0:06

This is your favorite story of the day

0:09

here, isn't it? Priya, your food and your

0:11

mood. So I think, as I alluded to

0:13

at the start, I think we often

0:15

talk about the physical benefits of food

0:17

and we talk about it in terms

0:19

of heart disease risk and bowel cancer

0:21

risk, but what we eat can impact

0:23

our brain and our mood. And

0:25

in fact, there's research been published

0:27

in the Australian New Zealand Journal

0:29

of Psychiatry, which has found that

0:32

if people adhere to certain diets,

0:34

like if people adhere to certain

0:36

diets, and the dash diet, it

0:38

can actually help to treat depression.

0:40

And that's pretty amazing. Now this

0:42

isn't in the absence of psychological interventions

0:44

or other lifestyle interventions or medication, but

0:46

as a GP who does a lot

0:49

in this space, I find this quite

0:51

exciting, which is what else can we

0:53

prescribe patients that they can do at

0:56

home that may potentially benefit their mood?

0:58

So I asked Felice Jucker, who's distinguished

1:00

professor of nutritional psychiatry, founder and director

1:02

of the Food and Mode Center at

1:05

Deacon University, to find out more. And

1:07

we were joined by Dr. Tetiana Rox,

1:09

who's a dietician and lead of the

1:12

Food and Motor Academy. The Mediterranean

1:14

style diet is the diet that's

1:16

been studied the most, so that's

1:18

where most of the evidence is

1:20

of course, but we also know

1:22

that traditional diets around the world,

1:24

whether they're, you know, Brazilian or

1:26

Norwegian or Japanese, higher adherence to

1:28

those traditional dietary patterns are associated

1:30

with a dramatically reduced risk in

1:33

developing depression, about 35% and also

1:35

Mediterranean style diets have been used

1:37

to treat even very severe depression.

1:39

But when we say Mediterranean style,

1:41

It's not like you have to

1:43

adhere to a very particular diet.

1:45

It's more around whole foods, real

1:47

foods and avoiding the ultra-process foods.

1:50

You've said whole foods, ultra-process foods.

1:52

Can we just give people what

1:54

this actually looks like? So I

1:56

actually had an endocrinologist recently say

1:58

to me, they used... as

2:00

the example and said, you know, eating

2:02

corn off the cob is ideal and

2:05

then having, you know, some sort of

2:07

corn flake is actually ultra-processed. It's been

2:09

processed. So you're saying people should ideally

2:12

be reaching for that whole food. What's

2:14

the kind of key takeaway for people

2:16

there? So when you look at food

2:19

and the way they categorize ultra-process food,

2:21

this is really confusing for people and

2:23

I think we get hung up on

2:26

the details. It's meant to be something

2:28

that informs public health guidelines and

2:30

things, but essentially process foods is

2:32

fine, like process foods might be

2:34

like good quality bread, cheese, etc.

2:37

Canned corn, etc. and it's been

2:39

taken, it's been cooked, it's been

2:41

various aspects of it, have been

2:44

extracted, maybe extruded, it's had vitamins

2:46

and minerals, maybe added to it,

2:48

flavorings, colourings, emulsifiers, artificial sugars, whatever

2:50

it is, and people think that

2:53

because the label says, oh it's

2:55

low fat or it's low sugar

2:57

or something like that or it's

2:59

got vitamins or minerals or fibre

3:01

that it's okay, but actually our

3:04

emerging evidence suggests that the body...

3:06

the gut, the brain, interpret it

3:08

differently. And so how do people

3:10

implement that? Because you say Mediterranean

3:12

style of eating, and maybe this

3:14

is for you, Tatiana. What are

3:16

some practical tweaks that someone could

3:18

make today? to adhere to this style

3:20

of eating. So in general, we understand

3:23

that Mediterranean diet, it's all about joyful

3:25

consumption of various food. And that's what

3:27

we need to think about. We need

3:30

to think about what we can add

3:32

to our everyday eating. So one thing

3:34

we want people to remember that we're

3:37

not talking about restrictions. We need to

3:39

start with additions. So think about what

3:41

you might enjoy a little bit more

3:44

today. Do you like fruit? Fantastic. Eat

3:46

bit more fruit. You enjoy vegetables. Look,

3:48

we all like some vegetables. Eat

3:50

more of them and see how

3:53

you go, how it makes you

3:55

feel. Usually it feels pretty good

3:57

and that's what helps us on

3:59

our... road to build this motivation,

4:01

to build this self-efficacy, to continue

4:04

making changes. We see from research

4:06

that even small changes can bring

4:08

significant difference to how we feel.

4:10

So there's the brain benefit, you

4:12

know, the way we eat can

4:15

impact our mood, our brain, but

4:17

there's often the added benefit too,

4:19

isn't there, in terms of physical

4:21

stuff? Yeah of course and you

4:24

know the Royal Australian New Zealand

4:26

College of Psychiatry they were the

4:28

first pick body in the world

4:30

to release their updated clinical guidelines

4:32

for treating mood disorders and they

4:35

put what is essentially lifestyle medicine

4:37

as the foundation. diet, movement, sleep,

4:39

subsidisation, but they call it foundational.

4:41

And I think that that's the

4:44

key. If you get those foundations

4:46

right, then whether it's a physical

4:48

disease, whether it's an emotional problem,

4:50

everything is going to work better.

4:52

So how do we implement it?

4:55

Because this research has essentially looked

4:57

at dietary patterns, found that it

4:59

can potentially help mood symptoms in

5:01

depression. Is this in the absence

5:04

of medication psychological interventions or is

5:06

it alongside? So the Smiles trial

5:08

that we led which is the

5:10

first randomized control trial using diet

5:12

to treat moderate to severe major

5:15

depressive disorder like very often people

5:17

have been very sick for a

5:19

long time. But the people in

5:21

that trial were on largely other

5:24

medications, psychotherapy, these sorts of things.

5:26

So most of the evidence in

5:28

this area of nutritional psychiatry has

5:30

shown that it's definitely not an

5:32

either or. It's a plus. What

5:35

we did do too just recently

5:37

is publish the results of the

5:39

calm trial. Now this is very

5:41

important because what we did, this

5:44

is called a non-inferiority trial. So

5:46

we weren't seeing if one thing

5:48

was better than the other. but

5:50

we randomly assigned people with elevated

5:52

depressive symptoms to receive either group

5:55

therapy from dieticians exercise. physiologists in

5:57

lifestyle, you know, how to improve

5:59

these things. and the other group

6:01

got gold standard psychotherapy delivered by

6:04

clinical psychologists and we found that

6:06

both were equally effective. Wow. Which

6:08

is excellent because it just gives

6:10

us more avenues to support people

6:12

in treatment and it's also a

6:15

give people choice because look maybe

6:17

not everyone is ready, willing or

6:19

can change their diet right now

6:21

so we can review other ways

6:24

of improving the way we take

6:26

care of our body. So what

6:28

do we know then to Tiana

6:30

about the best way to implement

6:32

dietary pattern interventions for patients? As

6:35

I mentioned before we talk about...

6:37

adding stuff in, not removing stuff

6:39

out. We also talk about reducing

6:41

that decision fatigue, particularly for people

6:44

living, you know, under some kind

6:46

of mental health disorder or anything

6:48

else. Look, we all busy, so

6:50

why complicate life? So this is

6:52

why we ask practitioners to provide.

6:55

people with some kind of tools

6:57

or printout, something very basic and

6:59

simple, which shows that you don't

7:01

need 50 ingredient ragu every night,

7:04

you know, to bring the vegetables

7:06

in. There's a simple, you know,

7:08

frozen veggies, canned goods, pre-prepared meals.

7:10

There's enough option to help us

7:12

take care of our body. Felice,

7:15

this might be for you. Why

7:17

does what we eat impact mode

7:19

and brain? Well if you think

7:21

about diet, I mean food is

7:24

really the petrol that drives pretty

7:26

much every aspect of our functioning

7:28

in our body and brain. When

7:30

we eat it influences a whole

7:32

lot of pathways that also really

7:35

interact with our mental health. So

7:37

things like our immune system is

7:39

very very important and something called

7:41

inflammation. Now that's key that's definitely

7:44

involved in mental health. The way

7:46

our genes work and express themselves,

7:48

so epigenetics, our stress response system.

7:50

the mitochondria that live in our

7:52

cells, the way we produce neurotransmitters.

7:55

All of these things are influenced

7:57

by diet and in turn influence

7:59

our mental health. But the really

8:01

big one that we focus on

8:04

now is the human gut microbiome

8:06

because that actually affects all those

8:08

other things. So 70% of our

8:10

immune system is really in our

8:12

gut. And the gut microbes, their

8:15

main role is to digest the

8:17

bits of food that our human

8:19

enzymes can't digest. and that's primarily

8:21

complex carbohydrate fiber, different types of

8:24

fibers, but also things like polyphenols

8:26

you would have heard of. And

8:28

when they do that, they produce

8:30

thousands of molecules. And these molecules,

8:32

they influence the way our genes

8:35

express themselves. They very powerfully influence

8:37

our immune system. The level of

8:39

serotonin in the brain is influenced

8:41

by how the gut breaks down

8:44

tryptophan, for example. So the gut

8:46

is very, very quickly affected by

8:48

what we eat, and in turn,

8:50

it very quickly affects our physiology

8:52

from top to toe. It's so

8:55

fascinating, isn't it? How complex it

8:57

all is. What more do we

8:59

need to find out? Look, you

9:01

know, with science you can go

9:04

forever and you can dig very

9:06

deeply. What I'm very, very focused

9:08

on now is how planetary health

9:10

interacts with human health via the

9:12

microbes because the microbes in the

9:15

soil are a very important aspect

9:17

of nutrition in food. So when

9:19

you have microbole, really active soil,

9:21

you get vegetables and plants that

9:24

are much higher in nutrient density

9:26

and much higher in what is

9:28

known as nutritional dark matter. So

9:30

these are the phytochemicals. Now we

9:33

know about 8,000 of them, this

9:35

is like the polyphenols, flavonoles, people

9:37

know them as antioxidants. Okay. But

9:39

there may be as many as

9:41

150,000 of these and we don't

9:44

know what they do, how they

9:46

interact with receptors in our body,

9:48

and then you've got of course

9:50

macromicrobial nutrients all together. the complex

9:53

package of a food matrix and

9:55

this is why you don't want

9:57

ultra-process foods because they don't have

9:59

any of that complexity but I

10:01

do want to just say one

10:04

thing so we don't run out

10:06

of time. If you look at

10:08

all the observational evidence around the

10:10

world, so that's not experiments, it's

10:13

just looking at what people eat,

10:15

taking into account things like their

10:17

socio-economic circumstances and all sorts of

10:19

other things, and look at the

10:21

risk for depression, we see that

10:24

it's reduced in people who have...

10:26

better quality diets with more whole

10:28

foods and less of those ultra-process

10:30

foods. This is completely independent of

10:33

body weight. And this is the

10:35

big issue around food for the

10:37

last 20 or so years is

10:39

that all focuses on obesity as

10:41

if body weight equals health and

10:44

it's the only thing that matters.

10:46

Now this is actually not true.

10:48

We need to stop thinking about

10:50

the way people look and focus

10:53

much more on how we nurture

10:55

ourselves, how we feed our body,

10:57

our brain, our gut, to be

10:59

happy and healthy and have a

11:01

wonderful relationship with beautiful real local

11:04

food. That was Felice Jaka who

11:06

is a distinguished professor of nutritional

11:08

psychiatry and founder and director of

11:10

the Food and Mode Centre and

11:13

Dr Tetiana Rocks who's the lead

11:15

of the Photomode Academy.