Just As Well, The Women's Health Podcast - What To Eat To Build Better Mental Health

Episode Date: March 12, 2020

We suspect you’ve felt the feel-good benefits of diving head first into a bowl of pasta first-hand. But beyond the emotional response that food can trigger, what you eat every day can have a very real impact on the day to day workings of your brain - and how you feel. Enter nutritional psychiatry: a growing field of research that’s unpicking the relationship between food and feelings. Sounds complicated, but it’s actually really simple to put into practise. Here to help us translate the science into a shopping list is Kimberley Wilson, Chartered Psychologist and author of the brand new book How To Build A Healthy Brain.  Join Women’s Health on Instagram: @womenshealthuk Join Roisín Dervish-O’Kane on Instagram: @roisin.dervishokane Join Kimberley Wilson on Instagram: @foodandpsych Have a goal in mind that you want us to put to the experts? Shoot on a DM on Instagram - we're @womenshealthuk. Or drop us an email on [e-mail]. Topics:  What is nutritional psychiatry?  What are cooled carbs, and why are they so useful?  What’s the perfect meal to eat for brain health? How does alcohol affect the brain? PLEASE NOTE: This episode includes a mention of where to buy your tickets for Women's Health Live. Since this episode was recorded, the event has been cancelled, due to the ongoing situation with Covid-19. For full details on this decision, and information on how to get a refund, click here. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

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Yep, it's the most powerful iPhone ever, plus more peace of mind with your bill over five years. This is big. Get the new iPhone 17 Pro at tellus.com slash iPhone 17 Pro on select plans. Conditions and exclusions apply. Hello, everyone, and welcome to Going for Goal, the weekly women's health podcast with me, Roshin DeVosher Kane. Today we're looking at the goal of eating for better mental health, inspired by many responses from an Ask Me Anything we shared in our Instagram stories last week. When we talk about mental health, it's important to get across that there is no silver bullet strategy

that you can adopt to get yours in a good place. Maintaining good mental health is a team effort. But whatever line-up works for you, be that running, therapy, calling your mom, logging out of social media or taking medication, nutrition really does deserve a place in that squad. Here to explain why. It's chartered psychologist Kimberly Wilson, author of New Book, How to Build a Healthy Brain. Welcome, Kimberly. Hi there.

Great to have you on. So together, we're going to be delving into the latest in-lab developments from the field of nutritional psychiatry. Yes, that's a thing. To learn what the science says about the relationship that exists between food and feelings. Kimberly will also be sharing the totally doable switches that you can make right now to nourish your neurons and nudge your brain towards a healthier place. Kimberly. So I feel like we should say up front that this isn't just a topic for someone who has received like a formal mental health diagnosis, is it? No. And we should also really be careful about, as you say, how we get that message across that it's not that we're saying, if you have a salad, you're just going to feel better. You know, that would be insulting and also untrue and unhelpful. But what we are really talking about is how nutrition and food can affect the structure and function of the brain. And as an extension of that, how we might be able to.

use nutrition as a supportive or preventative measure in mental health concerns. Totally. So this isn't putting food out there as some kind of cure-all. Okay, so you have had an interesting varied career. When did you start becoming interested in the relationship between nutrition and mental health? It was really when I was working in prisons. So when I started my career, I took my first placements and then my first proper job in what was at the time Europe's largest women's prison. And I was running the therapy service. there. And there was a replication study around that time of an earlier piece of work. And that earlier piece of work was published in 2002. And it showed that with young offenders, you could

reduce violence, so incidents of violence in the prison by 37% with a nutritional supplement. Wow. Really, really astonishing stuff. The replication came out around the time that I was starting my career. And there's now been another replication. So, Another two trials using RCT have found that nutritional supplementation can reduce violence in prisons by 20% and then it was at 34%. So on average, 30%. And so I was astonished. And obviously, I thought this was fascinating, important and really quite a powerful intervention for something that doesn't have side effects, which is cheap, which is accessible. and therefore something that I feel like we should be making much more use of.

Absolutely. So I think we touched on it before when we're talking about nutritional psychiatry. We've kind of defined what it isn't and what it isn't is saying, hey, have a salad and it will fix everything. Omega-3 fatty acids are fine, throw away your antidepressants. But what is it? So the field of research is the understanding the impact of food and nutrients on brain structure. and function, and therefore, whether it has a role in aspects of behaviour or mental illness. Brilliant, thank you. And what are some of the key developments at the moment? Well, it's really, it's a very young field, but it's really a booming field. So one of the big

landmark studies was what's called the Smiles trial. And that was published in 2017 now. And again, that was the first RCT, so a causal relationship demonstrating study that found that nutritional improvement could reduce depression. So in this trial, what they did was to take a group of people who already had a clinical diagnosis of depression and also had a clinically defined poor diet, so one that was low in fibre, one where there wasn't very much fruit and vegetables. And again, they split them into two groups and had one group have social support. And we know that social support improves mental health, you know, having connections with people, talking to people can make you feel better.

We know that. But they were the control group. And the other group got 12 weeks of meetings with a dietitian and food boxes to help them improve their diet to something approximating the Mediterranean-style diets, lots of fruit and vegetables, whole grains, nuts, legumes, you know, and plenty of oily fish. But after just three months, what they found was that a third of the people in the group who had been on treatment, they were receiving either medication or, psychotherapy. But a third of the group went into remission, which means they no longer had

clinically defined depression. This is an extraordinary finding, and particularly in the context, that depression is now the leading cause of global disability, which means more people are suffering with loss of satisfaction from life, poor function, you know, loss of quality of life from depression than any other illness. So it's really one of the driving factors. So it's really one of the driving factors for global mental health concern. And as I say, no, we're not saying that food is the problem for everyone because there are lots of different causes and triggers and contributors to depression. But it's certainly a powerful finding to think that at least for some people, that improvements in diet or, you know, getting the right nutrients might be really, really supportive

for their mental health. And something so simple. Yeah. Every day. Anyway, It's not you doing something big and revolutionary and what I've found with the foods that you use. It's nothing, there's no foods that you couldn't pick up in Tesco. No, and it's about the thing about this kind of intervention is that it's probably our most accessible intervention for mental health concerns, right? Not everybody can have access to a psychologist or a psychiatrist or just a mental health team. Not everybody wants or can tolerate psychotropic medications. You know, it's not necessarily accessible. and then sometimes the side effects can make that an untenable treatment for some people.

But yes, we all eat. We all eat several times a day. And so we all have at least the opportunity to make little shifts and nudges in the direction of something that's going to be a little bit more brain supportive. And that's really the kind of message that I'd like people to take that it doesn't necessarily have to be a huge overhaul. In the SMAS trial, for example, they allowed what they called extra food, so fried foods and swathes. sweets and cakes up to about three times a week so that even on the trial people were eating these foods every other day and still got these important. So there's some allowance even within the study for, you can still live your life. Being a human. Yeah, exactly. You still go out and

have birthday cake with your friend. So that message of accessibility and really a very gentle middle ground, it doesn't have to be at the extremes, is one that you sometimes miss in some of this research. And I think it's really important that people understand that. that this isn't, as I say, about completely transforming your life and doing a complete overhaul of your diet and cutting things out. It's much more important about the things that you put in rather than the things that you're cutting out. Yeah, that's a really positive way of looking at it.

And when we think of some of the key areas at the moment and thinking perhaps of like the gut-mind connection, what have we found out about that in recent years that is influencing the way that experts are saying we should think about feeding ourselves for our mental health? Well, there's a tremendous amount that we don't yet. know about the impact of the gut on the brain. We're just kind of scratching on the surface, isn't it?

Really. I think the researchers think maybe we're 1% in, you know, really right at the beginning. But one of the things that does seem to be consistent is that, A, you're better off getting a diverse range of foods. And that seems to be not just good for the gut, but also good for the brain. But also, the big question is around what's called inflammation. So inflammation is the body's response, the immune system's response to. illness or injury. And really, the gut is this kind of central hub of the immune system, around 70% of your kind of white blood cells are in and around the gut. And that makes sense

because the gut is the main access point for anything that might do you harm, right, if it's a spoiled piece of meat or, you know, some other kind of food-borne bug. It's going to get in that way. So you want your immune system to be ready to address an issue that might arise. But what we know about a poor diet, when we say poor diet, I mean one that's low in fibre, is that what that can do is to make the gut more vulnerable and can raise this inflammation. And it's this state of inflammation that actually can trigger inflammation in the brain. And when we get neuroinflammation, then we have these additional risks of things like depression, but also we know neuroinflammation is associated with things like schizophrenia and bipolar disorder

and Alzheimer's disease dementias. So again, that's not to say that we can fix these things with food, but to say that they all play a part and that the health of the brain is the health of the whole body and that you need to be thinking more broadly about how you're taking care of yourself, that the brain doesn't just sit in a jar all by itself completely unaffected by what's happening in the rest of the body, that the brain is profoundly affected by what you eat, how much sleep you get.

And we can see that every day, right? As soon as you have a glass of wine, you suddenly have this profound effect on your brain, right? It's this immediate effect. And food has the same capacity to affect the brain. It's just that it does it at a much lower level. It accumulates much more slowly. So people don't really appreciate that food can have these profound brain effects in the same way that perhaps we can think of alcohol or caffeine.

So it seems like from what you're saying, eating for your mental health, you don't just do it in a vacuum. and seems that what you would be doing to eat to improve your mental health is probably going to be improving other things elsewhere in your diet. Would you agree then that it's all kind of connected? Yeah, it absolutely should all be connected, right? Because it wouldn't make sense for you to try and completely overhaul your diet if you're only sleeping three hours a night and smoking and doing all this other stuff. It all needs to be related. And again, it's not about one individual superfood.

It's not about, you know, if you have, I don't know, spirulina, it's going to make everything right. because we know that food has these multiple effects on the body. So it affects maybe your gut microbiome, but maybe it also affects how flexible your blood vessels are. And that's important because your brain has this huge demand for blood, flow and oxygen. So having flexible blood vessels is really important, and certain foods can support that. We know that certain fats actually make up the structure of the brain.

So being able to take in those essential fats is going to be really important. So it's not about focusing on one area, but really this broad spectrum, this broad intake of nutrients, this broad intake of fibre to support that gut microbiome. And also, you know, I'm going to bang on forever and ever and ever about essential fats. Keep going. Because one of the things I think people really don't appreciate is that your brain is made up of fats that your body can't produce. You have to get them from your diet. So these essential fats, they're called omega-3s, and in particular,

EPA and DHA. And these fats make up a third of the membrane of each of your brain cells. They come predominantly from oily fish and seafood. And if you're not therefore getting enough of those, then your brain can't use them. And what it will do is to substitute different fats in place of them, which is not good because what's special about these fats is that they're very flexible. So they allow things to cross the membrane appropriately into the cell and out of cell. And so if you don't have the right facts, then the cell membrane can become inflexible, and that can affect

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when you can go for the gold at Golden Nugget Online Casino. Gambling problem call connects Ontario 6-00, 19 and over, physically present in Ontario, eligibility restrictions apply. See golden nuggettcasino.com for details. Please play responsibly. If someone does want to start using food to strengthen their own mental health as part of their holistic health, where does someone start? I would start probably with some quite simple switches. So if you habitually eat white rice, white bread, then I would be switching to, whole grain varieties. So doing what you can to increase that fiber. Also, leafy greens are hugely associated with better brain health. So what I sometimes suggest to people is literally, even if you're buying a shop-bought sandwich for your lunch, buy a bag of greens, have a handful of

spinach in your sandwich so that you're also getting the benefit of the nutrients from those leafy greens. So it doesn't have to be, as I say, complex. You don't have to be slaving over a stove. You don't be chopping carrots for hours and hours and hours. It's just about where you can add these things in. A handful of nuts is associated in all of the research to a handful of nuts a day to better brain health. So, you know, can you snack on some nuts during the day? And that's one thing. And it's about building up and accumulating all of these tiny changes so that over time they build up into a broader brain healthy lifestyle. Yeah. And what about then, just to come back to your point earlier about omega-3s. So they're essential for the cells in our brain.

What do people do if, you know, so many more people are becoming vegan these days? What should those people do? Are there other ways that they can get those essential fats? Yeah, the best and pretty much the only kind of dietitian recommended way is to take an algae-based DHA supplement because algae is essentially where the fish get it from in the first place. the algae synthesize the DHA, then the fish eat it, and then we eat the fish and we kind of get it from them, along with some other nutrients. Right, okay. So you kind of go to the sauce.

You go to the sauce. You cut out the middleman and you go to the source. So if you don't eat fish, you don't like to taste of fish or you're on a plant-based or vegan diet, then we would be highly recommending that you be taking a supplement to make sure that you're not losing out on these essential fats. And I think on that note as well, making sure that vegans and people on plant-based diets are also taking a B12 supplement, because B12, again, is another brain essential nutrient that is largely found in animal foods.

And what we know about B12 is that it's so crucial for brain function that a deficiency in it can mimic dementia. It can cause problems like confusion, memory loss, what's called neuropathy, which is pins and needles and tingling and pain in the nerves. And if it's left too long, it can do irreparable damage. but if you catch it early enough, then the damage can be reversed. So DHA and B12 for vegans or people who don't eat very many animal foods. What are some more of the other really kind of key foods for mental health?

It doesn't have to be specific ones or kind of groups that when people are building their shopping list. Because there's a brilliant bit in your book when you've got a little checklist. And it's almost like, I love it. It's basically like an order. And it's like, how many of these things are you doing? So can you tell the listeners what's on there? Sure. Yeah.

And so I break down in the book into the big groups. So see if I can remember them. Leafy greens are big ones. So things like kale and spinach and watercress, trying to get some of those as often as possible, at least once a day if you can. And I say things like Spanocopater. So again, it doesn't have to be the big bowls of raw lettuce.

But lovely Greek feta and greens pie counts, right? So find ways to make greens more interesting. Berries is in there and other kind of. of polyphenol rich foods like green tea, like coffee, like dark chocolate. So these foods that are rich in polyphenols or the kind of colour compounds, so brightly coloured fruits and vegetables, I thought to be quite important. And most of the research is around blueberries, because when you do studies, you have to break them down into like an individual ingredient. But we know that foods like blueberries can increase that perfusion, so that blood flow to the brain. And that's

associated with better concentration, attention, memory, function and cognitive flexibility. So you can improve your performance through the foods that you eat. Then there's a big group around fiber and in that fiber group, so all of the whole grains are in there. But I also include what's called cold carbs. So carbs have been cooked and cooled. So things like potato salad or pasta salad or sushi where you've got cooked and cooled rice. What happens when you cook and call a carbohydrate is you change the molecular structure. You make it difficult for the stomach to break it down into sugars, but you make it available to the gut. It's called resistant starch. It resists digestion, but it ends up being a good source of food for the gut microbiome. So that can be a good way. So if you

like sushi, that's a great way. Pocke bowls are also really great because they also give you the essential fats if you have salmon on top, but also, you know, a mixture of vegetables. And maybe you get a little bit of of kimchi or something on the side. You get some fermented foods in there as well so that's great. So that is a win for the whole gutbrain. It's really almost a perfect lunch. And so delicious. So good.

Okay, brilliant. And so yeah, as you were saying before, it's important for these changes to become a habit, for them to have any noticeable effect. It's not about lionising one type of food and saying this is going to have a brilliant effect. It's this cumulative impact. There's so much about nutrition that is not properly understood,

but we're looking much more now at overall dietary patterns, not individual foods, not individual foods that are excluded, but how your diet looks broadly over an expanse of time. So it might be that, for example, you have one day where you've mostly just eaten Harrowboat, I don't know, like you know, you've just gone for the pick and mix. We wouldn't necessarily say that that was a problem if more broadly you have a much more balanced diet that's rich in fruits and vegetables, nuts, seeds and oily fish. So it's not about saying this one thing is terrible for you, never eat it again. It's about taking a much more generous overview of your overall diet. And yeah, so much of the way that we eat is habitual, right? We stumble down the stairs in the morning and prefer probably the same breakfast we had the day before.

And so few people are really thinking about the variety. So it's really about trying to encourage people to think a little bit more broadly outside of their cereal box and thinking about other things that they can add in just to add. that little bit of diversity and also additional nutrients into their food. Interesting. So we talk there about the poke bowl being the almost quote unquote perfect lunch and blueberries being like a really great snack. What else would be a really good breakfast and dinner? So you might want to go one of two ways. So oats is a really good way to start. So any, and I like to say again, think about the variety. So what you can do is pick up a musli base.

And what that is is a mixture of oats, rye, barley, and wheat flakes and spelt flakes, and use that as your porridge-based. So again, it still tastes like porridge, same texture as porridge, but you're getting more diversity in the types of fibres that you're taking in. Right. Super simple switch. And if you top that with some chopped mixed nuts, maybe some pumpkin seeds, maybe some blueberries or sliced banana,

then actually you're getting a really good mix of fibres. Polysinos, oily fats, fibers. And if you put a dollop of yogurt on top of that, then almost we're laughing, right? On the savory side, eggs is a great start. Eggs are really rich in a chemical called coline. And choline makes up a neurotransmitter called acetylcholine, which is essential in the brain for learning and memory. And again, this is one of the things that we're concerned about

people who aren't eating very many animal foods, not getting enough choline. It is in plant foods. You just need to make sure you're getting enough of them. So if you wanted to have eggs on whole grain toast, or maybe going to revive a classic and have kippers and poached eggs. So then you'd be getting again those oily fats, the coline, the B vitamins, and if you're having it with some whole grain toasts, some fibre as well.

Perfect. And what about dinner? Dinner, I think, again, it's about making your regular meals just a little bit more sort of brain friendly, if you like. So if you're someone who just loves a bowl of pasta, I'd be saying have whole grain pasta with a homemade tomato sauce, throw in a handful of spinach or have a salad. salad and then maybe again if you'd want to add in some tin sardines or some

mussels to add in that little bit of seafood so if your normal evening meal is pasta and sauce there are ways that you can kind of just pimper it up a little bit yeah now I love that and also the way that because we think of fish has been very expensive

but actually looking some of the most nutritious fish is actually the stuff that comes in the little tins absolutely and there's no problem with them at all. I eat tin fished a lot. And people are very concerned about things like mercury. And the general recommendation is that if you're eating the smaller fish, so sardines and mackerel, pilchards, then they accumulate much less mercury and you should be fine. This is a really positive conversation. There's so much more fun to think about what we can put in and what we can do rather than saying, don't do this, don't do that. But we talked about

sugar. So there is, there is research, isn't there to say that sugar can have a detrimental impact. on mental health. So it's not simply sugar. What the evidence seems to suggest is particularly sugar-sweetened beverages that are problematic in as far as it's a very unnatural amount of sugar that gets absorbed very, very quickly into the bloodstream. So, you know, there's, there isn't really any evidence to say having, you know, a slice of cake is pro-inflammatory, no. But it tends to be diets that are a rich in sugar-sweetened beverages and rich in refined carbohydrate food. because they tend to be low in fibre. So it's a kind of a seesaw.

Sure. So people often look at it and say, oh, it's the sugar. Actually, it might be the lack of fibre, which is a bigger problem. Totally. And when we say sugar, we think sugar is the molecule as opposed to sugary sweet treats. But when we're talking about, say, sugary sweet, nutritionally vapid treats, which are okay to have. Of course they're okay to have. If someone wants to eat with their mental health in mind, is there a number or whatever that you think people should be aiming towards? So I would probably be saying stick with the evidence.

And the evidence suggests, so again, with the smiles trial that we're looking at around three times a week, as well as putting in all of those other good foods and those supportive foods. Totally. We also have to talk about alcohol. What does alcohol do? Like, what are the mechanics of what alcohol can do to have an impact on our mental health? So alcohol has really what's called pliotropic effects on the brain. It affects lots of different neurotransmitters, dopamine, serotonin, and sutilcholine, you know, it has this broad effect all over the brain. So much of the research throws up a little bit of a paradox insofar as a very small amount.

So we're talking around or just less than a glass of red wine a day may be supportive of brain health. people who tend to have a little bit, to be moderate drinkers, tend to have less risk of dementia, for example, than people who are teetotal. However, a few people drink that little, you know, if we're being honest. And also, there is a very, very clear tipping point with alcohol, at which point it becomes neurotoxic. First of all, absolutely try to avoid binge drinking. It's almost, you know, it's like punching your brain. It's so bad for the brain. It's just bad news. Binge drinking should be avoided as much as possible.

And you should be looking at having two alcohol-free days a week, non-consecutive, again, if possible for you. And then generally trying to stay within the NHS guidelines for alcohol. We will stick those in the show notes. So what effect then does alcohol have on conditions that maybe our list is might be dealing with right now? So things like maybe their tendency towards depression, or anxiety or panic. Sure. So we know that alcohol is a depressant.

And one of the bigger effects that it has on brain health is also the way that it disturbs sleep. So people often have alcohol and they find it kind of knocks them out. It has a sedative effect. And that much is true. It does get you off to sleep faster. But what it will do is to prevent you getting good quality sleep. You get much more fractured, broken, fragmented sleep after a night of drinking. And what can also happen is that you have this kind of wake up at 3 a.m.

Yes. I think everyone listening to that is like, yep, can think about the last time that happened. When the alcohol starts to be metabolized and basically a kind of mini alcohol withdrawal that happens if you've had a heavy night of drinking. That's what wakes you are. That's what wakes you are. It throws your body into a stress response and we know that stress is bad for the brain. So we want to be doing that less often. and also more kind of sociologically, it is a disinhibitor.

So it lowers your inhibitions. Everybody knows that it makes you more talkative. You talk to strangers. You're staggering around. Makes you a great singer. Right? Great dancer. But it also makes you more prone to risk.

You lose your capacity to make good decisions when you've been drinking. And so if that is someone who's already struggling with a mental health condition, we would consider that quite risky because you're more likely. to make poor judgments, you know, take risks and perhaps make a decision that you wouldn't make sober. And then I guess it's harder as well if you're hung over or even if you're not properly hung over, but you've got that kind of brain fog that you have maybe from just a few glasses of wine. It's probably going to be so much harder to think, I'm going to buy that bag of spinach and put it in my sandwich. Or I'm going to try something a bit different for tea.

Like it makes sense then to say that if someone is struggling with a mental health issue, then limiting alcohol. Absolutely. And there are also those people who are constitutionally likely to become anxious after a night of drinking. So that's really important to point out as well. Especially if people haven't made that connection. They might, you know, go drinking with their friends or after work and then the next day wake up very, very, very anxious and think that it's an anxiety disorder or think that they've got having a panic attack. When actually for them, it's their body's response to alcohol, their brain's response to alcohol. So that's something that they'll need to be watching out for as well. Interesting. So there's a lot of watching and listening to your own body. Absolutely. And working out what works for you. Okay. If there's one thing that's going to help people eat in a way that's going to be protective and positive for their mental health, what would it be? I am growing increasingly convinced that people are dangerously low in essential fats.

My concern is that most people aren't supplying their brain with the basic building blocks of what they need to be healthy. and we know, for example, that people aren't getting those fats have smaller hippocampi, which is a part of the brain that's important for memory, and tend to have worse memory performance. So I guess I would say, if you can, eat some oily fish, and if you don't eat oily fish, please supplement. Thank you very much, Kimberly, for coming on. And a reminder that Kimberly's debut book, How to Build a Healthy Brain, is out now.

And before I go, a reminder that, as a going for goal listener, you have an exclusive discount to Women's Health Live. That's our three-day health fitness and wellness festival that's taking place from the third to the fifth of April. There you'll be able to catch some of the world's biggest fitness stars like Kayla at Zinas, Gillian Michaels and Anna Victoria, sweat your way through the biggest glasses in the capital and hear from over 100 top-tier health, fitness, nutrition professionals,

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Bye-bye. See you next week.