Diet and Mental Health - a literature review Some things that have worked well for people for mental heath are: "no grains, avoid sugar, more healthy fats, medium amounts of protein, and most importantly, lots of vegetables" and "lots of greens and salads, healthy fats, protein and limiting fruits" for others, low sugar diets, Mediterranean, and DASH diets have been suggested. Others swear by ketogenic diets and "Low glycemic index foods seem to improve attention, memory and functional capacity". Dietary diversity seems to correlate with moods, so getting a variety of foods is said to be important. Dietary patterns seem important in severe mental illness [1] and have in some populations been associated with things like depression, stress and social support satisfaction [2]. Four-Week Supplementation in healthy individuals with a multi-vitamin/mineral preparation treatment was "associated with significantly improved mood, as measured by reduced scores on the "depression-dejection" subscale of the Profile of Mood States" [3] Omega-3 PUFAs Review on omega-3: https://www.ncbi.nlm.nih.gov/pubmed/27472373/ Individual vitamins: Vitamin A: There is a longstanding notion that vitamin A plays a role in psychiatric illness likely based on the profound effects of retinoids on brain development and processes such as long-term potentiation (LTP) and mood regulation. Proposed to be a player and therapeutic in ASD: "supplementation is a reasonable therapy at least for a subset of children with autism" [4]. B-group vitamins: Thiamine (B1): Exerts antidepressant/anti-stress effects in animal models [5] and improved standard treatment in patients with depression [6] In a small study, thiamine supplementation significantly improved anxiety scores, general well-being and reduced fatigue in patients with Generalised Anxiety Disorder [7] "An improvement in thiamine status was associated with reports of being more clearheaded, composed and energetic. These influences took place in subjects whose thiamine status, according to the traditional criterion, was adequate." [8] Not much has been done on B2, B3 and B5 in psychiatry but they are proposed to play a 1 role. A recent animal study suggests that B2 or B6 vitamins restored the levels of DA and reduced oxidative stress in brain [9] B6: Inadequate amounts of vitamins B6 is linked with a higher incidence of depression and impaired neurotransmitter synthesis. It is proposed to be an effective therapeutic for some women (along with combinations) [10]. Improved attentional performance in males was significantly correlated with increased levels of vitamin B6 B12: Insufficient vitamin B12 status has been linked to poor neurodevelopment and cognitive decline. A significant improvement in depressive symptoms was observed after SSRI and vitamin B12 therapy in one study [11] Folate: Folate deficiency is associated with depression, attention issues, and other neuropsychiatric disorders, along with irritability and behavioural problems. Cerebral folate deficiency has been linked to self-injurious behaviour. In ASD, "In clinic I have certainly seen some very beneficial effects of using the active forms of folate in ASD" Inflammation induced by by low folate concentrations can significantly be attenuated through treatment with appropriate supplementation and result in cognitive function improvement and decrease of peripheral inflammatory cytokine levels Vitamin C: adding vitamin C alone to citalopram did not increase the efficacy of citalopram in MDD patients [12]. That said, in animal models it exerts antidepressant effects dependent on the activation of the opioid system, especially μ-opioid receptors, which might be an indirect consequence of NMDA receptor inhibition elicited by ascorbic acid administration. It may involve an activation of GABAA receptors and a possible inhibition of GABAB receptors, similarly to ketamine. It might be dependent on the activation of PI3K and mTOR, inhibition of GSK-3ß as well as induction of HO-1. These are important mood targets. Vitamin D supplementation, thought to modulate many areas of mental health, is associated with lower depressive and anxiety symptoms in psychotic illness [13] and addition of vitamin D to conventional antidepressive agents can improve antidepressive effect [14]. The core symptoms of ASD fluctuated in severity with changes in serum vitamin D levels in children: high-dose vitamin D3 regimens may ameliorate the core symptoms [15, 16] Vitamin E (α-tocopherol) has been linked to a decrease in the frequency of depressive symptoms. α-tocopherol is a lipid modulator of the cannabinoid system [17] Vitamin E has pain-relieving, antioxidant, antidepressant [18] and anxiolytic-like activities [19]. A low dietary intake of vitamin E is related to altered mood and depression, depression is accompanied by significantly lower serum vitamin E concentrations, vitamin E intake being directly related to the depression score [20].The cognition promoting effects of omega 3 PUFAs may be dietary vitamin E status related [21] and recently, omega-3 and vitamin E co- supplementation was effective in improving parameters of mental health in some individuals with conditions of inflammatory basis [22]. 2 Minerals: Calcium: Ca and Mg may be involved in depression; however there are few data on these mineral nutritional statuses concerning depression and data from human-studies are limited. It thought that Ca intake is related to depression and mental disorders Chromium: Seems to have important effects on insulin signalling and mood. Preclinical and clinical studies reported its potential antidepressant properties [23]. Chromium has shown the most promise for treating subtypes of depression that affect carbohydrate cravings and appetite regulation [24] In some women it "reduced mood symptoms and improved overall health satisfaction" [25] Iodine: Deficiency causes brain structural alterations likely to affect cognition. Low iodine- rich food intake was associated with increased brain volume shrinkage [26] Iron: In one study, iron deficiency in rats resulted in impairment in learning, due to the dopaminergic and cholinergic systems being affected with disturbances in circadian behaviours (e.g. the sleep-wake cycle) and cognitive impairment. Human studies link anxiety-driven behaviour and mood changes to poor iron status but excess iron in the brain is detrimental. It is proposed imbalanced iron metabolism plays a role in modulating anxiety and emotional behaviours [27] Magnesium: Magnesium is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated [28] Magnesium influences the neurotransmission involved in emotional processes, such as the serotonergic, noradrenergic, dopaminergic, GABAergic and glutamatergic systems. Potassium: may be useful in the treatment of mood disturbances - low potassium levels may be linked to symptoms of depression. Selenium: "Intake was associated with a general elevation of mood and in particular, a decrease in anxiety." [29] When taking the selenium the subjects reported a substantial improvement in mood at 100 mcg [30] Persons with low selenium status might experience relatively depressed moods [31] That said, another study found "no evidence that selenium supplementation benefited mood or quality of life in these elderly volunteers" [32]. It is suggested to play an important role in psychological functioning [33]. Zinc: Preclinical and clinical studies have demonstrated that zinc possesses antidepressant properties and that it may augment monoamine-based antidepressants [34] Meta-analyses support zinc for depression [35] It is proposed to cause general improvement in neuronal plasticity as well as reduction of neuronal atrophy and neuronal cell loss, modulation of the serotonergic system including postsynaptic 5-HT1ARs with a possible involvement of dopaminergic neurotransmission [36]. Peripheral Zn concentration may play a role in the physiopathology of some domains of cognitive function, "there was a significant positive correlation between plasma Zn levels and the concentration subcategory" [37] 3 Less/other mentioned: Boron: Boron supplementation altered EEG such that there was a shift toward less activity in the low frequencies and more activity in the high, dominant frequencies of the EEG leading to improved psychomotor skill, and cognitive processes of attention and short term memory [38]. Choline sources: "The extent to which higher intakes of choline have the potential to enhance or influence cognition during childhood, adulthood, and/or age-related cognitive decline needs further investigation" [39]. Carotenoids significantly corresponded to global cognitive abilities including verbal learning, verbal fluency, memory recall, processing speed, and perceptual speed. Serum lutein, zeaxanthin, and β-carotene concentrations were most consistently related to better cognition. Serum zeaxanthin had significant relationships with most measures of cognitive function, with higher concentrations being significantly related to global cognitive performance,and better concept formation/abstraction. Serum concentrations of β- carotene were also significantly correlated to most measures of cognitive function. Serum lutein concentrations were significantly related to measures of global cognition, lower dementia severity, and executive function. Carotenoid levels have also been shown to protect cognitive function in older adults with mild cognitive impairment. Supplements have shown strong cognitive enhancement benefits over longer term studies [1] https://www.ncbi.nlm.nih.gov/pubmed/30359969 [2] https://www.ncbi.nlm.nih.gov/pubmed/29113038 [3] https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/26529011/ [4] https://www.ncbi.nlm.nih.gov/pubmed/29122693 [5] https://www.ncbi.nlm.nih.gov/pubmed/27825907 [6] https://www.ncbi.nlm.nih.gov/pubmed/26984349 [7] https://pdfs.semanticscholar.org/.../53c8c4dbfdccf441a16b ... [8] https://www.ncbi.nlm.nih.gov/pubmed/9122365 [9] https://www.ncbi.nlm.nih.gov/pubmed/30413185 [10] https://www.ncbi.nlm.nih.gov/pubmed/28178022 [11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3856388/ [12] https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25873303/ [13] https://www.ncbi.nlm.nih.gov/pubmed/30245372 4 [14] https://www.ncbi.nlm.nih.gov/pubmed/29460820 [15] https://www.ncbi.nlm.nih.gov/pubmed/29629638 [16] https://www.ncbi.nlm.nih.gov/pubmed/27868194 [17] https://www.ncbi.nlm.nih.gov/pubmed/21843633 [18] https://www.ncbi.nlm.nih.gov/pubmed/20144659 [19] https://www.ncbi.nlm.nih.gov/pubmed/30251258 [20] https://www.ncbi.nlm.nih.gov/pubmed/28531460 [21] https://www.ncbi.nlm.nih.gov/pubmed/29656360 [22] https://www.ncbi.nlm.nih.gov/pubmed/29306057 [23] https://www.ncbi.nlm.nih.gov/pubmed/24101396 [24] https://www.verywellmind.com/chromium-for-depression-1066922 [25] https://www.ncbi.nlm.nih.gov/pubmed/24237190 [26] https://www.ncbi.nlm.nih.gov/pubmed/29083437 [27] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253901/ [28] https://www.ncbi.nlm.nih.gov/pubmed/28654669 [29] https://www.ncbi.nlm.nih.gov/pubmed/1873372 [30] https://www.ncbi.nlm.nih.gov/pubmed/2096413 [31] https://www.ncbi.nlm.nih.gov/pubmed/8717610 [32] https://www.ncbi.nlm.nih.gov/pubmed/16181615 [33] https://www.ncbi.nlm.nih.gov/pubmed/12509066 [34] https://www.ncbi.nlm.nih.gov/pubmed/28299207 [35] https://www.ncbi.nlm.nih.gov/pubmed/28988944 [36] https://www.ncbi.nlm.nih.gov/pubmed/28319749 [37] https://linkinghub.elsevier.com/.../S0531-5565(18)30063-9 [38] https://www.ncbi.nlm.nih.gov/pubmed/25063690 [39] https://www.ncbi.nlm.nih.gov/pubmed/29451849 5