The surprisingly dramatic role of nutrition in mental health | Julia Rucklidge | TEDxChristchurch

Translator: Mayumi Oiwa-Bungard Reviewer: Queenie Lee In 1847, a doctor named Semmelweis recommended that all doctors wash their hands before touching a pregnant woman, to prevent puerperal fever. His research showed that death rates from sepsis could be reduced from 18% to 2% simply by washing your hands with chlorinated lime. His medical colleagues refused to accept that they themselves were responsible for the spread of the infection. Semmelweis was ridiculed by his colleagues, fired, and the criticism and violent reactions destroyed him and he died in a nursing home, two weeks later, of septicemia, at the age of 47. What I'm going to talk about today may sound like As radical as it seemed to a mid-19th century doctor to wash his hands, it is equally scientific.

It's the simple idea that optimizing

nutrition

is a safe and viable way to avoid, treat, or lessen

mental

illness. Nutrition matters. Poor

nutrition

is an important and modifiable risk factor for the development of

mental

illness. According to the 2013 New Zealand Health Survey, rates of psychiatric illness in children have doubled in the past five years. Internationally, there has been a 3-fold increase in ADHD, a 20-fold increase in autism, and a 40-fold increase in bipolar disorder in children. And this graph shows that the number of people with disabilities as a direct consequence of an underlying psychiatric illness has multiplied by four.

Rates of mental illness are increasing. So how do we deal with this problem? Currently, our

health

care system operates within a medical model. Now, this means that you will usually be offered psychiatric medications first, followed by psychological therapies and other forms of support. Our reliance on medications as a first-line form of treatment is evident in rising prescription rates. For example, in 2012, half a million New Zealanders (that's one-eighth of us) were prescribed an antidepressant; that's 38% more than five years earlier. Similarly, antipsychotic prescription rates doubled between 2006 and 2011. Given that this medical model is fairly universal across Western societies, one would reasonably expect it to be working well.

And in fact, in some cases, these treatments save lives. And I'm not here to rule it out completely. However, if a treatment is truly effective, shouldn't rates of disorder and disability as a direct consequence of that disease decrease rather than increase? That's why we need to consider the

role

medications might play in some of these outcomes. If we take any kind of medication: antipsychotics, anxiolytics, antidepressants; the pattern is the same. In the short term, these treatments are usually very effective, but in the long term they are not. And in some cases, they make life worse. If we look, for example, at the studies being done on children with ADHD treated with stimulants or Ritalin, in the short term they are better and respond better than any other form of treatment, but in the long term, they do worse than children with ADHD. who were never prescribed these medications.

Another study showed that despite our increasing reliance on antidepressants, recovery and relapse rates are no better now than they were 50 years ago, before the advent of these medications. And children with depression who were treated with antidepressants are three times more likely to develop bipolar disorder than children who never received these medications. And people who were randomly assigned to maintain their dose of antipsychotic medications are less likely to recover from long-term schizophrenia than people who were randomly assigned to a dose reduction or complete elimination of the drug. And I can show you more and more studies that highlight the same bleak picture.

So, pretty depressing. (Laughs) Is there another way to go? Almost two decades ago, my PhD supervisor at the time, Professor Bonnie Kaplan, told me about some families who were being treated with nutrients in southern Alberta, Canada. Now they had bipolar disorder, psychosis, depression. These are serious conditions, and my education in clinical psychology had taught me that nutrition and diet were of trivial importance to mental

health

and that only medications or psychotherapy could treat these serious conditions. But she and others were publishing preliminary data earlier this century showing that people recovered and stayed well. So I decided to study nutrients, and that's what I've done for the last decade.

In 2009, I received funding to conduct a randomized, placebo-controlled trial using minerals and vitamins, also known collectively as micronutrients, for the treatment of ADHD in adults. And this study was published in the British Journal of Psychiatry in April of this year, and this is what we found. In just one 8-week period, twice as many people in the micronutrient group responded compared to placebo; Twice as many people went into remission from their depression in the micronutrient group. Hyperactivity and impulsivity were reduced to the normal, nonclinical range, and those taking the micronutrients were more likely to report that their ADHD symptoms were less disruptive and interfered less with their work and social relationships than people taking the placebo.

And a year later, people who continued taking the micronutrients maintained their changes or showed further improvement, and those who switched to medications or stopped the micronutrients actually showed a worsening of their symptoms. Now, I need to tell you something here, and that is that when I say micronutrients, I actually mean a higher dose than what you would get from a supermarket-bought vitamin pill. In this study, we gave participants up to 15 pills a day with 36 nutrients. Therefore, it would be unlikely that if you were to get an over-the-counter supplement, you would not see these positive benefits, both because the dosage is lower and because the variety of nutrients is lower.

Now, these positive benefits are not limited to a single study. My laboratory at the University of Canterbury is the Nutrition and Mental Health Research Group, and we have published over 20 articles in medical journals, all of which document the benefits of micronutrients. For example, this study showed that we could reduce bipolar disorder symptoms in children by 50% with a simultaneous reduction in medications. This study showed that we could reduce rates of probable PTSD from 65% to 18%, after the Christchurch earthquakes, with a micronutrient intervention for one month, with no changes in those not taking the nutrients. Even a year later, people who had received the nutrients were doing better than those who didn't.

And we just replicated these findings in collaboration with researchers at the University of Calgary, following the June 2013 floods in Alberta, Canada. To me, the message is clear: a well-nourished body and brain are better able to withstand ongoing stress and recover from illness. Administering micronutrients in adequate doses can be an effective and cost-effective public health intervention to improve the mental health of a population after an environmental disaster. In my 20-year career, I have rarely seen these

dramatic

responses from conventional treatments. When people get better, they do so across the board, not just in the symptoms we treat, but also in other areas, such as improved sleep, stabilization of mood, reduced anxiety, and reduced anxiety. need for cigarettes, cannabis and alcohol.

My research and that from around the world has shown that between 60% and 80% of people respond to micronutrients, which shows how powerful this intervention is. And internationally, there have been 20 randomized placebo-controlled trials (this is the gold standard we use to make clinical decisions) showing that we can reduce aggression in prisoners, slow cognitive decline in the elderly, treat depression , anxiety, stress, autism and ADHD. And they could even be more cost-effective than current conventional treatments. This study here documented the treatment of a 10-year-old boy with psychosis. When his six-month inpatient drug treatment was unsuccessful, he was treated with micronutrients.

Not only did the micronutrients completely eliminate his hallucinations and delusions (changes that were maintained six years later), but the cost of the treatment was less than 2% of the cost of the failed hospital treatment. The cost savings alone makes it imperative that our society pay attention to the broader benefits of this approach. And there is more good news. Treatment: Taking supplements before a mental illness arises can actually stop these problems from developing in the first place. This fantastic study looked at 81 adolescents at risk for psychosis and randomized them to receive omega-3 fatty acids in the form of fish oils (essential nutrients for brain health) or placebo over a 12-week period.

A year later, 5% of those given fish oil had developed psychosis compared to 28% of those given placebo. That represents an 80% reduction in the chances of you developing into psychosis, simply by giving fish oil. I wonder if I know what some of you are thinking. I wonder if some of you are thinking, "Wait! Why don't I eat better?" "Why don't I tell everyone to eat better?" And in fact, there are some fantastic studies documenting the strong relationship between dietary patterns and mental health, although we're still in the early days of scientific research. We don't know who would benefit from dietary manipulation alone and who might need the extra boost of additional nutrients.

But even in the last five years there have been 11 epidemiological studies, cross-sectional and longitudinal, in large populations around the world, and they all show the same thing. The more you follow a conservative, Mediterranean or unprocessed diet, the lower your risk of depression. And the more you follow the Western diet or processed foods, the higher your risk of depression. I only know of one study that has not found this association, and no studies show that the Western diet is good for our mental health. (Laughs) What is the Western diet? Well, it's one that is highly processed, high in refined grains, sugary drinks, takeaways, and low in fresh produce.

And the healthy diet is one that is fresh, rich in fruits and vegetables, rich in fish, nuts, healthy fats and low in processed foods. What your grandmother would recognize as food. (Laughs) There are still many questions about the relationship between mental health and nutrition. What

role

does genetics play in determining who will respond to nutrients and who needs additional nutrients than they can get from their diet? What role does an infected and inflamed intestine play in nutrient absorption? It's not that we are what we eat; It is we who absorb. And what role do medications play in determining the effectiveness of nutrients?

Combining medications and nutrients is really complicated and we need more research to better understand these interactions. But ultimately we need to know how long these good benefits last. So with all this data, this rich data that highlights the power of nutrition, I think we can now make some individual and collective changes. We might reconsider our current treatment approach: prioritizing lifestyle factors, healthy eating, exercise, supplements, and, when necessary, psychological treatments, and reserving medications for when these approaches don't work. If nutrients work, shouldn't they be covered by our healthcare system? Take universal prevention seriously by optimizing the nutrition of those who are vulnerable.

We don't wait for a heart attack to occur to change lifestyle behaviors that we know contribute to heart disease. It should be no different with mental health. An easy way to implement universal prevention would be to have pregnant women, not pregnant women: midwives explain to pregnant women the importance of nutrition. Nutrient-deficient mothers produce nutrient-deficient children. Nutrient-poor foods during pregnancy increase the chances of your child having a mental health problem. Know the risks of cheap, processed foods. As Michael Pollan stated, cheap food is an illusion; There is no such thing as cheap food. The price is paid somewhere, and if it is not paid at the cash register, it is charged to the environment and the public treasury in the form of subsidies, and it is charged to health.

All children need to learn to cook. All children need to know that food doesn't have to come in packages. Schools could reflect on the content of their lunch menus. Too often, children are rewarded with processed foods​​for his good behavior. We need to reflect on whether or not this pairing makes sense intuitively. Ultimately, we have a responsibility to teach them that every time they put something in their mouth, they make a decision: eat something nutritious or something devoid of nutrients. In the 19th century, doctors were offended when Semmelweis suggested they wash their hands before giving birth.

We now ask you to consider whether the medications you prescribed are contributing to poor long-term outcomes for some people with mental illness. But eating well and, where appropriate, providing additional nutrients can improve the mental health of many people. He left you with one last reflection. Randomized trials conducted in the 17th century showed that putting files on board ships on long voyages completely eliminated 40% of scurvy mortality. But it took 264 years for the British government to order that all ships carry citrus fruits for their sailors. How long will it take for our society to pay attention to research showing that suboptimal nutrition is contributing to the mental illness epidemic?

So here's my idea worth spreading: nutrition matters, and if we're really prepared to get serious about mental health, we need to take seriously the critical role that nutrition plays. Thank you. (Applause) (Cheers)