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Food is medicine.
At Modyfi, we know that a sustainable mental health plan needs to include more than just tablets and capsules. Our team takes a holistic approach to care, looking at multiple factors that impact mental health (and health in general) including sleep, exercise, mindfulness, hydration, and nutrition. We look at the whole person, using a multi-pronged approach, to change lives for the better. Nutrition can be a confusing topic, but because it is linked so closely to improved mental health outcomes, we are breaking it down with a simple, customizable grocery list.
Poor Diet and Mental Health- What’s the link?
Although what we eat and how we feel may not always seem related (or we don’t want to acknowledge they are related) research continues to show that they are intricately linked. Nutrition significantly impacts most of the major chronic diseases we see in the US, including heart disease, cancer, obesity, diabetes, and depression. These diseases are all linked to disability.
One mechanism through which diet impacts mental health is inflammation. Heightened inflammation has been seen in nearly one third of all cases of depression and is seen in many other mental health conditions. Diets that are low in refined carbohydrates, low in saturated fats, high in protein, and high in omega-3 fatty acids have anti-inflammatory effects in the body (1).
Brain-derived neurotrophic factor (BDNF), a protein often referred to as “miracle grow for the brain”, can have a big impact on mental health. Luckily, targeted nutrition can help improve BDNF production! BDNF works to create and strengthen brain cells, improve brain cell communication, and promote positive changes in the brain. High levels of BDNF are associated with a decrease in depressive symptoms, improved sleep, protection of the brain against degenerative diseases (such as Alzheimers and Parkinsons), and the promotion of healthy weight loss. Antioxidants and polyphenols found in dark chocolate, berries, turmeric, coffee, and green tea can all improve BDNF levels (3).
When we eat fiber rich foods we fill up faster, take in fewer calories, and lose weight sustainably. When we eat healthy, nutrient dense foods, we start to feel better overall - Sleep, mood, and energy levels will improve. When we are well rested and relaxed, it is easier to continue making better choices for mental health, such as exercising, meditating, participating in therapy, and remaining compliant on medication regimens. Targeted nutrition can be the kick-off to a cascade of mental-health promoting behaviors!
Choice architecture, a concept in psychology, is key to promoting positive mental health behaviors.Choice architecture is a way to design and layout different options (or, choices) in an effort to nudge one towards a specific option. The choice architect is the person who is designing the layout of options. You, as the choice architect of your nutrition and house, can keep healthy options in sight and easily accessible while keeping unhealthy options put away or even out of the house. Keeping a fresh fruit bowl on the counter where you can see it can help you choose fruit for a snack instead of a bag of chips. Other examples include keeping cut vegetables in the fridge, keeping nuts and seeds in your desk at work, and cooking extra food at dinner for lunch the next day.
Nutrients to Keep in Mind
A diverse diet of unprocessed, multicolored, and nutrient dense foods should provide the building blocks to improve overall health. There are certain nutrients however, that deserve special recognition for the role they play in keeping our brains healthy.
Omega-3 fatty acids are powerful anti-inflammatory agents in the body. They work to prevent cancer, cardiovascular disease, neurological issues, and mental health conditions. There are 3 forms of omega-3s- EPA, DHA, and ALA. EPA and DHA are easier for the body to use and found in fatty fish, such as salmon, herring, and mackerel. ALA is found in chia seeds, flax seeds, and walnuts (6).ALA must be converted in the body to EPA and DHA and that conversion is inefficient. Anywhere from 8-21% of ALA is converted to EPA and 0-9% is converted to DHA. Women can convert ALA more efficiently than men (it is thought that estrogen plays a role).(4)
B vitamins are a group of compounds that work to improve immune function (such as fighting inflammation), strengthen neurotransmitter signaling, and improve energy production. Folate plays an important role in neurotransmitter synthesis and can be found in leafy green vegetables, whole grains, and legumes. Folate, along with vitamins B12 and B6, work to decrease high levels of the amino acid homocysteine, which is linked to high levels of meat consumption, cardiovascular disease, and neurological impairments (5). B12 is found in liver, eggs, and nutritional yeast. Vegetarians and especially vegans are at an increased risk for B12 deficiency and will likely benefit from B12 supplementation after consulting with your provider. About 30-40% of the population has a gene mutation that limits the ability for folate to be readily available by the brain. This can be treated with an FDA regulated food, L-methylfolate (Deplin), and your Modyfi provider can order laboratory testing to assess if you have this polymorphism.
Vitamin D is critical for brain function. It is highly neuroprotective, in addition to its role in supporting bone health. Low vitamin D levels are correlated with major depression and cognitive impairment (issues with memory, attention, etc) (2). Vitamin D is found in eggs and fortified foods, but sunlight is best! We can synthesize our own vitamin D from sunlight, so be sure to regularly spend time outdoors, in the sun, and nature. Your Modyfi provider can order laboratory testing to assess for Vitamin D deficiencies and toxicities, working to achieve ideal levels between 50-60ng/ml. Varying levels of Vitamin D supplementation are available, but it’s important to keep in mind that Vitamin D can accumulate to toxic levels if supplementation is too high. 2000iu daily will likely not cause toxicity, but we recommend always consulting with your provider.
Magnesium is a mineral that supports over 300 reactions in the body, including those associated with decreased anxiety and improved depressive symptoms. This important mineral helps to quell inflammation, calm the nervous system, and regulate glutamate activity (an excitatory neurotransmitter) (5). Magnesium can be found in leafy green vegetables, whole grains, legumes, nuts, and seeds.
Shortfall Nutrients
Unfortunately, many nutrients beneficial for mental health are also nutrients that at least 25% of the US population is not consuming in adequate amounts. These shortfall nutrients include: calcium, fiber, magnesium, potassium, vitamin A, vitamin C, vitamin D, vitamin E, and vitamin K. Any food addressing these shortfalls will be in italics on the grocery list.
The Grocery List:
Your cart should have all the colors of the rainbow and be as fresh as possible:
Produce
Fruits
Avocados (high in folate, fiber, vitamin K, and potassium),
Tomatoes (high in vitamin A and vitamin C)
Berries (high in vitamin C, vitamin K, and contain antioxidants)
Oranges and other citrus fruits (great source of vitamin C)
Melons (high in vitamin A and vitamin C)
Apples (high in vitamin C, vitamin A, and potassium)
Stone fruits such as peaches and plums (high in vitamin C, potassium, and fiber)
Bananas (B6, potassium, magnesium, fiber)
Mangos (high in B6, folate, vitamin A, vitamin C, fiber, potassium)
Pears (high in fiber)
Dates (high in fiber)
Pears (high in fiber)
Vegetables:
Leafy greens (folate, vitamin K, vitamin E, iron, calcium, fiber, potassium, antioxidants) such as:
Kale
Spinach
Collard greens
Arugula
Cruciferous veggies (high in fiber, folate, vitamin K, vitamin E, and iron) such as:
Brussels sprouts
Broccoli
Cauliflower
Cabbage
Peppers (high in folate, vitamin C, vitamin A, and potassium)
Onions (high in vitamin C)
Squash (vitamin C)
Green beans (high in vitamin K)
Romaine or butter lettuce (high in vitamin A and vitamin K)
Celery (high in vitamin K and fiber)
Meat & Seafood
Oily Fish
Salmon (omega 3s, vitamin D, B3, B12)
Trout (B vitamins, vitamin D, and omega-3s)
Mackerel (B vitamins, vitamin D, and omega-3s)
Herring (B12, B6, vitamin D, omega-3s)
Pilchard (B vitamins, vitamin D, omega-3s, iron, magnesium)
Tuna (B12, omega-3s)
Anchovy (omega-3s, B3, vitamin D, iron, magnesium)
Sardines (B3, B12, vitamin D, omega-3s)
Shellfish
Clams (B12, iron, calcium)
Shrimp (B12)
Meat
Grass-fed Beef- 3-4oz, max 3x/wk (B3, B12, B6, iron)
Grass-fed Lamb- 3-4oz, max 3x/wk (B3, B12, iron)
*Grass-fed meats tend to be higher in omega-3 fatty acids and antioxidants than their grain-fed counterparts.
Refrigerated
Eggs- max 6/wk (vitamin D)
Unsweetened greek yogurt- 1 metric cup, max 3/wk (B2, B12, calcium)
Unsweetened and fortified almond or soy milk (calcium, vitamin D, vitamin E)
Canned & Packaged
Plant Based Proteins
Tempeh (B2, B3, iron, potassium, fiber, magnesium, vitamin K)
Tofu (calcium, iron, magnesium)
Legumes
Lentils (B1, B6, folate, iron, magnesium, fiber)
Edamame (B1, folate, iron, magnesium,fiber, vitamin K)
Chickpeas (folate, iron, magnesium, fiber)
Black beans (B1, folate, fiber, iron, magnesium)
Kidney beans (fiber, vitamin K)
Peas (B1, vitamin A, vitamin C, vitamin K, fiber)
Nuts & Seeds
Almonds (B2, vitamin E, magnesium, fiber)
Walnuts (fiber, omega-3s)
Pistachios (fiber, B6)
Pumpkin Seeds (magnesium, fiber)
Chia Seeds (iron, magnesium, omega-3, vitamin K)
Flax Seeds (omega-3s)
Hemp Seed Hearts (B1, magnesium, omega-3s)
Sesame Seeds (iron, magnesium, fiber)
Fermented Foods
Kimchi (vitamin A, vitamin C, vitamin K)
Sauerkraut (vitamin A, vitamin C, vitamin K)
Kefir (B2, calcium)
Kombucha (varies but can contain vitamin C, vitamin A, and antioxidants)
Whole Grains
Brown Rice (B1, B3, magnesium, fiber)
Oats (B1, iron, magnesium, fiber)
Barley (magnesium, fiber)
Farro (B1, B3, magnesium, fiber)
Whole grain and whole wheat breads (B vitamins, magnesium, fiber)
Quinoa (folate, iron, magnesium)
Bulgur (B1, B3, B6, iron, magnesium, fiber)
Buckwheat (magnesium, fiber)
Spelt (B1, B3, B6, iron, magnesium, fiber)
Muesli (B vitamins, iron, magnesium, fiber)
Cooking & Flavoring
Fresh Herbs
Olive Oil (great with balsamic vinegar, salt and pepper as a salad dressing)
Avocado Oil (great for grilling and high-heat cooking)
Vinegars
Red wine vinegar
Balsamic vinegar
White wine vinegar
Rice vinegar
Apple cider vinegar
Lemon Juice
Lime Juice
Dark chocolate- 85% or higher (magnesium, iron, antioxidants)
Helpful Tips:
This list is meant to be a guide and is easily customizable to your lifestyle and dietary needs. Stick mainly to the aisles on the perimeter of the store, as that is where the grains, protein, vegetables, and fruits are typically. Ideally, the cart should be as free from boxes and bags as possible, but frozen and canned vegetables, fruits, and protein are great ways to extend the shelf life of your food or keep on hand for emergencies. Beans can be bought dry or canned. Canned tuna and salmon is helpful to keep in the pantry for days when you don’t have much time to cook. Buy and eat different produce each week for variety and to ensure you aren’t missing out on any nutrients. If possible, visit a farmers market for fresh, local produce, and some free Vitamin D from the sun :)
Care Beyond Your Grocery List:
While nutrition is an important piece of the mental health puzzle, it is not the only piece. Nutrition is a powerful tool and works best when used in conjunction with exercise, appropriate sleep habits, psychotherapy and possibly medication. At Modyfi, we will be a team, working with you to create sustainable change, focussed on your goals for your future. Are you ready to start your journey or take the next step? Book an appointment today to get started!
References:
Firth, J., Gangwisch, J. E., Borsini, A., Wootton, R. E., & Mayer, E. A. (2020). Food and mood: How do diet and nutrition affect mental wellbeing? BMJ, m2382. https://doi.org/10.1136/bmj.m2382
Gracious, B. L., Finucane, T. L., Friedman-Campbell, M., Messing, S., & Parkhurst, M. N. (2012). Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study. BMC Psychiatry, 12(1). https://doi.org/10.1186/1471-244x-12-38
Gravesteijn, E., Mensink, R. P., & Plat, J. (2021). Effects of nutritional interventions on BDNF concentrations in humans: A systematic review. Nutritional Neuroscience, 1–12. https://doi.org/10.1080/1028415x.2020.1865758
Higdon, J. (2019). Essential Fatty Acids. Linus Pauling Institute. https://lpi.oregonstate.edu/mic/other-nutrients/essential-fatty-acids.
Martínez-Cengotitabengoa, M., & González-Pinto, A. (2017). Nutritional supplements in depressive disorders. Actas Espanolas De Psiquiatria, 45(Supplement ), 8–15. https://pubmed.ncbi.nlm.nih.gov/29171639/.
U.S. Department of Health and Human Services. (2021). Omega-3 Fatty Acids: Fact Sheet for Health Professionals . NIH Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/.
