1 Institute of Psychiatry, Psychology & NeuroscienceSandrine Thuret, PhD Institute of Psychiatry, Psychology & Neuroscience Basic and Clinical Neuroscience Cells & Behaviour Unit The Impact of Diet on Mental Health Corporate Wellness and Benefits Summit Friday 27th of May 2016
2 Impact of Diet Physical Health WHAT Mental When Health How much We eatCardiovascular Diseases Weight Management Diabetes Mental Health Mood Depression Cognitive decline Learning & memory Abilities WHAT When How much We eat WHAT We eat We are very aware in our society that what we eat will have an impact on our physical health- such as play a role in the development of cardiovascular disease, how to manage our weight, or have an impact on diseases such as diabetes On the over hand, our society is not well informed on the impact of what we eat on mental health. We will see today that it has an impact on such as on mood/depression-on learning and memory abilities or cognitive decline associated with ageing
3 ? Diet, cognition and mood WHAT When How much We eatIn the first part of the talk I will give you some evidence from published research articles demonstrating that diet and some nutrients in particular have an impact on general learning and memory performances as well as on mood and depression. In the second part of the talk We will also investigate possible mechanisms mediating the effect of nutrition on mental health.
4 ethanol Resveratrol High saturated fat Calorie restriction Soft dietHigh sugar Vitamin E deficiency High saturated fat Omega 3 fatty acids Calorie restriction Vitamin b defficiency Soft diet blueberries Vitamin A defficiency Folic acid zinc flavonoids curcurmin ethanol Intermittent fasting caffeine So what we DO can have an impact, but also what you EAT can modulate the production of new neurons! Here [Go to slide 11] you see all the diets that have been shown to modulate neurogenesis and I am just going to point out a few. Limiting calorie intake (of 30%) or doing intermittent fasting (eating every-over-day) increase neurogenesis, flavonoids contained in cocoa and fruits with dark skins like blueberries will increase neurogenesis, omega 3 FA contained in ioly fish like salmon will increase the production of neurons. Conversely diets rich in saturated fat will decrease neurogenesis, alcohol will also be detrimental to the production of new neurons- However resveratrol contained in red wine has a positive effect – so next time you are at a dinner party you know which drink to take- a possible neurogeneis neutral drink! Now for a quirky one, there are entire groups of Japanese scientists fascinated about the role of food texture, and they have shown that soft food (as opposed to crunchy food) will decrease neurogenesis. These data are derived from animal work, but the same diets have been shown to impact memory and mood in human studies. And food modulates behaviour in the same direction as food modulated neurogenesis: Decreasing Calorie intake, intake of flavonoids, omega 3 FA as they increased the production of new neurons, will improve cognition and mood. Conversely diets rich in saturated fat will decrease learning and memory abilities and exacerbates symptoms of depression, and soft food seems to be linked to poorer learning and memory abilities.
5 They are a component of the brain.Omega-3 Fatty Acids Omega-3 fatty acids are Polyunsaturated essential fatty acids: The body cannot make them -- you have to get them through food. They are a component of the brain.
6 Omega-3 Fatty Acids: Not all equalα-linolenic acid (18:3, n−3; ALA) Flaxseeds, soybeans, pumpkin seeds, walnuts… eicosapentaenoic acid (20:5, n−3; EPA) Cold water fish such as salmon, mackerel, sardines, herring… Mental Health Effects docosahexaenoic acid (22:6, n−3; DHA) EPA and DHA are the one having the health effect- You will see that in the next slides in clinical trials or research studies, only EPA and DHA are used as supplement- the reason is that our bodies are very inefficient at making epa and dha from ALA- only 5 % of the ALA will become EPA and DHA. So intake of ALA is very inefficient Omega−3 fatty acids that are important in human physiology are α-linolenic acid (18:3, n−3; ALA), eicosapentaenoic acid (20:5, n−3; EPA), and docosahexaenoic acid (22:6, n−3; DHA) Fish, plant, and nut oils are the primary dietary source of omega-3 fatty acids. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in cold water fish such as salmon, mackerel, halibut, sardines, tuna, and herring. ALA is found in flaxseeds, flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil. The health effects of omega-3 fatty acids come mostly from EPA and DHA.
7 Omega-3- Fatty Acids and Cognition• Low intake of Ω-3 FA is associated with cognitive decline in elderly. • Whereas a diet rich in Ω-3 FA is associated with the prevention of cognitive decline. • Rodents with Ω-3 FA deficiency showed impaired performance in spatial memory tasks- which could be rectified after supplementation. Low intake of omega 3 FA is associated with cognitive declines in elderly especially docosahexaenoic acid (DHA)- number: freemantle docosahexaenoic: 41.6 and 49.5 micrograms/ml serum respectively- 20% less Participants with dementia had significantly lower n-3 FA plasma levels (2.9% vs 3.2%; p <.05)= 10% less Whereas a diet rich on fa is assocaited with the prevention of cognitive decline- numbers: An average difference of approximately 380 mg/d in EPA+DHA intake was associated with a 1.1-point difference in cognitive decline (P = 0.01) decline (MMSE, Mini-Mental State Examination) van gelder et al. 2007 MMSE, Mini-Mental State Examination Rodent with omega3 deficiency showed impaired performance in spatial memory tasks- which could be rectified after replenishment Fedorova &salem, 2006 Moreover omega3 concentration are lower in patients with depression+ numbers? Logan docosahexaenoic: 41.6 and 49.5 micrograms/ml serum respectively- 20% less Emerge as treatments: numbers? Frangou et al., 2006: There was no apparent benefit of 2 g over 1 g ethyl-EPA daily. Significant improvement was noted with ethyl-EPA treatment compared with placebo jazayeri et al., 2008 Fluoxetine and EPA appear to be equally effective in controlling depressive symptoms mg EPA or 20 mg fluoxetine (trade name Prozac) 8 weeks Freemantle et al. 2006; van Gelder et al. 2007; Fedorova & Salem, 2006
8 ! Omega-3- Fatty Acids and Mood• Ω-3 FA serum concentrations are 20% lower in patients with depression • Fluoxetine (Prozac) and EPA appear to be equally effective in controlling depressive symptoms in major depression (1g EPA = 20 mg fluoxetine for 8 weeks) ! Low intake of omega 3 FA is associated with cognitive declines in elderly especially docosahexaenoic acid (DHA)- number: freemantle docosahexaenoic: 41.6 and 49.5 micrograms/ml serum respectively- 20% less Participants with dementia had significantly lower n-3 FA plasma levels (2.9% vs 3.2%; p <.05)= 10% less Whereas a diet rich on fa is assocaited with the prevention of cognitive decline- numbers: An average difference of approximately 380 mg/d in EPA+DHA intake was associated with a 1.1-point difference in cognitive decline (P = 0.01) van gelder et al. 2007 MMSE, Mini-Mental State Examination Rodent with omega3 deficiency showed impaired performance in spatial memory tasks- which could be rectified after replenishment Fedorova &salem, 2006 Moreover omega3 concentration are lower in patients with depression+ numbers? Logan docosahexaenoic: 41.6 and 49.5 micrograms/ml serum respectively- 20% less Emerge as treatments: numbers? Frangou et al., 2006: There was no apparent benefit of 2 g over 1 g ethyl-EPA daily. Significant improvement was noted with ethyl-EPA treatment compared with placebo jazayeri et al., 2008 Fluoxetine and EPA appear to be equally effective in controlling depressive symptoms mg EPA or 20 mg fluoxetine (trade name Prozac) 8 weeks Logan et al., 2004; Jazayeri et al., 2008; Lin et al. 2012
9 Omega-3 Fatty Acids 1g=1000mg of EPA/DHA per day1 serving (85g) of salmon or sardines/day OR 3 servings (255g) of tuna or cod or pollock/day (OR 10 eggs/day – or 3kg of beef!)
10 ethanol Resveratrol High saturated fat Calorie restriction Soft dietHigh sugar Vitamin E deficiency High saturated fat Omega 3 fatty acids Calorie restriction Vitamin b defficiency Soft diet blueberries Vitamin A defficiency Folic acid zinc flavonoids curcurmin ethanol Intermittent fasting caffeine
11 Dietary/Energy Restriction: Well-known physical health benefitsOverweight participants under CR (over 400 studies) Non-Overweight participants under CR (Calerie study, Witte et al. 2009) and IF (Vallejo study) Diminution of hospital admission (50%) Reduction of Type-2 diabetes risk factors Improvement of the immune system Diminution of cardiovascular diseases risk Increase lifespan Animal Models under CR or IF Review in Mattson, 2001, 2008, 2012 Review in Redman et al., 2008
12 Dietary/Energy Restriction: Mental Health BenefitsOverweight participants under CR Decrease Concern about body size and shape (Human) Non-Overweight participants under CR (Calerie study, Witte et al. 2009) and IF (Vallejo study) Diminution of depressive symptoms Improved Verbal memory (Human) Improved Spatial learning and memory (Mice) Animal Models under CR or IF Review in Zainuddin and Thuret, 2012, Murphy and Thuret, 2015
13 50 healthy participants aged between 50 and 80,Dietary/Energy Restriction: Mental Health Benefits 50 healthy participants aged between 50 and 80, BMI between 21 and 25. Calorie Restriction with a daily reduction of 30% for 3 months + Control Group (no change in diet) CR +30% Control Witte et al., 2009
14 ? Diet, cognition and mood WHAT When How much We eatTHERE IS INDEED CLEARLY A LINK BETWEEN DIET AND L&M AND MOOD. HOWEVER THE MECHANISMS BY WHICH DIET MODULATE MENTAL HEALTH ARE NOT WELL UNDERSTOOD
15 Hippocampus, cognition and moodInterestingly, One of the brain structure associated with learning and memory and mood is the hippocampus In humans and other primates, the hippocampus is located inside the medial temporal lobe, beneath the cortical surface
16 Diet, Hippocampus, cognition and moodWHAT When How much We eat IT IS HYPOTHESIZED THAT THE HIPPOCAMPUS COULD MEDIATE THE ACTION OF DIET ON MENTAL HEALTH
17 Hippocampus: Neurogenesis: birth of new nerve cellsInterestingly, a very special feature of the hippocampus is that it is one of the 2 brain structure where the adult brain has the ability to generate new neurons throughout life what we call adult neurogenesis and those new neurons are important for L&M and mood.
18 ethanol Resveratrol High saturated fat Calorie restriction Soft dietHigh sugar Vitamin E deficiency High saturated fat Omega 3 fatty acids Calorie restriction Vitamin b defficiency Soft diet blueberries Vitamin A defficiency Folic acid zinc flavonoids curcurmin ethanol Intermittent fasting caffeine And yes, you will have guessed, in animal studies- all the dietary intervention having an impact on cognition or mood have an impact in neurogenesis- such as
19 Neuro genesis Diet, Hippocampal NEUROGENESIS, cognition and mood WHATWhen How much We eat Neuro genesis Bringing evidence that neurogenesis is likely the mediator of the impact of diet on mental health. Which open our next question- what other factors can modulate neurogenesis- there is no time to discuss that now- but we now that stress for example will decrease neurogenesis- whereas exercise will increase neurogenesis
20 Impact: Present and Future Health“An integrated approach, recognising the interplay of biological, psychological, social and environmental factors is key to challenging the growing burden of mental ill-health in western nations. Diet is a cornerstone of this integrated approach. The time is now right for nutrition to become a mainstream, everyday component of mental health care, and a regular factor in mental health promotion.” Dr Andrew McCulloch Former Chief Executive The Mental Health Foundation Until we have more time- it is time to conclude on our topic and I would like to quote…
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22 Amount used in Human studies Food rich in Nutrient Serving equivalentFlavonoids 100 to 800 mg flavanols/day Cocoa (2.5mg/g) Citrus fruits, berries Tea, Wine Flavonoids constitute about 25% of the dry weight of fresh tea leaf- 200-ml cup of tea, the mean total content of flavonoids is mg for green tea, and mg for black tea Citrus fruits 40g to 160g of 99% dark chocolate/day OR 80g to 320g of 50% dark/milk chocolate/day OR 1 to 3 cup of tea/day Blueberries 500ml fresh wild blueberry juice/day 600g of fresh blueberries/day Curcumin 500mg to 3g/day of curcumin powder Tumeric powder Eating one curry dish/day! Zinc Recommended daily intake: 8 to 11 mg/day Oysters, Red meats, liver, nuts… 1 oyster OR 8 table spoon of wheat germs OR 1 cup of peanuts or 100g of beef Caffeine <100mg beneficial >500mg detrimental coffee One espresso: 51mg (Starbucks) 157mg (Costas) Vitamin E 15mg/day Seed/nut oil, nuts 4 teaspoons of sunflower oil OR 100g of almonds OR 1kg of spinach OR 1.5kg of mango Vitamin A 700 to 900 μg/day (no more than 3000μg/day) Cod liver oil, Carrots, Butter, Spinach… 1/3 of a tea spoon of cod liver oil Or 100g of carrots