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Chapter 1: What is the main topic discussed in this episode?
Diet is really an interesting example of the mind-body connection. If we can improve the health of our body, it's also improving the health of our mental well-being and our brain health.
Welcome to When Science Finds Way, a podcast about the science changing the world. I'm Alisha Wainwright, and on this series, I'm talking to the global experts who are making a difference, as well as the people who have inspired and contributed to their work. Now, it's obvious that the food you eat has a big influence on your physical health.
In this episode, we're going to talk about something that's less widely understood, how diet could impact your mental health. This is the question driving an emerging field, nutritional psychiatry. Nutritional psychiatry is the evidence-backed investigation of how the food we eat affects our mental and brain health.
This is not about fad diets, and it's not really about general mental health wellbeing either. As we'll hear, there is promising evidence from multiple small-scale pilot studies about how diets could work in combination with other treatments as effective interventions for a range of diagnosed mental health conditions. Now the field is ready to test this hypothesis in larger trials.
Joining me to discuss this area of research is Dr. Wolfgang Marx. He's senior research fellow and deputy director of the Deakin University's Food and Mood Center. In this episode, we'll get an idea of the breadth of nutritional psychiatry and discuss two research projects looking at how two different diets could help to reduce the symptoms of bipolar disorder.
We'll also hear how the lived experience of patient communities and the questions of implementation and personalization are incorporated in this field. So let's get into it. So when we think about food and mood, you know, I think about the old saying, you are what you eat. But I wonder how true that is when it comes to our mood and mental health. What do you what do you say to that?
Yeah, I think there's some truth to that. I mean, it's an old saying. And I think when you look really at any culture across time, there's this understanding or this sort of intuitive understanding that what we eat is linked somehow to our physical health, but also our well-being, how we feel. And I think even as individuals, we think,
well, that time where I perhaps hadn't been eating so well, I feel a little bit lethargic, a little bit fatigued. I'm not quite on as I usually am. And there's times when I've been eating really well and I've been eating really healthily. I feel a little bit sharper. I feel a little bit better in myself.
But I think what's new is that we've added that scientific method to interrogate this intuition, this feeling to determine whether Well, is that actually true? And if it's true, what's going on? Why is that true?
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Chapter 2: How does diet influence mental health?
And how true is it? You know, is it a small effect? Is it a large effect? These are all the things that have been happening in the field of nutritional psychiatry probably within the last 10 odd years.
I want to talk about... How does diet impact our mental health? What are the mechanisms and what do we know so far and what are you most curious about?
I guess there's sort of three layers or three sort of converging pathways as I sort of see it. The first one is the biological mechanisms related to diet and mental health. And so by that, I mean, diet has substantial literature showing that various components of the diet, things like omega-3 fatty acids, polyphenols, dietary fiber, various nutrients, vitamins, minerals,
all have a role in reducing inflammation, improving our antioxidant defenses, interacting with our gut microbiome. All these sorts of various pathways that we're now understanding is also linked to our mental health. But then in addition to that, I think two other areas that perhaps don't receive as much attention is the effect of diet on metabolic health.
So we know that areas like insulin resistance, obesity, cardiovascular disease, all the rest are highly comorbid in people with mental disorders.
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Chapter 3: What is nutritional psychiatry and why is it important?
And that the dysfunction that's caused by these diseases can interrupt and have a negative effect on the various mechanisms related to our mental health as well. So by eating better, by reducing our risk of these various cardiometabolic disorders, I see this as a pathway of also improving our mental health. It really... Diet is really an interesting example of the mind-body connection.
If we can improve the health of our body, it's also improving the health of our mental wellbeing and our brain health. And then the final area is around that behavioural and psychosocial sort of mechanism. Food isn't like a medication. Food is quite unique in that it's not just fuel. It's identity. It's culture. It's celebration. It's routine. It's politics. It's environment.
It's not like brushing your teeth. It's something that happens in front of other people sometimes. With people, yeah. With people, yeah.
Yeah. And so, you know, the psychosocial components of sitting down with friends and family to eat, to the skill building that comes with, you know, trying new recipes, the flavors that give pleasure, all these sort of psychosocial mechanisms, I think, sometimes get sidelined because everyone's like, ooh, gut microbiome, how interesting.
But these are really important parts of the human experience of eating good food with people. And I think that has a strong effect on how food can help our mental well-being as well.
So when you work with the Food and Mood Centre, I wonder if you can describe what you do, but also how it relates to the way maybe the average person thinks about food and food consumption, diet, things like that.
Yeah, so I guess as the name suggests, our primary focus is the relationship between the food that we eat and our mood, our mental health. Right on the nose. But we run a diverse clinical trial platform. We ran the first randomized controlled trial that looked at a dietary intervention for major depressive disorder and people with clinical diagnosis of major depressive disorder.
We've also looked at various sort of real world studies, so trying to move beyond that very tightly controlled environment of a clinical trial to see how these approaches actually work in the real world setting. And then the other pillar of our center is really around that education and implementation, because there is all sorts of misinformation.
As you were saying, there's all sorts of conflicting research, messaging, particularly within social media. We want to not just publish papers so that it's within the academic sphere. We want to actually bring our research to the people that are interested, the people that need it.
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Chapter 4: What are the biological mechanisms linking diet and mental health?
If you feed an animal during their most active period, you can strengthen the animal's circadian rhythms. And he was able to show that that was great for the animal's metabolic health. Many other people around the world began to work on clinical trials with humans to say, hey, could the timing of eating help people's metabolic health and their sleep patterns?
Nobody had done that in bipolar disorder, and that's what we wanted to do, is to say, can we help people adjust the timing of their eating, follow the kind of most active period of their day, and see if that improves circadian rhythms for people with bipolar disorder. There are a lot of versions of time-restricted eating, and it's kind of part of a broader family called intermittent fasting.
We're using a really specific version of this, though. We want to make sure that people just basically eat during their 10 most active hours. So wait an hour or so after you wake up to have your first calories. And then a couple hours before you go to sleep, quit the eating. No midnight snacks.
In our study worldwide, we'll give people tools and support and coaching to shift to a time-restricted eating, and we'll look to see if we're making a difference in symptoms. We can actually measure the activity of clock genes in their body. throughout the course of a day by just swabbing their cheek and getting some clock gene kind of data.
And we'll be able to see if we're making a difference in clock gene expression and see a much more regular biological rhythm, day-night rhythm, for people as they follow the time-restricted eating. I think when it comes to diet and bipolar disorder, we definitely need randomized controlled trials.
We need to understand mechanisms because that'll sometimes help us be even more refined about the diets. But there's another whole piece of this, which is to test how well does it work in the hands of real life human beings? How hard is it to pull off? What do we need to shift to make it feasible for people? Who's going to find it easier to kind of follow a diet? Who's going to find it harder?
What kinds of support do we need to give them? So I think there's a whole set of things about how acceptable it is, how feasible it is, what kind of context of support we have to give people.
Wow. Sherry's note about how does this work in real life human beings, I think, is a really tricky question because you can compile a lot of research. But in what you study, this has to be implemented in your average person experiencing, in this instance, bipolar disorder. So how do you do that?
How do you how do you take this evidence that you've learned and implement that in a real life human being?
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