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Nutritional Psychiatry as Treatment for Mental Health Disorders

From chips to beans to meat, all foods play a role in a person’s body by giving the body the nutrients it needs. These nutrients also play a role in a person’s mental health. An imbalance of nutrients can cause an imbalance of chemicals that affects a person’s brain and behavior, leading to mental health disorders. With this in mind, eating foods heavy with the nutrients the body can help balance out the body. This is called nutritional psychiatry and can be used as a treatment for mental health disorders. Every illness has a different imbalance of nutrients that can be fixed by eating foods rich in the missing nutrient. What a person eats, rather than what a person doesn’t eat can directly affect their brain and, therefore, mood and behavior.


Sahasra Boga, Grade 12, Marvin Ridge High School, NC




Nutritional Psychiatry Research Paper (1)
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Nutritional Psychiatry as Treatment for Mental Health Disorders

By: Sahasra Boga

Mentors: Dr. Rajagoal Appavu and Jothsna Kethar


Abstract

From chips to beans to meat, all foods play a role in a person’s body by giving the body the nutrients it needs. These nutrients also play a role in a person’s mental health. An imbalance of nutrients can cause an imbalance of chemicals that affects a person’s brain and behavior, leading to mental health disorders. With this in mind, eating foods heavy with the nutrients the body can help balance out the body. This is called nutritional psychiatry and can be used as a treatment for mental health disorders. Every illness has a different imbalance of nutrients that can be fixed by eating foods rich in the missing nutrient. What a person eats, rather, what a person doesn’t eat can directly affect their brain and, therefore, mood and behavior.


Introduction

Mental health disorders affect a person’s mood, thinking, and brain. There are also several types of disorders such as anxiety disorders, mood disorders, psychotic disorders, personality disorders, and eating disorders. These disorders are commonly thought to stem from behavioral and social factors such as one’s life experiences and the environment one surrounds themself with. However, they also are caused by biological factors such as inflammation in the brain which is associated with a lack of nutrients. While there are many types of treatment available for mental illnesses such as different types of medication and therapy, another type of treatment comes in the form of nutritional treatment. Nutritional psychiatry is a new and developing field of research that has grown popular in the last 15 years and focuses on using food and food supplements to improve a person’s overall mental health, especially to help with mental health disorders. Though antidepressants are the most popular choice of treatment, research by Professor David Healy has found that taking the medication makes patients feel suicidal. He also believes that the medication might not be safe for long-term use. However, nutritional psychiatry has no such qualms and is, in fact, safer for a person's health overall. This paper will discuss two mental health disorders and their causes and symptoms of it, along with the nutritional treatment that can be taken to help with the illness.


Depression

Depression is one of the most common mental health disorders. It is characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. Symptoms include feelings of intense sadness, emptiness, and hopelessness, often resulting in suicidal tendencies. Though it was well believed that an imbalance of chemicals initially caused depression, specifically an imbalance of serotonin, this theory has diminished due to insufficient evidence. This being said, depression medication that was made to increase serotonin and other neurotransmitters still work. This is because serotonin is a neurotransmitter responsible for mood, so increasing the levels of this chemical will help your mood, and therefore, depression. As mentioned in various studies, many depression medications often use the amino acids tryptophan, tyrosine, and phenylalanine (See Figure 1). These amino acids are key components for the production of many neurotransmitters including serotonin and dopamine. Studies have shown that tryptophan levels increase with many protein-rich meals such as milk, cheese, meats, and poultry. This being said, protein-meals increase tryptophan but also other amino acids resulting in tryptophan being unable to significantly increase because it is being balanced out with other amino acids. However, a study by Parker G and Brotchie H. has shown that eating carbohydrates lowers other amino acids and causes insulin secretion. Though it doesn’t affect tryptophan directly, by lowering other amino acids, tryptophan is automatically “increased.” A study by Natsuki Tsujita, Yasunori Akamatsu, Márcio Makoto Nishida, Tatsuya Hayashi, and Toshio Moritani showed the effects of tryptophan in young adults with subclinical depression. Students at a university with symptoms of depression based on the Central for Epidemiologic Studies Depression Scale (CES-D) were chosen to be subjects, and their blood was then sampled to measure the tryptophan levels. Subjects were then randomly divided into a supplement group (tryptophan, vitamin B, and nicotinamide-containing supplement group) and a placebo group (lactate). After some tests, another blood sample was taken. The results showed that for the CES-D scores, both tryptophan and placebo both showed that they decreased the effects of severe depression, though they did very little for mild to moderate depression. (See Figure 2) On the other hand, Tyrosine is a dopamine precursor and norepinephrine precursor. Dopamine and norepinephrine are both neurotransmitters: dopamine plays a role in motivation and mood while norepinephrine plays a role in arousal and attention. There have been links that show that low levels of dopamine and/or norepinephrine are a result of depression, particularly since depression is defined by a state of low motivation, arousal, and attention (among others). An animal behavioral study by Abdelrahman Alabsi, Adel Charbel Khoudary, and Wassim Abdelwahedb tested the anti-depressional effects of L-tyrosine in rats using behavioral tests. The rats received L-tyrosine, fluoxetine, or a placebo for 21 days (The Antidepressant Effect of L-Tyrosine-Loaded Nanoparticles: Behavioral Aspects, 2019). The results showed that L-tyrosine had positive effects through behavioral tests. These behavioral tests included “open-field and forced swim tests”, from which the traveled distance, immobility time, and total activity (among others) were collected. The open-field tests act as the “indicator of its emotional state during both acute and chronic stress exposure”, while the forced swim tests “is characterized by considerable reliability for depression assessment in the experimental animals.” (The Antidepressant Effect of L-Tyrosine-Loaded Nanoparticles: Behavioral Aspects, 2019). The traveled distance during the open-field test showed an initial decrease but then a gradual increase of the traveled distance over time using the tyrosine nanoparticles compared to the control, which was the non-stressed group. (See Figure 3). Additionally, the immobility time after a forced swim test showed a decrease in immobility time using tyrosine nanoparticles. (See Figure 4). Lastly, the total activity showed a decrease but a gradual increase to almost control levels for the tyrosine nanoparticles. (See Figure 5) For this amino acid, both carbohydrate meals and protein meals will increase the levels of tyrosine. Some foods that are heavy with them are soy products, meats, nuts such as almonds and peanuts, some fruits such as avocado and banana, and some seeds such as pumpkin and sesame. In addition to these two amino acids, phenylalanine is also an amino acid that is linked to depression. This amino acid is a precursor to the chemical norepinephrine, as well as dopamine, and also for the production of tyrosine, which is directly produced by phenylalanine. Hence by eating foods with phenylalanine, levels of tyrosine will increase, causing dopamine and norepinephrine to also increase, which will help a patient’s mood. Some foods that are high in phenylalanine are meats, poultry, seafood, eggs, dairy, whole grains, nuts, and soy products. Omega-3 fatty acids are fat that can also be used to help with depression. It is a polyunsaturated fatty acid that helps to build and maintain a healthy body, especially for metabolism. There are 3 types of fatty acids: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). (See Figure 6) ALA is the most commonly found fatty acid as it is found in plant foods such as kale, spinach, soybeans, walnuts, and nuts. It is a precursor to EPA and DHA, but this doesn’t happen often so it usually gets stored away as energy to be used later. EPA produces a molecule that is involved in many physiological roles, while DHA is an important structural component for the skin. These two fatty acids are both commonly found in seafood and fish oil such as fish and algae. There has been evidence shown that suggests EPA reduces depression symptoms. According to a study by Julian G Martins, symptoms of depression did not decrease when using pure DHA or supplements that had 50% or greater levels of DHA. However, symptoms of depression significantly decreased when using pure EPA or supplements using 50% or greater levels of EPA. An overall study by Hanah Nemets showed that when using omega-3 fatty acids, children’s depression rating scales were significantly lower than the patients who used a placebo. (See Figure 7)


Attention-deficit/hyperactivity disorder

Attention deficit/hyperactivity disorder also known as ADHD is a very common neurological disorder in children. It is a disorder where children are constantly having trouble focusing, behaving, and controlling their impulses. Some causes of ADHD are brain injury, alcohol and tobacco use during pregnancy, premature delivery, low birth weight, or exposure to environmental risks during pregnancy (CDC, 2021). However, it is commonly believed that ADHD results from environmental factors and diet, but there is no evidence to support these theories. That being said, environmental factors and diet can make the symptoms worsen over time. As diet can worsen symptoms, diet can also make symptoms lessen. A mineral that can help with symptoms is zinc. Zinc plays a role in the immune system and metabolism, as well as producing melatonin which regulates dopamine function and signaling. Studies have shown that insufficient levels of zinc are common in patients with ADHD as well as play a role in ADHD symptoms. Specifically, zinc deficiency results in restlessness and trouble with concentration. In a double-blind study conducted by Shahin Akhondzadeh, Mohammad-Reza Mohammadi, and Mojgan Khademi where children who met the diagnostic criteria for ADHD were randomly split into two groups: methylphenidate in the zinc group and methylphenidate in the placebo group. The outcomes were then reported by teachers and parents on a rating scale. The results of the study showed that both teachers and parents reported a lower rating for children who took methylphenidate with zinc. (See Figures 8 and 9). Therefore, eating foods with zinc will help with ADHD. Some foods that have a high zinc level are oysters and other seafood, red meat, poultry, dairy products, beans, nuts, and whole grains. (Vitamins & Supplements for ADHD, 2008). Low iron levels have also been linked to ADHD. This is because iron has been linked to the neurotransmitter dopamine. Imbalances in dopamine can lead to stiffness in muscles, tremors, irrepressible urges to move while at rest, and problems with attention, concentration, and motivation (Deans, 2015). While there is limited research for adults, research has shown that for children with ADHD taking iron have eased their symptoms. Iron-rich foods include red meat, pork, and poultry, especially the liver and kidney, seafood, beans, and dark green leafy vegetables.


Conclusion

This paper discusses the nutritional treatment of depression and ADHD. Both disorders are very common: depression is common in young adults while ADHD is common in children. Regardless, both illnesses have been linked to having nutritional implications, usually a result of an imbalance of some nutrition. Foods with heavy levels of tryptophan, tyrosine, phenylalanine, and omega-3 are great for depression, while foods heavy with zinc and iron are great for ADHD. The problem, however, is the lack of research in the field of study. For example, the studies presented, while they do give promising results, are conducted with a small study sample. If more research were to be conducted, patients can use nutritional psychiatry as a treatment that will not only help their disorder but also their overall health. The question is, whether nutritional treatment is sufficient enough to work independently and long-term.


References:

Alabsi, A., Khoudary, A. C., & Abdelwahed, W. (2016). The Antidepressant Effect of L-Tyrosine-Loaded Nanoparticles: Behavioral Aspects. Annals of neurosciences, 23(2), 89–99. https://doi.org/10.1159/000443575


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Cavaye, J. (2018, March 1). Why nutritional psychiatry is the future of mental health treatment. The Conversation. https://theconversation.com/why-nutritional-psychiatry-is-the-future-of-mental-health-treatment-92545


Deans. (2015, November 29). Iron, Dopamine, and ADHD. Psychology Today. https://www.psychologytoday.com/us/blog/evolutionary-psychiatry/201511/iron-dopamine-and-adhd


Hjalmarsdottir, M. F. S. (2019, May 27). The 3 Most Important Types of Omega-3 Fatty Acids. Healthline.https://www.healthline.com/nutrition/3-types-of-omega-3#_noHeaderPrefixedContent


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Link, M. R. S. (2021b, November 12). Phenylalanine: Benefits, Side Effects, and Food Sources. Healthline. https://www.healthline.com/nutrition/phenylalanine


Martins J. G. (2009). EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. Journal of the American College of Nutrition, 28(5), 525–542. https://doi.org/10.1080/07315724.2009.10719785


Nemets, H., Nemets, B., Apter, A., Bracha, Z., & Belmaker, R. H. (2006). Omega-3 treatment of childhood depression: a controlled, double-blind pilot study. The American journal of psychiatry, 163(6), 1098–1100. https://doi.org/10.1176/ajp.2006.163.6.1098


Parker, G. and Brotchie, H. (2011), Mood effects of the amino acids tryptophan and tyrosine. Acta Psychiatrica Scandinavica, 124: 417-426. https://doi.org/10.1111/j.1600-0447.2011.01706.x


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Tsujita, N., Akamatsu, Y., Nishida, M. M., Hayashi, T., & Moritani, T. (2019). Effect of Tryptophan, Vitamin B6, and Nicotinamide-Containing Supplement Loading between Meals on Mood and Autonomic Nervous System Activity in Young Adults with Subclinical Depression: A Randomized, Double-Blind, and Placebo-Controlled Study. Journal of nutritional science and vitaminology, 65(6), 507–514. https://doi.org/10.3177/jnsv.65.507


Vitamins & Supplements for ADHD. (2008, October 10). WebMD. https://www.webmd.com/add-adhd/childhood-adhd/vitamins-supplements-adhd


Wani, A. L., Bhat, S. A., & Ara, A. (2015). Omega-3 fatty acids and the treatment of depression: a review of scientific evidence. Integrative medicine research, 4(3), 132–141. https://doi.org/10.1016/j.imr.2015.07.003


What is ADHD? (2021, January 26). Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/facts.html#:%7E:text=ADHD%20is%20one%20of%20the,)%2C%20or%20be%20overly%20active.


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