How Food Affects Mood (Part 2)
In Part 2 of this series on the food-mood connection, Nutrition Diva continues her conversation with Savvy Psychologist Dr. Ellen Hendriksen. Can omega-3s help treat depression? Can psychology help you lose weight? Click to find out.
Monica Reinagel, MS, LD/N, CNS
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How Food Affects Mood (Part 2)
Dr. Ellen Hendriksen, host of the new Savvy Psychologist podcast, is my guest again this week. On last week’s Nutrition Diva show, we talked about strategies for using food to boost your mood. Then, on last week’s Savvy Psychologist show, Ellen and I talked about the ways in which our state of mind can affect our food choices. Be sure to check out those episodes.
This week, Ellen has some great information on nutrients that can help fight depression as well as ways that psychology can help support your weight loss. .
Can Omega-3 Fats Prevent or Treat Depression?
Nutrition Diva: A higher intake of omega-3 fatty acids, such as those in fish and flax seeds, has been correlated with a lower risk of depression. But what if you already suffer from depression? Does evidence support omega-3 as a therapy to alleviate depression, either together or in combination with medications?
Savvy Psychologist: “Correlation does not imply causation” was drilled into my head during my research training to the point that I probably mumble it in my sleep. That said, yes, the evidence does play out in favor of omega-3s as a supplemental treatment boost for those on antidepressant medication. The American Psychiatric Association even has an Omega-3 Fatty Acids Subcommittee, and they recommend that individuals with a mood disorder should consume 1 g EPA plus DHA every day.
ND: One gram – that’s 1,000 mg if you’re taking a supplement. A small serving of salmon or sardines would also do the trick.
Folate Fights Depression Too
Low folate levels have been associated with an increased risk of depression.
SP: Another adjunctive treatment is folate. Low blood folate levels are associated with a poorer response to antidepressant medication, and, on the flip side, higher folate levels when you start taking antidepressants are associated with better response, especially in women. And even folks who aren’t on medication may want to watch their folate: low folate levels have been associated with an increased risk of depression.
ND: Wow, I wasn’t aware of that connection. Thank you for mentioning it! And I notice that you say folate (the natural form of the vitamin) rather than folic acid, which is the more potent form used in supplements.
Although folic acid supplementation can be essential to healthy pregnancies, there appears to be a link between high doses of folic acid and increased incidence of colon cancer in older people. Just to be on the safe side, I recommend that people who are not pregnant or trying to get pregnant avoid high dose folic acid supplements and focus instead on upping their intake of folate from foods. Good sources of folate include leafy greens and legumes.
See also: Folic Acid and Folate
But now, I’d like to pivot to a different topic. As everyone knows, the rates of overweight and obesity in this country are pretty staggering—and there’s a lot of debate about what, as a society, we can and should do to address this public health disaster. Do you think psychology is underused as a tool in the fight against obesity?
Psychology Can Help in the Fight Against Obesity
SP: Absolutely. I think the fight against obesity is hugely emotional. Our first world environment and our genetics do stack the deck against us, to be sure—processed foods are designed to be irresistable and convenient, and our genetics are no match for trans fats and fake sweeteners.
I worked briefly in the bariatric surgery center in a well-known hospital and assessed people who wanted to have gastric bypass surgery. I found people fell into 4 general categories: first were folks who just didn’t know enough about healthy eating to make changes—those folks were best helped by a nutritionist. Then there were the people who knew but didn’t care—we didn’t see those folks. Then there were those for whom it really was genetic. They could exercise and eat well, but their body was just programmed to be a certain shape.
Over-eating may be a symptom of an underying emotional or neurological issue.
Finally, there was a huge contingency of folks for whom food was an emotional issue. They could rattle off what was healthy, what wasn’t, portions, exercise, everything—but they felt out of control or couldn’t manage to match their behavior to their knowledge. These folks didn’t tend to do as well.
I knew a woman with unresolved emotional eating who went through a gastric bypass, only to become an alcoholic. I saw another become a compulsive shopper. It was clear the over-eating was just a symptom of the actual issue; it was something psychological and probably neurological underneath.
Anyway, that’s a long way of saying that not all of obesity is psychological—on a societal scale, much of the fight against obesity is fighting corporations who make and market processed pseudo-food, and instead promoting exercise and activity, and making healthy food more broadly available.
But on an individual scale, helping those with emotional eating, facilitating big and small habit change, motivating ourselves to be more active, and supporting each other’s healthy lifestyle choices are all places where psychology can play a leading role.
ND: Well put! We need to fight obesity on both the societal and the individual front! Ellen, for those who do struggle with emotional eating, are there any good books, groups, or other resources you can recommend?
SP: For emotional eaters, I recommend Binge No More, by Dr. Joyce Nash, an eating disorders specialist. This book is on the shelf of every psychologist who treats disordered eating. A book I recommend for sensible weight loss is The Beck Diet Solution, by Dr. Judith Beck, daughter of the founder of cognitive behavioral therapy. And a fantastic expose that will make you want to throw your soda can at the junk food industry was the front cover of the New York Times Magazine last year.
ND: Thank you so much, Dr Ellen Hendriksen, for bringing your Savvy Psychology tips to us here on the Nutrition Diva show. I encourage all my readers and listeners to check out the Savvy Psychologist podcast for more great advice on living your happiest, healthiest life.
Additional Resources
Emotional Eating Self-Test (Psychology Today)
Normal Eating (Online Support Group
References
Alpert, M., Silva, R.R., Pouget, E.R. (2003). Prediction of treatment response in geriatric depression from baseline folate level: interaction with an SSRI or a tricyclic antidepressant. Journal of Clinical Psychopharmacology, 23, 309–313.
Coppen, A. & Bailey, J. (2000). Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. Journal of Affective Disorders, 60, 121–130.
Freeman, M.P., Hibbeln, J.R., Wisner, K.L et al. (2006). Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. Journal of Clinical Psychiatry, 67, 1954-67.
Kendrick, T., Dunn, N., Robinson, et al. (2008). A longitudinal study of blood folate levels and depressive symptoms among young women in the Southampton Women’s Survey. Journal of Epidemiology & Community Health, 62, 966–972.
Nemets, B., Stahl, Z., & Belmaker, R.H. (2002). Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. American Journal of Psychiatry, 159, 477-79.
Papakostas, G.I., Petersen, T., Mischoulon, D. et al. (2004). Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 1: predictors of clinical response in fluoxetine-resistant depression. Journal of Clinical Psychiatry, 65, 1090–1095.
Su, K.P., Huang, S.Y., Chiu, C.C. et al. (2003). Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. European Neuropsychopharmacology, 13, 267-271.
Watanabe, H., Ishida, S., Konno, Y. et al. (2012). Impact of dietary folate intake on depressive symptoms in young women of reproductive age. Journal of Midwifery & Women’s Health, 57, 43–48.
Omega-3 foods, leafy greens, and stop obesity images courtey of Shutterstock.
About the Author
Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes’ most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation’s leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show.