ArticlePDF Available
Clinical Psychological Science
2016, Vol. 4(6) 1082 –1084
© The Author(s) 2016
Reprints and permissions:
DOI: 10.1177/2167702616641050
Short Communication/Commentary
This series is intended to showcase the diversity of stud-
ies being conducted in a new, rapidly emerging field of
nutrition and mental health, coined by leaders in the field
as nutritional psychiatry (Sarris, Logan, etal., 2015). The
series begins with an article by Sánchez-Villegas,
Ruiz´-Canela, Gea, Lahortiga, and Martínez-González
(2016) that fits into the field of nutritional epidemiology
but expands it significantly. Over the past decade, there
has been a steady increase in epidemiological studies
investigating the relationships between dietary patterns
and mental states. Both cross-sectional and longitudinal
studies have shown that the more one eats a Western or
highly processed diet, the more one is at risk for develop-
ing psychiatric symptoms such as depression and anxi-
ety. Conversely, the more one eats a diet rich in fruits and
vegetables, high in healthy fats, nuts, and fish, and low in
processed food (a Mediterranean-style diet), the more
one is protected from developing a mental disorder
(Akbaraly etal., 2009; Jacka etal., 2010; Jacka etal., 2011;
Sánchez-Villegas et al., 2009; Sánchez-Villegas et al.,
2012). In several studies, the dietary pattern has been
shown to precede the onset of psychiatric symptoms,
clearly supporting the direction of causality (dietary pat-
tern does influence mental health, although we tend to
attribute poor dietary patterns to being carbohydrate
craving induced by low mood).
Sánchez-Villegas and colleagues broaden their analy-
ses beyond the Mediterranean diet to Mediterranean life-
style variables. What they report is of great relevance to
our understanding of how lifestyle variables fit together:
Dietary pattern, physical activity, and social activities were
all independently and inversely associated with risk of
depression. Taken together, the reduction in risk for those
at the highest levels on all three variables was about 50%.
If a drug with no side effects were to be associated with
that significant a reduction in risk, it would be prescribed
often. Is it time for our health professionals to prescribe
Mediterranean diet, physical activity, and social activities?
Although some of the research in clinical patients
involves intervention (changing dietary habits and exam-
ining associated changes in cognitive function and
mental symptoms), other studies, such as the article by
Chang, Jingling, Huang, Lu, and Su (2016) in the current
series, evaluate correlations between some aspect of
dietary intake in relation to mental health. In a small
group of 21 children diagnosed with attention-deficit/
hyperactivity disorder (ADHD) and 21 non-ADHD con-
trols, three types of variables were compared: n-3 fatty
acid intake based on a food frequency questionnaire for
the prior 3 months, the physical signs and symptoms
known to indicate a deficiency in essential fatty acids
(e.g., dry skin or hair, dandruff, brittle nails), and perfor-
mance on some laboratory tasks of cognitive function
and inhibition. One intriguing finding was that although
there were no group differences in omega 3 intake, there
were group differences in signs of essential fatty acid
(EFA) deficiency. Does this finding mean that children
with ADHD might require more EFA intake than normal
children to prevent signs of deficiency? This possibility
does require further exploration but may tie into Bruce
Ames’s hypothesis that some people may inherit an in-
born error of metabolism that results in the need for a
greater intake of the nutrient(s) not being well metabo-
lized (Ames, 2004; Ames, Elson-Schwab, & Silver, 2002).
The study by Chang etal. also found that greater ADHD
symptoms were correlated with lower n-3 fatty acid
intake and higher severity of symptoms indicative of EFA
deficiency. EFA deficiency was also correlated with higher
delay aversion in the laboratory tasks of inhibitory
The series includes two articles that explore micronu-
trient treatment, one looking at a single nutrient (Sarris,
Oliver, Camfield, & Dean, 2016) and one exploring the
potential of multinutrient treatment (Lothian, Blampied,
& Rucklidge, 2016). When examining the potential of any
new therapy, a question often emerges: Who might be
most likely to benefit from this approach? Using data
641050CPXXXX10.1177/2167702616641050Rucklidge, KaplanNutrition and Mental Health
Corresponding Author:
Julia J. Rucklidge, University of Canterbury, Psychology Department,
Private Bag 4800, Christchurch 8140, New Zealand
Nutrition and Mental Health
Julia J. Rucklidge1 and Bonnie J. Kaplan2
1University of Canterbury and 2University of Calgary
Received 2/22/16; Revision accepted 3/2/16
by guest on November 14, 2016cpx.sagepub.comDownloaded from
Nutrition and Mental Health 1083
from a previously published clinical trial of N-acetyl-cys-
teine (NAC) in the treatment of obsessive compulsive dis-
order (OCD; Sarris, Oliver, etal., 2015), Sarris etal. asked
whether there were any meaningful variables that pre-
dicted responsiveness to NAC. Their analyses uncovered
the role of age, type of OCD, and duration of illness as
potential moderators of treatment response. It is not sur-
prising that the younger someone is and the shorter the
duration of illness, the more likely one will respond to
this one nutrient, advocating for early intervention as
well as possibly using this approach before trialing medi-
cations. Certainly there is room for much greater explora-
tion of determining who might benefit from directed
nutrients: Epigenetic research and studies of biomarkers
of inflammation may begin to illuminate this potential.
The article by Lothian etal. (2016) serves a dual pur-
pose in this series. First, it introduces the use of broad-
spectrum micronutrients (by which we mean having a
large number of dietary minerals and vitamins) as a
treatment modality for mental health problems. And
second, it also displays innovations in the analysis of
the data. Insomnia is an interesting symptom to target
for treatment as it is associated with so many mental
health problems, exacerbating them all. Many other
studies have shown alleviation of other psychological
symptoms with micronutrient treatment: depression,
anxiety, explosive rage, irritability (another symptom
that crosses many diagnosticcategories), and attentional
problems (Rucklidge & Kaplan, 2013). So in that sense,
this contribution, showing substantial improvements in
sleep in this sample, adds to the growing evidence that
many forms of psychological distress can be amelio-
rated by nutritional therapies. They also presented the
data in an innovative way, using modified Brinley plots,
to permit both idiographic individual and group out-
comes to be evaluated concurrently.
There is an increasingly vast literature on mechanisms
of action related to oxidative stress, mitochondrial dys-
function, gastrointestinal dysbiosis, and inflammation
(Kaplan, Rucklidge, McLeod, & Romijn, 2015). In fact, our
journey toward editing this special series began with our
article published in this journal last year that attempted to
present a simple explanation of how the framework that
depends on these functions inevitably relates to nutrients
and their critical role in health and disease.
The final article in the series, by Akbaraly and colleagues
(2016), adds to the growing literature on mechanisms by
providing some intriguing insights into the complex rela-
tionships among biomarkers and diets identified as being
proinflammatory. In terms of epidemiologic findings, their
data reinforce the relationship between dietary patterns
and expression of depressive symptoms 5 years later
(observed only in women, not men). But in addition, they
describe the “dietary inflammatory index,” which was
correlated at baseline with biomarkers of inflammation
(CRP and IL-6). Perhaps surprising, these markers of inflam-
mation did not influence the long-term association between
the dietary inflammation index and recurrent depressive
symptoms. Such a finding reinforces the complexity in
understanding the role markers might play in the expres-
sion of illness. These relationships are not straightforward
and require much additional research.
We hope this series brings further attention to this
growing field of research. We are pleased to be a part of
this new venture and hope that other scientists see the
relevance to their own work.
Author Contributions
Both authors worked collaboratively on this introduction and
both approved the final draft.
Declaration of Conflicting Interests
The authors declared that they had no conflicts of interest with
respect to their authorship or the publication of this article.
No external funding supported this work.
Akbaraly, T. N., Brunner, E. J., Ferrie, J. E., Marmot, M. G.,
Kivimaki, M., & Singh-Manoux, A. (2009). Dietary pattern
and depressive symptoms in middle age. British Journal
of Psychiatry, 195, 408–413. doi:10.1192/bjp.bp.108.058925
Akbaraly, T. N., Kerleau, C., Wyart, M., Chevallier, N.,
Ndiaye, L., Shivappa, N., . . . Kivimäki, M. (2016). Dietary
inflammatory index and recurrence of depressive symptoms:
Results from the Whitehall II Study. Clinical Psychological
Science, 4, 1125–1134.
Ames, B. N. (2004). A role for supplements in optimizing health:
The metabolic tune-up. Archives of Biochemistry and
Biophysics, 423, 227–234. doi:
Ames, B. N., Elson-Schwab, I., & Silver, E. A. (2002). High-dose
vitamin therapy stimulates variant enzymes with decreased
coenzyme binding affinity (increased K(m)): Relevance to
genetic disease and polymorphisms. American Journal of
Clinical Nutrition, 75, 616–658.
Chang, J., Jingling, L., Huang, Y.-T., Lu, Y.-J., & Su, K.-P. (2016).
Delay aversion, temporal processing and n-3 fatty acids
intake in children with attention deficit hyperactivity disor-
der (ADHD). Clinical Psychological Science, 4, 1094–1103.
Jacka, F. N., Kremer, P. J., Berk, M., de Silva-Sanigorski, A.M.,
Moodie, M., Leslie, E. R., . . . Swinburn, B. A. (2011).
A prospective study of diet quality and mental health in
adolescents. PLoS ONE, 6, e24805. doi:10.1371/journal
Jacka, F. N., Kremer, P. J., Leslie, E. R., Berk, M., Patton, G. C.,
Toumbourou, J. W., & Williams, J. W. (2010). Associations
between diet quality and depressed mood in adolescents:
by guest on November 14, 2016cpx.sagepub.comDownloaded from
1084 Rucklidge, Kaplan
Results from the Australian Healthy Neighbourhoods Study.
Australian and New Zealand Journal of Psychiatry, 44,
435–442. doi:10.3109/00048670903571598
Kaplan, B. J., Rucklidge, J. J., McLeod, K., & Romijn, A.
(2015). The emerging field of nutritional mental health:
Inflammation, the microbiome, oxidative stress, and mito-
chondrial function. Clinical Psychological Science, 3, 964–
980. doi:10.1177/2167702614555413
Lothian, J. A., Blampied, N., & Rucklidge, J. J. (2016). Effect of
micronutrients on insomnia in adults: A multiple-baseline
study. Clinical Psychological Science, 4, 1112–1124.
Rucklidge, J. J., & Kaplan, B. J. (2013). Broad-spectrum micronu-
trient formulas for the treatment of psychiatric symptoms: A
systematic review. Expert Review of Neurotherapeutics, 13,
49–73. doi:10.1586/ern.12.143
Sánchez-Villegas, A., Delgado-Rodriguez, M., Alonso, A.,
Schlatter, J., Lahortiga, F., Serra Majem L., & Martinez-
Gonzalez, M. A. (2009). Association of the Mediterranean
dietary pattern with the incidence of depression: The
Seguimiento Universidad de Navarra/University of Navarra
follow-up (SUN) cohort. Archives of General Psychiatry, 66,
1090–1098. doi:10.1001/archgenpsychiatry.2009.129
Sánchez-Villegas, A., Ruiz´-Canela, M., Gea, A., Lahortiga, F., &
Martínez-González, M. A. (2016). The association between
the Mediterranean lifestyle and depression. Clinical
Psychological Science, 4, 1085–1093.
Sánchez-Villegas, A., Toledo, E., de Irala, J., Ruiz-Canela, M.,
Pla-Vidal, J., & Martínez-González, M. A. (2012). Fast-
food and commercial baked goods consumption and the
risk of depression. Public Health Nutrition, 15, 424–432.
Sarris, J., Logan, A. C., Akbaraly, T. N., Amminger, G. P.,
Balanzá-Martínez, V., Freeman, M. P., . . . Jacka, F. N. (2015).
Nutritional medicine as mainstream in psychiatry. Lancet
Psychiatry, 2, 271–274. doi:10.1016/S2215-0366(14)00051-0
Sarris, J., Oliver, G., Camfield, D. A., & Dean, O. M. (2016).
Participant characteristics as modifiers of response to n-acetyl
cysteine (NAC) in obsessive-compulsive disorder. Clinical
Psychological Science, 4, 1104–1111.
Sarris, J., Oliver, G., Camfield, D. A., Dean, O. M., Dowling, N.,
Smith, D. J., . . . Ng, C. H. (2015). N-acetyl cysteine (NAC) in
the treatment of obsessive-compulsive disorder: A 16-week,
double-blind, randomised, placebo-controlled study. CNS
Drugs, 29, 801–809. doi:10.1007/s40263-015-0272-9
by guest on November 14, 2016cpx.sagepub.comDownloaded from
... One modifiable risk factor for mental illness identified in recent interventional studies is the quality of individuals' diet (Marx et al., 2022). In several studies, the onset of psychiatric symptoms followed poor dietary practices, clearly highlighting the direction of causality (Rucklidge & Kaplan, 2016). At the University of British Columbia (UBC), Canada, Rossa-Roccor et al. (2021) found a significant positive association between junk food component and depression and anxiety. ...
... The selection of respondents for the study was based primarily on the unit/department where they work, supported by data obtained from the unit/department head. The exclusive use of health professionals from the psychiatric unit was informed by recent evidence which supports the essential role of mental health workers in nutritional care of their clients (Alshwaiyat et al., 2013;Freeman, 2013;Gill et al., 2017Gill et al., , 2021Offor et al., 2021;Rossa-Roccor, Richardson et al, 2021;Rucklidge & Kaplan, 2016;Strassnig et al., 2013). ...
Full-text available
Contemporary evidence suggests that proper nutrition plays a key role in the treatment and prevention of mental illness. This hospital-based descriptive cross-sectional study sought to examine health professionals’ knowledge, attitudes, and practices toward patient nutritional care. The study was conducted at the Bono Regional Hospital in Sunyani, Ghana. Eighteen (18) health professionals working at the hospital’s psychiatric unit were recruited for the study through the census. Semi-structured, self-administered questionnaires, prepared and administered via Google forms, were used to collect data for the study. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 25. There was a 100% response rate. Males constituted 66.7% of the sample. More than one-fourth (27.8%) of the respondents were community mental health officers, and the majority of them were full-time workers (66.7%). Most of the respondents worked 3-5 days per week (77.8%) and 6–8 hours per day (83.3%). The larger proportion of the sample had worked in the health sector for less than 2 years (72.2%). Based on our specified criteria, most of the respondents had adequate knowledge (83.3%), a positive attitude (94.4%), and good practices (83.3%) toward patient nutrition. Overall, knowledge, attitude, and practices toward patient nutritional care were good, suggesting that nutritional care has been recognized as an essential component of the treatment and prevention of mental illness at Bono Regional Hospital. It is however important that the management of the hospital ensures timely and adequate provision of essential logistics and resources needed for patient nutritional care.
... Positive nutrition has been associated with diets such as the Mediterranean diet and the Keto diet which is low in processed foods, rich in fruits and vegetables, legumes, whole grains, healthy fats, fish, nuts and rich in omega-3 fats leading to higher mental wellbeing (Hanson & Mendius, 2009;Hefferon, 2013;Korn, 2013;Korn, 2016;Sofi et al., 2008;), with an increase in energy, vigor and contentment (Akbaraly et al., 2009) and a lower incidence of mental disorders (Heferron 2013; Jacka et al., 2010;Jacka et al., 2017;Rucklidge & Kaplan, 2016;Sanchez-Villegas et al., 2009). Correlational, longitudinal, and experimental studies across multiple populations have shown an emerging patternindividuals eating more fruits and vegetables (FV) were associated with greater wellbeing (Holder, 2019) including higher life satisfaction, an increase in creativity, curiosity, vitality, flourishing, motivation, and better mood (Dreher, 2018;Otake & Kato, 2017). ...
... Multiple studies have validated the physicality of trauma (Chakraborty & Burns, 2020;Gordon, 2019;Kendall-Tackett, 2009;Van der Kolk, 2015) and participants like Ally and Beatrice who suffered from trauma induced migraines and gut issues leaned on nutrition to combat their physical symptomology (Kendal-Tackett, 2009). This led to higher wellbeing through foods, resulting in growth (Heferron 2013;Holder, 2019;Korn 2013Korn , 2016Rucklidge & Kaplan, 2016;Sadhukhan, 2020). ...
... Pada tingkat Jawa Timur terdapat 653 ribu balita yang mengalami stunting (BKKBN, 2022) Salah satu penyebab terjadinya stunting adalah asupan nutrisi yang kurang seimbang, kurangnya pengetahuan ibu mengenai kesehatan dan gizi, terbatasnya layanan kesehatan dan masih kurangnya akses kepada makana bergizi dan kurangya akses air bersih dan sanitasi (Haryani, Astuti, & Sari, 2021). Patofisiologi stunting karena adanya envronmental enteric dysfunction (EED) di mana kondisi kurang gizi, malabopsi nutrisi serta terjadinya radang menyebabkan gangguan pada struktur dan fungsi usus halus sehingga berdampak pada gangguan penyerapan nutrisi yang akan berpengaruh pada tumbuh kembang anak (Vonaesch et al., 2018) kondisi pandemi Covid-19 yang berdampak pada aspek ekonomi berpengaruh juga terhadap pemenuhan nutrisi dan gizi anak (Melyani & Alexander, 2021) Penelitian yang dilakukan di Iran menunjukkan bahwa status gizi anak juga berpengaruh terhadap perkembangan kesehatan mental anak (Rucklidge & Kaplan, 2016) yaitu pada perkembangan emosional dan sosial. (Papotot, Rompies, & Salendu, 2021) RW 16 Desa Pepe berada di kecamatan Sedati, Kabupaten Sidoarjo, di RW 16 terdapat 17 Ibu yang mempunyai anak usia di bawah 5 tahun sebagian besar dari ibu bekerja sebagai ibu rumah tangga dengan usia yang berada di rentang 20 -40 tahunan. ...
ABSTRAK Anak yang kekurangan asupan gizi akan berdampak pada keterlambatan pertumbuhan dan perkembangan otak, tulang, dan gangguan emosi. Tujuan kegiatan ini adalah untuk memberikan pengetahuan pada ibu tentang stunting dan manfaat pemberian daun kelor pada anak. Kegiatan ini diikuti oleh 17 ibu yang memiliki anak balita di RW 16 Pepe Sidoarjo. Kegiatan dilakukan dalam dua tahap, tahap pertama memberikan pengetahuan tentang stunting dan asupan gizi untuk anak, tahap kedua melakukan demonstrasi cara membuat puding daun kelor. Tingkat pengetahuan ibu tentang stunting dan gizi anak diukur dengan menggunakan kuesioner. Dari hasil pengukuran sebelum diberikan edukasi didapatkan 10 responden yang pengetahuan kurang dan setelah kegiatan terdapat 2 responden yang pengetahuannya cukup. Orang tua penting untuk mengetahui jenis asupan gizi yang baik untuk anak, makanan yang perlu diberikan tidak harus mahal karena banyak makanan di sekitar kita yang terbukti secara ilmiah mempunyai kandungan nutrisi yangbaik untuk membantu pertumbuhan dan perkembangan anak yang optimal.Kata Kunci: Anak, Kelor, StuntingABSTRACTChildren who lack nutritional intake will have an impact on delays in growth and development of the brain, bones, and emotional disorders. The purpose of this activity is to provide knowledge to mothers about stunting and the benefits of giving Moringa leaves to children. This activity was attended by 17 mothers with toddlers in RW 16 Pepe Sidoarjo. The activity was carried out in two stages, the first stage was to provide knowledge about stunting and nutritional intake for children, the second stage was to demonstrate how to make Moringa leaf pudding. Mother's level of knowledge about stunting and child nutrition was measured using a questionnaire. From the measurement results before being given education, it was found that 10 respondents had less knowledge and after the activity there were 2 respondents who had sufficient knowledge. It is important for parents to know the type of good nutritional intake for children, the food that needs to be given does not have to be expensive because there are many foods around us that are scientifically proven to have good nutritional content to help optimal growth and development of children.Keywords: Children, Kelor, Stunting
... As nutritional deficiencies have been associated with various psychiatric and neurological disorders (Nawaz et al. 2020;Pfaender and Grabrucker 2014;Rucklidge and Kaplan 2016), looking into the role of nutritional and herbal supplements in OCD has become of interest (Kuygun Karcı and Gül Celik 2020). This chapter provides a summary of the research about nutrients and their potential therapeutic role in OCD. ...
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by intrusive distressing thoughts, images, or impulses (obsessions) and/or repetitive excessive behaviors performed in response to these obsessions (compulsions). The recommended treatment for OCD is medications with serotonin reuptake inhibitors and/or cognitive behavioral therapy using exposure and response prevention. In recent years, an increasing body of evidence has investigated nutrition and nutritional deficiencies in OCD. This chapter reviews and summarizes the current knowledge about the potential role of nutritional elements, including amino acids, plants and herbal supplements, vitamins, trace minerals, and other nutrients in the pathophysiology and treatment of OCD. Nutrition-based interventions need to be supported by more rigorous research. Greater attention to this type of treatment is warranted given that nutrients can be of low cost, safe, and acceptable.
... Closely linked in the literature to quality of nutritional intake (Rucklidge and Kaplan 2016;Conner et al. 2017;Firth et al. 2020), there were relatively high rates of students at risk of reduced wellbeing, especially amongst girls at secondary school. We observed no differences in student wellbeing according to advantage of the school community (school decile), however, girls in secondary schools experienced poorer wellbeing than boys and wellbeing declined with increasing body size. ...
Our current food system is failing to deliver on equitable health outcomes, wellbeing and food security and the Hawke’s Bay region of New Zealand has high inequities and one the highest levels of childhood obesity nationally. This articlereports baseline quantitative data from 2087 students (aged 9 or 13) from 41 primary and secondary schools, including schools participating in the Ka Ora, Ka Ako Healthy School Lunch programme. Students answered an online survey covering food security, general wellbeing (WHO-5), eating behaviours and physical activity and were measured/weighed for body size. 16.8% of students experienced food insufficiency in the home and 31.3% of 13-yr-olds did not eat breakfast. Overall, only 12.9% met the national vegetable intake guidelines and 39.6% met fruit intake guidelines. Students in high advantage schools (decile 8–10) were twice as likely to meet the vegetable intake guidelines. 47.1% of 13-year old girls were at risk of reduced wellbeing. 54.6% of students had a healthy weight and 44.5% experienced overweight or obesity; in low advantage (decile 1–3) schools 64.4% experienced overweight or obesity. The data form a baseline for an evaluation of multiple public health initiatives underway in Hawke’s Bay to improve food environments and nutritional wellbeing.
... [12][13][14][15][16] Factors associated with higher levels of well-being include exercise, socialization, proper nutrition, and participation in healthy activities unrelated to work. 5,[17][18][19] Additional sources of well-being specific to physicians in residency training include appropriate supervision and receiving high-quality teaching. 20 Low well-being among veterinarians has been associated with student debt and financial dissatisfaction. ...
OBJECTIVE To describe veterinary house officers’ perceptions of dimensions of well-being during postgraduate training and to identify potential areas for targeted intervention. SAMPLE 303 house officers. PROCEDURES A 62-item questionnaire was generated by use of an online platform and sent to house officers at participating institutions in October 2020. Responses were analyzed for trends and associations between selected variables. RESULTS 239 residents, 45 rotating interns, and 19 specialty interns responded to the survey. The majority of house officers felt that their training program negatively interfered with their exercise habits, diet, and social engagement. House officers reported engaging in exercise significantly less during times of clinical responsibility, averaging 1.6 exercise sessions/wk (SD ± 0.8) on clinical duty and 2.4 exercise sessions/wk (SD ± 0.9) when not on clinical duty ( P < 0.001). Ninety-four percent of respondents reported experiencing some degree of anxiety regarding their physical health, and 95% of house officers reported feeling some degree of anxiety regarding their current financial situation. Overall, 47% reported that their work-life balance was unsustainable for > 1 year; there was no association between specialty and sustainability of work-life balance. Most house officers were satisfied with their current training program, level of clinical responsibility, and mentorship. CLINICAL RELEVANCE Veterinary house officers demonstrated a poor balance between the demands of postgraduate training and maintenance of personal health. Thoughtful interventions are needed to support the well-being of veterinary house officers.
... El trastorno depresivo mayor (TDM), el trastorno bipolar (TBP), la esquizofrenia y el trastorno obsesivo compulsivo (TOC) se han reconocido como los trastornos mentales más comunes (2) . En los últimos años, múltiples estudios epidemiológicos han investigado la relación entre los patrones dietéticos y el estado mental (3) , puntualizando la influencia de los factores genéticos y ambientales, incluidos el estrés, la dieta y la inactividad física, en el desarrollo de dichos trastornos (4) . Aunado a esto, se ha propuesto que un mal estado nutricional durante el período perinatal emerge como un determinante negativo en los resultados ulteriores de la salud mental en los niños, y la desregulación emocional y conductual son condiciones asociadas durante la infancia (5,6) . ...
Full-text available
Mental as well as neurological disorders are among the leading causes of disability worldwide. In recent years, multiple epide-miological studies have investigated the relationship between dietary patterns and mental status, emphasizing the influence of genetic and environmental factors on the development of such disorders. It has also been recognized that neuronal deve-lopment is certainly influenced by nutri-tional factors dependent on an adequate intake of essential nutrients, vitamins and minerals. Vitamin D, B complex, omega 3 fatty acids, iodine, iron, prebiotics and pro-biotics are considered essential nutrients for brain structure and development, who-se alteration can negatively compromise mental health. A wide variety of pathologi-cal pathways involved in the development of these disorders have been postulated. Low-grade chronic inflammation, influen-ced by certain psychosocial stressors, sti-mulates the network of proinflammatory cytokines, resulting in neurobehavioral changes. On the other hand, the gut mi-crobiota (GM) plays an important role in multiple neurobiological pathways, due to its involvement in the modulation of the brain-derived neurotrophic factor, as well as in the metabolism of tryptophan. Gut microbiota deregulation is an important factor in individual behavior
... El trastorno depresivo mayor (TDM), el trastorno bipolar (TBP), la esquizofrenia y el trastorno obsesivo compulsivo (TOC) se han reconocido como los trastornos mentales más comunes (2) . En los últimos años, múltiples estudios epidemiológicos han investigado la relación entre los patrones dietéticos y el estado mental (3) , puntualizando la influencia de los factores genéticos y ambientales, incluidos el estrés, la dieta y la inactividad física, en el desarrollo de dichos trastornos (4) . Aunado a esto, se ha propuesto que un mal estado nutricional durante el período perinatal emerge como un determinante negativo en los resultados ulteriores de la salud mental en los niños, y la desregulación emocional y conductual son condiciones asociadas durante la infancia (5,6) . ...
Full-text available
Las enfermedades mentales y los tras-tornos neurológicos se encuentran entre las principales causas de discapacidad a nivel mundial. En los últimos años, múltiples estudios epidemiológicos han investigado la relación existente entre los patrones dietéticos y el estado mental, con énfasis en la influencia de factores genéticos y ambientales en el desarrollo de dichos trastornos. Asimismo, se ha reconocido que el desarrollo neuronal está ciertamente influenciado por factores nutricionales, dependientes de una ingesta adecuada de nutrientes esenciales, vitaminas y minerales, y la vitamina D, el complejo B, los ácidos grasos omega 3, el yodo, el hierro, los prebióticos y los probióticos son nutrientes indispensables tanto en la estructura como en el desarrollo cerebral, cuyas alteraciones pueden comprometer negativamente la salud mental. Por una parte, se ha postulado gran variedad de vías patológicas implicadas en el desarrollo de dichos trastornos; entre ellas se destaca la inflamación crónica de bajo grado, la cual se ve influenciada por ciertos estresores psicosociales que, en conjunto, estimulan la red de citocinas proinflamatorias, lo que resulta en cambios neuroconductuales. Por otra parte, la microbiota intestinal (MI) desempeña un papel importante en múltiples vías neurobiológicas debido a su rol en la modulación del factor neurotrófico derivado del cerebro, así como en el metabolismo del triptófano, y su desregulación es un factor importante en el comporta-miento del individuo.
Full-text available
Latar Belakang: Zat gizi memiliki peranan penting untuk menjaga kesehatan mental seseorang. Hasil studi menjelaskan bahwa ketika seseorang dengan kondisi kesehatan mental yang tidak baik, akan sering mengalami kekurangan zat gizi tertentu, vitamin essensial, mineral, asam amino dan asam lemak omega-3. Dalam beberapa penelitian juga membuktikan bahwa semakin banyak seseorang mengonsumsi suatu makanan yang kaya akan buah-buah dan sayuran, tinggi lemak sehat, kacang-kacangan dan ikan serta rendah makanan olahan, maka semakin seseorang akan terlindungi dari gangguan mental. Tujuan: Studi ini dilakukan untuk mengetahui upaya preventif dalam mengatasi masalah kesehatan mental dengan mengoptimalkan asupan zat gizi. Metode: Literatur yang digunakan dari referensi article, e-book dan research selama 10 tahun terakhir, yaitu 2013-2021, dengan menggunakan kata kunci asupan zat gizi, kesehatan mental, peranan dan upaya preventif. Ulasan: : Berdasarkan literatur yang digunakan dari referensi article, e-book dan research selama 10 tahun terakhir, yaitu 2013-2021, didapatkan hasil bahwa adanya pengaruh pengaturan pola konsumsi makanan yang sehat dengan menambah asupan-asupan zat gizi, seperti asam lemak omega-3, asam folat, asam amino (protein), vitamin B12, vitamin A, C, D dan E, Selenium, Zinc, dan Probiotik terhadap kesehatan mental seseorang. Kesimpulan: Kofaktor zat gizi dalam mikronutrien dapat memainkan peran penting dalam mengarahkan proses metilasi DNA dan regulasi epigenetik telah banyak terlibat dalam perkembangan otak dan kesehatan mental. Dengan demikian, pengoptimalan asupan zat gizi, seperti asam lemak omega-3, asam folat, asam amino (protein), vitamin B12, vitamin A, C, D dan E, Selenium, Zinc, dan Probiotik, dapat menjadi salah satu alternatif yang dapat dilakukan oleh masyarakat sebagai upaya preventif dalam mengatasi masalah kesehatan mental.
Full-text available
Background This study assessed whether perceived stress and depressive symptoms were associated with the frequency of consumption of specific food groups among female university students. Methods A cross-sectional study was conducted among female university students using a simple random sampling method. The response rate was 97%, with a total number of 385 participants. The associations between stress levels and most/least-consumed food groups, and between depressive symptoms levels and most/least-consumed food groups were assessed. The questionnaire included a 12-item self-administered food frequency questionnaire, Cohen's Perceived Stress Scale, and the Beck Depression Inventory-II. The study was approved by the University Ethical Committee prior to the data collection. One-way Analysis of Variance (ANOVA) and an independent-sample t -test were performed to test the equality of population means across the categories of each independent variable depending on the number of categories of the independent variable. Results Overall, this group of female university students fell under the mild mood disturbance category (depressive symptoms) (BDI-II) and had moderate perceived stress (PSS). Perceived stress was associated with more frequent consumption of salad/raw vegetables and cooked vegetables and less frequent consumption of cake/cookies and meat/sausage products ( p < 0.05). Additionally, depressive symptoms were associated with less frequent consumption of fresh fruits and increased consumption of fast food/canned food and soft drinks ( p < 0.05). Conclusions The data showed that stress and depression were associated with different dietary preferences, which is consistent with the distinctions between stress and depression in human behavior. Specifically, the results revealed associations between soft drinks consumption and higher depressive symptoms and between frequent consumption of salad/raw vegetables and cooked vegetables and higher perceived stress among this group of female university students.
Full-text available
This research assessed the association between the adherence to a Mediterranean lifestyle beyond the Mediterranean diet and the risk of depression in a prospective cohort of Spanish university graduates. Through a dynamic cohort study method, diet was assessed with a validated semiquantitative food-frequency questionnaire. The baseline assessment included a validated questionnaire on physical activity and average time spent with friends (socializing). Mediterranean lifestyle was defined as the joint exposure to Mediterranean diet, level of physical activity, and level of socializing. After a median follow-up of 8.5 years, 806 cases of depression among 11,800 participants were observed. Participants with the highest adherence to the Mediterranean lifestyle showed a 50% relative risk reduction in depression risk as compared to those participants with the lowest adherence (multivariable hazard ratio = 0.50; 95% confidence interval = [0.32, 0.81]). The Mediterranean lifestyle might reduce depression risk in the Seguimiento Universidad de Navarra cohort study beyond the known effects of the Mediterranean diet.
Full-text available
We live in a transformational moment for understanding the etiology of mental disorders. The previous leap in understanding occurred 60 years ago, which led us to incorporate psychopharmacology into our curricula to address the chemical basis of neurotransmitter function, especially as explained through the then-popular catecholamine hypothesis. The current revolution is broader, consisting of the rapidly accumulating knowledge of how inflammation, microbiome imbalance (gut dysbiosis), oxidative stress, and impaired mitochondrial output affect brain function. Suitable interventions for fighting inflammation, restoring normal gut function, reducing oxidative stress, and improving mitochondrial metabolism incorporate lifestyle variables, including nutrients and probiotics. This article invites readers to stay abreast of this emerging model of the biological basis of mental illness, given that it has particular relevance for those readers interested in alleviating the suffering of individuals with mental disorders. This overview describes the basis for a new field in mental health: nutritional psychiatry/psychology.
Full-text available
We live in a transformational moment for understanding the etiology of mental disorders. The previous leap in understanding occurred 60 years ago, which led us to incorporate psychopharmacology into our curricula to address the chemical basis of neurotransmitter function, especially as explained through the then-popular catecholamine hypothesis. The current revolution is broader, consisting of the rapidly accumulating knowledge of how inflammation, microbiome imbalance (gut dysbiosis), oxidative stress, and impaired mitochondrial output affect brain function. Suitable interventions for fighting inflammation, restoring normal gut function, reducing oxidative stress, and improving mitochondrial metabolism incorporate lifestyle variables, including nutrients and probiotics. This article invites readers to stay abreast of this emerging model of the biological basis of mental illness, given that it has particular relevance for those readers interested in alleviating the suffering of individuals with mental disorders. This overview describes the basis for a new field in mental health: nutritional psychiatry/psychology.
Full-text available
Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefi ts in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional defi ciencies) and mental health, and for the select use of nutrient-based supplements to address defi ciencies, or as monotherapies or augmentation therapies. We present a viewpoint from an international collaboration of academics (members of the International Society for Nutritional Psychiatry Research), in which we provide a context and overview of the current evidence in this emerging fi eld of research, and discuss the future direction. We advocate recognition of diet and nutrition as central determinants of both physical and mental health.
There is a growing interest in understanding the role of inflammation in the diet–depression relationship. The present study examined whether the Dietary Inflammatory Index (DII; a measure of the inflammatory potential of individuals’ diets) is associated with recurrent depressive symptoms (DepS) (Center for Epidemiologic Studies Depression Scale score > 16 or taking antidepressants both at baseline and follow-up) assessed over 5 years in middle-aged men (n = 3,178) and women (n = 1,068) from the Whitehall II Study. For each increment of 1 SD of DII score, odds of recurrent DepS increased by 66% (95% confidence interval [CI] = [1.30, 2.12]) in women, whereas no significant association between DII and recurrent DepS was observed in men (odds ratio [OR] = 1.12; 95% CI = [0.92, 1.36]). This association was little attenuated after adjustment for confounders and after taking into account levels of interleukin-6 and C-reactive protein. In conclusion, there is an association between proinflammatory diet and recurrent DepS in women that seems to not be driven by circulating inflammatory markers.
This study investigates the association between polyunsaturated fatty acid (PUFA) intake and neurocognitive functions in children with attention-deficit/hyperactivity disorder (ADHD). We recruited 21 drug-naïve children diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders and 21 non-ADHD controls. The n-3 intake and essential fatty acid (EFA) deficiency severity were recorded while the children were assessed for inhibitory control, delay aversion, and temporal processing with the Go/No Go Task, Delayed Reaction Time Task, and Finger Tapping Task, respectively. The ADHD group had more EFA deficiency symptoms (p =.02) and poorer performance in delay aversion (p =.02) and temporal processing (p <.001). Moreover, ADHD symptoms correlated negatively with n-3 intake and positively with EFA deficiency. In addition, EFA deficiency was associated with higher delay aversion (p <.001). Children with ADHD had a higher deficiency of EFA, and EFA deficiency had a positive association with ADHD severity and delay aversion.
Insomnia is a debilitating condition causing psychological distress and frequently comorbid with other mental health conditions. This study examined the effect of 8 weeks of treatment by broad spectrum micronutrients (vitamins and minerals) on insomnia using a multiple-baseline-across-participants open-label trial design. Seventeen adults were randomized to 1-, 2-, or 3-week baseline periods (14 completed). Self-report measures were the Consensus Sleep Diary–Morning (CSD-M), the Pittsburgh Insomnia Rating Scale (PIRS), and the Depression, Anxiety, Stress Scale (DASS). Baselines were generally stable. Treatment completers reported reliable and clinically significant change in insomnia severity (PIRS), in depression, stress, and anxiety (DASS), and on at least two aspects of sleep measured by the CDS-M. All completers were treatment-compliant, and side effects were minimal. Nutritional supplementation is shown to be a novel, beneficial treatment for insomnia in adults. Follow-up research using placebo-controlled designs as well as comparisons to cognitive-behavioral and other treatments is recommended.
We previously reported on a 16-week, double-blind, randomized placebo-controlled trial (RCT) using 3 grams per day of N-acetyl cysteine (NAC) (1.5 grams twice per day) in 44 participants (aged 18–70) with DSM-5-diagnosed obsessive-compulsive disorder (OCD). We now report on an analysis of age, severity and duration of illness, OCD presentation type, baseline anxiety and depression scores, as well as the use of antidepressant medications as potentially modifying factors. Results revealed a significant effect (p = .037) for younger participants (under mean age of 34) responding to NAC. This remained significant using OCD severity as a covariate (p = .044). For those under 34 years of age with less than 17 years of OCD duration, this was also significant (p = .037). Regression analysis within the NAC treatment group also revealed that duration of OCD presentation was a significant predictor of Yale-Brown Obsessive Compulsive Scale (YBOCS) change at study endpoint (p = .019), whereas baseline Montgomery–Asberg Depression Rating Scale scores were also a trend-level predictor (p = .060) of YBOCS change in the NAC group.
Background: Obsessive-compulsive disorder (OCD) is a disabling mental illness for which pharmacological and psychosocial interventions are all too often inadequate. Recent preclinical and clinical studies have implicated dysfunction of glutamatergic neurotransmission in the pathophysiology of OCD. The amino acid-based nutraceutical N-acetyl cysteine (NAC) is a safe and readily available agent that has been found to modify the synaptic release of glutamate in subcortical brain regions via modulation of the cysteine-glutamate antiporter. Objective: The aim of this study was to assess the efficacy and safety of NAC in treating OCD. Methods: A 16-week, double-blind, placebo-controlled, randomised trial using 3 g/day of NAC (1.5 g twice daily) in 44 participants (aged 18-70 years) with Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)-diagnosed OCD, during 2013-2015. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS), conducted every 4 weeks. Results: Analysis of the full sample (intention-to-treat) with repeated measures mixed linear modelling revealed a nonsignificant time × treatment interaction for the YBOCS scale total score (p = 0.39). A per-protocol analysis removing protocol violators also failed to show a significant time × treatment interaction for YBOCS total score (p = 0.15). However, a significant time × treatment interaction was observed for the YBOCS 'Compulsions' subscale in favour of NAC (p = 0.013), with a significant reduction observed at week 12 (dissipating at week 16). At 16 weeks, only four (20 %) participants were considered 'responders' (YBOCS ≥35 % reduction at endpoint) versus four (27 %) in the placebo group. The NAC was well-tolerated, aside from more cases of heartburn occurring compared with placebo (p = 0.045). Conclusion: Further research involving NAC for OCD may require larger samples to detect moderate or small effect sizes, involve dosage or formulation differences, use in concert with exposure therapy, or an additional post-study observational period to mitigate study withdrawal. Trial registration: ACTRN12613000310763.