You Are-And Your Mood Is-What You Eat

It’s time to send your patients to the “Farm-acy,” Drew Ramsey, MD, told attendees at the American Psychiatric Association Annual Meeting. Ramsey, assistant clinical professor of Psychiatry at Columbia University College of Physicians & Surgeons, was one of several speakers at the standing room only workshop “Prescription Brain Food: From Bench to Table.”

The brain, Ramsey explained, needs to be nourished; he noted it consumes about 420 calories a day. To function properly, the brain requires omega-3 fatty acids, folate, fiber, choline, iron, zinc, and vitamins B₁₂, D, and E among other nutrients. So can a patient’s diet affect their mood and mental (in addition to physical) well-being?

Yes, Ramsey answered, pointing to some interesting studies exploring diet, nutrition, and mood disorders. In one study, researchers followed 10,094 initially healthy participants for a median of 4.4 years.¹ To better understand the association between diet and mood, participants were assigned a Mediterranean dietary pattern score, which positively weighted the consumption of vegetables, fruit and nuts, cereal, legumes and fish.  A monounsaturated- to saturated-fatty-acids ratio and moderate alcohol consumption also had a positive influence on the score. On the other hand, consumption of meat, meat products, and whole-fat dairy were negatively weighted. The researchers found an inverse relationship between adherence to the Mediterranean diet and risk for depression, suggesting this diet has a protective role against the development of mood disorders.

Similarly, Ramsey told attendees about a study comparing a diet high “whole” foods (eg, high in vegetables, fruits and fish) with a diet high processed foods.² Tasnime N. Akbaraly, PhD, and colleagues found that those who most closely followed the whole foods diet had lower odds of depression as measured by the Center for Epidemiologic Studies – Depression scale (odds ratio = 0.74) while those who had ate diets high in processed foods had increased odds of developing depression (OR = 1.58). This could have great clinical implications, Ramsey explained, since patients with psychiatric disorders often don’t eat properly.

The diet-mood link seems to be evident across the lifecycle, he added. Ramsey shared findings from a study of 7,114 adolescents aged 10-14 years.³ Participants completed dietary questionnaires, which were then used to determine healthy and unhealthy diet quality scores. The Short Mood and Feelings Questionnaire was used to measure depression. Once again, this study found an inverse relationship between good, healthy eating and the development of depression. Indeed, adolescents with higher unhealthy diet scores had a 79% increased risk of depression, Ramsey noted.

With increasing data supporting good nutrition for improved mood, Ramsey said all clinicians should take the time to chat with their patients about their diet, nutrition, and making good choices. “It is a low-cost, risk free intervention that will help your patients,” he said.

He advised clinicians to routinely discuss diet and nutrition with patients during visits, inquiring about what they eat and creating an open dialogue. He counsels his patients as appropriate to try to include healthier choices, like beans to increase folate intake. Mushrooms add lycopenes to the diet, he added. He reminds patients to consume fatty fish, and reminds them that there are options beside salmon. He suggests that his patients swap berries for other sugar-filled desserts and to favor grass-fed beef when consuming meat.

At the very least, patients will be eating healthier. But Ramsey believes these steps and patients’ visits to the “Farm-acy” will help them to build a better brain.

References:1. Snchez-Villegas A, Delgado-Rodrguez M, Alonso A, et al. Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Arch Gen Psychiatry. 2009;66:1090-1098. Available at http://archpsyc.jamanetwork.com/article.aspx?articleid=210386.
2. Akbaraly TN, Brunner EJ, Ferrie JE, et al. Dietary pattern and depressive symptoms in middle age. British J Psychiatry. 2009;195:408-413. Available at http://bjp.rcpsych.org/content/195/5/408.long.
3. Jacka FN, Kremer PJ, Leslie ER, et al. Associations between diet quality and depressed mood in adolescents: results from the Australian Healthy Neighbourhoods Study. Aust N Z J Psychiatry. 2010;44:435-442. Available at http://www.ncbi.nlm.nih.gov/pubmed/20397785.