How Diet Influences Mental Health: New Findings, New Advances

Drew Ramsey, MD: Hi. Welcome to Brain Food. I'm Dr Drew Ramsey.

Emily Deans, MD: And I'm Dr Emily Deans. We are so excited this year to bring you all sorts of information that you can share with your patients about diet, lifestyle, and mental health.

Dr Ramsey: In this monthly column, we're going to do a deep dive into all the subjects that you're hearing about, all the different types of diets, lifestyle factors, exercise, and the microbiome—lots of things to help you and your patients.

Emily, why don't you start us out? We have some exciting imaging data.

Dr Deans: Right. One of the most exciting studies comes from Felice Jacka, an amazing researcher out of Australia whom both Drew and I have had the wonderful opportunity to meet. She came up with the PATH study,^[1] which followed people who are 60-65 years of age and measured their hippocampal volume. It turns out that those who ate more of a Western junk food diet had a smaller hippocampus at the end of 5 years than those who ate more traditional whole foods.

Dr Ramsey: Next on our list is the group statement^[2] from the International Society for Nutritional Psychiatry Research. This was published in March in Lancet Psychiatry. It is a nice piece that summarizes the data on why we are talking to patients about food and why nutrition is on the radar when it comes to brain health. The overall thrust suggests that we need more research and that there is a clinical utility in talking to patients about food, just like we do in other specialties of medicine.

Another study,^[3] in a top moment for us in 2015, showed that high glycemic index foods were correlated with an increased risk for depression. Those data came out of the Women's Health Initiative.

Dr Deans: When we talk more specifically about talking with our patients about food, we like to talk about chocolate and cocoa. This is actually a dark chocolate-covered macadamia nut that my sister was kind enough to bring me home from Hawaii. It was from the tail end of 2014, but all the news coverage was in early 2015 on a great study^[4] that showed that the administration of cocoa seemed to improve cognitive function in older Americans. It was a randomized controlled trial.

Dr Ramsey: How exciting—a molecule from nature that can reverse age-related memory decline. We're excited about follow-up studies on that. Certainly, patients like to talk about dark chocolate.

Dr Deans: Right. I love recommending it to my patients.

Dr Ramsey: A great moment for both of us, I think, was at the American Psychiatric Association (APA) annual meeting in Toronto, where we led the annual workshop called "Food and Brain."

Dr Deans: That's right. You and I were there to a sellout crowd, as always. We're actually going to do another one at the APA meeting in 2016. We have a 3-hour symposium on food and the brain in Atlanta. Please be there. We'd love to have you.

Dr Ramsey: We're pretty sure that there will be some first-ever events, like last year, when we shucked oysters for the first time at the annual conference. If you want to hear more about what we cover at Food and Brain and learn a little bit more about nutritional psychiatry, please check out the great coverage of that workshop by Medscape Psychiatry in 2015.

Dr Deans: One of the most exciting things to come out in 2015 was not just a bunch of observational data, which we've had since 2009. There has been a very strong, consistent message from observational data that a whole-foods diet is associated with better mental health, better cognitive function, less depression, less anxiety, less bipolar disorder, and on and on. In 2015, we had the completion of a couple of randomized controlled trials, one of which was a modified Mediterranean diet for the treatment of major depressive disorder. This was a Mediterranean diet without restricting red meat. Although the data collection is complete, the paper is not yet written. Drew and I were in contact with the authors, and they said that the preliminary results are very exciting.

Dr Ramsey: There is at least one other randomized controlled trial^[5] that we know of that looked at the effect of nutrition intervention for the treatment of depression. There was one great randomized controlled trial^[6] that ended 2015 with a bang. It was on one of your favorite subjects, Dr Deans: a study on probiotics for the treatment of major depression.

Dr Deans: That's right. It was a randomized controlled trial measuring probiotic administration and symptoms of depression and metabolic problems, as well as C-reactive protein. The results were quite positive with probiotic administration.

Dr Ramsey: Those were some of the top moments from 2015 in the world of brain food. We're excited to be talking to you monthly with our new Medscape Psychiatry column.

Thanks for tuning in to Brain Food. For Medscape Psychiatry, I'm Dr Drew Ramsey.

Dr Deans: And I'm Dr Emily Deans. We just want to remind you that talking about food with your patients is a no-brainer.

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