Good Health and Happiness

How can good lifestyle and plant-based dietary choices help combat depression?

A mind-blowing statistic (published in the journal Nutritional Neuroscience) grabbed my attention: Higher consumption of vegetables may cut the odds of developing depression by as much as 62 percent! This review article concluded that, in general, eating LOTS of fruits and vegetables may present “a non-invasive, natural, and inexpensive therapeutic means to support a healthy brain.” Wow! Let’s explore the link between depression, diet and lifestyle further.

In 1946, the World Health Organization defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

One can be in excellent physical health – with no underlying disease such as heart disease, and be physically fit – but that does not necessarily mean that one is healthy. MENTAL HEALTH can be just as important as PHYSICAL HEALTH. Major depression and anxiety is one of the most commonly diagnosed mental illnesses.

Depression statistics have always been high  – and these stats have climbed exponentially since the Covid-19 pandemic. The Lancet (November 06, 2021) states that “before 2020, mental disorders were leading causes of the global health burden, with depressive and anxiety disorders being leading contributors to this burden .The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental healthcare are exacerbated.” The article also cites “an additional 53.2 million cases of anxiety disorders globally (an increase of 25.6%) = +/-4800 cases per 100 000 population. Altogether, major depressive disorder caused 49.4 million DALYs (disability-adjusted-life-years, i.e. the loss of the equivalent of one year of full health) and anxiety disorders caused 44.5 million DALYs globally in 2020.”

SA statistics 2022: South Africa has one of the lowest mental health scores in the world. A report surveyed 12 000 South Africans, comparing them to 223 087 people across the globe. Meaning that South Africa scored the lowest average score on the mental health well-being scale. The rate of distressed or struggling on the scale increased by 8%, from 28.5% in 2020 to 36%.

Everyone feels sad occasionally: all emotions (anger, happiness, sadness, joy, bad mood – and many more) are part of what makes us human. DEPRESSION, however, is not just sadness. Depression is characterized by symptoms such as weeks and months of low or sad mood, diminished interest in activities that used to be pleasurable, weight gain, weight loss, chronic fatigue, inappropriate guilt, difficulty in focusing on work or other tasks at hand, and recurrent thoughts of death/suicide. Major depression can indeed be a life-threatening illness.

How does depression work?

NOTE: there are many theories, and in no way do I intend to over-simplify this extraordinarily complex condition. Each person is unique, with their own unique experiences in life. It is known that there are both extrinsic (external) factors (inter alia, personal trauma, negative environments, drug or alcohol abuse) as well as intrinsic (blood / brain chemistry) contributing to depression and/or anxiety. A medical specialist (psychologist, psychiatrist) is an essential part of the team of support that treats a depressed individual.

One of the theories is THE MONOAMINE THEORY:

This theory suggests that depression arises out of a chemical imbalance in the brain. The (millions of) neurons in the brain communicate with each other via neurotransmitters. Neurotransmitters bridge the gap between the neurons. One class of neurotransmitters are called monoamines, and include SEROTININ and DOPAMINE. Monoamine oxidase (MAO), an enzyme, controls serotonin and dopamine, breaking down any excess monoamines. People who are depressed appear to have elevated levels of MAO in their brains, causing low levels of serotonin and dopamine. A drug known as a monoamine inhibitor blocks the excess monoamine, BUT this drug has serious (even dangerous) side effects, so is not often used. Other drugs have subsequently been developed to boost levels of serotonin, dopamine and other neurotransmitters.

The goal of treatment here is to reduce the MAO enzyme levels SAFELY. Of interest is the fact that many plant foods, including apples, berries, grapes, onions, and green tea, contain phytonutrients that appear to naturally inhibit the MAO. Spices such as cloves, oregano, cinnamon and nutmeg also have this effect. This MAY explain why those eating whole food plant based diets have lower rates of depression.

 

The link between mental and physical health

Scientific research shows that there is a definite relationship between optimal mental AND physical health. Many research studies have emerged over the past two decades showing that positive psychological wellbeing is associated with reduced risk of physical illness.  Which comes first: are people healthier because they’re happy, or are people just happier because they’re healthy? It is true (as proved in seventy studies on mortality) that “positive psychological wellbeing has a favourable effect on survival in both healthy and diseased populations” – meaning that those who are happier appear to live longer. BUT, while positive mental states may be associated with less stress and more resilience to infection, positive wellbeing might also be accompanied by a healthy lifestyle.

In general, people who are contented and happier appear to smoke less, drink less alcohol, exercise more, and eat healthier. The question remains though: is being happier just an indication of good health and not a cause of it? Further studies have shown that people with increased positive emotions infected with the common cold or influenza  were associated with decreased verified illness rates. HAPPIER PEOPLE ARE LESS LIKELY TO GET SICK.

Knowing that mental health appears to play a part in physical health, means that it is essential to choose foods that support both the MIND and BODY.

Nutrition facts

  • The more fruits and vegetables eaten in a day, the happier, calmer, and more energetic one feels that day – AND this positivity can spill over into the next day. BUT… for one’s diet to have a meaningful psychological impact, one may need to consume approximately seven servings of fruits and eight servings of vegetables each day!
  • SEROTONIN (the happiness hormone): many foods contain serotonin BUT the serotonin from food cannot cross the blood-brain barrier, so these foods do not move into the brain where the serotonin is needed.

However, there is an ESSENTIAL amino acid called TRYPTOPHAN (the building block of serotonin) that CAN be consumed in food format, absorbed into the blood – and then into the brain. Studies have shown that a tryptophan-deficient diet causes irritability, anger, and depression. In contrast other studies show that tryptophan is beneficial for: mood, depression, learning, memory skills, visual cognition and aggression control. Tryptophan is an amino acid found in protein-rich foods. The RDA for tryptophan is 250-425mg/day. Most people consume more than double this. However, a protein-rich diet did NOT actually improve tryptophan absorption into the brain (this is due to many factors). In fact, many studies have shown that diets higher in unrefined carbohydrates and lower in fats and protein resulted in less depression, hostility, improved moods and less anxiety.  Carbohydrates do indeed facilitate tryptophan transport into the brain, but one still needs a dietary (NOT supplement) source.

Foods rich in tryptophan:  

  • Sesame seeds, sunflower seeds and pumpkin seeds
  • Nuts such as peanuts
  • SOY products contain plenty of this essential amino acid. E.g. 1 cup cooked tofu contains an impressive 592mg tryptophan, soy milk has 92mg/cup and soy porridge (Soya Life Porridge) has >100mg/serving
  • Fruits such as banana, apples and prunes also contain tryptophan.
  • SAFFRON (spice) given in a Prozac-equivalent dose has been shown to have the exact same effect in reducing depression symptoms without the side effects, of Prozac. However, it is extremely expensive (more than double the price of Prozac). Fun fact: one study showed that even smelling saffron reduces symptoms of anxiety!
  • COFFEE: the research shows! Coffee IS beneficial – here are some fun facts:
    • A Harvard University Review of 3 large cohort studies of >200 000 American men and women, found that people who drank two or more cups of coffee daily have only half the suicide risk than non-coffee drinkers.
    • A Kaiser Permanente study of >100 000 people found that suicide risk seemed to continue to drop with increases in coffee intake. People who drank >6 cups a day were 80% less likely to commit suicide. BUT drinking 8 or more cups a day has been associated with increased suicide risk.
    • Adding sugar to coffee though may negate many of coffee’s positive effects on mood. Frequent consumption of sweetened beverages has been shown in the NIH-AARP study (which followed hundreds of thousands of Americans for a decade) to increase the risk of depression in older adults.
  • EXERCISE vs antidepressants: even a single workout / walk can elevate mood. Many studies have been carried out in this regard. The main outcome is that people who exercise regularly have 25% less incidents of a major depression diagnosis.
  • ANTIOXIDANTS: research shows that FREE RADICALS (highly unstable molecules that cause tissue damage and contribute to ageing) may play an important role in the development of various psychiatric disorders, including depression. Free radicals can cause the death of nerve cells and the subsequent shrinkage of certain emotion centers in the brain. Once again, the theory is that by eating plenty of fresh fruit and vegetables which are rich in antioxidants, one is protected from depression. Research has proved this theory, concluding that eating antioxidant-rich-plant foods may “dampen the detrimental effects of oxidative stress on mental health.”

Carotenoid phytonutrients (antioxidants found in yellow, orange and red fruits and veggies) – when measured in the blood – was found to be directly linked with depression: higher levels resulted in a lower risk of depression. The red pigment in TOMATOES (lycopene) has the highest antioxidant activity. One specific study demonstrated that it reduced the risk of depression in the elderly by 50%!

Note: Food sources of antioxidants are far better than supplements, as there are many other food components that come into play.

  • FOLATE: found in beans and leafy green veggies, help prevent depression. Recent studies following people over time suggest that low dietary folate intake may increase the risk of severe depression by as much threefold. Eat plenty of greens to ensure adequate folate intake and achieve a good mood!

We have looked at the GOOD nutrients. What about the BAD ones?

Considering the negative impact of animal proteins on mental health, one specific compound stands out: arachidonic acid (mainly found in chicken and eggs, and also in beef, pork and fish). Arachidonic acid is a proinflammatory compound found in animal products that can “adversely impact mental health via a cascade of neuroinflammation.”

Overall omnivores appear to consume about nine times more arachidonic acid than those eating plant-based diets. One interventional study was done on men and women, whereby chicken, egg and meats were removed from their diets, and mood states were measured. Within just two weeks, the study subjects experienced a significant improvement in mood states. The researchers concluded that “perhaps eating less meat can help protect mood in omnivores, particularly important in those susceptible to affective disorders (such as depression).”

Improved mood at work

We all know that healthy bodies and minds in the workplace, translates into improved productivity. When one’s mood is good, one is a better team player, and concentration is improved (making employers happy too!). A group of employees following a whole-food, plant-based diet experienced improved digestion, increased energy and better sleep, as well is significant improvement in their physical functioning, general health, vitality and mental health, compared with a control group who ate a standard diet containing animal foods. INCREASED PRODUCTIVITY was the overall positive outcome!

To summarize:

In order to prevent and assist in the treatment of depression and anxiety disorders, try the following dietary and lifestyle tips as part of your overall treatment program:

  • Eat 7 servings of fruits and 8 servings of vegetables each day!
  • Eat foods rich in tryptophan as a means to boost serotonin (the happy hormone in the brain):
    • Sesame seeds, sunflower seeds, and pumpkin seeds
    • Nuts such as peanuts
    • SOY products contain plenty of this essential amino acid. E.g. 1 cup cooked tofu contains an impressive 592mg tryptophan, soy milk has 92mg/cup and soy porridge (Soya Life Porridge) has >100mg/serving
    • Oats
    • Fruits such as banana, apples and prunes also contain tryptophan.
  • ANTIOXIDANTS: Eating plenty of fresh fruit and vegetables which are rich in antioxidants, to protect one from depression. Research has proved this theory, concluding that eating antioxidant-rich-plant foods may “dampen the detrimental effects of oxidative stress on mental health.”

Eat plenty of carotenoid phytonutrients (antioxidants found in yellow, orange and red fruits and veggies)

Eat TOMATOES (lycopene) daily (fresh, tinned, pureed)

Note: Food sources of antioxidants are far better than supplements, as there are many other food components that come into play.

  • FOLATE: found in beans and leafy green veggies, help prevent depression. Eat plenty of greens and beans to ensure adequate folate intake and achieve a good mood!
  • SAFFRON (spice) – use it in high amounts if you can afford it (!) – alternatively smell it to reduce anxiety!
  • COFFEE: drink 2 – 4 or a maximum 6 cups of unsweetened coffee per day to reduce depression and suicidal thoughts. Avoid drinking 8 or more cups a day.
  • EXERCISE vs antidepressants: 30-60min per day will elevate mood and reduce depression.
  • Avoid frequent consumption of sweetened beverages as much as possible.
  • Follow a WHOLE FOOD PLANT-BASED DIET, to boost intake of the brain- and mind-healthy foods. And minimize intake of animal proteins in order to reduce the proinflammatory effect on the neurotransmitters in the brain.

Daily lifestyle tick list for a HAPPIER YOU!

  • Positive thoughts
  • Breathing exercises
  • Exercise: 30-60min
  • 2-4 cups of coffee
  • 8 glasses water

Basic meal plan as follows: (include 7 fruits + 8 veggies)

Breakfast:Soya Life Porridge + sunflower seeds and 2 servings of berries (2 fruit)
Mid-morning:Wholegrain bread / crackers + hummus / nut spread, celery, snap peas, carrot sticks, mini corn
Lunch: Salad / Stir-fry / Vegetable soup (4 veggies) – add tomato, sprouts, seeds and nuts *
Mid-afternoon: Fruit Smoothie / Green Smoothie (include 3 fruits + spinach and/or carrots)
Supper: Plant-based meal with vegetables, mushrooms, tomatoes, tofu, soybeans, lentils,
chickpeas, butter beans (4 veggies) *
Dessert: Fruit (2)

*Note: you may include a small portion of meat / chicken / fish / eggs three times a week

A healthy lifestyle is a powerful tool that can help lessen the symptoms of depression. Making good dietary choices and exercising regularly are two key components to living a healthier life. If you or someone you know is struggling with depression, encourage them to make some lifestyle changes and see how it affects their mood. Have you made any lifestyle changes that have positively impacted your mental health?

 

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