You probably know that a good diet (less saturated fat, less sodium, more fruits and veggies) is important to heart health. But research is increasingly finding that eating the right foods can protect mental health, as well. A 2019 meta-analysis, the first study to evaluate the existing data on the effects of diet on depression and anxiety, found that diet may have a positive effect. For example, one study found that after three weeks on the Mediterranean diet, a group of young adults (ages 17–35) reported, on average, that their depression scores fell from moderate into the normal range. They also reported less anxiety. The control group, who continued to eat a typical diet low in fruits and veg and high in processed foods and refined carbohydrates, saw no reduction in depression scores.
A change in diet has also been shown to potentially reduce the risk of dementia. These findings have led to the development of the MIND diet, a mash-up of the Mediterranean and DASH diets, combining an emphasis on healthy fats, fruits, vegetables, whole grains, and nuts along with dietary strategies to lower blood pressure. The evidence of dietary interventions for other mental conditions is less robust, but growing.
It’s still not clear why eating well might help with mental illness, but researchers speculate that diet might influence mental health through its effects on inflammation, oxidative stress, and mitochondrial dysfunction. And, of course, the gut microbiome is very likely to be involved.
A New Specialty
This growing body of evidence has led to a new field of medicine: nutritional psychiatry. Although the field is still young (and you probably won’t find it easy to locate a psychiatrist who’ll incorporate food into your treatment plan), it is potentially game-changing for psychiatry. “Psychiatry has really struggled to be in the world of prevention,” says Drew Ramsey, assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and a pioneer in the field of nutritional psychiatry. Paying attention to nutrition may be a good way to maintain mental health and prevent mental illness.
Still, Ramsey cautions, “There is no magic bullet to mental health.” Nonetheless, Ramsey, author of Eat to Beat Depression and Anxiety, believes that the field needs to do a better job of educating and empowering the public about the individual’s role in protecting mental health. Traditionally, mental health has been thought of as something passive: “You have it until you don’t,” he says. But we can’t sit around hoping we won’t get depressed. In 2020, one in five U.S. adults experienced some kind of mental illness. This makes the potential of diet as a key means of staving off trouble very exciting, he says.
This does not mean the field of nutritional psychiatry is at the point where your doctor can give you a prescription for the farmers market, even if you managed to find a doctor on board with the new approach, explains Uma Naidoo, director of nutritional and lifestyle psychiatry at Massachusetts General Hospital, and another pioneer in the field. Though careful not to overstate the research, Nadioo says she's seen the evidence connecting diet and mental health firsthand. “I’ve seen it in my clinical practice; people start to make these changes, and they start to feel better.”
Naidoo, author of This Is Your Brain on Food, is also a trained chef. She credits her training at culinary school with helping her develop discipline and the habit of planning. But her skills as a chef help her patients, too. In her practice, she actually walks people through planning meals, batch cooking, shopping for groceries, and other tasks that make eating well easier.
While teaching patients how to eat better is crucial, the real challenge may be teaching doctors how to use dietary approaches in practice. Doctors get notoriously little training in nutrition, and it can take a while, even when the evidence is robust, for new approaches to trickle into routine practice. But Naidoo is on it. “It’s become my ambition to help train other providers to do this type of work, so that we can help more people,” she says.
Good, and Good for You
Meanwhile, there is no risk in eating well. While dietary approaches should never replace medication or other therapies advised by physicians, paying more attention to diet is a great way to maintain mental health. It can also be an adjunct to pharmaceutical or talk therapy.
If you’re thinking you’ll be counting blueberries and weighing kale, or that you might be forcing down foods you don’t really like, you’ll be happy to know that eating well for health — mental or otherwise — is much simpler and far more adaptable than that.
Ramsey suggests thinking in terms of categories rather than specific foods. “What really matters is our dietary pattern,” he says. And he shares a little rhyme to guide you: “Seafood, greens, nuts and beans — and a little dark chocolate.” What seafood and which greens are up to you.
He also suggests what he calls “simple swaps.” You can make a huge difference in the quality of your diet by simply replacing soda with unsweetened tea or flavored seltzer or by ordering the guacamole instead of the cheese dip.
Eating well is not as expensive as you may think, either. Seafood can be pricey, especially these days. But, Ramsey says, inexpensive canned tuna is just as healthy as a slab of sockeye salmon. In fact, it may be better — especially if you’re more likely to eat it three times a week. Frozen vegetables are good, too, and often more nutritious than fresh.
The key, says Naidoo, is to tap into foods that you like to eat. “I'm a very big believer that in order to be healthy, we don't have to give up anything in terms of flavor or enjoyment.”