By Deb Risden
In a poll conducted of 2,200 adults in March 2023, the American Psychological Association found 66% said they feel knowledgeable about the relationship between diet and mental health; 81% would be willing to change their diet to improve their mental health.
According to the APA, “More Americans say work (70%), family stress (68%), exercise (65%) and social habits (61%) have a more significant impact on their mental health compared to their diet (58%).
The Mayo Clinic defines depression as “a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.”
Alexandria Kurtz, D.O., who is with Meah Modern Psychiatry in Colorado Springs, is a board-certified psychiatrist specializing in integrative and nutritional psychiatry. Kurtz said the field of nutritional psychiatry is gaining traction as people are recognizing the importance of what we eat and the impact on brain health, which has been supported by research studies.
It’s food that breaks down into the nutrients our bodies need to make serotonin, dopamine and norepinephrine, chemicals our bodies naturally produce that are targeted with depression medications. “If we can target these through nutrition, we can get that good foundation for brain health.”
Alexandria Kurtz, D.O., a board-certified psychiatrist specializing in integrative and nutritional psychiatry
Explaining the mechanism of nutrition and brain health, including depression, Kurtz said, “The brain is always ‘on’ and does so much work for us. It needs a lot of fuel. We get our fuel from food that the body breaks down into carbohydrates, proteins, fats, vitamins and minerals. These macro- and micronutrients are so crucial for all the biochemical reactions that have to happen to keep the body and brain running as it should. They form the building blocks for neurotransmitters, which are what we need to regulate mood.” She said it’s food that breaks down into the nutrients our bodies need to make serotonin, dopamine and norepinephrine, chemicals our bodies naturally produce that are targeted with depression medications. “If we can target these through nutrition, we can get that good foundation for brain health,” Kurtz said.
Erica Golden, RDN, LD, IFNCP, is a Colorado Springs registered dietitian nutritionist specializing in mental health, gastrointestinal health and gut-brain access disorders. Read more about her at https/www.nourishedmindnutrition.com. Golden said there are multiple factors involved in mental health, and diet is emerging as a significant component.
Golden said she has been working with mental health issues, such as depression, eating disorders, dementia, post-traumatic stress disorder and alcohol and substance abuse for most of her career. Golden said. “When I looked at the whole person, I started seeing connections between disease such as diabetes and depression and irritable bowel syndrome and depression. If we help to treat one, we can help to treat the other.
“When researchers started doing studies on the Mediterranean diet or the group of eating patterns associated with the diet, they found dramatic improvement in peoples’ symptoms. I began thinking there is a lot more here than meets the eye.”
Kurtz said the Mediterranean diet is probably the most thoroughly studied diet for depression and mental health. The Mediterranean diet focuses on healthy fats (those found in olive oil, nuts and seeds), fruits, vegetables, fish and whole grains.
Before making recommendations to her patients, Kurtz performs a full diagnostic assessment that includes looking at their symptoms and what might be the root cause. “It can be life stress, nutrition, lifestyle and maybe they have health symptoms they’ve struggled with for a long time,” Kurtz said. She often requests patients keep a diet and symptom log after their first visit. “We can then discover what they are eating, what they like to eat, their cultural background and if they have food intolerances. Then we can look at where we can make tiny tweaks,” Kurtz said. She said it’s more than recommending a specific diet to her patients. Rather, it’s the components of that diet that are important for brain health.
Kurtz said that depending on the severity of the patient’s condition, treatment can include medications. She said a common reason patients come to her is because of problematic side effects of medications. “We can treat through nutritional psychiatry or have them on less medications or for a shorter term,” Kurtz said. “Nutrition is an important foundation for mental health across the board.” She said when she prescribes medications, she does so in conjunction with other treatment options. Kurtz takes a patient-centric approach to treatment. “We present options and we want the patient to be in the driver’s seat,” Kurtz said.
Golden said she sees many patients who are taking medications for depression. Some want their medications to work more effectively, some struggle with side effects and some experience treatment resistance, meaning they take three or more psychiatric medications without adequate success.
“If a patient wants to decrease their medications or eliminate them entirely, I want to make sure I do that with their prescriber being onboard and knowing what their goals are,” Golden said. “Often, medications need to be tapered. People shouldn’t do that by themselves. In a lot of cases, we can add diet adjustments, lifestyle changes, therapeutic mindfulness activities and supplemental treatments.”
Lifestyle change can be difficult and the amount of change necessary to make substantial changes in mental health can be far reaching, Golden said. “I want people to feel that it’s accessible and feel empowered to take those steps. When you’re trying to do this on your own, you try to do too much and you get overwhelmed and burn out quickly. Or you pick one thing and do that forever,” she said.
Golden sees changing eating habits as more a matter of addition rather than subtraction. People should not think about eliminating one certain food. She builds a plan for each individual that includes confidence, self-care, stress factors and exercise, to name a few, she said.
“I don’t tell people to cut out meat. I don’t tell them to fully cut out anything. We try to work on increasing the things that we know are good for us,” Golden said. “Naturally, as we do that, some of those ultra-processed foods that we know are not good for us, we naturally eat less (of them) if we’re eating other things.”
Kurtz said the following nutritional components are important for brain health:
- High quality fat
- Omega 3 fatty acids (for brain and cellular health)
- A wide array of fruits and vegetables, most notably for fiber, which is good for gut health, as well as phytonutrients for brain health
- A balance of lean protein, low fat dairy and whole grains
- Fewer processed foods and refined sugars
Kurtz said she finds that once patients eat better they feel better and it motivates them to make a change. “People are aware of the fact their brain and body are intimately connected,” Kurtz said. “What we do and what we eat impacts how we feel about ourselves and our lives. We haven’t had anyone say they aren’t looking for that.”
