A New Theory for How Food Impacts our Mental Health
Welcome to this week’s edition of Vitamin Z, a newsletter about health and wellness with 3,000+ subscribers. If you are new, you can join here.
In this issue:
Brain Energy and the metabolic theory of mental health
Ketogenic diets and their role in treating neurological disorders
The rise of nutritional psychiatry and metabolic psychiatry
“Many people think about food in terms of their waistlines, but it also impacts our mental health,” said Dr. Uma Naidoo, a psychiatrist at Massachusetts General Hospital, in a New York Times article. “It’s a missing part of the conversation.”
A number of studies have shown that dietary changes can lead to meaningful improvements in mood and mental well-being.
New research suggests this has to do with food’s role in regulating metabolic health.
I spoke recently to a neurologist at a top academic medical center. I was working with a biopharma company developing new treatments for epilepsy, a neurological disorder that affects 50 million people worldwide.
There are dozens of prescription drugs available for epilepsy. Yet they have limited effectiveness.
The neurologist told me one of the most effective ways to treat epilepsy is the ketogenic diet: A high-fat, low-carbohydrate diet that forces the body to burn fats for energy rather than carbohydrates.
Increasingly, doctors are recommending that patients with epilepsy try a ketogenic (or keto) diet. The keto diet has been proven effective to help epilepsy. About 40% to 50% of children who start the keto diet have 50% fewer seizures.
Research shows the ketogenic diet reduces the amount of glutamate in the brain and enhances the synthesis of the neurotransmitter GABA, making it less likely for a seizure to occur.
I was reminded that the food we eat affects our brain chemistry—in ways we are just beginning to understand.
The theory of brain energy
A new book called Brain Energy by Harvard psychiatrist Dr. Chris Palmer describes a metabolic theory of mental health.
The book’s central argument: Mental disorders are metabolic disorders of the brain.
Dr. Palmer says abnormalities in brain energy metabolism are likely root causes of psychiatric conditions: anxiety, depression, Alzheimer’s, and other neurological disorders. He explains why dietary and metabolic approaches can help people for whom pharmaceutical approaches haven’t worked.
How can the food we eat influence our mental health?
Better food, better mood
Most of us know intuitively that what we eat affects how we feel. It’s one reason I minimize my intake of sugar, gluten, and dairy.
I’ve noticed how much better I feel on days I eat well. When I avoid foods that spike blood glucose—like cookies or fruit juice—I’m calmer, more focused. My sleep is better.
On the other hand, when I eat processed foods high in sugar, my energy levels fluctuate wildly. I’m more anxious. By the afternoon I feel sluggish, lethargic.
Poor eating habits can lead to obesity, high blood pressure, diabetes. Doctors often refer to these as metabolic disorders.
What does it mean to have a metabolic disorder? It means some of the cells in your body have mitochondrial dysfunction. The mitochondria in your cells—aka your cells’ power plants—aren’t operating properly.
As Dr. Palmer explains, there are many things that can cause mitochondrial dysfunction: Poor diet, exercise, smoking, stress, environmental toxins. These things are all damaging our cells’ mitochondria. They’re risk factors for poor mental health and neurological disorders.
Diets high in ultra-processed foods may be poisoning people’s mitochondria and slowing their metabolism. This makes people more likely to become anxious, depressed, have OCD or bipolar disorder. As people’s metabolic health is failing, so is their mental health.
A study of 67 patients with depression showed that people who switched from a diet heavy in processed and sugary foods, to a Mediterranean-style diet rich in fruits, vegetables and fiber, showed significantly greater improvement in depression symptoms after three months, and a third of them achieved full remission.
Depression has become the leading cause of disability globally over the past five years. We are just beginning to understand the link between metabolism, diet, exercise and mental health.
Research on metabolic health suggests that diabetes shares the same roots with depression, epilepsy, Alzheimer's disease: They are all related to metabolic dysfunction. They are all metabolic disorders.
How to support good metabolic health
Aging is associated with mitochondrial dysfunction and a decreased number of mitochondria in our cells. As we get older, our metabolic health declines. Metabolic insufficiency results in chronic disease, from diabetes to Alzheimer’s.
We can prevent metabolic failure, says Dr. Palmer, with lifestyle changes: Improving sleep, exercise, or diet. In particular, diets like the ketogenic diet that minimize sugar and highly processed foods.
The classic ketogenic diet consists of a high-fat and low-protein and carbohydrate diet. The diet mimics the fasting state, altering the metabolism to use fats as a primary fuel source.
Research suggests the ketogenic diet does a few important things:
Stimulates autophagy, a general repair process for old and damaged cell parts
Stimulates mitophagy, getting rid of old and defective mitochondria and replacing them with new ones
Stimulates a process called mitochondrial biogenesis, which means your cells will have more mitochondria and those mitochondria will be healthier after the ketogenic diet
This dietary change can help people with mental health disorders, epilepsy, type 2 diabetes, or even help people lose weight. They’re all related to metabolism and mitochondrial health.
Who should consider the ketogenic diet? There are many paths to achieving metabolic health, says Dr. Palmer. Low-carb diets like the ketogenic diet can be helpful for some people. For others, it may be enough to eliminate processed foods, get more exercise, or improve sleep.
Doctors typically look at five components to assess metabolic syndrome: Blood pressure, insulin resistance, excess abdominal fat, low HDL cholesterol, high triglycerides.
These are the hallmarks of metabolic syndrome. If those things are off, it means there is metabolic failure somewhere in the brain or body. It could be what’s making you feel anxious or depressed.
The rise of metabolic psychiatry
Stanford recently launched the Metabolic Psychiatry Clinic, the world’s first academic specialty clinic which provides evaluation and treatment for patients struggling with psychiatric illness and metabolic abnormalities.
Health experts believe metabolic psychiatry could become an important part of mental health treatment. It won’t replace other treatments for mental health, like talk therapy and prescription drugs. But it could help people address the root causes of mental disorders on a cellular level.
About 20 percent of everything we eat goes to the brain, according to Dr. Drew Ramsey, a psychiatrist at the Columbia University College of Physicians in New York.
Research in nutritional psychiatry has outlined an Antidepressant Food Scale that lists 12 antidepressant nutrients linked to the treatment and prevention of depression.
Certain nutrients play a critical role in supporting brain health: omega-3 fats; minerals like zinc and magnesium; and folate and vitamin B12, which help your body produce serotonin. Foods like seafood, greens, nuts, beans and dark chocolate are good sources of these nutrients.
I’d be curious to hear your thoughts. Have you noticed that your diet affects your mood? What’s been effective for you?
Thank you for reading this week’s edition of Vitamin Z.
Until next time,
By Daniel Zahler
Hi there and thanks for reading. If you stumble on my newsletter, you will notice that I write about health and wellness, and ways to optimize cognitive, physical and emotional health. I work with the world’s leading healthcare and life sciences companies to develop innovative new solutions to improve health globally. I was trained as a research scientist at Harvard, and I serve as a GLG council member where I advise global business leaders on healthcare innovation.
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Great article Dan!