Food For Thought: A look at diet and mental health
Presenting Author(s): Dr. Jennifer Swainson, MD, FRCPC
Date and time: 24 Mar 2018 from 15:10 to 16:00
Location: Hawthorn B
Learning Objectives:
- To explore the complex relationship between diet, mental health, and metabolic syndrome, and review our role as psychiatrists
- Review the insulin based model of obesity and introduce the Lower Carbohydrate Healthy Fat (LCHF) Diet as a potential weight loss tool for patients with mental illness.
- Review literature to support dietary advice as an adjunctive treatment approach for depression
Literature Reference:
1) Jacka et al (2017) A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Medicine 15:23.
2) Fung, Jason. The Obesity Code. (2016)
3) Noakes T, Windt J. 2017. Evidence that Supports the Prescription of Low-Carbohydrate High-Fat Diets: A Narrative Review. Br J Sports Med. 51: 2.
4) Parletta et al. (2017): A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED), Nutritional Neuroscience, DOI: 10.1080/1028415X.2017.1411320
5) Rahe et al (2014) Dietary patterns and the risk of depression in adults: a systematic review of observational studies. Eur J Nutr. 54:997-1013
6) Dehghan et al (2017) Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. The Lancet. 390:. 2050-2062
Abstract:
Mental illnesses including depression, bipolar disorder and schizophrenia are risk factors for Type II Diabetes. Medications used to treat these conditions also carry the unfortunate side effects of weight gain and metabolic syndrome. A body with Metabolic syndrome and a depressed mind may have a reciprocal relationship through pathways involving insulin, fat tissue, and inflammation. One approach gaining traction in general medicine to treat metabolic syndrome is the Lower Carbohydrate Healthy Fat (LCHF diet), which focuses on modulating insulin response by lowering carbohydrate intake in order to prevent weight gain and facilitate weight loss. This differs from previous low fat/low calorie dietary dogma. The premises and misconceptions of the LCHF diet, as well as recent literature debunking the harms of fat consumption will be reviewed. Mental Health Professionals can consider potential applications of this intervention to our patient population for metabolic management. Similarly, while the most recent CANMAT Depression guidelines do not address diet, recent studies have suggested that dietary interventions similar to the LCHF diet can improve symptoms of depression. Both physician and patient barriers to providing and following dietary advice will be explored. In spite of these, advising an LCHF diet to psychiatric patients carries little risk of harm and potential for significant benefit.