Those who suffer from depression have likely, at some point in time, been given the advice from well meaning friends and family to simply smile more often! Yes, smiling is great, but to think that it can be a magical cure for a multifaceted, deep rooted illness such a depression is, in my opinion, rather short sighted.
In this series of posts, my goal is to provide a powerful set of strategies that have been proven to help with symptoms of depression. When used together, they can help a person mitigate and, in time, reverse symptoms of depression.
In last week's post, we saw the detrimental effects the Standard American Diet (SAD) has on our mental health. Unfortunately, the SAD is replete with processed foods, which are laden with additives, preservatives, fillers, stabilizers, etc that negatively effects our mood and behavior. Moreover, these foods are stripped of the natural nutrients we find in whole, unprocessed foods. Processing foods make them more shelf stable, so they can sit on grocery store shelves longer. However, when foods are processed, they are also stripped of their natural flavor. To compensate for this, food companies now add sugar and artificial sweeteners to 74% of foods in the US supply chain. Sadly, this added sugar makes these foods even more addicting.
In fact, one study of laboratory rats found sugar water to be more addicting than cocaine! Even more surprising, rats that were already addicted to cocaine started choosing sugar water instead of cocaine over a period of time when given the choice.
If you want to reduce your symptoms of depression, it is clear that all processed foods and refined sugar should be avoided. So what exactly should you be eating if you are suffering from depression?
The evidence is clear that an antidepressant diet should include a wide variety of whole, unprocessed foods including vegetables, leafy greens, fruits, and legumes, which when served together should make for a colorful palette. "Eating the rainbow" is a way of describing what a diet should look like when it includes colorful fruits and vegetables like tomatoes, kale, blueberries, peppers, blueberries, etc. Natural chemicals called phytonutrients give these foods their color. These phytonutrients help fight inflammation throughout the body, which has been connected to almost every major chronic disease. These phytonutrients, moreover, reduce inflammation in the brain and promote the growth of new brain cells as we age, thus decreasing the likelihood of suffering from depression.
As I mentioned in my last article, the 'SMILES' trial was the first randomized controlled trial to evaluate the relationship between dietary intervention and depressive symptomatology. The results stunned researchers as 30% of participants educated on specific dietary interventions achieved complete remission of major depression! What diet were these participants encouraged to consume?
The subjects in this group were counseled to eat a modified Mediterranean diet, with 6 servings of vegetables per day, 3 servings of fruit, 5 servings whole-grain cereals, 2 servings of oily fish per week, 3 to 4 servings of legumes per week, raw and unsalted nuts and seeds (1x per day), and extra virgin olive oil (3 tablespoons per day). Moreover, they were encouraged to enjoy 3 to 4 servings of red meat per week since red meat is a rich source of iron, vitamin B12, and zinc, all which have been found to play a protective, preventative role in common mental disorders.
Moreover, participants were encourage to consume up to 2 glasses of red wine per day, always with a meal. Lastly, they were asked to significantly reduce or eliminate all sweets, refined cereals, fried food, fast-food, processed meats, and sugary drinks.
Another study published in 2016, sought to provide, according to study authors, “practical dietary recommendations for the prevention of depression, based on the best available current evidence, in order to inform public health and clinical recommendations.”
The five guidelines they suggested include:
2. Increase consumption of fruits, vegetables, legumes, whole-grain cereals, nuts and seeds.
3. Include a high consumption of foods rich in omega-3 polyunsaturated fatty acids.
4. Replace unhealthy foods with wholesome nutritious foods.
5. Limit your intake of processed foods, fast foods, commercial bakery goods and sweets.
In September of 2018, researchers Dr. Laura R LaChance and Drew Ramsey took a novel approach to fighting depression with food. They methodically dug through all available research to find nutrients known to have an antidepressant effect. Their efforts led them to identify 34 nutrients that, when deficient, have been shown to cause depression. Next, they analyzed various foods to find which ones had the highest density of these nutrients. They assigned an Antidepressent Food Score (AFS) to each of these foods.
Which foods came out on top?
1. Bivalves — Oysters, clams, mussels
2. Seafood — particularly wild-caught Alaskan salmon, herring, sardines and anchovies
3. Organ Meats — Spleen, kidneys, or heart, and poultry giblets
4. Leafy greens — Watercress, spinach, mustard, turnip, chicory, beet greens, Swiss chard, dandelion, collard greens and the herbs cilantro, basil, parsley and kale
5. Lettuces— Red, green and romaine
6. Peppers — Bell, Serrano and jalapeno
7. Cruciferous vegetables — Cauliflower, kohlrabi, red cabbage, broccoli, Brussels sprouts
Study authors determined these 7 categories of foods tended to reduce the impact of inflammation on the body the most. Also, the authors found that the plant based items on the list to be especially high in fiber content, which feeds healthy bacteria in the gut. Moreover, In the course of their investigation, the researchers identified nutrient deficiencies that were most highly correlated with the development of depression. These nutrients include omega 3 fatty acids, B vitamins, zinc, magnesium and vitamin D.
Further research is certainly needed to test the effectiveness of a diet replete with these antidepressant foods. However, it is clear that all of these foods can certainly be a part of a well balanced, healthy diet and can provide guidance for someone looking to change their diet to help with their symptoms of depression.
In summary, what would one need to do to eat an antidepressant diet?
1. Eat only real foods and eliminate processed junk and refined sugar
2. Consume plenty of colorful fruits and vegetables
3. Eat a diet rich in Omega 3 polyunsaturated fats
4. Enjoy plenty of nuts and seeds
5. Increase consumption of foods that are high in anti-depressant nutrients (as listed above).
Other antidepressant dietary strategy that was not mentioned in this week's article includes eating fermented foods such as kefir, sauerkraut, kimchi, kombucha, etc. This idea will be elaborated upon in upcoming posts.
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Dr. Ram Cheruvu, Pharm.D.
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