Nutrition: a Mega Theme for Psychiatry of the Future
In several articles I have in the past pointed out in this blog the importance of nutritional factors for mental health. Now the International Society for Nutritional Psychiatry Research (ISNPR) has underscored this by conducting its first international congress, which is currently taking place in Bethesda, Maryland, USA (July 30 to August 2, 2017).
Internationally renowned experts show that nutrition is not simply a marginal factor among many that influences the development and course of mental illness. For example, Michael Crawford, director of the Institute of Brain Chemistry and Human Nutrition at Imperial College London, has shown in a plenary lecture, which was celebrated with standing ovations, that the supply of human beings with the omega-3 fatty acid docosahexaenoic acid (DHA), which has been crucial for the evolution of the human brain, has been declining for decades. He, as well as other plenary speakers, impressively demonstrated that the world’s changing dietary habits are a global social problem affecting the development of all humanity. Crawford noted the steady increase in the importance of mental disorders, expressed in WHO’s global burden of disease studies, and the associated exploding costs as the “most serious crisis for mankind”, even exceeding climate change. Alan Logan of the in-FLAME network, USA, criticized the fact that NASA’s budget was many times higher than that of the National Institute of Mental Health (NIMH). “Mars can wait”, when it comes to the mental health of man, he pointed out.
The president of the society, Felice Jacka from Deakin University of Australia, pointed out that hypertension and poor diet are the two biggest killers of man. The cost of poor nutrition in 2030 amounted to $ 30 trillion. Western diet is associated with higher rates of depression, while the Mediterranean diet is reducing this.
Susan Prescott, of the University of Western Australia, pointed out in her impressively illustrated plenary lecture that the change in diet observed in all Western societies (with a dramatic increase in processed food) over the decades led to a decrease in the diversity of bacterial strains in the human intestine (the so-called “microbiota”). [Microbiome is the totality of all bacterial genomes, microbiota is the totality of microorganisms]. We now know that brain and microbiome are closely related. Several of the speakers, including John Cryan, a world-renowned expert from the University College Cork in Ireland, postulated that the long-term change of the microbiome must lead to changes in the mental health of the Western world and with the spread of Western dietary habits throughout the world.
Several speakers also dealt with nutrition of pregnant women. Above all Marlene Freeman from Harvard University pointed out that the nutrition of a pregnant woman not only directly affects the development of the fetus but also – through epigenetic mechanisms – subsequent generations. In animals, it can be shown clearly that a reduced supply of pregnant women with omega-3 fatty acids leads to developmental disorders in the offspring. However, also in humans, malnourishment in pregnancy seems to be related to the occurrence of certain neurodevelopment disorders such as autism spectrum disorders or attention deficit hyperactivity disorder (ADHD). Felice Jacka also emphasized that the diet during pregnancy has an influence on the cognitive development of the offspring. For example, there are indications that the volume of the hippocampus is directly influenced by the diet. Susan Prescott, in turn, pointed out that infant feeding significantly affects the microbiome. A dramatic increase in allergies in children in recent decades is due at least in part to the changing diet of infants.
The list of the interesting findings presented in Bethesda, which often still have the status of hypotheses, could be continued at will. However, the influence of dietary factors on human mental health is now undisputed. They are above all of preventive importance, but also therapeutic approaches, e.g. with omega-3 fatty acids, are increasingly being tested. The problem here, however, is that industry is not interested in conducting such studies, which is why they are often too small to demonstrate the effectiveness of the intervention. Here, federal governments have to promote the testing of these approaches with sufficient resources.
I am convinced that the topic of nutrition is not yet adequately perceived by psychiatry, although it is one of the megathemes of a psychiatry of the future.