By Akanksha Srivastava, M.Sc.
February 10, 2021
Did you know that the lack of specific vitamins and minerals can cause stress, depressed mood, and anxiety? Unhealthy diets and poor mental health are linked to mortality and morbidity worldwide. The challenge is that little information is available for health practitioners to guide evidence-based recommendations for nutrition interventions to manage anxiety and mood disorders.
My conversations during the last year with healthcare professionals, psychiatrists, psychologists, and policymakers on improving mental health have underscored the importance of nutrition in mental wellness. There are nutrients that play a crucial role in lowering the levels of adrenalin and cortisol in the body as well as the stress chemicals that trigger fight and flight response (1), and several growing research studies establish the relationship between both diet quality and nutrients on mood.
The Global Burden of Disease (GBD) study showed an analysis of 15 dietary risk factors in adults aged 25 years or above, and across 195 countries reported, 11 million deaths were diet-related from 1990 to 2017. The study found that worldwide, there is less consumption of an adequate amount of whole grain, fruit, vegetables, legumes, nuts, and seeds. On the contrary, people over-consume processed meat, sugar-sweetened beverages, and sodium (salt) (2). Similar findings were reported in the Supporting the Modification of Lifestyle in Lowered Emotional States (SMILES) trial in 2017 (3).
In this article, I will outline some important steps to ensure psychosocial well-being in combination with nutrition to improve health outcomes among the general adult population.
The Role of Specific Nutrients on Mood and Mental Health
Nutritional factors are interconnected with human cognition, behavior, and emotions (4). Here’s what we know:
- Deficiency of niacin (vitamin B3) and folic acid (vitamin B9) may lead to depression (5)
- Deficiency of pantothenic acid (B5), and pyridoxine (B6) can result in depression, irritability, fatigue, and other physical conditions
- Low intake of omega-3 fatty acids (docosahexaenoic acid and eicosapentaenoic acid) and minerals (zinc, magnesium and selenium) are associated with the diagnosis of depression and symptoms like irritability, insomnia, and loss of appetite (6)
- Optimal levels of dietary neurotransmitters (serotonin and dopamine) play a role in mood, anxiety, sleep, energy levels, and appetite
Recommended Steps for Healthcare Providers to Screen Mood Disorders and Anxiety
Step 1: Context setting
Establish rapport and set the context for psychosocial well-being. Healthcare providers may start a conversation with statements such as, “We would like to know about your emotional health as part of routine healthcare. Are you feeling low and depressed? What have you been eating these days?” Explain to the patients the following:
- Use routine checkups as a catalyst for change: Along with routine checkups for weight/height/BP, healthcare providers can identify stress and related conditions through specific signs and symptoms, such as sleeplessness, anxiety, and mood swings. Screening for signs and symptoms can optimize the efficacy of routine checkups and allow providers to help patients access further advice or interventions.
- Explore mental health as well as physical health : Most people associate symptoms of tiredness, lack of concentration, and mood swings with physical conditions and often overlook mental health conditions. Health providers can monitor both physical and mental health to facilitate prompt intervention. Encourage patients to discuss any of their stressors/tensions.
Step 2: Examine treatment options:
Treatment options can be tailored to individual needs and can include:
- Facilitation of IEC materials on well-being: Distribute a well-being toolkit containing information on the importance of mental health, effect of food on mood, and practical ways to help young people manage their mood and ensure healthy eating habits.
- Advocacy through online services: Health professionals can disseminate information on nutrition-based strategies to promote emotional health using social media tools.
- Provision of referral to specialists: Depending upon the diagnosis, referral to psychiatrists and dietitians should be made.
Decreased levels of neurotransmitters and nutritional deficiencies are just a few of the many factors that can lead to a depressed mood, lack of interest/pleasure, feelings of guilt/low self-worth, disturbed sleep, low appetite, low energy, and poor concentration among others, in depressed individuals (7).
Experts say a well-balanced diet with particular nutrients that includes complex carbohydrates, amino acids, omega-3 fatty acids, vitamins, and minerals through natural foods helps ensure a balanced mood and mental well-being. A higher intake of vegetables, fruits, lean red meats, whole grains, whole legumes, pulses, nuts, seeds reduces the risk and symptoms of depression.
Education/counseling of the patient, cognitive-behavioral therapy (CBT), providing supportive psychotherapy, telepsychiatry, along with nutritional psychiatry may have a positive effect on mental health. A healthy diet, with the inclusion of certain nutrients in the daily diet, acts not just as an adjunct therapy to bring about mental well-being, but it also helps in achieving good overall health.
Explore HMS CME Online courses in nutrition for healthcare professionals:
- Culinary Health Education Fundamentals (CHEF) Coaching—The Basics
- Lifestyle Medicine: Nutrition and Metabolic Syndrome
- Nutrition Management: Treating Cardiometabolic Disease
- Singh K. Nutrient and stress management. Journal of Nutrition and Food Sciences. 2016, 6:4.
- GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2019, 393 (101184): 1958-1972.
- Jacka FN, O’Niel A, Opie R et al. A randomized controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med. 2017, 15:23.
- Sathyanarayana Rao TS, Asha MR, Ramesh BN, Jagannath Rao KS. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008, 50:77-82.
- Zoomi Singh and Neelam Yadav. A Review on Impact of Food Folate, Their Biological Roles and Deficiency Diseases. Plant Archives.2020; 20:42-46.
- Cornah D. Feeding minds: The impact of food on mental health. Mental Health Foundation. 2005. NHS Choices (2016) Clinical Depression. Retrieved from https://www.nhs.uk/conditions/clinical-depression/.
Akanksha Srivastava is a public health nutritionist, freelance writer, and speaker. Her expertise includes counseling, teaching, and writing research articles in the field of nutrition. She is passionate about her profession and helps people adapt to a healthy lifestyle through nutrition counseling and customized diet plans.
*OPINIONS EXPRESSED BY OUR GUEST AUTHORS ARE VALUABLE TO US AT LEAN FORWARD, BUT DO NOT REPRESENT OFFICIAL POSITIONS OR STATEMENTS FROM HARVARD MEDICAL SCHOOL.