Food choices to improve depression

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

A 2017 systematic review of 21 studies  across 10 countries looking at food pattern and depression found that there was an association between food pattern and depression (1).

What food patterns were found to have an DECREASED risk of depression? 

  • The study authors (1) found that high intakes of fruit, vegetables, fish, olive oil, low-fat dairy, antioxidants, and whole grain was associated with a decreased risk of depression (1)
  • Another review found that seafood, vegetables, fruit and nuts based food patterns was associated with a reduced risk of depression. (2)
  • A study of 15,980 adults over 10.8 years found that higher consumption of fruits and nuts, while lower consumption of fast food led to a reduced depression risk (3).

What food patterns were found to have an INCREASED risk of depression? (1)

  • The study authors (1) found that high consumption of red and/or processed meat, refined grains, (added sugars)/sweets, high-fat dairy products, butter, potatoes and high-fat gravy was associated with an increased risk of depression (1).

Are there clinical studies where food pattern was used to TREAT depression? 

Yes. The HELFIMED (4) and SMILES trials (5) used food as a treatment of depressive disorders.

How effective was this?

In both of these trials (4,5), the improvement was almost 50%, which is comparable to some therapies and some antidepressant medications; and benefits lasted for several months afterwards.

What are some caveats?

  • These studies show that nutrition can be helpful to improve depression, but further study is needed.
  • Nutritious food choices DO NOT have to be expensive food choices, and in many cases whole foods can be more affordable than processed foods.
  • For some people, good nutrition is not enough replace counseling or medications, but can be a useful addition.
  • Different people can be healthiest on different styles of eating, depending on a variety of factors.
  • Even with good food choices, it is important to get enough calories; and not engage in restriction or disordered eating behaviors.
    • TDEE calculators and this chart may be helpful in estimating daily calorie needs.
  • Individuals with eating disorders should seek professional assistance via nutritionist, eating disorder specialist, etc. when considering nutritional adjustments.
  • The Food Pantry at OSU is another useful resource.

Any other resources to improve nutrition?

How is your nutrition? What is the quality of your food choices? Are you eating enough or too much food? Are you eating foods that worsen or improve depression?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Li, Ye & Lv, Mei-Rong & Wei, Yan-Jin & Sun, Ling & Zhang, Ji-Xiang & Zhang, Huai-Guo & Li, Bin. (2017). Dietary patterns and depression risk: A meta-analysis. Psychiatry Research. 253. 10.1016/j.psychres.2017.04.020.
  2.  Martínez-González MA1, Sánchez-Villegas A2. Food patterns and the prevention of depression. Proc Nutr Soc. 2016 May;75(2):139-46. doi: 10.1017/S0029665116000045. Epub 2016 Feb 22.
  3. Fresán, U., Bes-Rastrollo, M., Segovia-Siapco, G. et al. Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort. Eur J Nutr (2018). https://doi.org/10.1007/s00394-018-1653-x
  4. Natalie Parletta, Dorota Zarnowiecki, Jihyun Cho, Amy Wilson, Svetlana Bogomolova, Anthony Villani, Catherine Itsiopoulos, Theo Niyonsenga, Sarah Blunden, Barbara Meyer, Leonie Segal, Bernhard T. Baune & Kerin O’Dea (2017) A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED),Nutritional Neuroscience,  DOI: 10.1080/1028415X.2017.1411320 
  5. Jacka FN, O’Neil A, Opie R, et al. A randomised controlled trial of dietary improvement for adults with major depression (the “SMILES” trial). BMC Medicine. 2017;15:23. doi:10.1186/s12916-017-0791-y.

Dealing with too much stress

What is stress?

Stress can be thought of as a response by the brain and body respond to any demand (1).

Some stress is useful in helping us perform in life, achieve goals, grow, etc.

Too much stress can harm both physical and emotional health in many different ways.

What does too much stress feel like?

Different people respond to stress in different ways.

 What are some common emotional responses to excessive  stress?

Too much stress can cause:

  • Changes in mood, sleep, irritability, body aches (3).
  • Changes in appetite, difficulty concentrating, etc.

What are some unhealthy ways of dealing with too much stress?

  • Increasing use of caffeine, alcohol, tobacco, drugs.
  • Unhealthy eating habits.
  • Increased behaviors of isolation/avoidance. Too much time away from the problem might make the problem worse by causing you to miss deadlines, meetings, assignments, etc.

What are some healthy ways  of dealing with too much stress?

The American Psychological Association’s help center suggests (2):

  • Take a break. A few minutes away from what is stressing you might help you have a new perspective or give you a chance to practice stress management techniques. (Links below).
  • Smile and laugh. This might help relieve some tension and improve the situation.
  • Get social support from others or a counselor. Talking to someone might help you feel better, collect your thoughts, gain new insights into the situation.

The following are adapted from National Library of Medicine (3) stress management page:

  • Recognize and accept the things you can’t change.  This can help you let go and not get upset. For instance, you might not change rush hour traffic, but you can look for ways to relax during your commute, such as listening to a podcast or book.
  • Avoid stressful triggers when possible. For example, if your family squabbles during the holidays, give yourself a breather and go out for a walk or drive.
  • Exercise. Regular exercise or physical activity most days for about 30 minutes can help your brain release chemicals that make you feel good, and help you release built-up energy or frustration.
  • Change your outlook. Are you being too negative? Work on more positive attitude toward challenges by replacing negative thoughts with more positive ones.
  • Do something you enjoy preferably daily even if it’s just for a few minutes. Examples include reading a good book, listening to music, watching a favorite movie, or having dinner with a friend, a new hobby or class.
  • Get 7 to 9 hours of sleep per night. This can help you think more clearly, and have more energy.
  • Eat enough AND eat healthy foods. This can help fuel your body and mind. Skip the high-sugar snack foods and load up on vegetables, fruits, raw nuts, lean proteins, good fats.
  • Learn to say no. Set limits if you feel over-scheduled, cut back or defer where you can. Ask others for help when you need it.

Are there useful stress management resources on campus?

Anything else?

Other ideas to manage stress:

Gratitude and mindfulness exercises to manage stress:

Benefits of Play and Leisure:

Smartphone apps for mental health: https://u.osu.edu/emotionalfitness/2017/05/

 

What are some signs that YOU are under too much stress?

What healthy strategies have you tried?

Which ones work for you to help manage stress?

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://www.nimh.nih.gov/health/publications/stress/index.shtml
  2. http://www.apa.org/helpcenter/manage-stress.aspx
  3. https://medlineplus.gov/ency/article/001942.htm

 

 

Study: Caffeine, Stress, and Brain function

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

According to the Food and Drug Administration, caffeine is widely available and upto 80% of adults have caffeine everyday, upto 200mg, which is about 10 ounces of coffee (1).

Sometimes caffeine is used to help stay awake, alert, keep up with academic demands, etc.

While the many benefits of caffeine have been widely documented, problems and side effects caffeine are not as widely known.

One study looked at the impact of caffeine on stress (2).

Who was involved in the study? (2)

  • 25 participants who used caffeine regularly or were light user of caffeine.
  • Subjects received placebo or caffeine (3.5mg per kilogram of body weight, about 238mg for a person weighing 150 pounds)

What was measured? (2)

  • Blood pressure, cortisol (stress hormone), norepinephrine and epinephrine (also involved in stress response and other functions).
  • Measurements were taken at rest, during a stressful laboratory task, and afterwards at rest.

What were the results? (2)

  • Compared to placebo, caffeine caused more than DOUBLE the levels of epinephrine and cortisol, both involved in stress response.
  • Effects were similar in both habitual and light users.
  • Habitual use of caffeine did not development of tolerance to the bodily response.
  • Even at rest, caffeine increased blood pressure and plasma norepinephrine levels.

What do the results mean?

Caffeine may increase your stress level whether you are using caffeine sporadically or regularly.

What are some other effects of too much caffeine?

  • Caffeine had as early as 7am lead to less efficient sleep and reduced total sleep at 9pm (3).
  • Some people have more daytime sleepiness because of caffeine related sleep disruption (4).
  • Caffeine can reduce bloodflow to the brain by up to 27% (5)
  • Too much caffeine can cause (1):
    • Worsening of anxiety
    • Jitteriness
    • Nervousness
    • Sleep disturbance
    • Headaches
    • Make your heart beat faster,  palpitations, high blood pressure, abnormal heart rhythms

What are some caveats?

  • This is a small study and there are many studies showing positive and negative effects of caffeine.
  • Not everyone has the same benefits or side effects caffeine.
  • The AMOUNT of caffeine that has beneficial and harmful effects can be different for different people.
  • Some people can metabolize caffeine much faster or slower than others (6).
  • For some people, it can take days to weeks to see benefits from reducing or eliminating caffeine.
  • Stopping caffeine abruptly can lead to withdrawal headaches, irritability, and other symptoms.

Are you feeling stressed, irritable or anxious? How is your caffeine intake? Could you benefit from less?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://www.fda.gov/downloads/ucm200805.pdf
  2. Land JD, Adcock RA, Williams RB, Kuhn CM. Caffeine effects on cardiovascular and neuroendocrine responses to acute psychosocial stress and their relationship to level of habitual caffeine consumption.  Psychosom Med. 1990 May-Jun;52(3):320-36.
  3. H.P. Landolt, E. Werth, A.A. Borbely, D.J. Dijk.  Caffeine intake (200 mg) in the morning affects human sleep and EEG power spectra at night. Brain Research, 675 (1–2) (1995), pp. 67–74.
  4. T. Roehrs, T. Roth. Caffeine: sleep and daytime sleepiness. Sleep Med Rev, 12 (2) (2008), pp. 153–162.
  5. Addicott M.A., Yang L.L., Peiffer A.M., Burnett L.R., Burdette J.H., Chen M.Y.. et al. The effect of daily caffeine use on cerebral blood flow: how much caffeine can we tolerate? Hum. Brain Mapp. 2009;30:3102–3114.
  6. Cornelis, M. C. et al. Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption. Mol. Psychiatry 20, 647–656 (2015).