Episode 059: Which Foods are Good for Mental Health?

On this week’s episode of the podcast, I interview Dr. Drew Ramsey, a nutritional psychiatrist. When I was a resident, I saw him give a lecture on diet and how it affects our mood, and I’ve been wanting to interview him for a long time. He is the author of several books about diet and health.

By listening to this episode, you can earn 0.75 Psychiatry CME Credits.

Other Places to listen: iTunes, Spotify

Article Authors: David Puder, MD

Dr. Ramsey receives royalties from Brain Food Media for his intellectual property rights.

Dr. Puder does not have any conflicts of interest.

I will be transcribing many of Dr. Ramsey’s thoughts here, and they will be mixed a bit with my thoughts as well.

Most people who work in nutrition don’t consider brain health and mental health when they talk about food—they’re mostly counting calories, macros, or working towards muscle gain or weight loss. One of the main things people miss is that our brain is fueled by our food. When we don’t feed it what it needs, it can’t function properly. 

One well known fact is that inflammation and depression have a bi-directional relationship (Kiecolt-Glaser, 2015)

The mediterranean diet reduces risk of depression, stroke and cognitive impairment (Psaltopoulou, 2013)

We also know that healthy food increases BDNF, which is like miracle grow for the brain.

• One study showed that the American diet reduced BDNF (Molteni 2002)

• Mediteranean diet with nuts increased BDNF in depressed patients (Sánchez-Villegas, 2011)

Treating Patients With Nutrition

Within the realm of mental health, patients often feel out of control, or hopeless, like their disorder or disease has taken over their lives. When they come to my office, it is often because they feel like they can no longer deal with their mental health issues on their own anymore. Many of my patients are surprised when I prescribe them diet and exercise regimens to help them. There are direct correlations between our sensorium and our mental health. When possible, in conjunction with therapy, it is usually my first course of action. My patients who follow the diet and exercise suggestions have experienced noticeable positive benefits. 

Another point Dr. Ramsey brings up is that with diet and nutrition, we can arm our patients with things that are within their control—eating healthy—and can give them the tools to make those changes in their lives. At a time when they feel out of control, such as when they end up in our offices, it can be helpful for them to have something they feel they can contribute to their well being. 

Many health fads come and go, and many diets claim they are a solution for depression. Some patients you meet will already be on a diet plan. Dr. Ramsey suggests it’s important to ask questions about why they chose their diet (keto, veganism, paleo, gluten free) in order to understand their motivations. 

The Basic Diet For Depression Or Mood

Dr. Ramsey and I both agree that the overall healthiest guidelines for a good diet to feed the brain and improve mental health is the Mediterranean diet. If people are seeking health from food, there is a ton of information out there that is incredibly detailed and confusing. That’s why, for the purpose of this podcast and this article, we are going to keep it simple.  

• Eat more plants than meat. This will help reduce inflammation. 

• Avoid processed foods. 

• 12 nutrients have significant evidence that they’re involved in relieving depression, and these nutrients are largely found in a spectrum of plant-based foods and seafoods. 

  • Folate

  • Iron

  • Long-chain omega-3 fatty acids (EPA and DHA)

  • Magnesium

  • Potassium

  • Selenium

  • Thiamine

  • Vitamin A

  • Vitamin B6

  • Vitamin B12

  • Vitamin C

  • Zinc

• Eat leafy greens.

• Try to maximize nutrients to calorie count.

• Eat higher quality meats.

Here are a few, brief notes Dr. Ramsey mentioned in the episode about specific foods: 

Fats

EPA and DHA are the two fats we need to focus on within the omega 3s realm. DHA is the longest fat that is transported into the brain. EPA is a natural blood thinner and is full of anti-inflammatory agents. Different seafood, nut and plant-based fats are also excellent sources of omega 3s. 

Nuts

Nuts are incredibly healthy for you. Most people feel like nuts are too fattening and calorie dense to eat, but they are great sources of protein, fats, and slow-burning carbohydrates. They’re also packed with minerals. Our brains are made predominately of fat, so eating high quality fats, like organic nuts, is a great way to feed our brains. Try to buy raw, organic nuts if you can. 

Organic Foods

For many people, organic means unaffordable. However, we know that pesticides are neurotoxins. There isn’t a tremendous amount of long-term data out there yet that they are extremely damaging, however, try not to eat them, because they obviously aren’t healthy for you. There is a ton of pesticide residue on produce. Try to go organic, if you can afford it, and if not, clean them well before you use them, usually by soaking in saltwater, water with vinegar, or another fruit and vegetable cleaning solution. The Dirty Dozen and the Clean Fifteen are good lists to figure out what you should be buying organic, and what may be okay to just purchase and clean thoroughly, if you need to. 

Shellfish

Dr. Ramsey says that eating mussels and clams a few times a month is an excellent way to feed your brain because of their high vitamin B12 content. 

Beans

Beans are inexpensive sources of protein, fiber and carbohydrates. They are incomplete proteins, but they are still a good choice because of the fiber content. 

Dark chocolate 

Dark chocolate has tons of health benefits. It’s plant based, fermented, gives you energy, and is good for your brain. Only one mineral has ever been shown to reverse memory decline, and dark chocolate has it. 

It’s also a great example of a core principle of psychiatry—food should be filled with pleasure, joy, and not angst. Dark chocolate is enjoyable to eat.

Mindful eating  

Because food is pleasurable, pausing after a few bites to breathe and relax, can slow down our eating and increase our enjoyment. It also gives us a chance to chew our food, which is healthier for digestion.  

Food should be about love. Making food for friends and family. Eating meals together increases connection. Exploring creative cooking (and sometimes making mistakes and being ok with that!) Exploring delicious tastes and textures.

Here is my other episode on diet: Diet on Cognitive Function, Brain Optimization