Mental Health -Exploring the Relationship with Antidepressants and Gut Microbiota
Mental Health As a specialist dietitian, I continually raise awareness about the impact and importance of diet on mental health. The recent Panorama programme regarding the difficulty of antidepressant withdrawal has highlighted the vast numbers of dependants, the need for alternatives, and if possible, avoiding them in the first place. This blog hopes to shed light on the important need and connection between diet and mental well-being exploring the intricate relationship between diet, mental health, antidepressants, and gut microbiota. The Significance of Diet in Mental Health The saying “you are what you eat” holds true when it comes to mental health. We have understood for many years there is a gut-brain axis, and know the complex communication network between the gut and the brain plays a vital role in mental well-being. Numerous pathways have been identified through which diet could plausibly affect mental health. These include modulation of pathways involved in inflammation, oxidative stress, epigenetics, mitochondrial dysfunction, the gut microbiota, tryptophan–kynurenine metabolism, the HPA axis, neurogenesis and BDNF (brain-derived neurotrophic factor), epigenetics, and risks with obesity. Mental Health – The Role of Nutrients We know multiple nutrients have been linked to improved mental health. I have spent the past 15 yrs of my 26 yr career, working with my patients to perfect their diets not only to be optimal for their physical wellbeing but mental health too. One group of well-known and researched nutrients are the omega-3s. These fatty acids can be found in fatty fish, walnuts, and flaxseeds but also consumed by the gallon by people in supplement form as our bodies can’t make them. (YouTube Video). Omega 3’s have good and bad press with research finding that high dose supplementation may cause atrial fibrillation and increase risk of bleeding. Consumed in their natural form is the best option as they have a known potential in reducing symptoms of depression and anxiety when consumed as part of a bigger nutrient selection. If needing a supplement using a plant based option is ideal (see below). Another well-known group of nutrients are B vitamins, found in whole grains, leafy greens, and legumes, are important for brain function and mood regulation. I see hundreds of patients take these in high doses either in singles like high dose B12 or high dose B6 believing “more is better” whilst continuing a poor quality diet. This is not recommended and can actually be at best making expensive urine and at worst cause toxic neuropathy, insomnia, headache, palpitations, anxiety and acne…. Understanding Antidepressants Antidepressant medications are commonly prescribed to manage mental health conditions such as depression and anxiety. Common ones include: citalopram (Cipramil) dapoxetine (Priligy) escitalopram (Cipralex) fluoxetine (Prozac or Oxactin) fluvoxamine (Faverin) paroxetine (Seroxat) sertraline (Lustral) vortioxetine (Brintellix) These medications work by increasing neurotransmitters in the brain, such as serotonin and noradrenaline. Whilst the exact mechanism of how these chemicals affect mood is not fully understood, it is believed that they help to regulate emotions and improve overall well-being. In the UK, around one in seven now take an antidepressant. Globally they have made the pharmaceutical industry billions. When the current generation of drugs was launched 35 years ago, they promised a safe and effective treatment, free from the side effects of older medicines. But have they lived up to those claims? While many people say they have benefited from taking antidepressants. Panorama revealed evidence of some companies trying to conceal concerns about their drugs, following patients who have suffered serious side effects as they continue their fight to be heard. The Panorama programme highlighted they are not a standalone solution and should be used in conjunction with other therapeutic approaches. Diet and Antidepressants: Interactions and Considerations It’s important to remember that what we eat can also play a significant role in how our bodies respond to antidepressant medications if they are taken. Certain foods and supplements can interact with these drugs, potentially reducing their effectiveness or causing unwanted side effects. Therefore, it’s essential for individuals taking antidepressants to be mindful of their diet and speak with their healthcare provider about any potential interactions that may occur. One example Grapefruit, is a nutritious and delicious fruit that is commonly consumed as part of a healthy diet. However, many people are unaware that grapefruit and its juice can interact with certain medications, impacting their effectiveness and potentially causing harmful side effects. Mental Health and Gut Microbiota The gut microbiota, the trillions of microorganisms residing in our digestive tract, have gained significant attention for their influence on mental well-being. Emerging research suggests that imbalances in the gut microbiota, known as dysbiosis, may contribute to mental health disorders. A healthy, diverse gut microbiome is associated with improved mood and cognitive function. Research suggests that the neurochemicals produced by the gut microbiome can have a direct impact on mental health and behaviour. One such example is serotonin, which plays a crucial role as a signalling molecule in the gastrointestinal tract. Enterochromaffin (EC) cells utilize serotonin to activate afferent neurons that transmit signals to the central nervous system, making it an important sensory transducer. Research suggests that the gut is responsible for producing a large portion of the body’s serotonin (over 90%) and roughly half of its dopamine (Berger et al., 2009). Studies conducted on germ-free mice have shown that serum levels of serotonin decrease and tryptophan increase without the presence of gut microbes, further highlighting the important role the gut plays in neurotransmitter production.(Wikoff et al, 2009) The Impact of Diet on Gut Microbiota Diet plays a pivotal role in shaping the composition and diversity of our gut microbiota. A diet rich in fibre, found in fruits, vegetables, whole grains, and legumes, provides nourishment for beneficial bacteria in the gut. On the other hand, diets high in processed foods added sugars, and unhealthy fats can negatively impact the gut microbiota. Mental Health – Probiotics Probiotics, beneficial live bacteria and yeasts, have shown promise in promoting mental well-being. Specific strains of probiotics, such as Lactobacillus and Bifidobacterium, have
Seven Top Tips for Gaining Weight
Here, Gillian Killiner, Director And Principal Dietitian At 121 Dietitian discusses common reasons why people lose weight and shares her top tips for gaining weight. I am 22 years in the health business and the most popular misconception I face is that all I do is advise people on weight loss! This couldn’t be further from the truth. My unique role as a Dietitian is first and foremost about increasing nutrients and ensuring health is optimal from top-to-toe. This involves fixing; cellular function, gut health, mental health, checking genetics, bloods etc. One area that gets very little press however is how to gain weight. There are lots of reasons why people lose weight such as a poor appetite, nausea, difficulty eating, eating disorders, surgery, illness or a traumatic event. Extra good quality nutrition and extra energy are important to help gain weight along with addressing lifestyle issues that may be connected. It may seem wrong but it is important to eat healthy choices when needing to gain weight as processed high sugar poor quality foods affect health negatively. When gaining weight it is essential to add muscle and replenish healthy levels of fat around the body, while not gaining unhealthy fat around the abdomen and organs. My top seven tips for gaining weight are as follows: If appetite is small have small, frequent meals and snacks during the day. Try to eat or drink something every few hours. Three meals and three snacks is a good pattern to follow. Add small amounts of olive oil/cream/cheese to your food. This is an easy way to increase the energy in your diet while volumes do not increase by much. Choose high energy from protein foods at both meals and snacks. Make every mouthful count! Don’t fill up on low energy foods like water, tea, coffee, ‘diet’ food and drinks or plain fruits and vegetables. Follow the ideas below to increase the energy and protein content of some common low energy foods. Choose full cream dairy products and use high energy milk. To make high energy milk, add one–two tbsp skim milk powder to every 250mls of full cream milk. If nausea is a problem: Cold foods and drinks may be better than hot as hot foods often have a stronger smell. Avoid eating late at night if nausea is notable in the morning. Don’t let your stomach get too full or empty as this will increase nausea. Eat and drink slowly– If the smell of cooked foods puts you off try to avoid kitchen smells until you are feeling better. 7. Avoid taking a large amount of fluid when eating a meal and snack. Drinking 20 minutes after is better. 8. Ask someone else to assist you where possible so you are not wasting the energy and weight you are trying to build. Adding high energy and protein foods (such as cream, cheese and margarine) to your meals really does make a big difference! The examples below show just how many calories/ kilojoules (KJ) you can add to a typical meal. This is an easy way to increase energy without having to eat lots of extra food! Whether you need help with weight loss, weight gain or understanding your dietary needs, get in touch with Gillian today. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed]
Incredible Hulk Recipe – Cannelloni Style
This Incredible Hulk Recipe – Cannelloni Style, is a fab way to use all the greens that you may not be keen on! Normally cannelloni is made with just spinach however adding variety with other greens allows you to consume a wider range of nutrients without compromising on flavour. All cruciferous vegetables (cabbage family) contain cancer-fighting plant compounds and vitamin C. Kale in particular also has bone-boosting vitamin K, vision- and immune-boosting vitamin A, and even anti-inflammatory omega-3 fatty acids. The rest of the ingredients in the Incredible Hulk Recipe need a mention too! Tomatoes are tasty and a wonderful source of lycopene and cancer fighting antioxidant. But the benefits don’t just end there. Tomatoes provide: vitamin A, vitamin K, vitamins B1, B3, B5, B6, B7, excellent vitamin C, folate, iron, potassium, magnesium, chromium, choline, zinc, and phosphorus. The tomatoes I used for this recipe were home-grown from excess surplus from our green house! Ricotta cheese provides excellent protein, calcium, phosphorus, Zinc, Vitamin B1, B12 and Vitamin A. If you are worried about excess fats (which by the way because this recipe is natural not processed you shouldn’t be!), you can add a tub of quark in instead. Incredible Hulk Recipe Ingredients – Cannelloni Style Olive oil/coconut oil 1 -2 onions/asafoetida powder* 1 small cabbage 1/2 bag of kale 1 broccoli head* Ricotta/quark or lacto free cream cheese* or vegan soft cheese Pasta – wholemeal (gluten free) lasagne sheets to roll or cannelloni rolls 1-2 cans of chopped tomatoes or 500ml passata (can add or include garlic*, olives, basil, peppers, chilli peppers/flakes) Hard cheese to top (parmesan or vegan cheese) More fresh basil leaves to top Large salad for serving: Spinach, cucumber, peppers, spring onion*, beetroot… your choice! How to make the Incredible Hulk Recipe Heat the oil in a large pan sauté the onions till brown and sweet or add asafoetida powder Take 1 small head of green cabbage, 1/2 bag of kale and 1 small head of broccoli roughly chop Add to the cooked onions and heat for 10 minutes Take off the heat and add the soft cheese or alternative Blitz in a blender Take the cannelloni tubes or cooked lasagne sheets and generously fill these with the green mix Place these into a oven proof dish, when complete top with the tins of tomatoes/ passata and any additional flavours for taste and spice! Top with sprinkle of parmasan Cook at 180c for 25-30 minutes Serve with 1/2 plate covered in salad This menu has been adapted for Fodmaps and coeliacs. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018 and 1st January 2023
