The role of micronutrients and mental health
A rainbow diet, the answer to our growing population, getting sicker by the day?
Years of clinical practice and more and more people confused about nutrition, it is important to reframe our perceptions about food and how some (natural) food constituents are essential to our survival.
If food is not medicine, why are we still alive? And, why are we getting sicker and sicker, and fatter and fatter, since the industrial revolution? And, why the major part of the planet is obese, eating too much and too often, and yet malnourished, while the rest doesn’t have access to food and is also malnourished?
Studies after studies, national reports and statistics, malnutrition is a clear problem in our modern societies. Nutrient deficiencies are becoming a great concern, as only few people ever consume their 5-a-day. The issue here is that in the same way RNIs (recommended national intake) or RDIs (recommended dietary intake), the concept of the 5-a-day was designed to prevent deficiencies. Meaning that if you do not consume a minimum of 5 servings of fruits and vegetables daily, your diet will lack essential nutrients to support your health and overall well-being, but also your mental health. Therefore, dysfunction is inevitable and disease the only route left for the body to warn you that what you are doing is ‘wrong’.
Symptoms are signals generated by the body in a way to ring the alarm.
Symptoms (including pain) are not to be ignored. In a way headaches can translate from dehydration or sensorial, mental or emotional overload, any type of symptoms have a cause and this is why in functional medicine and naturopathic medicine, we aim to identify the cause of the symptoms (or your disease). Without identifying the cause, and by prescribing drugs (with a long list of ‘direct’ effects — no side effects, as we are led to believe) your doctor is only giving you a band-aid. Nothing more. Imagine you are a balloon filled with water, how long do you think the band-aid will last? How many band-aids can you have before the balloon eventually burst? What would it take for you to listen to your body, to understand what your body is telling you, and seek long-term help?
Nutrient deficiencies, a common problem
Nutrient deficiencies are so common in fact, that it is recognised by many associations and governmental bodies the world around, that fibre, most essential minerals, like magnesium, calcium, potassium, selenium and zinc, and vitamins, like vitamins A, D, E, and C, as well as B vitamins, particularly B12 and folate, are missing from the diet of the major part of the population.1
Many of these nutrients are considered essential because any deficiency will cause dysfunction in the body and eventually lead to certain chronic diseases.
A severe lack of fresh vegetables and fruits in the diet is the main cause of malnutrition but multiple factors also play role in nutrient deficiencies, including the prevalence of highly processed Western-style diets characterised by a whole lot of ‘white’ stuff — food that is stripped from fibre and those essential nutrients and often replaced by the food industry by synthetic (man-made) versions that the body doesn’t recognise, and more often than not utilise.
It has been established that top soil erosion — the result of overuse of pesticides and synthetic fertilisers (usually made from petrochemicals), monocropping (the agricultural practice of growing a single crop year after year on the same land) and intensive farming (rotation is immediate, and from one harvest to the next, the land never rests) and increasing loss of microbiota (the soil relies on bacteria like the gut to survive, and help provide nutrients for plants), and synergy between plants and nature (e.g., fungus are vital to the circle of life, by communicating with the roots of ALL plants, and yet are destroyed by fungicides and plants not able to release deep-enough roots and become part of the ecosystem) has decreased the nutrient content of the soil beyond recognition. It is believed that the nutritional content of fresh fruits and vegetables has reduced by 40% in the last 40 years and that there is only 60 years left before the top soil becomes sterile.
Monsanto (owned by Bayer) and similar companies are still producing poisonous substances by the tonnes every single day that are sprayed indiscriminately on soils and crops. This exercise is not to provide more food on our table, but simple to create genetically altered plants that can be drenched over and over by pesticides. In fact, GMO stands for pesticide-ready. Not health-ready.
Food insecurity or limited access to healthy foods and variety is also a problem in our Western parts of the world. Many people on low income or living under the level of poverty may only have accessed to cheaper, ultra-processed manufactured (nutrient-poor) food products. It is also recognised that most people’s baskets ever contain the same 8 products each week. This is the main reasoning behind supermarkets changing their aisles: to interest you to buy new products, when looking for your ‘regulars’.
All of the above problems leading to malnutrition (nutrient deficiencies in one or more essential vitamins or minerals), may negatively impact both physical and mental health, and potentially lead to chronic illness. To compound the issue, chronic psychological and environmental stress and anxiety may negatively impact micronutrient concentrations in the body, leading to micronutrient depletion.2 We know that adrenal glands require larger stores of vitamin C for the synthesis of stress hormones, including cortisol. Many nutrients act as co-factors in enzymatic processes and so are also essential for the functioning of all those processes — missing co-factors prevent enzymes to fulfil their function. Antioxidants enzyme function, including the life-preserving action of glutathione, for example, may lead to tissue death and poor cellular function, if unable to prevent free radical damage occurring as a result of cellular respiration (and energy production), every single second of every day.
In a time when stress-related statistics indicate significantly higher symptoms of anxiety and depression due to the pandemic,3 a nutrient-dense diet made up of foods full of vitamins, minerals, and phytonutrients can be a powerful tool in promoting mental wellness and combating chronic disease. However, in most cases, deficiencies are so pronounced that supplementation may be essential to recovery and better stress (and anxiety) management.
Nutrient deficiencies, their impact on anxiety and depression
On the top of the list of essential nutrients is magnesium, one of the least consumed micronutrients. Yet, it is present in a variety of foods, from greens (kale, spinach, collard greens, turnip greens and mustard greens) to seeds, and from beans to whole grains. It is accepted by many researchers that low levels of magnesium intake have been associated with depression.4,5,6 As a result of increasing evidence correlating dietary preferences and depression and depression and dementia (and Alzheimer’s), a 2019 cross-sectional analysis of medical records from 3,604 adults found a positive link between lower serum magnesium levels and depressive symptoms.7
Beneficial effects of magnesium supplementation on anxiety and stress-related symptoms have been suggested, opening the door to better understanding the role of magnesium on our mental and emotional well-being.8,9
Some B vitamin deficiencies have also been associated with an increased risk of depression, and consistent and sufficient intake of those nutrients, specifically folate and vitamin B12, may potentially decrease the risk of depression (as well as relapse) and the onset of symptoms in an at-risk population.11 A 2019 systematic review and meta-analysis suggested that B vitamin supplementation benefited both at-risk (poor nutrient and mood status) and healthy populations specific to improving their reported stress symptoms and overall mood.12
Nutrient deficiencies, the role of phytonutrients and antioxidants
A diet that includes a varied and colourful rainbow of fruits, vegetables, whole grains, spices, and herbs provides essential minerals and vitamins, especially antioxidants (usually known as pigments; therefore the deeper the colour potentially the greater the content in antioxidant). I want to add that up to a few decades ago, vegetables were known as herbs. However, the foods we call herbs today are forgotten heroes. They are the richest foods in antioxidants and phytonutrients on the planet and should be consumed by the handful daily. For example, parsley is an excellent source of bioassimilable Vitamin C, and coriander (cilantro) is a nutrient powerhouse that has been studied extensively for its health-supporting properties.
Those phytochemicals that contribute to the colour, taste, and smell of plants have been studied for centuries for their health benefits both physical and mental. Curcumin, a compound found in turmeric, is one the most studied substances on the planet. It is remarkable for it displays amazing anti-inflammatory properties but it also shows significant antidepressant effects as an adjunctive treatment for major depressive disorder, as well as reducing anxiety in depressed adults.13,14
Indeed, research confirms that acute and chronic psychological stress is associated with increased inflammatory activity in the body, contributing to the adverse mental health symptoms and furthering inflammatory processes.15 This is why it is important to consider the anti-inflammatory properties of dietary phytonutrients and antioxidants and to incorporate those in our daily diet. 5-a-day is thus simply enough. By understand their importance you may want to increase your intake to perhaps 10-a-day, which is easier than you think.
A diet rich in those health-preserving nutrients can help reduce psychological stress and improved emotional and physical health.16 Antioxidants such as vitamins A, C, and E may also play a role in the development and alleviation of anxiety and depressive symptoms. After a six-week treatment of vitamins A, C, and E, a significant increase in blood levels of antioxidants and a significant reduction in anxiety and depression is usually reported reported.17
Inflammation is very often at the core of modern diseases and this is really to understand the signals the body is sending. Because our diet is mostly pro-inflammatory it is essential to rethink the diet and incorporate more anti-inflammatory foods with every meal. Small, wild fatty fish, like sardines, herrings, mackerel, and anchovies are well-known for their oil rich in omega-3 polyunsaturated fatty acids. River trout is also a good source. Omega-3s are essential for cell membrane and electrical polarity of our body cells, they are also essential to build healthy brain cells and this is why research suggests that omega-3s are protective against depression and reduce depressive symptoms.18-20
Peer-reviewed studies show great benefits from omega-3 supplementation in patients with major depressive disorders, including reduced symptoms of depression, anxiety sensitivity, and sleep disturbances and improved regulation of their emotions.21
Clinical Considerations
At Nutrunity UK, we understand the power of nutrition and antioxidants and phytonutrients, and thus promote healthy eating. For this very reason, diet quality is a crucial consideration when evaluating chronic physical and mental health conditions and when implementing personalised interventions that address imbalances in order to optimise your overall wellness. Dietary patterns that include adequate and varied consumption of colourful foods that are rich in essential micronutrients, including antioxidants and phytonutrients, positively impact mental health. And we will always recommend you to follow this type of diet to support your overall health and as well as your mental health.
Remember that stress depletes the body of essential nutrients so addressing stress or anxiety is a pivotal aspect that we will assess during our consultation. We will design a plan that include every aspect of your life, including lifestyle and dietary habits that will promote mental and physical wellness, so you can go back to life a full, vibrant life. Let it be your new beginning.
References
US Department of Health and Human Services and US Department of Agriculture. 2015-2020 Dietary Guidelines for Americans.8th ed. Office of Disease Prevention and Health Promotion; 2015. http://health.gov/dietaryguidelines/2015/guidelines
Lopresti AL. The effects of psychological and environmental stress on micronutrient concentrations in the body: a review of the evidence. Adv Nutr. 2020;11(1):103-112. doi:10.1093/advances/nmz082
Czeisler MÉ, Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic – United States, June 24-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr.mm6932a1
Wang J, Um P, Dickerman BA, Liu J. Zinc, magnesium, selenium and depression: a review of the evidence, potential mechanisms and implications. Nutrients. 2018;10(5):584. doi:10.3390/nu10050584
Rosanoff A, Dai Q, Shapses SA. Essential nutrient interactions: does low or suboptimal magnesium status interact with vitamin D and/or calcium status? Adv Nutr. 2016;7(1):25-43. doi:10.3945/an.115.008631
Tarleton EK, Littenberg B. Magnesium intake and depression in adults. J Am Board Fam Med. 2015;28(2):249-256. doi:10.3122/jabfm.2015.02.140176
Tarleton EK, Kennedy AG, Rose GL, Crocker A, Littenberg B. The association between serum magnesium levels and depression in an adult primary care population. Nutrients. 2019;11(7):1475. doi:10.3390/nu11071475
Boyle NB, Lawton C, Dye L. The effects of magnesium supplementation on subjective anxiety and stress—a systematic review. Nutrients. 2017;9(5):429. doi:10.3390/nu9050429
Pouteau E, Kabir-Ahmadi M, Noah L, et al. Superiority of magnesium and vitamin B6 over magnesium alone on severe stress in healthy adults with low magnesemia: a randomized, single-blind clinical trial. PLoS One. 2018;13(12):e0208454. doi:10.1371/journal.pone.0208454
Almeida OP, Ford AH, Flicker L. Systematic review and meta-analysis of randomized placebo-controlled trials of folate and vitamin B12 for depression. Int Psychogeriatr. 2015;27(5):727-737. doi:10.1017/S1041610215000046
Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A systematic review and meta-analysis of B vitamin supplementation on depressive symptoms, anxiety, and stress: effects on healthy and ‘at-risk’ individuals. Nutrients. 2019;11(9):2232. doi:10.3390/nu11092232
Kanchanatawan B, Tangwongchai S, Sughondhabhirom A, et al. Add-on treatment with curcumin has antidepressive effects in Thai patients with major depression: results of a randomized double-blind placebo-controlled study. Neurotox Res. 2018;33(3):621-633. doi:10.1007/s12640-017-9860-4
Lopresti AL, Drummond PD. Efficacy of curcumin, and a saffron/curcumin combination for the treatment of major depression: a randomised, double-blind, placebo-controlled study. J Affect Disord. 2017;207:188-196. doi:10.1016/j.jad.2016.09.047
Maydych V. The interplay between stress, inflammation, and emotional attention: relevance for depression. Front Neurosci. 2019;13:384. doi:10.3389/fnins.2019.00384
Stringham NT, Holmes PV, Stringham JM. Supplementation with macular carotenoids reduces psychological stress, serum cortisol, and sub-optimal symptoms of physical and emotional health in young adults. Nutr Neurosci. 2018;21(4):286-296. doi:10.1080/1028415X.2017.1286445
Gautam M, Agrawal M, Gautam M, Sharma P, Gautam AS, Gautam S. Role of antioxidants in generalised anxiety disorder and depression. Indian J Psychiatry. 2012;54(3):244-247. doi:10.4103/0019-5545.102424
Sublette ME, Ellis SP, Geant AL, Mann JJ. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry. 2011;72(12):1577-1584. doi:10.4088/JCP.10m06634
Mozaffari-Khosravi H, Yassini-Ardakani M, Karamati M, Shariati-Bafghi SE. Eicosapentaenoic acid versus docosahexaenoic acid in mild-to-moderate depression: a randomized, double-blind, placebo-controlled trial. Eur Neuropsychopharmacol. 2013;23(7):636-644. doi:10.1016/j.euroneuro.2012.08.003
Carney RM, Steinmeyer BC, Freedland KE, Rubin EH, Rich MW, Harris WS. Baseline blood levels of omega-3 and depression remission: a secondary analysis of data from a placebo-controlled trial of omega-3 supplements. J Clin Psychiatry. 2016;77(2):e138-e143. doi:10.4088/JCP.14m09660
Jahangard L, Sadeghi A, Ahmadpanah M, et al. Influence of adjuvant omega-3-polyunsaturated fatty acids on depression, sleep, and emotion regulation among outpatients with major depressive disorders – results from a double-blind, randomized and placebo-controlled clinical trial. J Psychiatr Res. 2018;107:48-56. doi:10.1016/j.jpsychires.2018.09.016