The Intimate Relationship Between Food and Mental Health

I recently co-led a program at Kripalu on the science of yoga, designed especially for physicians and other health professionals. During one session, a doctor stood up, heartbroken, and described her stress and burnout. As I was listening to her, I thought of how, for the first time ever, life expectancy has dipped here in the United States. Sanjay Gupta, CNN’s medical editor, calls it “the despair index”—upticks in deaths from suicide, opiates, and cirrhosis of the liver are primary culprits.

We are all in it. Stress is on the rise, and eating poorly, combined with our increasing levels of stress, creates an internal biochemistry that can adversely impact our mental health. A recent study of university students in Greece found that the more closely that students adhered to the whole-foods, plant- and seafood-rich Mediterranean diet, the better they did academically and health-wise. Most students, however, did not eat well. Here in the United States, while the Centers for Disease Control and Prevention recommends that we eat somewhere between nine and 11 servings of fruits and vegetables a day, the average intake is closer to three. Following trendy diets that eliminate certain foods or eating so “clean” that it becomes restrictive can contribute to both inadequate nutrition and a disordered relationship with food.

Nutritional Adequacy Makes Psychiatry Work Better

Researchers are reporting on new links found between sound nutrition—eating a reasonably balanced diet like the Mediterranean pattern—and both prevention of mental-health issues and enhanced efficacy of treatment. Dr. Julia Rucklidge, head of the Mental Health Nutrition Research Group at the University of Canterbury, New Zealand, described her discoveries regarding the link between nutritional status and mental health on the Mad in America podcast. She had noticed that, despite the best treatments, her patients were not healing as well as she’d predicted, while her colleague was treating her patients with a therapeutic diet tailored to their individual needs, and saw a positive effect on their psychiatric treatments. Julie’s own work with those with ADHD has since focused on the role of nutrition as part of treatment.

Nutritional Psychiatry

Mental-health challenges such as depression, anxiety, and bipolar disorder devastate individuals and families, and treatments currently focus mainly on antidepressants and psychotherapy. Now, sophisticated approaches to nutrition therapy—both diet and supplementation based on a nutrition-focused evaluation that includes health and symptom history and genetic testing—can be combined with traditional modalities to improve outcomes, an approach known as nutritional psychiatry.

The evidence suggesting that sound, balanced nutrition is critical to mental health is on the rise. The nutrition-centric processes of inflammation, oxidative stress, the gut microbiome, epigenetic modifications, and neuroplasticity each come into play, are highly individual, and are deeply tied to nutritional choices. 

The Yin and Yang of Testing and Supplementation

While an integrative approach to nutrition has great promise, current testing and supplementation is not a perfect solution to all mental-health issues. The evidence supporting this functional approach continues to evolve. While some nutrition testing is increasingly covered by health insurance, many are not, and they can be cost-prohibitive. In some cases, a skilled nutrition therapist can undertake a thorough nutrition-focused physical that can point the way to the therapeutic diet and supplements that may be helpful.

The world of supplements is likewise complex. While nutraceuticals can be powerful medicines for individuals out of balance, most supplements available are poor in quality and sourced in countries whose regulatory environment is nonexistent. There are high-quality supplements that are better sourced and formulated based on clinical evidence, but finding them takes ongoing investigation and review. Nutraceuticals showing promise in mental-health clinical trials include n-3 fatty acids, certain forms of folate, S-adenosylmethionine (SAMe), N-acetyl cysteine, and probiotics. Taking supplements based on hearsay can create new problems, such as introducing unwanted contaminants. Instead, work with a qualified nutritionist to use supplements in concert with a therapeutic diet.

Thoughtful treatment of mental-health issues requires a cohesive medical team that includes a primary care physician, psychiatrist, dietitian, and mind-body therapist (such as an osteopath, naturopath, or Ayurvedic practitioner) that can help an individual based on their specific needs and preferences.

The Takeaway

The food choices you make intimately impact your mental health and well-being. For most of us, the whole-foods, plant-based Mediterranean diet (usually consistent with an Ayurvedic approach) is an excellent place to begin.

If you, like so many in our country today, grapple with stress or depression, and particularly if it is impacting your diet, you can choose to work with a healthcare professional versed in therapeutic nutrition who can provide the testing and personalized approach necessary to support your health and well-being. Some dietitians have this specialized training, as do some naturopaths, physicians, and psychiatrists, so ask your primary care provider, local counselor, or nutritionist about taking the next step toward your optimal wellness.

Annie B. Kay, MS, RDN, E-RYT 500, C-IAYT, is an author, nutritionist, Kripalu faculty member, and important voice in whole-foods nutrition and yoga.

Full Bio and Programs