Mental illness including depression, anxiety, and bipolar disorder are a significant driver of global disability and a substantial social, economic and heath burden. Treatment including pharmacotherapy such as antidepressants and psychotherapy such as Cognitive Behavioural Therapy avert less than half of the disease burden. Novel strategies are needed to prevent and treat mental disorders.
There are now consistent mechanistic, observational and interventional data to suggest diet quality and the microbiome may be a modifiable risk factor for mental illness. This presentation aims to overview of the nutritional psychiatry field. It includes a discussion of the neurobiological mechanisms such as inflammation likely modulated by diet, and focusses on the use of dietary, microbiome and nutraceutical interventions in mental disorders.
Potential biological pathways influenced by diet and potentially related to mental disorders include inflammation, oxidative stress, the gut microbiome, epigenetic modifications and neuroplasticity. Epidemiological data, particularly in depression, suggests an association between diet quality and mental health, across multiple populations and age groups; these do not appear to be explained by reverse causality or other demographic or lifestyle factors. Our treatment trial provides now replicated clinical evidence that dietary interventions in clinically diagnosed populations are feasible and can provide significant clinical benefit. Nutraceutical approaches including omega-3 fatty acids, folate, S-adenosylmethionine, N-acetyl cysteine and probiotics, amongst others, are promising. Intervention studies in large cohorts and other disorders like schizophrenia, bipolar and anxiety disorders are a key next step.