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

Critical Reviews in food science and research 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

Association, not causation

• 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 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

Other studies • Systematic review of PB diet for people with type 2 DM 1 • Broad Study: within and between group improvements in self-esteem 2 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

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

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) • 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 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

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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