Food has an incredible impact on our mental health. This field of research has been growing exponentially in recent years and couldn’t be more relevant with the stresses of 2020. We discuss this fascinating area of health and nutrition with Miles Price, Functional Medicine Specialist, to dive into what we really know so far.

Q: Does what we eat really make a big difference to our mental health?

Food has a direct influence on our mental health in many ways. It contains the building blocks of neurotransmitters which control how ‘excited’ or how ‘relaxed’ our brain is₁. The basic building blocks of all neurotransmitters comes from amino acids, which are sourced from eating protein in our diets. Secondly, food contains the enzymes and co-factors which help to make neuro-transmitters from amino acids. The brain also relies on a variety of fuel sources. It is very demanding organ, requiring much energy to function. Typically glucose is relied on as the main fuel coming from carbohydrates, but new research is indicating that ketones, which come from the metabolism of fats may actually be a better fuel for the brain_2. It stabilizes brain energy flow, and doesn’t have the negative side effects of hypoglycemia or hyperglycemia on the brain. Both hypo and hyperglycemia are related to a poor regulation of carbohydrates which occurs after eating an excess of carbohydrates over many meals. Typically this occurs when a patient is either diabetic or has poor adrenal function regulating cortisol production. Essentially food needs to be balanced with proteins fats and carbohydrates for good brain function. In some circumstances people need to be following a ketogenic diet, with more ketones as fuel for the brain, when they have underlying conditions like epilepsy, diabetes, heart disease, high blood pressure or cancer.

Q: What are some key nutrients that support healthy mood?

Having sufficient amino-acids as the building blocks of the neuro-transmitters is critical for a healthy mood. Circumstances where this may not happen for people is when someone is following a vegan diet and not obtaining the correct balance of nuts, seeds, legumes or grains. Or when someone is taking Proton Pump Inhibitors (stomach acid lowering medication like antacids) which reduces the ability to break down protein into amino acids, or there’s an underlying irritable bowel disease whereby amino acids absorption is compromised. The key amino-acids from the diet include, Phenylalanine, tryptophan, glycine, histidine and arginine.

Vitamin B6 is the main co-factor which co-ordinates the conversion of amino acids to a variety of neuro-transmitters,₃ including dopamine, adrenalin and noradrenalin. These neuro-transmitters stimulate energy, focus, drive and vitality in our brain function. Vitamin C is another important nutrient acting as a co-factor converting amino acids to neurotransmitters.₄ Key minerals to support are Zinc, which is essential for the correct firing of neurons and their transmission of electrical signals₅, Iron, which is essential for neuro-transmitter synthesis and developing the myelin, the protective sheath around neurons₆ and magnesium which is essential for neuro-transmission of signals and also for its protective effects of excessive toxicity of excitatory neuro-transmitters, essentially providing a balance.₇

Q: What are some key nutrients that support mental clarity and cognition?

Being focused, not distracted, calm and energized is an optimal mental state we all wish to achieve daily. To achieve this there are some key amino acids and co-factors which support this status. Phenylalanine and its subsequent amino acid L-tyrosine are the building blocks of making dopamine and adrenalin – the key neuro-transmitters for focus and drive. But this needs to be balanced with GABA and Serotonin so that we don’t become too ‘excited’ in our mental functions. GABA is made from the amino acid Glutamine₈ and Serotonin is made from the amino acid tryptophan_9. Typically where these imbalances occur is not so much with the amino acids but lifestyle factors like sleep patterns, drug and alcohol use, high-stress and poor diets (low co-factors of vitamins, minerals) which contribute to the poor synthesis and metabolism of neurotrasmitters in question. It is the correct modification of lifestyle which can have the biggest influence on clarity and congition._10,11,12.

Q: Are there any dietary patterns that work well for supporting mental health?

Certainly the most recent focus in dietary terms is using the benefits of Fasting and Ketogenic diets on mental states. One study highlight some improvements in mood specifically in anger, tension and mental energy whilst fasting.₁₃ Additional research is needed to clarify more the length and duration of fasting required. Ketogenic diets, with their production of ketones have proven to show anti-inflammatory effects on the brain, together with improvements in energy production, mitochondrial repair, reducing oxidative stress, and having mood-stabilizing effects.₁₄ Combining these two modalities together amplifies the cognitive benefits. More clinical studies over the coming years will reinforce this approach.

Q: How do you think this field will grow and what are researchers currently looking into?

Applying the application of functional medicine in assessing and treating mood and mental health disorders is gaining a lot of attention. Rather than looking at mental health and the nervous system in isolation, we know from clinical studies that the key influences of gut, human interaction, lifestyle choices, toxins in addition to diet all have an influence on mental health._15,16,17 They include modifying lifestyle behaviors which don’t encourage addiction or isolation, and understanding more the function of the gut and general hormonal profile of the patient. Key hormones which influence mental health are the thyroid, insulin, sex hormones (testosterone, estrogen) and steroid hormones (pregnenolone and cortisol). Looking at these factors as well as diet helps to drive to most effective outcome.

References:

1. Institute of Medicine (US) Committee on Military Nutrition Research. The Role of Protein and Amino Acids in Sustaining and Enhancing Performance. Washington (DC): National Academies Press (US); 1999. 14, Amino Acid and Protein Requirements:
2. Hernandez AR, Hernandez CM, Campos K, et al. A Ketogenic Diet Improves Cognition and Has Biochemical Effects in Prefrontal Cortex That Are Dissociable From Hippocampus. Front Aging Neurosci. 2018;10:391. Published 2018 Dec 3.
3. Sato K. Why is vitamin B6 effective in alleviating the symptoms of autism? Med Hypotheses. 2018 Jun;115:103-106. doi: 10.1016/j.mehy.2018.04.007. Epub 2018 Apr 12. PMID: 29685187.
4. Travica N, Ried K, Sali A, Scholey A, Hudson I, Pipingas A. Vitamin C Status and Cognitive Function: A Systematic Review. Nutrients. 2017;9(9):960. Published 2017 Aug 30.
5. Pfeiffer CC, Braverman ER. Zinc, the brain and behavior. Biol Psychiatry. 1982 Apr;17(4):513-32.
6. Jáuregui-Lobera I. Iron deficiency and cognitive functions. Neuropsychiatr Dis Treat. 2014;10:2087-2095. Published 2014 Nov 10.
7. Jáuregui-Lobera I. Iron deficiency and cognitive functions. Neuropsychiatr Dis Treat. 2014;10:2087-2095. Published 2014 Nov 10.
8. Wang L, Maher TJ, Wurtman RJ. Oral L-glutamine increases GABA levels in striatal tissue and extracellular fluid. FASEB J. 2007 Apr;21(4):1227-32. doi: 10.1096/fj.06-7495com. Epub 2007 Jan 11.
9. Jenkins TA, Nguyen JC, Polglaze KE, Bertrand PP. Influence of Tryptophan and Serotonin on Mood and Cognition with a Possible Role of the Gut-Brain Axis. Nutrients. 2016;8(1):56. Published 2016 Jan 20.
10. Krishnakumar D, Hamblin MR, Lakshmanan S. Meditation and Yoga can Modulate Brain Mechanisms that affect Behavior and Anxiety-A Modern Scientific Perspective. Anc Sci. 2015;2(1):13-19.
11. Banerjee N. Neurotransmitters in alcoholism: A review of neurobiological and genetic studies. Indian J Hum Genet. 2014;20(1):20-31.
12. Briguglio M, Dell’Osso B, Panzica G, et al. Dietary Neurotransmitters: A Narrative Review on Current Knowledge. Nutrients. 2018;10(5):591. Published 2018 May 10.
13. Hussin NM, Shahar S, Teng NI, Ngah WZ, Das SK. Efficacy of fasting and calorie restriction (FCR) on mood and depression among ageing men. J Nutr Health Aging. 2013;17(8):674-80. doi: 10.1007/s12603-013-0344-9.
14. Brietzke E, Mansur RB, Subramaniapillai M, Balanzá-Martínez V, Vinberg M, González-Pinto A, Rosenblat JD, Ho R, McIntyre RS. Ketogenic diet as a metabolic therapy for mood disorders: Evidence and developments. Neurosci Biobehav Rev. 2018 Nov;94:11-16..
15. Genuis SJ. Toxic causes of mental illness are overlooked. Neurotoxicology. 2008 Nov;29(6):1147-9. doi: 10.1016/j.neuro.2008.06.005. Epub 2008 Jun 24.
16. Butler MI, Mörkl S, Sandhu KV, Cryan JF, Dinan TG. The Gut Microbiome and Mental Health: What Should We Tell Our Patients?: Le microbiote Intestinal et la Santé Mentale : que Devrions-Nous dire à nos Patients? Can J Psychiatry. 2019 Nov;64(11):747-760. doi: 10.1177/0706743719874168. Epub 2019 Sep 17. PMID: 31530002;
17. Lara DR. Caffeine, mental health, and psychiatric disorders. J Alzheimers Dis. 2010;20 Suppl 1:S239-48. doi: 10.3233/JAD-2010-1378.

Written by Miles Price, Functional Medicine Practitioner & Clinical Nutritionist

Miles did his initial training at Hawthorn University with an M.Sc. Holistic Nutrition. He followed this up with a professional accreditation to practice with BANT (UK) the British Association of Applied Nutrition and Lifestyle Medicine in 2017 and subsequently obtained a Functional Medicine Diploma with Functional Medicine University in 2017. This was shortly followed by enrolling with the Institute of Functional Medicine on their practitioner program.