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Archive for August, 2009

A Balanced Diet May Be Your Best Anti-Depressant

A recently published study by the Columbia University Medical Center and the New York State Psychiatric Institute found that over a period of just ten years (1996 to 2005) the number of Americans taking regularly antidepressant medication has doubled – from 13.3 million to 27 million. That means ten percent of all people living in America feel depressed enough to seek medical help.

There may be any number of reasons for this epidemic spreading of depression in the population. Since I’m not a psychologist, I have neither the expertise nor the inclination to voice an opinion in this matter. However, as a clinical dietitian, I have seen a great number of patients over the years for whom diet and lifestyle changes had also a significant impact on their mental and emotional well-being.

Unfortunately, there is no definite scientific evidence of a causal relationship between “food and mood.” But, while a specific diet to treat depression effectively does not exist, it is widely accepted in the medical profession that certain lifestyle and dietary guidelines can contribute to the successful treatment of clinical depression.

The uninterrupted presence of certain nutrients – such as vitamins, minerals, water, carbohydrates, protein and fat – is essential for the proper maintenance of all our body functions, including our brain functions. A healthy, well-balanced diet can provide all these nutrients in sufficient amounts. However, if important nutrients are missing over extended periods of time, negative effects will inevitably manifest themselves, including in the brain. Simply put: Neither the body nor the mind can work on a poor diet for long without getting sick.

When people are overly stressed, exhausted or suffer from depression, they often don’t have enough energy left to take care of their health needs. Some lose their appetite and let themselves go in other ways. Smoking, drug and alcohol abuse may contribute to a rapid downward spiral. Some seek relief by indulging in unhealthy “comfort” foods that are often loaded with empty calories, fat or sugar. The inevitably resulting weight gain only adds to the scenario.

On the upside, carbohydrates can have a mood-boosting effect. Bread, pastries and pasta all raise the level of serotonin, a chemical in the brain that has typically a calming effect. For the purpose of easing the symptoms of depression, eating carbs is not necessarily a bad idea. But not all carbs are the same. Whole grain breads, fruits, vegetables and legumes also contain carbohydrates and are much better choices than food items made of refined carbs.

Protein can also serve as an energy booster. Foods rich in protein contain tyrosine, an amino acid that helps to increase the levels of dopamine and norepinephrine in the brain which are responsible for alertness and concentration. Protein does not only come from meat and poultry, but also from beans, dairy products, soy and, of course, fish. We are only beginning to understand all the nutritional benefits from omega-3 fatty acids which are richly present in fish, especially salmon, but also in flaxseed and nuts. In fact, clinical studies have suggested that a significant deficit in omega-3 fatty acids may be associated with depression.

Antioxidants, which are found in whole grains and many fruits and vegetables, also play a very important role as a preventive “medicine.” The brain seems especially vulnerable to so-called “free radicals,” which are harmful toxins naturally produced in the metabolism during the digestive process, but they are also caused by many environmental pollutants we’re all exposed to every day. Free radicals can wreak havoc by damaging cells, thereby causing diseases, including cancer, and accelerating aging. Antioxidants, such as vitamin C and E as well as beta-carotene have been proven to combat these free radicals quite effectively by strengthening the inner defense mechanisms of the cells against such destruction, thereby preventing diseases and, perhaps, slowing down the natural aging process.

A lack of vitamin D is another potential cause for depression. Insufficient exposure to sunshine is common among office workers and the elderly. Thankfully, vitamin D deficiency can easily be treated with dietary adjustments and a daily multi-vitamin supplement. But it is important to get regularly tested for vitamin D deficiency.

Our understanding of depression is far from complete. But we have good reasons to believe that the pursuit of a healthy lifestyle and balanced nutrition has much to contribute to any treatment we can think of, for now and in the future.

As I mentioned before, there is no definite diet plan that has been scientifically proven to be effective in the treatment of depression. Thus, the menu below can only be considered as a contribution to a diet plan designed to overcome nutritional deficiencies that may partly be responsible for depression.

Dietary Treatment of Depression
(Sample Menu)

Designed to optimize the effects of food on mood- and energy cycles

Breakfast
Fresh Blueberries
3 Egg White Omelet with Low Fat Cheese and Fresh Tomato Salsa
Whole Wheat Toast
8-ounce Glass of Fat Free Milk
Decaffeinated Coffee

Lunch
Tuna Salad on Whole Wheat Pita Bread
Spinach Salad topped with Chick Peas and Low Fat Dressing
Iced Herbal Tea

Mid-Afternoon Snack
Orange
Sparkling Mineral Water

Dinner
Heart of Romaine Salad with Low Fat Caesar Dressing
Whole Wheat Pasta with Marinara Sauce
Fresh Steamed Asparagus
Whole Grain Sourdough Bread
Sparkling Mineral Water

Evening Snack
Graham Crackers
8-ounce Glass of Fat Free Milk

 This menu suggest that you eat most of the high protein food items early in the day and carbohydrate-rich meals and snacks later. I also recommend to have good sources of the vitamins that are being studied for benefits in the treatment of depression. Whole wheat toast, pita bread, pasta, orange and spinach are among those foods found to be particularly helpful because of their high content in folate. Also important: Thiamin (B-1), found in the chick peas and Riboflavin (B-2) in milk, asparagus and spinach. Niacin (B-3) is found in the bread, pita and tuna. Pyridoxine (B-6)  is present in all whole wheat products, eggs and tuna fish. Milk is always a good source of Vitamin D. Vegetables, fruit, whole wheat breads and chick peas are all solid sources of fiber.

Please note the importance of sufficient water consumption. Six to eight 8-ounce glasses of water daily are highly recommended. Since alcohol and caffeine can induce mood changes, you should try to abstain from those beverages.

Dear Reader – August 2009

Timi Gustafson, R.D. Hope springs eternally. Although we hear better news about the economy again, for many of us it is still too early to exhale. Anxiety over job loss, foreclosures, affordability of health care and college tuition and countless other concerns still wreaks havoc on people all over the country. In the face of so much adversity, it can be hard to stay upbeat. A recently published study by Columbia University and New York State Psychiatric Institute shows that depression is dramatically on the rise in America. One in ten of all Americans are on some kind of anti-depressant prescription medication these days. Needless to say, this is an alarming trend indeed.

Although depression as a disease is not fully understood yet, we have strong indications that diet and lifestyle have a strong role to play in the treatment of clinically depressed patients. So, in this month’s column I have tried to shed some light on the subject of depression and diet. For practical purposes, I have also included a short meal plan that is geared toward the treatment of depression based on dietary measures. Go to Newsletter of August 2009…