Food for Mood—Does the Way We Feel Really Reflect the Way We Eat?

doi:10.4236/ojd.2014.31001

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Open Journal of Depression

2014. Vol.3, No.1, 1-2

Published Online February 2014 in SciRes (http://www.scirp.org/journal/ojd) http://dx.doi.org/10.4236/ojd.2014.31001

Food for Mood—Does the Way We Feel Really

Reflect the Way We Eat?

Ursula Werneke

Associate Professor in Psychiatry Umeå University and Consultant Psychiatrist

Sunderby Research Unit, Umeå University, Umeå, Sweden

Email: [email protected]

Received November 10th, 2013; revised December 25th, 2013; accepted January 5th, 2014

tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the

original work is properly cited. In accordance of the Creative Commons Attribution License all Copyrights ©

are guarded by law and by SCIRP as a guardian.

Introduction

Trying to influence the way we feel through the way we eat

continues to enjoy immense popularity. Its intuitive appeal is

greatly amplified by modern electronic media. For instance,

keying “food for mood” recently into my search engine yielded

a staggering 153,000,000 hits on 4th June 2013. Within ten days,

this number had gone up by an impressive eight million to

161,000,000 hits. But what is the food-mood connection; does

the way we eat influence the way we feel or does the way we

feel impact on the way we eat or does it work both ways? And

how can we therapeutically capitalize on such a connection, ir-

respective of which way it may work?

Out of Balance—Out of Mind?

The concept “food for mood” originates from the idea that an

illness occurs when the body is out of balance. Thus, it seems

only natural that restoring the balance through eating well could

restore health. The idea is over 2000 years old. It has been part

of the different ancient medicine systems such as traditional

Chinese medicine and the Aryurveda, the traditional Indian me-

dical practice. For the Western world, Hippocrates developed

similar views (Hillier, 1991). But at the turn of the 19th century,

it became increasingly possible to pin down many illnesses to

specific causes. For the first time, it became possible to develop

effective and specific cures for many acute illnesses of the time,

such as the treatment of infections with antibiotics. This was

followed by the development of modern antidepressants and

antipsychotics. Undoubtedly, this led to great advances in the

treatment of mental disorders such as depression; most physi-

cians and patients alike would not want to do without. But it

also led to a tendency to see health problems just in biological-

medical terms and ignore social and environmental factors (Hil-

lier, 1991). And despite this medical view of mental ill health, it

has proven difficult to find specific biological causes and cures

for many mental heal th problems including depression.

For the sufferer of low mood, this increasingly uni-dimen-

sional approach may lead to a sense of loss of control. Some of

the control may be “clawed back” by modifying our lifestyle

including the way we eat. But there are also downsides to this

concept. Firstly, there may be a sense of guilt in those who

think that some poor life style choice has brought on a mental

health problem in the first place. Then, there is a risk that pa-

tients and physicians alike may drown in the sheer dearth of re-

commendations of how to live and eat well. More likely than

not, most physicians will neither have the time nor the expertise

to discuss life-style decisions in detail in busy out-patient clin-

ics. Finally, many people, particularly when depressed, may not

be able to process and appraise information given on diets and

lifesty le.

A Banana a Day…

The idea of tracing illness back to a lack of a specific food

component lies somewhat between the concept of illness as a

system out of balance and illness as a result of a single medical

cause. Indeed, for some health problems, when there is a clearly

identified deficiency, this model works very well. For instance,

we know that a lack of vitamin C lies behind scurvy. We also

know that lack of iodine may lead to an underactive thyroid

gland. But for other health problems it seems to work less well.

We know that depression is associated with a lack of seroto-

nin, yet eating foods containing high amounts of the precursor

L-tryptophan, such as bananas or turkey, do not cure depression

(Young, 2007). Chocolate, containing polyphenols that may act

on gamma-amino-butyric acid and adenosine, has been classi-

cally credited with mood-lifting properties. But clinical evi-

dence for individuals suffering from major depression remains

limited, even an increased sense of calmness and contentedness

has recently been demon strated for people without mental hea lth

problems (Pase et al., 2013). Also, chocolate products tend to

contain considerable amounts of sugar and fat. This is required

to make cocoa palatable, but adds more calories to our diet. So

what about oily omega-3 fatty acids found in oily fish, foods

rich in vitamin D or folic aid? Again, the evidence remains li-

mited (Sanhueza et al., 2013), most likely because food-based

intervention trials are extremely difficult to conduct.

Supplements for Anyone?

Even trials using standardized supplements instead of non-

standardized foods often yield only preliminary or inconclusive

results. For instance, a recent meta-analysis concluded that the

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U. WERNEKE

treatment effect of omega-3 fatty acids was non-significant

(Hannestad & Bloch, 2012), only to be countered by a re-anal-

ysis finding the opposite (Martin et al., 2012). Some supple-

ments, such as folic acid, may work best if used complementa-

rily, i.e. in addition to, rather than alternatively, i.e. instead of

conventional treatments (Taylor et al., 2004). Vitamin D sup-

plements may only be worth considering in people who clearly

have a vitamin D deficit or who live in geographical regions

where sun exposure is low during winter time (Parker & Brot-

chie, 2011). They may work less well in those without an ob-

vious vitamin D deficiency. This suggests that nutritional defi-

cits identified in mental disorders do not automatically pave the

way to treatment strategies. It is much easier to show that the

lack of substance may lead to a deterioration of mood than the

replacement of the substance lead to an improvement. Because

once a depressive episode is set into motion, it may maintain

itself, even if a precipitating factor such as a nutritional deficit

is corrected.

The Tip of the Iceberg

Possibly, the failure to deliver robust evidence for food or

supplement based interventions also stems from the fact that

major depression is a multi-factorial condition. Genetic, social

and psychological factors may play an equally important role as

food deficiencies and all these factors may conspire together to

bring on a major depressive episode. But if many factors cause

or contribute to a mental health problem, it is unlikely that fix-

ing just one factor will solve the whole problem. However, if a

factor such as a clearly identified nutritional deficiency, could

be rectified it should. Thus, correcting underlying nutritional

deficit s may be necessary to treat depression, but in most cases

this is not sufficient and nor will it ever be.

Lifestyle Instead of Diet

As multifactorial problems require multifactorial solutions, it

follows that lifestyle interventions covering various aspects of

wellbeing may be superior to dietary interventions for most suf-

ferers of major depression. We know for instance that physical

activity is beneficial for mood (as long as we do not overdo it).

Alcohol, smoking and substance abuse are other worthwhile as-

pects to consider (Berks et al., 2013). And finally, supportive

psychotherapy and motivational interviewing are integral con-

stituents of many life-style interventions. Sometimes, it is even

possible to get the best of both worlds through one single in-

tervention. After all, the bes t way to stock up on vi ta mi n D is to

go out and take a walk in the sun.

Conflict of Interest

Ursula Werneke is writing a book in a related area to be pub-

lished by Kiener Verlag, Munich, Germany

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