How Your Gut Health Affects Your Mental Health
It might be fair to say that we all would rather boost & keep our mood regulated - naturally - much more than we’d like to take medication. We want to feel our best! But oh, do we sometimes end up so far off track without realizing it. In this blog post, I’m going to share a lot of information for you to help highlight the ways that what we eat and what we are exposed to affect our mental health. Anxiety, depression, and other mental health disorders can often be completely reversed simply by changing our diet! Beware, this is a long one :-)
Let’s take a deep dive together.
Remember, I’m not a doctor, but I’m always stoked to share the information I learn and research in Functional Health. Take it or leave it! This isn’t my medical advice to you. If any of the below strikes you with inspiration, hop all in! If you want support in implementing any of these diet and lifestyle changes, I’m available for a free introductory call with you to see if Health Coaching is a right fit for you.
The Underlying Cause of Anxiety, Depression, and Mental Health Disorders - from a Functional Medicine Perspective: Inflammation
These issues are almost always primarily caused by inflammation
Potential causes of high inflammation include gut pathology/inflammation, diet, sleep deprivation, not enough exercise, too much exercise, and environmental toxins
When considering eliminating inflammation with regard to our diet, you’d basically just cut the “junk” food!
Excess sugar, caffeine (be sure to ween off, as stopping can cause withdrawal symptoms) and omega-6 fatty acids (industrial seed oils common in restaurants and packaged foods)
Avoid refined cereal grains, bread, flour, grain-based desserts, beer
Note: Gluten intolerance is exacerbated with pesticides sprayed on industrially grown grains (contributes to intestinal permeability)
Chemicals and preservatives found in highly processed and refined foods such as artificial flavors, colorings, etc., have been linked to behavioral problems and hyperactivity in children. They may also cause food allergy and sensitivity reactions that affect brain function.
Minimize or completely avoid these ingredients and stick to whole foods with little to no additives
Cook from scratch as much as possible for more control over what you eat
Environmental considerations with inflammation - avoid toxins!
Pathogens like mold or bacteria, heavy metals, and chemicals in cleaning and cosmetic products expose us to toxins that disrupt our cognitive function
Switch to natural cleaners and toxin-free cosmetics
Check your home for mold if mold exposure is suspected
Consider installing a high-quality air filter to reduce airborne toxins and pathogens
Gut Microbiome & the Brain
Chemicals, like cortisol, that bacteria produce in the gut have a significant impact on mood and brain function
Research on gut bacteria of animals and humans exposed to various stressors early in life show changes in brain function later in life
There are significant differences seen in the gut microbiome of patients with major depression compared to healthy controls
Consuming probiotics found in foods and also supplements can:
Reduce anxiety by lowering cortisol and decreasing stress response
Improve emotional and cognitive response and improve mental well-being
Disruptions in the gut microbiome and intestinal permeability lead to systemic inflammation, which we know is associated with mental health disorders including depression and anxiety
Endotoxins such as lipopolysaccharide provoke the release of inflammatory cytokines
Depression – the inflammatory cytokine model
Gut pathology via gut–brain connection stimulates production of inflammatory cytokines in the gut, resulting in systemic low-grade chronic inflammation
The cytokines travel through the bloodstream up to the brain, cross the blood–brain barrier, and suppress the frontal cortex, leading to major depressive disorder
SSRIs, the major class of antidepressant drugs, have been shown to have an anti-inflammatory effect, which may be how they help *when/if* they are effective
SIBO – is also associated with depression, anxiety, and mood disorders
50% to 85% of irritable bowel syndrome (IBS) may be caused by SIBO
Disrupted gut microbiome causes/contributes to irritable bowel syndrome (IBS)
Can be an imbalance of good/bad microbes/pathogens or a pathological change in the function of the gut
Celiac disease and non-celiac gluten sensitivity
Associated with a variety of neurological and psychiatric complications
22% of patients with celiac disease develop cognitive dysfunction
57% of people with neurological dysfunction of unknown origin test positive for anti-gliadin antibodies
Neurological conditions associated with gluten sensitivity include seizure disorder, neuropathy, ADD, ADHD, autism, ataxia, anxiety, depression, and schizophrenia
Testing:
Standard testing with anti-gliadin antibodies alone is not accurate, likely resulting in an underdiagnosis of celiac/non-celiac gluten sensitivity
Recommend that you work with your practitioner for proper gluten sensitivity testing with Cyrex Array 3 – especially if you have neurological dysfunction
After testing: recommend that you do a 60-day complete gluten elimination
Malnutrition contributes to anxiety, depression, and cognitive disorders:
Inadequate macronutrients ratios (your protein, fat, and carbohydrates) is common in today’s world. We “just eat” without much regard to a good balance of these. And further, with our soil’s depletion of nutrients through over-agriculture and time, we aren’t getting the micronutrients we need either (more on micronutrients further on in this post).
Protein:
Too little or excess protein intake can exacerbate mood disorders because neurotransmitters are created from amino acids provided by protein in the diet
Make sure your diet contains all of the essential amino acids
Ideal protein intake: between 0.5 and 1 grams per pound of body weight or 1 to 2 g/kg of body weight per day
We don’t need to adjust protein as much as carbohydrates, and we’ll generally crave more if our brain needs more. Our brain has mechanisms for regulating protein consumption.
In general, aim for 10-30% of your daily calories coming from protein.
Don’t go above 35% of a day’s calories in protein because the body has a limited ability to metabolize protein. Once you’ve resolved the issue that puts you at 30-35% protein it’s suggested going back to a general health range.
Insufficient or excess micronutrients
One of the most common issues is excess intake of methionine, an amino acid that is found in muscle meats and eggs, which can lead to imbalance in the methionine-to-glycine ratio (excess methionine and insufficient glycine) = this leads to neurological symptoms. (Check out my other post that dives more deeply into amino acids and protein here)
The basic recommendation is to increase intake of glycine found in bones, joints, tendons, bone broth, cuts of meat such as chuck roast, brisket, oxtail, or shanks that have more collagen in them to protect against neurological conditions and improve brain function
May also help with sleep and anxiety by having better production of serotonin and melatonin
Carbohydrate intake:
Personalize carbohydrate intake based on your health, physical activity, and experience with high- and low-carbohydrate diets
Most people do well on a moderate carb intake. 15-30 percent of total calories in a single day coming from mainly starchy vegetables, tubers, and fruits… 200 grams for a 2600 calorie diet and 75-100 grams for a 2000 calorie diet
Higher carbs: Athletes, breastfeeding women, and children
Lower carb: elderly, sedentary people, insulin resistant/blood sugar issues, Alzheimer’s, or dementia
Initially, a low-carb diet can contribute to cognitive deficits (low mood and brain fog) as the body adjusts to using fat for fuel
This may not persist
If symptoms continue or worsen after a week or two = red flag, and add more carbs back in
Exercise caution in considering a long-term, very-low-carbohydrate diet
Especially in women and with any presence of HPA axis dysfunction (adrenal fatigue)
Carbohydrates have a big impact on sleep nutrition and mental health:
Based on clinical experience, both low-fat and low-carbohydrate diets seem to increase the likelihood of insomnia.
Carbohydrates help increase the production of serotonin and melatonin (both of which help you fall asleep). If you eat a low-carb diet, and struggle with falling asleep at night, try eating a few more carbohydrates, particularly with dinner. Even if you already eat a moderate carbohydrate diet, you can still adjust your carbs so that most are eaten later in the day.
Dietary fat and cholesterol - The human brain is made up of at least 60 percent fat, mostly saturated fat and cholesterol
Your total caloric fat intake will be the remaining percentage after determining your carbohydrate and protein intake needs.
Cholesterol is a component of the myelin sheath, the insulation around the neurons in the brain
Inadequate or excess cholesterol can cause neurological impairments
Recommend mixed fat intake
Monounsaturated fats increase the neurotransmitter acetylcholine and blood flow to the brain
Choline improves memory and protects against cognitive decline (found in cholesterol-rich foods such as eggs and liver)
Medium-chain triglyceride and beta-hydroxybutyrate can improve cognitive function in older adults with memory disorders such as Alzheimer’s (found in coconut oil and butter)
Goal: Balance of essential omega-3 and omega-6 fats
Long-chain omega-3 fat DHA is particularly important
Vegetarians have 30% lower EPA and DHA levels
Vegans have 50% to 60% lower EPA and DHA levels
Micronutrients of Concern in Mental Health
B12 deficiency
In a typical lab reference range for B12 when you get panels drawn, the lower end is actually too low - Research suggests deficiency symptoms can begin as low as 450 pg/mL
B12 malabsorption is typically caused by: gut dysbiosis, leaky gut, inflammation, pernicious anemia, alcohol intake, medications, hypochlorhydria (which is low stomach acid), celiac disease, inflammatory bowel disease, and particularly Crohn’s (involves inflammation of the terminal ileum where B12 is absorbed)
Deficiency is common even in those consuming meat - Vegetarians (68% more) and vegans (83% more) are at much higher risk
Folate deficiency
Decreases serotonin synthesis, s-adenosylmethionine (SAM), and increases inflammatory homocysteine
Associated with depression, epilepsy, psychiatric conditions (especially in the elderly)
Possible link between folate and homocysteine levels and aging, dementia, and Alzheimer’s disease
B6 deficiency
B6 is required to make serotonin, a crucial neurotransmitter that regulates mood and mental health. B6 deficiency is less common in a well-rounded diet
Consider this especially if anxiety, mental health, and depression are an issue for you. Symptoms of B6 deficiency includes poor stress control, nervousness, anxiety, and mood swings
Zinc and copper
Ideal ratio of serum copper to zinc is 0.7 to 1
Both function as neurotransmitters in the brain
Excessive copper and deficiency of zinc can cause: hyperactivity, ADD and ADHD, behavioral disorders, depression, autism, panic disorders, and paranoid schizophrenia.
Vegetarians diets:
Often have high copper intake and low zinc intake
Might have adequate intake but inadequate absorption because vegetarian diets reduce zinc absorption by 35%
Inflammation:
Copper is an acute-phase reactant and will be elevated in an inflammatory response (such as if you’re highly stressed)
Oxidative stress and inflammation can reduce zinc levels and increase copper levels
Vitamin D
This is actually a hormone which is vitamin-like and it activates genes that release neurotransmitters such as dopamine and serotonin
Vitamin D receptors are located in regions of the brain linked with depression and deficiency is associated with depression, other mood-affective disorders and schizophrenia
Vitamin D supplementation has been shown to be more effective than light therapy in treating seasonal depression
Magnesium
Most commonly deficient nutrient in modern diet due to soil depletion and removal from drinking water
Stress and excess caffeine increases magnesium wasting
Excess calcium can interfere with magnesium absorption
Can aid anxiety, depression, irritability, restlessness, headaches, etc.
Protects against excess excitatory neurotransmitters
Suppresses the stimulation of cortisol by the HPA axis
This prevents stress hormones from crossing the blood–brain barrier into the brain
Magnesium is therefore helpful with regard to mitigating adrenal fatigue
Iron: Deficiency and overload can cause problems
Iron overload
Accelerates mitochondrial decay ➜ impairs mitochondrial function = major source of cognitive and mood problems
Iron is a catalyst for oxidative damage and increases oxidative stress in brain cells that can cause cognitive/neurological problems and neurodegeneration.
Iron deficiency
Common concern, particularly in menstruating females
Iron is crucial for oxygen delivery which is required by the brain
Low iron leads to compromised oxygen delivery to the brain, contributing to mood and cognitive disorders
So what can you do to help balance your gut and therefore any mental health challenges and disorders?
Here are some tips on therapeutic diets. Let me know how this lands for you/if you have questions!
Eat a balanced Paleo diet – this is a great starting place & usually a great option for ongoing maintenance after doing a short-term, more intense diet change.
Eating Paleo helps because it’s naturally anti-inflammatory – it removes many foods that can provoke gut permeability, such as gluten, dairy, and grains
Moderate protein: 15% to 25% of daily caloric intake
Moderate carbohydrate: 20% to 40% of daily caloric intake
Determine protein and carb needs FIRST and get rest of your calories from fat
Healthy fats: 35% to 65% of daily caloric intake
HIGH VARIETY of plant and animal foods
Dairy: avoid it initially and reintroduce as tolerated, pasture raised, full-fat, and fermented
Eliminates industrial seed oils from processed foods and emphasizes a “whole foods” diet approach
Consume probiotic-rich fermented foods like yogurt, kefir, sauerkraut, kimchi, etc., for increased beneficial gut flora/promoted good gut bacteria.
Eat a wide variety of prebiotic, fiber-rich foods like fruits, vegetables, and starchy tubers to feed your beneficial flora
Work with your practitioner to treat any existing gut infections
If you have significant gut issues, then interventions such as the low-FODMAP diet, GAPS, or specific carbohydrate diet can be helpful, at least in the short term, to get those under control
Low-FODMAP diet: as tolerated, and not for extended duration
This diet emphasizes fermentable fiber/prebiotics that stimulate the growth of beneficial bacteria. Examples: onions, Jerusalem artichokes, legumes or lentils, fruits and non-starchy vegetables and starchy plants
Consider especially if you have IBS
Involves elimination of high-FODMAP foods that can reduce overgrowth of pathogenic bacteria in the small intestine.
Note: No evidence that a low-FODMAP diet will successfully treat OR cure SIBO or other gut infections without an antimicrobial treatment, either botanical or pharmaceutical
A few studies show that a long-term low-FODMAP diet, where all of these FODMAPs are removed, leads to undesirable changes in the beneficial bacteria in the colon
Likely because many FODMAPs feed the beneficial bacteria
Ultimately it is recommended that you reintroduce as many FODMAP foods as you possibly can to support the beneficial gut bacteria
Also try other non-FODMAP fermentable fibers such as soluble fiber to feed the bacteria; most people are not universally sensitive to all of the FODMAPs – might be more or less sensitive to a couple of categories (such as fructans: garlic and onions) but not as much to some of the other FODMAP foods
GAPS or specific carbohydrate diet:
High-fat, high-glycine, and low-specific-carbohydrate diet
“Specific” because it is low in complex sugars – permits monosaccharides, simple sugars
Prohibits disaccharides and polysaccharides – more complex carbohydrates
Removes many potential food allergens and fermentable carbohydrates because they are the longer-chain polysaccharides
Can help clients with: gut dysbiosis, intestinal permeability, and reduce gut–brain symptoms. Benefits have been seen in children with autism spectrum and other mental/behavioral disorders (ADHD)
Important notes: Worth a try in autistic children or ADHD and in adults with this kind of constellation of symptoms, but it *can* worsen your condition
Not unusual to have an initial period of getting worse, but if it just continues to get worse, discontinue this strategy
Additionally, NOT recommended to remove all the longer-chain carbohydrates long term as they feed the beneficial bacteria in the gut
Ketogenic diet
Can improve energy metabolism in the brain and reduce inflammation in the microglia
Can be beneficial for clients with:
Cognitive neurological disorders: Alzheimer’s, Parkinson’s, dementia
Mood disorders: such as depression, brain tumors, traumatic brain injury, seizure disorders
Severe blood sugar disorders
Important note:
Ketogenic diet is not necessarily preventative (no data showing prevention in those with a family history of these conditions)
Very-low-carbohydrate diet can worsen certain neurological conditions
This is a restrictive diet that can trigger disordered eating
Preliminary anecdotal data from the American Gut Project indicating individuals on very-low-carb diets have different gut microbiota possibly associated with adverse health impacts
Recall: many foods that feed the beneficial bacteria are carbohydrates
Consider other options where low carb is not necessary to produce ketosis
Adding MCT oil in fairly large quantities
100 g of carbohydrates (which is low) + low-protein intake + large amounts of MCT oil/coconut oil and ketogenic amino acids such as leucine
So what do you think of all this? Please, share your thoughts in the comments below!
Resources for this post include the exhaustive Functional Health content from the Kresser Institute ADAPT Certified Health Coaching Program, The Paleo Cure by Chris Kresser, and this Neurobiology of Disease article.