamins, minerals, and trace elements to operate optimally. Many individuals, including many of our patients, do not meet the recommended intakes of several brain-essential nutrients such as B vitamins, zinc, magnesium, and omega-3 fatty acids.1

Basically, enjoying a healthy diet with a wide variety of vegetables, nuts, legumes, low-fat dairy, and oily fish is associated with a reduction in mood swings, depression, and anxiety. Nutrients found in these vitamin-rich foods work together synergistically to increase the production of serotonin, which is associated with good mood and relaxation. High calorie–low nutrition foods such as pastries, cakes, donuts, chips, and cookies provide momentary pleasure, but over time can promote insulin resistance.

According to Dr. Dale Bredesen, insulin resistance is the “single most important metabolic contributor to Alzheimer’s disease development and progression.” In his book, “The End of Alzheimer’s,” Bredesen outlines strategies supporting the reversal of cognitive decline through a personalized protocol to rid the body and mind of factors that promote inflammation by altering diet, exercise, sleep, and stress.2 Not surprising, substantially increasing nutrients and antioxidants from a plant-rich diet is part of his successful ReCODE protocol to improve brain function and reverse Alzheimer’s. It is an interesting read.

The idea that good nutrition or the lack thereof can substantially affect brain function and mood is intriguing, and frankly, something everyone with a brain should take time to think about.

While data is still being gathered on dietary influences of good mental health, there are at least seven nutritional considerations that impact brain health and mood.

Omega-3 fatty acids—Omega-3 fatty acids are like the scaffolding of neuronal structure and function. Increasing omega-3 fatty acids in the diet has been shown to help relieve symptoms of depression, bipolar disorder, and posttraumatic stress disorder. Additionally, omega-3 fatty acids have been shown to exert anti-inflammatory properties for patients with chronic periodontitis.3 Sardines, salmon, anchovies, nuts, and seeds are good sources of omega-3 fatty acids.

B vitamins and folate—B vitamins have a critical role in the production of brain chemicals necessary for cellular and metabolic function. Interestingly, folate (B9) deficiency has been found in people suffering from depression who respond poorly to antidepressants. B vitamins have a synergistic effect, so when taking supplements it is best to take B vitamins together. Good sources of B vitamins are leafy green vegetables, legumes, and nuts.

Amino acids—Proteins are built from amino acids and are essential for the circuit system of the brain to function properly. The amino acid tryptophan is necessary for the production of serotonin, and the amino acid cysteine is instrumental in the production of the antioxidant glutathione. The supplemental amino acid N-acetyl cysteine (NAC) can be helpful with bipolar disorder, schizophrenia, and compulsive disorders, while S-adenosyl-L-methionine (SAMe) has been shown to help manage depression. Sources of amino acids are lean meats, seafood, legumes, eggs, and nuts.

Zinc, magnesium, and iron—Zinc is essential not only in many brain chemistry reactions; it also supports immune function. There is emerging evidence that zinc supplements work synergistically with antidepressants. Magnesium and iron deficiency have been linked to increased anxiety and depression, and iron deficiency is also implicated in developmental problems due to its role in transporting oxygen to the brain. You can find these minerals in lean meats, pumpkin seeds, legumes, soy, spinach, and nuts.

Vitamin D—Low prenatal levels of vitamin D have been linked to increased risk of schizophrenia and depression in the baby due to its vital role in brain development. Vitamin D is synthetized via sunlight and found in mushrooms, milk, and oily fish.

Polyphenols—Antioxidants derived from plants can offset the oxidative stress that damages DNA and increases the risk for dementia and depression. Blackberries, blueberries, raspberries, goji berries, mango, onions, garlic, kale, green tea, coffee, turmeric, and cumin are rich in polyphenols.

Microbiotics—The microbial balance in the gut is influential in preventing chronic inflammation, which negatively impacts the nervous system and brain function. Eating fruit skins and fermented foods such as kefir, yogurt, sauerkraut, and tempeh can help maintain a balanced gut microflora.

Even though mental health and prevention of mental disorders is complex, emerging evidence supports that dietary choices are as important to psychiatry as they are to cardiology, endocrinology, and gastroenterology. Dental professionals have the opportunity to guide patients toward healthy eating habits. By taking this role seriously, perhaps we can help patients feel better mentally, and maybe even help them prevent cognitive decline. These are worthy outcomes.

The International Society for Nutritional Psychiatry Research (ISNPR) is a clearinghouse of information to support evidence-based science, build collaborations, and encourage a multidisciplinary approach to nutritional psychiatry research. A valuable resource to investigate if you’re interested in helping patients feed their brains food that can act as medicine is ISNPR.org.


Karen Davis Grey

Karen Davis,RDH, BSDH, is the founder of Cutting Edge Concepts, an international continuing education company, and practices dental hygiene in Dallas, Texas. She is an independent consultant to the Philips Corp., Periosciences, and Hu-Friedy/EMS. She can be reached at Karen@Karendavis.net.

References

1. Sarris J, Logan AC, Akbaraly TN, et al. Nutritional medicine as mainstream in psychiatry.Lancet Psychiatry. 2015;2:271-274.

2. Bredesen DE. The End of Alzheimer’s. The First Program to Prevent and Reverse Cognitive Decline. New York. Avery: Penguin Random House, 2017.

3. El-Sharkawy H, Aboelsaad N, Eliwa M, et al. Adjunctive treatment of chronic periodontitis with daily dietary supplementation of omega-3 fatty acids and low-dose aspirin.Jour of Perio. 2010; Nov; 81(11):1635-1643.

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