There have been a lot of books published in the past few years that discuss food as a paramount solution to mental health problems like depression and anxiety.

Books like, The Food Mood Connection…Calm Your Mind with Food…Eat to Beat Depression and Anxiety…Fuel Your Brain, Not Your Anxiety—have successfully contributed to the nutritional education of our community and helped people further understand the healing nature of food. That said, can diet alone prevent, treat and cure mental illness?

Here is my thinking about this very important and complex matter.

Yes, diet and health are intertwined.

Poor nutrition is plaguing America. The average American gets 57% of their daily calories from ultra-processed foods (UPFs), like fast foods, frozen pizzas, white bread, soda, energy drinks, chips and other salty snacks, and cookies and other sweets. A database of 50,000 foods sold in the United States shows that 73% are ultra-processed—calorie-rich, nutrient-poor, and loaded with artificial ingredients.

Thousands of studies now link a diet rich in those UPFs to poor health, from high blood pressure, obesity, and diabetes, to heart disease, cancer, and dementia. Studies also link UPFs to poor mental health.

In a meta-analysis published in the June 21, 2022 issue of Nutrients, Australian researchers looked at 17 studies on the link between UPFs and mental health. They found a higher intake of UPFs increased the risk for depressive symptoms by 44% and the risk of anxiety symptoms by 48%.

UPFs are particularly punishing to developing brains. In fact, I’d go so far as to say UPFs are destroying the mental health of our children!

In a study published in the June, 2023 issue of the European Journal of Epidemiology, Dutch researchers looked at “pre-adolescent brain morphology” (measured by MRI) and the intake of UPFs. They found that children who ate a dietary pattern of “snack, processed foods and sugar” had smaller cerebral white matter volume at the age of 10, compared to children with a “whole grains, soft fats and dairy” dietary pattern. The “whole grains” children also had larger total brain and larger cerebral gray matter volumes. Not surprisingly, the children with poorer brain morphology had lower IQs.

And in a study from Brazilian researchers, published in the December 7, 2022 issue of Nutrients, adolescents who consumed six or more daily servings of UPFs “reported more frequent symptoms of poor mental health” compared to those consuming 3 or fewer daily servings.

Treat nutritional deficiencies first

The scientific evidence is clear: A diet of highly processed foods stunts and harms the brain, and an injured brain is a setup for cognitive and emotional problems.

But can eating a healthy diet restore mental health and well-being? I would say the answer to that question is no. Not alone.

That’s because a poor diet causes multiple nutritional deficiencies. And those deficiencies—of B vitamins, and minerals like magnesium and zinc, omega-3 fatty acids, and other brain-balancing nutritional factors—must be treated FIRST, with targeted nutritional supplementation.

Only after nutritional deficiencies are tested for and treated can diet (and other lifestyle recommendations) make a significant difference.

The most important lifestyle factors: sleep and social connection

And among lifestyle factors, diet may not be the most important in protecting mental health, according to a study published in the September, 2023 issue of Nature Mental Health.

The nine-year study analyzed health data from nearly 290,000 people, 13,000 of whom had depression, exploring the link between the risk of depression and seven lifestyle factors: healthy sleep, healthy diet, regular physical activity, low-to-moderate sedentary behavior (sitting, reclining or lying), frequent social connection, moderate alcohol consumption, and never smoking.

Of all these factors, getting a good night’s sleep (between 7 and 9 hours a night) made the biggest difference, reducing the risk of depression (including single depressive episodes and treatment-resistant depression) by 22 percent.

Frequent social connection (spending more time with family, friends, and other people) reduced the risk of depression by 18 percent. But social connection was the most protective of the lifestyle factors against recurrent depressive disorder.

These two depression-reducing lifestyle factors were followed in importance by:

• Never smoking (20 percent reduction)
• Regular physical activity (14 percent)
• Low-to-moderate sedentary behavior (13 percent)
• Moderate alcohol consumption (11 percent)
• And lastly, a healthy diet (6 percent)

Dietary change is difficult

Another important point: If you’re a mental health professional who has counseled a client to change their diet, you know how hard it is for them to do so!

Permanent dietary change is difficult—and relatively rare. If dietary habits were easy to change, 70 percent of Americans wouldn’t be overweight or obese. And that difficulty goes double for people who are depressed or otherwise mentally miserable; people for whom food is often comfort and consolation.

And the relative few who do manage to change their diet usually do so because they are strongly motivated to change from within—not because they’re dutifully following professional advice.

Summing up

In summation, the core concept of Psychiatry Redefined is whole-person, patient-centered, collaborative treatment based on testing.

First, test to discover the unique biological profile of the patient—including nutritional deficiencies caused by poor diet. Next, treat to address imbalances and deficiencies. Dietary and other lifestyle recommendations make sense after the imbalances and deficiencies are corrected. This is the clinical approach that really works.

If you are ready to implement a new model of care that incorporates these key areas, I hope you consider our Summer 2024 Functional Medicine for Mental Health Fellowship program. This comprehensive training for all mental health professionals begins in July and enrollment is now open.

Our Fellowship is referred to as the most comprehensive, practical, cost-effective program for  clinicians seeking to enhance their practice and deliver real patient wellness. In fact, 95% of our past fellows report improved client satisfaction after integrating functional medicine testing and treatment approaches.

I am happy to schedule a 1:1 call with you to determine if our Fellowship is right for you. We are also offering limited scholarships.

In health, 

James Greenblatt, MD
Founder & CMO, Psychiatry Redefined