Food & mood Delivered by Dr Adam Joiner P r o m o t i n g s u - - PowerPoint PPT Presentation

Food & mood

Delivered by Dr Adam Joiner

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Learning Objectives

• Learn about some of the evidence for diet on mental

wellbeing

• Learn about some of the evidence for diet on depressive

disorders

• Increase awareness of biological mechanisms underpinning

the influence of food on mood

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

https://www.mentalhealth.org.uk/a-to-z/d/diet-and-mental- health (October 2018)

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Title

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n Critical Reviews in food science and research

Association, not causation

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

• 281 people aged 18 to 21; over 21 days
• Fruit & Veg resulted in greater positive affect
• Same day and next day
• 7 to 8 servings for meaningful positive changes

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

• 171 psychology students aged 18 – 25; over 14 days
• All consume ≤ 3 portions F&V/day
• Control group; text reminders + vouchers group; 2 F&V group
• 2 F&V group increased energy, motivation, social measures
• No changes to mood/anxiety

Other studies

• Systematic review of PB diet for people with type 2

DM1

• Broad Study: within and between group improvements

in self-esteem2

• 1. Toumpanakis A, Turball T, Alba-Barba I. Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: A systematic review. BMJ Open Diaebetes Res

Care [Internet]. 2018;6(1):e000534

• 2. Wright N, Wilson L, Smith M, Duncan B, McHugh P. The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart

disease or diabetes. Nutr Diabetes [Internet]. 2017;7(3). Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L619864919%0Ahttp://dx.doi.org/10.1038/nutd.2017.3

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Dietary recommendations for the prevention of depression – Opie et al Nutritional Neuroscience 2017;20(3):161-171

1. Follow ‘traditional’ dietary patterns, such as the Mediterranean, Norwegian, or Japanese diet 2. Increase consumption of fruits, vegetables, legumes, wholegrain cereals, nuts, and seeds 3. Include a high consumption of foods rich in omega-3 polyunsaturated fatty acids 4. Replace unhealthy foods with wholesome nutritious foods 5. Limit your intake of processed-foods, ‘fast’ foods, commercial bakery goods, and sweets.

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Food & Depressive Disorders

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

• n=500; diagnosis of moderate or severe depression +1
• 70% raw, several restrictions, exercise, mindfulness, environment, juicing
• No control group
• 334 dropped out (66.8%) à 85% found modifications “too rigorous”; lack of time; family influences
• Outcomes: “health diaries”
• After 6 months à 78% of completers decreased/stopped anti-depressant medication

• n=67

n=31 diet; n=25 control at 12 weeks

• MADRS remission 32% (10) vs 8% (2); p<0.001; d=1.16
• NNT = 4.1

HELFIMED Trial – Parletta et al

Nutritional Neuroscience 2019;22(7):478-487

• RCT: Mediterranean-style diet plus fish oil supplements
• GP diagnosed or self-reported depression
• Use of Depression Anxiety Stress Scale (DASS-21)
• High attrition rate (retention: 63% tr; 49% ctrl, at 6 months)
• Both groups improved scores on DASS-21 (45% tr; 27% ctrl)
• Correlation between food groups and variety

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

n=1,025 12 months follow up

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Biological Mechanisms in Diet & Depression

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Biological Mechanisms

• Inflammation
• Oxidative stress
• Brain plasticity
• Gut-brain axis (microbiota)

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Inflammation

• Low grade inflammation (e.g. raised cytokines)
• Multi-factorial: diet, obesity, sleep, stress, smoking
• Whole plant foods reduce inflammation

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Oxidative stress

• Lower antioxidant levels and and antioxidant capacity in

people with depression compared to controls.

Moylan S et al. Neurosci Biobehav Rev 2014;45, 46–62 Lie T et al. PLoS ONE 2015; 10, e0138904

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Brain Plasticity

• Hippocampus and neurotrophins (e.g. BDNF)
• Western diet associated with smaller left hippocampus
• Polyphenols, Vit-E, O3FA stimulate neurogenesis; diets

high in fat and sugar impair neurogenesis

Jacka et al. BMC Medicine. 2015;13:215 Marx et al. Proceedings of the Nutrition Society. 2017;76:427-436 P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

Gut-brain axis (microbiota)

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

• Implicate in modulation of BDNF, serotonin, HPA stress

response

• Microbiota-deficient mice reduced BDNF + 5-HT, and

increased stress response

• Differences in gut microbiota of depressed patients vs healthy

control

• Faecal transplant to rats
• Increased interstitial permeability à depression (e.g. high fat

diet)

Marx et al. Proceedings of the Nutrition Society. 2017;76:427-436

Further Reading

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

P r o m o t i n g s u s t a i n a b l e h e a l t h a n d n u t r i t i o n

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