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Healthy eating and depression

How diet may help protect your mental health

HEALTHY EATING AND DEPRESSION

Written by Dr Lynn Harbottle, Consultant in Nutrition and Dietetics at the Health and Social Services Department in Guernsey, who is sponsored by an educational grant from Nutricia Clinical Care Endorsed by the Mental Health Group of the British Dietetic Association

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Diet and mental health

Most people are aware that a healthy diet is vital in order to reduce the risk of heart disease, diabetes, obesity and other common physical problems. Recent evidence also suggests that good nutrition may be just as important for our mental health and that a number of conditions, including depression, may be influenced by dietary factors.

Research in this area is still underway so it is not possible to draw any firm conclusions but the evidence does suggest that it is worth trying to follow a healthy diet in order to protect our mental health. Based on the evidence, this booklet suggests some positive changes you can make to improve your diet:

? Eat regularly throughout the day ? Choose less refined high sugar foods and drinks and more wholegrain cereals,

pulses, fruit and vegetables ? Include protein at each meal ? Eat a wide variety of foods ? Include oily fish (omega 3 fatty acids) in your diet ? Maintain a healthy weight ? Maintain adequate fluid intake ? If you drink alcohol keep within recommended limits ? Exercise regularly

This advice is for anyone who wishes to protect their mental health through healthy eating. It is particularly relevant for people recovering from mild or moderate depression and suggests how changes to their diet can help improve their mood.

People with severe depression are encouraged to seek medical help as a priority. While a healthy diet can help recovery, it should sit alongside other treatments recommended by your doctor.

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HEALTHY EATING AND DEPRESSION

Healthy Eating on a Budget

A healthy diet can be more expensive than a diet made up of more refined foods. Fish, fruit and vegetables can be particularly pricey. However, by cutting down on sugary drinks and snacks, takeaways and alcohol, you can save money to be spent on healthier items. Take care to buy only as much as you know you can use within the next few days to reduce waste. You can also cut your costs by taking advantage of special promotions and by shopping at market stalls which are often cheaper than supermarkets. If you live alone you could save money by splitting purchases with friends (larger pack sizes are usually cheaper) or by cooking several portions of a dish and freezing some of them. This also saves fuel and saves you the effort of preparing meals every day. Frozen fruit and vegetables are often cheaper than fresh produce and are usually just as good nutritionally (with no wastage). Fresh fruit and vegetables are usually cheapest when they are in season while using beans, lentils and soy mince in cooking in place of meat can also cut costs.

1. Eat regular meals throughout the day to maintain constant blood sugar

Make sure you eat at least three meals each day. Missing meals, especially breakfast, leads to low blood sugar and this causes low mood, irritability and fatigue. If you feel hungry between meals you may need to include a healthy snack e.g. fruit/nuts/cereals.

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2. Choose less refined high sugar foods and more wholegrain cereals, nuts, beans, lentils, fruit and vegetables

Sugary foods are absorbed quickly into the bloodstream (they may also be referred to as high glycaemic index foods). This may cause an initial `high' or surge of energy that soon wears off as the body increases its insulin production, leaving you feeling tired and low.

Wholegrain cereals, pulses, fruit and vegetables are more filling and generally have a lower glycaemic index than processed foods. Because the sugar in these foods is absorbed more slowly it prevents mood swings. These foods are also nutritionally much better, containing thiamin (B1), a vitamin that has been associated with control of mood, and folate and zinc (supplements of these nutrients have been shown to improve the mood of depressed patients in a small number of studies).

Choose:

? Breads - select wholemeal and granary types rather than white. Also try rye breads, pumpernickel, wholemeal pitta bread, wholemeal chapattis, oat cakes, rice cakes and corn cakes.

? Breakfast cereals ? choose high fibre, low sugar types e.g. wholegrain or bran cereals or porridge.

? Rice and pasta - choose Basmati and brown rice (this gives a nutty texture in salads). Use wholemeal pasta.

? Potatoes - serve boiled new potatoes in their skins (with a minimum amount of butter) or mashed or jacket potatoes. Potato wedges (lightly brushed with olive oil) are a lower fat alternative to chips and roast potatoes for those watching their weight. Try sweet potatoes or yams for a change - these are delicious baked and also have a low glycaemic index.

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HEALTHY EATING AND DEPRESSION

? Aim to eat at least 5 portions of fruit and vegetables a day e.g. 1 glass of orange juice or ? grapefruit for breakfast, a banana or apple for a mid morning snack, salad at lunch time and then two types of vegetable (a portion is roughly 2 serving spoons) and a pear or baked fruit at the evening meal.

NB: Green vegetables should be cooked in a small amount of pre-boiled water, and should not be overcooked or you will lose much of the vitamin content. Avoid sugar and sugary drinks, cakes, sweets and puddings. These are loaded with calories but have little nutritional value and may trigger a mood swing.

3. Include protein at each meal to ensure a continuous supply of the amino acid tryptophan to the brain

We all need to eat enough protein to maintain our skin, organ, muscle and immune function but recent research suggests that one particular component of protein, the amino acid tryptophan, is important in its effect on the brain, where it influences mood. Supplements of tryptophan were tested in studies and in some were shown to improve the mood of depressed individuals. However, the supplements were not considered safe and were removed from the market. However, you can ensure your brain gets a regular supply of tryptophan by including at least one good sized portion of protein at each meal i.e. meat, fish, eggs, milk, cheese, nuts, beans, lentils (dhal), or a meat substitute such as textured vegetable protein or mycoprotein. NB: peanuts are low in tryptophan so if you eat them at a meal-time include another source of protein (e.g. other nuts) at the same time.

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