When we are under high stress, we can often reach for foods that are “comforting” (like cookies, donuts, cake, pastries, and chocolate bars), but these foods may not be the best choice for feeding your brain under stressful and demanding circumstances. Comfort foods are often calorie-rich but nutrient-poor.

Further, under high stress (and it doesn’t actually matter what has caused the high stress, whether it be a natural disaster like an earthquake or fire, or witnessing something really traumatic), the reactions our body goes through can be quite similar. We release adrenaline. This is part of our natural alarm response system.

Adrenaline is an essential neurotransmitter that is released as part of the fight-flight response. It enables our body to get us to safety, shut down non-essential functions, and make sure the muscles needed for fight or flight get activated. Cortisol, a hormone, is also essential for the alarm system to function optimally.

Unfortunately, over extended periods of time, the alarm system can go into over-drive, and this is one factor that can lead to re-experiencing memories, flashbacks, hypervigilance, being on edge all the time, feeling anxious and panicky when reminded of the traumatic event, struggling with sleeping and having nightmares.

Making neurotransmitters and hormones requires micronutrients, which are numerous kinds of vitamins and minerals. This is a well-established scientific fact. Micronutrients like zinc, calcium, magnesium, iron, and niacin are all essential for making neurotransmitter chemicals for the brain and the body. If your body is depleted of these nutrients, then either it won’t have sufficient nutrients to make these essential chemicals, or it will redirect all resources to the fight or flight response (as it is so vital for survival) and there won’t be much left for ensuring optimal brain function to do things like concentrate, regulate moods and sleep.

Consequently, as micronutrients get depleted at a high rate during times of stress, we need to replenish them in greater quantity from our food (and perhaps other sources).

Where can we get these micronutrients from?

Answer: Nutrient-dense foods; real food, not ultra-processed foods.
Compare a banana to a cookie; one obtains far more of these micronutrients (like potassium, magnesium, folate) that are required for brain function from a banana. Eating kale chips over potato chips would also provide more nutrients. Reaching for a carrot stick and dipping it in hummus would be better for your brain than gorging down a commercial meat pie (although meat pies can be healthy if they contain lots of vegetables too). Choosing nuts and seeds over pretzels would also give you better brain food.

Overall, to cope well with stress your goal should be to increase intake of plant food and food high in nutrient density while still getting adequate protein, fats and carbs. Fish is a great source of protein and of essential fatty acids, which are also vital for brain function. In eating these types of foods, you would be shifting your diet from a Western type of diet (ultra-processed, high in sugar) to a Mediterranean-style diet (high in fruits and veggies, fish, nuts, healthy fats and low in processed foods).

Therefore, stop counting calories and start focussing on nutrients, especially nutrients that are good for your brain!

Would this be sufficient to sooth the over-activated alarm system in a situation of high and chronic stress? Possibly, although some people might need more nutrients than what they can get out of their diet, even if it is a healthy one. There are many reasons for this, some of which reflect reduced nutrient density in modern foods, some of which are due to our own specific genetic make-up, and some have to do with the health of our microbiome (the millions of helpful bacteria that live inside us, especially in our gut).

If you do need to consume more nutrients than what you can source from your diet, or you are struggling with cooking due to your particular circumstances and the stresses you are experiencing, or you are time poor because of family or work demands, what do you take in terms of a supplement? Research from the Mental Health and Nutrition Lab in Christchurch, NZ found that following the Christchurch earthquakes as well as other research on stressed communities shows that B vitamins, in particular, can be helpful. A recently published meta-analysis confirmed the positive effect of B vitamins on reducing stress. In addition, some may find a reduction of intrusive thoughts require additional minerals as well.

Nutrition resources for psychologists and mental health professionals working with people struggling with anxiety post-trauma:

When working with people struggling with stress/anxiety, research shows that it is essential that their diet includes foods that are nutrient-dense. This means being aware of foods that are high in vitamins and minerals as well as being a good source of fats, proteins and carbohydrates.

You can ask some simple questions:

  • How many times a week do you eat fast food meals or snacks?
  • How many regular fizzy drinks do you drink each day?
  • Snacks? Favourite Foods? Problem Foods?
  • Any restrictions? Allergies? Aversions?
  • How many servings of fruit do you eat each day?
  • How many servings of vegetables do you eat each day?
  • How often do you eat red meat (good source of iron, folate)?
  • Do you eat fish? (good to know if they are vegan, vegetarian, or gluten-free)

These questions can start the conversation to find out if they are eating nutrient dense foods.

Here are some basic tips:

  1. Start with whole foods diet approach including good fats, nuts, seeds, fish, a modest amount of meat, vegetables, fruit, whole grains
  2. Shifting towards eating “real” as opposed to processed foods naturally eliminates unnecessary food additives such as artificial colours, flavours, sweeteners and preservatives that do not add nutritional value and may contribute to psychiatric symptoms in some people
  3. Limit sugar intake (sugar is everywhere in processed foods, energy/fizzy drinks – encourage clients to look at labels to spot the hidden sugar)
  4. watch caffeine and alcohol intake doesn’t creep up
  5. Eat a good solid nutrient-dense breakfast: e.g., omelette with vegetables, muesli (oats, nuts, raisins) with milk, yogurt, fresh fruit
  6. If your client is struggling with cooking or a change in diet is not working enough to reduce psychological symptoms, you can consider suggesting supplements as there has been a lot of research on them. If suggesting supplements, stick to the data and published research, the best research is on adding additional B vitamins (like Blackmores or Berocca). For more information please email the Mental Health and Nutrition Research Group: mentalhealthnutrition@canterbury.ac.nz

Here are some useful resources:

A recent radio interview about dietary patterns and stress: https://www.radionz.co.nz/national/programmes/nights/audio/2018687489/nutrition-during-times-of-stress-and-trauma

Harvard Medical School has put together lots of resources on healthy eating, including the healthy eating plate: www.health.harvard.edu/staying-healthy/healthy-eating-plate

The Helfimed trial was a successful trial that showed the benefit of assisting people suffering from depression to nudge over to a more Mediterranean-based diet. They have lots of recipes on their website: http://helfimed.org/cgi-sys/suspendedpage.cgi

The Mood and Food Centre in Melbourne often blogs on diet-related topics. Check out their website: http://foodandmoodcentre.com.au/

Dr Drew Ramsey has some excellent resources on eating well on a budget: https://drewramseymd.com/uncategorized/brain-food-budget/

There are lots of great resources at this site: https://www.getselfhelp.co.uk/freedownloads.htm

Books that we have enjoyed reading on nutrition and mental health that do have some scientific basis to their recommendations:

  • Brain Changer – Prof Felice Jacka
  • Finally Focused – Dr James Greenblatt
  • The Mad Diet – Suzanne Lockhart
  • The anti-anxiety food solution –Trudy Scott
  • What the FAT? – Prof Grant Schofield (also includes recipes)

Rachel Kelly has devised a cookbook directly focused on eating foods that will contain nutrients help you feel mentally better:

https://www.rachel-kelly.net/books-apps/

How to eat well on a budget:
From the British Dietetic Association: 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.

Also, research from Australia has shown that a Mediterranean style diet was cheaper than a poor quality diet.

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Superfoods

Chia Who? – The Superfood Trend
I have a green smoothie every morning with chia seeds and acai berries, you should try it too! I feel so fit and healthy!” Have you ever heard this or a similar sentence in your life? In recent years, more and more people have been talking about superfoods. There are many new restaurants with superfoods on the menu and a sharp increase in coverage of superfoods in beauty, health and nutrition magazines. Increasing concerns about health and aging society appear to be an important driver of the superfood trend in Europe, as a rapid rise in new products enters a dynamic and growing market. Every season new products are introduced and advertised as superfoods. The United States are in first place at importing goods labeled as superfood, Germany ranks second (4).

But what are superfoods exactly and what makes it so “super” and different from functional food?
Superfood can be defined as food that is considered particularly nutritious and energy-dense. Foods that fall into this category include chia seeds, acai berries, blueberries, beetroot, soy, pomegranates, green tea, goji berries, coconut oil, salmon, dark chocolate, cocoa and kale (2). Some of these superfoods, like chia seeds or goji berries, have turned into established products that can be obtained in almost every supermarket or even in discounters. Among the superfoods, goji is the leading superfood product. “Goji” is the generic name for different plant species from the genus lycium (2). However, superfood is neither a registered trademark nor a legally protected term. All definitions have in common that they describe superfoods as a food that has a high nutrient density. This means a comparatively high amount of e.g. proteins, vitamins, minerals, polyunsaturated fatty acids, phytochemicals, and antioxidants. The problem is, however, that many of these products are extremely damaged by pollutants that can have even negative effects on our health. Also, they usually have long transport routes behind them, which is not only bad for the climate but can also decrease the nutrient density.

So what’s the conclusion and the recommendation?
Overall, superfoods are a good thing, but superfoods should not emphasize some single representatives or nutrients, because the variety and complexity of the entire nutrition is important for a healthy lifestyle. In addition, it depends on the lifestyle in general, so a lot of exercise, sufficient sleep, social contacts and a positive attitude to your life are key (3). A healthy diet with a lot of fruits and vegetables has not only positive effects on your physical health; it also has a significant influence on your psychological well-being. Therefore it is not only worthwhile for your body but also for the mind to significantly increase your personal fruit and vegetable consumption. It is crucial that your diet includes essential vitamins and nutrients which can help in relieving symptoms of depression, mood disorders, and other mental illnesses (6).

For some, lifestyle might be considered more important than sustainability at this point, because many local products like blackberries, linseeds, or peppers offer the same high vitamin content as superfoods, but do not have the wonderful image of superfood (1). So if you want to buy superfoods like goji berries or chia seeds, it makes sense to buy certified organic products. They are manufactured without the use of chemical pesticides and fertilizers. The Fairtrade seal is also a guarantee of more sustainability for products from distant countries. And don’t forget that agriculture in Germany and Europe also has many local “superfoods” to offer. Flax seeds, for example, are a real good alternative to chia seeds because they have similar “slime forming” properties.

Certainly, the trendy superfood products have many beneficial properties for our health. But the native fields provide all the vitamins that you need, too, often at a much lower price. For a healthy diet, berries (for example) are not required. Those who eat a varied and balanced diet can do it also with local fruits and vegetables. It is worthwhile in many ways to look for fresh, seasonal and organically grown fruits and vegetables on the market! And anyway – self harvested “superfood” tastes the best! (5).

REFERENCES:

  1. Ortner, J. (2018). In aller Munde – eine soziodramatische Betrachtung der Ernährung. Wiesbanden: Springer
  2. Wetters, S., Horn, T., Nick, P. (2018) Goji Who? Morphological and DNA Based Authentication of a “Superfood”.  Plant Sci.9:1859. doi: 10.3389/fpls.2018.01859
  3. Feichtinger, J. (2019). Heimisches Superfood: regional und nährstoffreich. In: Ernährung & Medizin 34(03):147-155
  4. Sikka, T. (2017). Contemporary Superfood Cults: Nutritionism, Neoliberalism, and Gender. In: Cargill, K. (2017). Food Cults. How Fads, Dogma, and Doctrine influence Diet. Maryland: Rowman & Littlefield
  5. https://www.oekolandbau.de/bio-im-alltag/einkaufen-und-kochen/trends-und-tests/superfoods/
  6. https://www.zentrum-der-gesundheit.de/news/gesunde-ernaehrung-psychisches-wohlbefinden-170204017.html
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Have you ever done your weekly grocery shopping and ended up with more than actually written on your grocery list?
Everybody has at least once experienced how it is to buy food in a supermarket with hunger and buy much more than planned. The widely known recommendation: Never go grocery shopping when you are hungry!!!

But is it only a myth or is there a grain of truth in that advice?
What exactly is the issue with going grocery shopping when you are hungry? If you do you probably buy more food than you need and planned to buy. Additionally, unhealthy food might be much more attractive for you than healthy food. The consequence: you have more food at home, so you might eat more and unhealthier. Imagine you are hungry and are coming home from work after a stressful day and now you get to choose between a frozen pizza and a healthy meal that has not been prepared yet – What would you choose? In that situation, I think I would definitely choose the frozen pizza.

High-calorie food and unhealthy food are associated with obesity. Obesity research found a moderate relationship between obesity and emotional disorders like depressive disorder and anxiety disorder (1). Thus, having fast food frequently might not only affect your physical, but also your mental well-being.

Let’s rewind to grocery shopping, but now consider you are not hungry. You probably would only buy the things that are on your grocery list, and also rather healthy food than an unhealthy one. So now you come home hungry from a stressful day at work and you don’t have the choice between healthy and unhealthy food, and the temptation of the frozen pizza isn’t there. So you would start to prepare your healthy food and thus automatically eat healthier.

Coming back to the question if these scenarios are devised or true, and thus representative for weekly grocery shopping.
Research has shown that impulsivity, obesity, and food buying behavior are related. People with obesity are more impulsive than slim people. Also, impulsive people eat more than less impulsive people. Hunger influences food buying behavior and food consumption, especially of high caloric food. The relationship between impulsivity and buying food might be state dependent: researchers have found that impulsive people bought more calories, especially from snack food, but only when they were feeling hungry. This means that impulsivity and hunger interact in their influence on consumption. Obese people are found to show a preference for energy-dense, high-fat food and eat more of these foods, compared to slim people (2).

So what’s the conclusion?
Yes, hunger influences your grocery shopping, especially in interaction with impulsivity. If you consider yourself an impulsive person, you might be more prone to buying more than intended when you go shopping hungry.

So if you have the chance: only go shopping for groceries when you are full and focused. If you accidentally get into a hungry grocery shopping situation, keep this blog in mind and try to focus on your grocery list.

REFERENCES:
Scott, K. M., Bruffaerts, R., Simon, G. E., Alonso, J., Angermeyer, M., de Girolamo, G., … & Kessler, R. C. (2008). Obesity and mental disorders in the general population: results from the world mental health surveys. International journal of obesity32(1), 192.

Nederkoorn, C., Guerrieri, R., Havermans, R. C., Roefs, A., & Jansen, A. (2009). The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket. International journal of obesity33(8), 905.

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According to the food and agriculture organization, about 1 billion people in the world were living in hunger or insecurity in the year 2010 (1). Additionally, 5 to 15 % of people in industrial countries experience food insecurity which makes it all the more a public health concern in Europe (2).

But, what exactly is food insecurity about?

Food insecurity means that the access to sufficient food, meeting the dietary and cultural needs and the individual food preferences for a healthy and active life is not possible. It is not only a lack of food, what`s more, is the feeling that the preferred food supply is not available or may be threatened in the future, which has, in turn, an effect on the eating behavior. That means even if food is sufficient, people may be food insecure, but not necessarily undernourished. Two risk groups are students, who do not have the money for buying their preferred food, and refugees, who can´t buy their traditional food in their new home towns. Food insecurity can result in a reduction on micro-and macronutrition intake. Macronutrients are large food components that the body needs to maintain its metabolism; it includes lipids (fats), sugars (carbohydrates) and proteins. Micronutritions, like vitamins, minerals (such as calcium or magnesium), trace elements (such as iron and zinc), are essential because, without them, numerous normal functions such as growth or energy production could not take place.

Effects on mental health

Food insecurity is also found more often in families with low social economic status (4). Researchers have found that food insecurity caused an increase of depression and anxiety symptoms (3). Furthermore the uncertainty of having food in the future produced stress and created desperation and hopelessness in the families. They perceived the situation as shameful and resigned or used drugs and alcohol to compensate. In addition to this ,children from food insecure families were also more likely to develop symptoms of depression/ anxiety, aggression and hyperactivity/inattention (2). However, when you control for many demographical and psychological variables such as immigrant status, family structure and income and paternal depression, only increased impulsive behavior and inattention seem to be specifically linked to food insecurity Another factor is maternal mental health. It has been shown that food insecurity is especially bad for children’s development if the mother has additional mental health problems like depression, domestic violence and psychosis.

Further insights can be derived from Canadian students (5). Here are financial constraints a primary contributing factor. It represents a barrier because often students can´t afford to buy qualitative and expensive food. Another important factor is insufficient time because the effort to buy, prepare and cook healthy meals takes time and requires planning. It may also be the limited access to culturally appropriate food. This could be a barrier especially for people from other countries, who don´t have the opportunity to buy their traditional food and spices in local supermarkets. In urban areas, more exotic and international food supply is possible, due to the higher demand. The consequences for students were feelings of shame, frustration and loneliness. Some have felt socially isolated, and in general the food insecurity was associated with high psychological stress. Nonetheless the students in the reports believed that the situation is temporary and that after university life gets better in terms of food quantity and quality. For now they accepted the current situation.

So overall, food insecurity may occur in different social classes, with different reasons and effects of varying intensity. It`s interesting to see that it can occur in developing countries and rich countries, and that it can have an influence on whole families and children of food insecure families and students. More studies about people with cultural issues (e.g. refugees) are needed.

So, if you have the chance:

Buy the food you prefer and take time for preparing your meal,                      to live your life as healthy as you want it to be!

REFERENCES

(1) Cole, S. M.; Gelson, T. (2011). The effect of food insecurity on mental health: Panel evidence from rural Zambia. Social Science & Medicine. 73 (7)1071-1079.

(2) Melchior M.; Chastang J.- F.; Falissard B.; Galera, C.; Tremblay, R.E.; Cote, S.M., Boivin, M. (2012). Food insecurity and children’s mental health: a prospective birth cohort study. PLoS One 7 (12).

(3) Weaver, L. J.; Hadley. C. (2009) Moving Beyond Hunger and Nutrition: A Systematic Review of the Evidence Linking Food Insecurity and Mental Health in Developing Countries, Ecology of Food and Nutrition, 48(4), 263-284.

(4) Melchior, M.; Caspi, A.; Howard, L.M.; Ambler, A.P.; Bolton, H.; Mountain, N; Moffitt, T.E. (2009) Mental health context of food insecurity: a representative cohort of families with young children. Pediatrics, 124 (4).

(5) Hattangadi, N.; Vogel, E.; Carroll, L. J.; Cote, T. (2019). “Everybody I Know Is Always Hungry…But Nobody Asks Why”: University Students, Food Insecurity and Mental Health. Sustainability. 11 (6).

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The popularity of yoga practice has risen sharply in recent years. In 2006, already 2.6 million people in Germany practiced yoga regularly (1). The arguments for yoga are widely spread in the population, for example the energy and immune function are increased and back pain, arthritis and stress are relieved (2). For others, the practice of yoga is an important factor in doing something good for themselves, while for others the discipline and control of the body is more in focus.

But, where does yoga come from?
The yoga tradition originates from India, the religion of Buddhism, and has a philosophical background with original roots reaching back over 2000 to 5000 years. The term “yoga” comes from the word “yui”, which has its origin in Sanskrit, a very ancient Indian language, and means “unite”. Accordingly, yoga refers to the union of body, mind and soul (3).

What exactly does a yoga practice involve?
In western countries the focus is especially on the Asana practice, the postures. The postures can be lying, sitting or standing and should be performed as attentively as possible. All Asanas have associated Sanskrit names and also pictorial names such as the Cobra (Bhujangasana) or the down looking dog (Adho Mukha Svanasana). Further essential elements are the breathing techniques (Pranayama), where the breath is consciously directed (e.g. Kapalabathi, alternative breathing) and the meditation (Dhyana), where the mind is consciously directed, by calming down, insight can be attained and a state of deep relaxation can be achieved.

But, can yoga really have a positive effect on mental and physical health?
In view of the study and literature available, YES! A meta-analysis results that yoga is effective as a complementary treatment for psychiatric disorders such as schizophrenia, depression, anxiety, and posttraumatic stress disorder (4).

Yoga can have a positive influence on the reduction of depression symptoms, the reduction of stress and anxiety, and can lead to an increase in self-love, awareness and life satisfaction (5, 6). On the physiological level, the results can also be found in the reduction of the stress hormone cortisol (7).

In the case of anxiety disorders, relaxation is a central component of yoga practice. Clients lack confidence, courage and stability, so that autogenic training, progressive muscle relaxation and deep relaxation can be beneficial.

In the presence of eating disorders, yoga can make an important contribution to increasing body satisfaction, awareness and receptivity as well as reducing self-objectivity and psychological symptoms (8). Prevention programs with concentration on yoga appear promising, as body satisfaction and social self-concept have been increased and bulimic symptoms reduced.

Conclusion: The integration into the health system for prevention and complementary therapy seems to be reasonable and as Mind Body Therapy, integrated into the treatment concept, positive effects on mental health can be achieved. In addition to body awareness, yoga concentrates on personal awareness and self-love and has an effect on the emotional, mental, cognitive and physical body levels. The yoga classes can be specifically adapted to the needs of the participants and can be set up in a disorder-specific way.

Advantages of yoga as a complementary therapy:
– Lower costs

– At the same time positive effect on the body
– No side effects
– Preventive and therapeutic support
– Less time required
– New contacts

What do you need to consider?
1. Choice of Yoga-Studio (atmosphere, costs, course offers)

2. Yoga teacher (e.g. education of teacher, authentic)
3. Yoga style (discover your preference, adapt to your daily state, examples follow)

– Vinyasa = flowing asanas, activating, breath and asanas in harmony
– Hatha = origin, breathing exercises, meditation, gentle asanas
– Ashtanga = powerful, always constant flowing sequences, condition
– Yin = relaxing, longer lasting asanas, calm, passive
– Acro Yoga = combination of acrobatics and yoga
– Kundalini = spiritual, mantras singing, meditation, energies

REFERENCES

  1. Klatte, R., Pabst, S., Beelmann, A. & Rosendahl, J. S. (2016). The efficacy of body-oriented yoga in mental disorders. Deutsches Arzteblatt international, 113 (20), 359. https://doi.org/10.3238/arztebl.2016.0195.
  2. Cramer, H., Ward, L., Steel, A., Lauche, R., Dobos, G. & Zhang, Y. (2016). Prevalence, Patterns, and Predictors of Yoga Use: Results of a U.S. Nationally Representative Survey. American journal of preventive medicine, 50 (2), 230–235.
  3. Jaquemart, P. & Elkefi, S. (1995). Yoga als Therapie. Lehrbuch für die Arzt und Naturheilpraxis. Augsburg: Weltbild Verlag.
  4. Cabral P, Meyer HB, Ames D. (2011). Effectiveness of yoga therapy as a complementary treatment for major psychiatric disorders: A meta-analysis. Prim Care Companion CNS Disord. 2011;13:pii: PCC10r01068.
  5. Ponte, S. B., Lino, C., Tavares, B., Amaral, B., Bettencourt, A. L., Nunes, T. et al. (2019). Yoga in primary health care. A quasi-experimental study to access the effects on quality of life and psychological distress. Complementary therapies in clinical practice, 34, 1–7. https://doi.org/10.1016/j.ctcp.2018.10.012
  6. Snaith, N., Schultz, T., Proeve, M. & Rasmussen, P. (2018). Mindfulness, self-compassion, anxiety and depression measures in South Australian yoga participants: implications for designing a yoga intervention. Complementary therapies in clinical practice, 32, 92–99. https://doi.org/10.1016/j.ctcp.2018.05.009
  7. Bershadsky, S., Trumpfheller, L., Kimble, H. B., Pipaloff, D. & Yim, I. S. (2014). The effect of prenatal Hatha yoga on affect, cortisol and depressive symptoms. Complementary therapies in clinical practice, 20 (2), 106–113. https://doi.org/10.1016/j.ctcp.2014.01.002
  8. Neumark-Sztainer, D. (2014). Yoga and eating disorders: is there a place for yoga in the prevention and treatment of eating disorders and disordered eating behaviours? Advances in eating disorders (Abingdon, England ), 2 (2), 136 145. https://doi.org/10.1080/21662630.2013.862369

 

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Our body is colonized by trillions of microorganisms that are important for vital processes. Gut microbiota are the microorganisms living in the intestinal gut and play an essential role in digestion, vitamin synthesis and metabolism, among others. The mouth and the large intestine contain the vast majority of gut microbiota whether the stomach only contains few thousands of microorganisms, especially due to the acidity of its fluids. Microbiota composition is constantly changing, affecting the well-being and health of the individual.

Each individual has a unique microbiota composition, and it depends on several factors including diet, diseases, medication and also the genetics of the individual (host) (Figure). Some medicines, especially antibiotics, reduce bacterial diversity. Strong and broad spectrum antibiotics can have longer effects on gut microbiota, some of them up to several years. Genetic variation of an individual also affects the microbiota composition, and the abundance of certain microorganisms is partly genetically determined by the host.

The main contributor to gut microbiota diversity is diet, accounting for 57% of variation. Several studies have demonstrated that diet’s composition has a direct impact on gut microbiota. For example, an study performed on mice showed that “Western diet” (high-fat and sugar diet), alters the composition of microbiota in just one day! On the other hand, vegetarian and calorie restricted diet can also have an effect on gut microbiota composition.

Prebiotics and probiotics are diet strategies more used to control and reestablish the gut microbiota and improve the individual’s health. Probiotics are non-pathogenic microorganisms used as food ingredients (e.g. lactobacillus present in yoghurt) and prebiotics are indigestible food material (e.g. fibers in raw garlic, asparagus and onions), which are nutrients to increase the growth of beneficial microorganisms.

In the last years the new term psychobiotics has been introduced to define live bacteria with beneficial effects on mental health. Psychobiotics are of particular interest for improving the symptomatology of psychiatric disorders and recent preclinical trials have show promising results, particularly in stress, anxiety and depression.

Overall, these approaches are appealing because they can be introduced in food and drink and therefore provide a relatively non-invasive method of manipulating the microbiota.

AUTHORS:
Judit Cabana-Domínguez and Noèlia Fernàndez-Castillo

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Psychobiotics are helpful bacteria (probiotics) or support for these bacteria (prebiotics) that influence the relationship between bacteria and brain. The human digestive system houses around 100 trillion of these bacteria, outnumbering the human body cells 10:1. Probiotics provide a great deal of functions vital to our well-being, like supporting the digestion process and improving the absorption of nutrients. Based on the latest research, helpful gut bacteria that can also positively affect the brain – psychobiotics – benefit people suffering from chronic stress, poor mood, or anxiety-like symptoms (1).

There are 3 ways psychobiotics can affect your mental health:

  • Brain chemicals like serotonin, dopamine, and noradrenaline can be produced in the intestines directly by gut microbiota.
  • Battling with and protecting from stress by modifying the level of stress hormones.
  • When an inflammation occurs, inflammatory agents are elevated throughout the body and brain and can cause depression and other mood and cognitive disorders. Psychobiotics can affect the brain by lowering inflammation.

Lactobacillus and Bifidobacterium are the most popular probiotics with respect to mental health (1).

Disruption of the balance of gut bacteria is quite common due to the use of different kinds of medications, antibiotics, artificial preservatives, poor food and water quality, herbicides, stress, and infections (2, 3, 4).

In order to support a healthy microbiota, one should start from eating a diverse range of foods rich in different plant sources. Foods that contain lots of fiber or are fermented also promote the growth of beneficial gut bacteria. Excessive consumption of sugar and artificial sweeteners should be minimized. Managing stress levels, exercising on a regular basis, not smoking and getting enough sleep are also important for keeping microbiota in good condition. When taking antibiotics, one should make sure to consume probiotics so the body can maintain the bacteria it needs to stay healthy.

For people needing help regarding mental health problems, psychobiotics may be a promising relief. Psychobiotics are well-adapted to the intestinal environment and naturally modulate gut–brain axis communications, thereby reducing the chance of adverse reactions.

It is possible that even simple prescribing of a particular diet may be sufficient to promote the selective proliferation of natural or therapeutically introduced psychobiotics (5). Further research focusing on the strain and dosage of psychobiotics, duration of treatment, and the nature of mental disorders will help to determine the most efficient ways of helping people to improve their mental health.

REFERENCES
Abhari A, Hosseini H (2018) Psychobiotics: Next generation treatment for mental disorders? J Clin Nutr Diet. 4:1. doi:10.4172/2472-1921.100063

Carding et al (2015) Dysbiosis of the gut microbiota in disease. Microb Ecol Health Dis. 26: 10.3402/mehd.v26.26191

Lozano et al (2018) Sex-dependent impact of Roundup on the rat gut microbiome. Toxicol Rep. 5:96–107. doi: 10.1016/j.toxrep.2017.12.005

Paula Neto et al (2017) Effects of food additives on immune cells as contributors to body weight gain and immune-mediated metabolic dysregulation. Front Immunol. 8:1478. doi:10.3389/fimmu.2017.01478

Kali (2016) Psychobiotics: An emerging probiotic in psychiatric practice. Biomed J. 39(3):223-224. doi:10.1016/j.bj.2015.11.004

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A hot topic these days, that one can hear more and more information about is the microbiota-gut-brain axis, the bidirectional interaction between the intestinal microbiota and the central nervous system nowadays, this has become a hot topic. We are becoming increasingly aware that gut microbiota play a significant role in modulating brain functions, behavior and brain development. Pre- and probiotics can influence the microbiota composition, so the question arises, can we have an impact on our mental health by controlling nutrition and using probiotics?

Burokas and colleagues aimed to investigate this possibility in their study (2017), where the goal was to test whether chronic prebiotic treatment in mice modifies behavior across domains relevant to anxiety, depression, cognition, stress response, and social behavior.

In the first part of the study, the researchers fed mice with prebiotics for 10 weeks. They were administered the prebiotics fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), a combination of both, or water. FOS and GOS are soluble fibers that are associated with the stimulation of beneficial bacteria such as bifidobacterium and lactobacillus.

Behavioral testing started from the third week including

  • the open field test (anxiety – amount of exploratory behavior in a new place),
  • novel object test (memory and learning – exploration time of a novel object in a familiar context), and
  • forced swimming test (depression-like behavior – amount of activity in the cylinder filled water).

Meanwhile, plasma corticosterone, gut microbiota composition, and cecal short-chain fatty acids were measured. Taken together, the authors found that the prebiotic FOS+GOS treatment exhibited both antidepressant and anxiolytic (anti-anxiety) effects. However, there were no major effects observed on cognition, nociception (response to pain stimulus), and sociability; with the exception of blunted aggressive behavior and more prosocial approaches.

In the second part, FOS+GOS or water-treated mice were exposed to chronic psychosocial stress. Behavior, immune, and microbiota parameters were assessed. Under stress, the microbiota composition of water-treated mice changed (decreased concentration of bifidobacterium and lactobacillus), which effect was reversed by treatment with prebiotics.

Furthermore, it was found that three weeks of chronic social stress significantly reduced social interaction, and increased stress indicators (basal corticosterone levels and stress-induced hyperthermia), whereas prebiotic administration protected from these effects.

After stimulation with a T-cell activator lectin (concanavalin A), the stressed, water-treated mice group presented increased levels of inflammatory cytokines (interleukin 6, tumor necrosis factor alpha), whereas in animals with prebiotics had these at normal levels.

Overall, these results suggest a beneficial role of prebiotic treatment in mice for stress-related behaviors and supporting the theory that modifying the intestinal microbiota via prebiotics represents a promising potential for supplement therapy in psychiatric disorders.

Watch YouTube Video:
https://youtu.be/E479yto8pyk

REFERENCES
Burokas, A., Arboleya, S., Moloney, R. D., Peterson, V. L., Murphy, K., Clarke, G., Stanton, C., Dinan, T. G., & Cryan, J. F. (2017). Targeting the Microbiota-Gut-Brain Axis: Prebiotics Have Anxiolytic and Antidepressant-like Effects and Reverse the Impact of Chronic Stress in Mice. Biological Psychiatry, 82(7), 472–487. https://doi.org/10.1016/j.biopsych.2016.12.031

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Recently, the idea that gastrointestinal microbiota are able to affect host behaviour is gaining momentum and it is based on studies conducted with animal models but also in humans with neurological disorders. However, the mechanisms that underlay this complex interplay between gut, brain and microbiota are not completely understood. Here we discuss recent findings on how microbial products could potentially affect the gut-brain axis.

Intestinal microbiota grow through the fermentation of undigested carbohydrates that end up in the large intestine. It was shown that absence of microbes or disruption of the microbiota, led to increased populations of impaired microglia cells in mice. Microglia cells are the primary effector cells for immune signalling to the central nervous system. The presence of a complex microbiota community, was shown to be essential for proper microglia maturation and function [1].

The main products of microbial fermentation in the gut are; acetate, propionate and butyrate, collectively known as short chain fatty acids(SCFA’s). Their beneficial role in human physiology have been well described, and recently evidence suggests that these molecules are able to cross blood brain barrier [2]. Moreover, gut microbiota have been associated with the brain barrier integrity. Mice raised in absence of bacteria are reported to have reduced brain barrier integrity. Once colonized with either a butyrate or an acetate/propionate producing bacteria, significant improvements were reported in the barrier [3]. Notably the integrity of the blood-brain barrier from the germ free mice was able to be restored through the oral administration of butyrate.

Gut_Microbes and Mental HealthSCFA’s are among the molecules having the privilege to cross the blood brain barrier and access the brain directly, their role should be studied in detail.

Recent studies also demonstrate that gut microbes regulate levels of intestinal neurotransmitters. The enteric nervous system interacts with a plethora of neurotransmitters (more than 30 have been identified so far.) Actually, the bulk of serotonin production ~90%, a neurotransmitter associated with mood and appetite is located in the gut. Specialized cells known as enterochromaffin cells are the main serotonin producers in the gut. In the absence of intestinal microbiota gastrointestinal serotonin levels are depleted. However, they can be restored by the addition of a specific spore forming consortium of intestinal bacteria. Specific bacterial metabolites have been reported to mediate this effect [4].

Other intestinal microbiota have been reported also to regulate the levels of the GABA neurotransmitter. Reduced levels of GABA have been associated with anxiety, panic disorder and depression. Bacterial GABA producers have been known to exist for years but it was not until 2016 that a gut bacteria was identified as GABA consumer [5]. For example, decreased levels of bacterial GABA producers were identified in a human cohort of depressed individuals. Studies in mice reinforce these findings. Intervention with the lactic acid bacteria Lactobacillus rhamnosus (JB-1) in healthy mice reduced anxiety related symptoms (accompanied by a reduction in the mRNA expression of GABA receptors in the Central Nervous System.) Lactic acid producing bacteria have also been reported to produce GABA in several food products such as kimchi, fermented fish and cheese [6].

Collectively, our gut microbiota encodes for ~100 times more genes than the human genome. The potential for some of these microbial genes to produce compounds able to interact with the nervous system and regulate critical pathways implicated in the gut brain axis is realistic and worth being explored.

Authors Prokopis Konstanti, MSc and Clara Belzer, PhD are working in the Department of Molecular Ecology, Laboratory of Microbiology, Wageningen University, Netherlands.

Footnotes

  1. Erny, D., et al., Host microbiota constantly control maturation and function of microglia in the CNS. Nature neuroscience, 2015. 18(7): p. 965-977.
  2. Joseph, J., et al., Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia? Frontiers in Neuroscience, 2017. 11(155).
  3. Braniste, V., et al., The gut microbiota influences blood-brain barrier permeability in mice. Science translational medicine, 2014. 6(263): p. 263ra158-263ra158.
  4. Yano, J.M., et al., Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell, 2015. 161(2): p. 264-276.
  5. P. Strandwitz, K.K., D. Dietrich, D. McDonald, T. Ramadhar, E. J. Stewart, R. Knight, J. Clardy, K. Lewis; , Gaba Modulating Bacteria of the Human Gut Microbiome. 2016.
  6. Dhakal, R., V.K. Bajpai, and K.-H. Baek, Production of gaba (γ – Aminobutyric acid) by microorganisms: a review. Brazilian Journal of Microbiology, 2012. 43(4): p. 1230-1241.

 

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