The Social Determinants of Mental Health
Mental health is the combination of complexities between your genes and your environment. As a field and to better help individuals we work with, it is integral to evaluate the role that non genetic social and environmental factors play in contributing to poor mental health and in causing and worsening mental illnesses.
The biopsychosocial model has served as a structure, primarily for clinicians to help them formulate a course and treatment plan for individual patients. The model essentially recognizes the interplay and interactions between biological, psychological, and social factors and how these factors contribute and influence the onset and course of mental (and physical) illnesses. The role of each of these factors is incredibly significant. Let’s take a look at the social determinants of mental health and why this is important and so influential.
What are Social Determinants of Mental Health?
The World Health Organization (WHO) defines the social determinants of health as the conditions in which people “are born, grow, live, work, and age and the wider set of forces and systems shaping the conditions of daily life.”
Michael T. Compton, M.D., M.P.H., and Ruth S. Shim, M.D., M.P.H in their book The Social Determinants of Mental Health write that the major social determinants of mental health are effectively the same as for physical health and that the “ “core” social determinants of mental health are: racial discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; poverty, income inequality, and neighborhood deprivation; poor access to sufficient healthy food; poor housing quality and housing instability; adverse features of the built environment; and poor access to health care.” They further state, “there are other social determinants of mental health that could be articulated, including inadequate or unequal access to transportation, exposure to violence, conflict, and war in childhood or adulthood, mass incarceration and poor relations between law enforcement and communities, environmental air, water, or land pollution, climate change, sexism and other forms of non–race-based discrimination; and adverse or unsupportive features of the workplace.”
These determinants suggest that mental health is deeply influenced by policies made at the government level and affecting change within these systems require change through policy and programs, as well as, collective and individual decisions within society.
This is an incredibly layered and complex topic. I want to highlight and emphasize the reason for this post which is that I think these factors are not as discussed as much as they should be in the context of mental health. We are living in a time when the responsibility of taking care of ourselves is being solely put on the individual. That if we have poor health and poor mental health, we aren’t taking the time to take care of ourselves. Indeed, this misses the greater environmental and social context in which we all live and are affected by both consciously and unconsciously. In order to have a real conversation about what we can do to take care of our mental health as individuals, we have to consider these factors and the roles they play in our individual and collective lives.
Why this is important for our Mental Health
These social determinants predispose individuals and populations to poor health outcomes. For example, at the individual level, being affected by one or more social determinants can lead to “poor” choices. If you don’t make enough money to be able to purchase enough grocery items at the store for your family, one of the only other options you may have is access to fast food restaurants due to it’s affordability. This decision and other decisions that may negatively affect mental health, could occur simply because of a lack of healthy and affordable options, which in turn leads to known risk factors (e.g., poor diet, substance misuse) for poor physical and mental health. On top of which, exposure to adverse social conditions like inadequate housing or unemployment, leads to stress and known psychological and physiological stress responses that biologically create more vulnerability like increased HPA-axis activation (stress) and inflammation, both of which increase the risk of mental illness.
In this context, there are limited options for people to engage with with regards to taking care of their mental health. These are systemic issues that lead to poor mental health outcomes and to advise people on an individual level to modify their diet or to practice pop psychology “self care” by taking bubble baths and meditating when they are faced with such circumstances that dramatically affect their mental health, is unhelpful at best and offensive at worst. For example, to recommend someone to purchase organic “non-processed” foods when they work 50 hours a week to afford rent, have a sick family member to take care of, and have children of their own, is again, both dangerous and oblivious to the larger context that affects us as individuals.
In order to actually take care of our mental health, we need to have our basic needs met. We also need our stress levels to be manageable. Living in a pandemic has made that incredibly difficult for most people. We also need public health recommendations that make sense, are accurate and rooted in scientific practice and literature, and we need change at a societal and individual level.
What can you do?
Are there any lifestyle and behavioral factors that are in your control even if it is very little? Are you able to move your body for 15 minutes a couple of times a week? Are you able to connect to some kind of social support system? Do you have access to processed foods? Because processed foods are great. I’m sure you never read that in an article discussing mental health and nutrition, but it’s true. Packaged foods like oatmeal, oats, lentils, wholegrain pasta, canned vegetables and fruits, canned beans, canned seafood, frozen fruit and vegetables, pasta sauce, ready to heat microwaved rice, spices, are all excellent options that help support your mental health.
Practice real self care by taking care of your personal hygiene as best as you can. Are you able to get some help from a friend, neighbor, or family member to help make you a meal or give you an hour to rest? Budget your money and time. Try and prioritize your sleep. Do what you can when you can. And know that you are doing the best you are able to for you and your family. There are greater changes that need to be made at the societal level in order for public mental health outcomes to change at a large scale. You can’t eat your way our of depression and anxiety with the best Mediterranean style diet when you are living with the constant stress of being able to pay your bills, living with a partner who has chronic mental illness, or are experiencing racial discrimination and sexual harassment in the workplace. If the only thing you can afford to eat right now is McDonalds twice a week because it ensures that you are able to eat enough calories, please do it. Anyone shaming you for making those choices is ignorant to your life context and is speaking from a place of privilege which they likely are unaware of.
References
https://focus.psychiatryonline.org/doi/pdf/10.1176/appi.focus.20150017#:~:text=the%20main%20%E2%80%9Ccore%E2%80%9D%20social%20determinants,healthy%20food%3B%20poor%20housing%20quality
https://www.paho.org/en/topics/social-determinants-health
Inflammation: What the current research says about it's role in mental health
Inflammation is defined as the immune system’s response to contact with harmful stimuli including physical injury and pathogens, and involves the amazing communication of immune cells and blood vessels. Inflammation is necessary in order for us to survive and is not a harmful process unless it becomes chronic.
Chronic inflammation can be caused by a variety of things including chronic infections, unrepaired tissue damage, allergens, or indigestible foreign particles. Chronic inflammation contributes to many chronic inflammatory diseases including diabetes, cardiovascular, bowel diseases, and more recently, brain and mental health disorders. It can also be caused by medical conditions, exposure to chemicals or pathogens, as well as lifestyle behaviors including a sedentary lifestyle, poor dietary patterns, and alcohol intake.
Recently, inflammation is thought to be one of the major mechanisms that influence the diet mental health relationship, with several studies concluding strong associations between inflammatory biomarkers (health markers that can be measured in a lab that indicates inflammation in the body) and specific mental health disorders including depression and schizophrenia. But these findings are not always consistent. This article will review the current literature to date elucidating the relationship between inflammation and depression as well as highlight some important nuance and context to help us understand this relationship.
How Inflammation is Measured
Specific molecules called cytokines are classified as type of “biomarker” which can be measured in blood tests that show alterations in the body or tissue fluids. There are both pro-inflammatory cytokines that promote inflammation as well as anti-inflammatory cytokines which help inhibit or stop inflammation. These pro-inflammatory cytokines are used in clinical applications to indicate normal and abnormal biological processes, as well as to properly assess a person’s responses to therapeutic interventions. This helps researchers and clinicians decide if an intervention helped to lower or promote inflammation in the body. Some common pro-inflammatory cytokines used in research include IL-6, CR-P and TNF alpha.
Diet and Inflammation: Current Research
The majority of the current research related to diet and inflammation mostly comes from observational and epidemiological research studies. These kind of studies allow us to see if one factor correlates or has a relationship with another. It is difficult to determine if one nutrient or food itself is inflammatory or anti-inflammatory for multiple reasons. One is simply because of how we eat. We do not eat foods or nutrients in isolation (i.e. only eating avocados every day). We need to eat a variety of foods which themselves include a variety of nutrients (vitamins and minerals). The other is that there is a lot of inter individual differences with regards to how people respond to certain foods. For me, tomatoes and peppers don’t cause any sort of digestive distress, but for others, tomatoes and peppers may cause them a lot of digestive issues, which may indeed affect peripheral measures of inflammation. In this way, labeling a food as “anti inflammatory” or “inflammatory” is futile. Beyond these reasons, one food or nutrient is not “inflammatory” or anti inflammatory” on it’s own. What is more constructive and practical with regards to attempting to make determinations for the public and nutrition recommendations, is looking at overall dietary patterns to assess if that alone affects inflammation. Broadly speaking, dietary factors that have been associated with decreased levels of inflammation are fiber, antioxidants, omega-3 fatty acids and fermented foods, as compared to other nutrients like saturated fat and sodium which have been associated with increased levels of inflammation.
Some of the best research we have on humans is from large epidemiological research studies like the Nurses Health Study. The Nurses Health Study is one of the longest and largest investigations into risk factors for chronic disease in women. One analysis from this long term study includes a more recent look at diet and inflammation in over 40,000 women who were clinically depressed at the start of the study. The purpose of the analysis was to see if consuming a kind of dietary pattern associated with higher levels of inflammatory markers increased the future risk of depression. The participants were followed up for 12 years and during that time there were over 9,000 incident cases of depression. The authors report that an inflammatory dietary pattern was associated with a higher risk of developing depression. Here’s what we can take away from this analysis in particular: there is an association in middle aged women between consuming an inflammatory dietary pattern and developing depression over a period of 12 years. A more obvious limitation with regards to generalizing these results to a broader population is the limited demographic of the population in this analysis as it was mostly Caucasian women working in healthcare age 55-77. More studies like these in more diverse and varied populations would help clarify if these associations occur in most people. This would help benefit more people across the world with the goal of really helping improve public health.
The Mediterranean Diet
I’m sure at this point you have heard and read about the Mediterranean Diet. Full of vegetables, fruits, whole grains, nuts, seeds, legumes, olive oil, seafood and limited dairy and lean meats, this diet has been studied extensively for it’s various health benefits including for brain health.
A recent review looking at over 60 observational studies reports that adherence to a Mediterranean and “anti-inflammatory diet” (as measured by dietary indices such as the Empirical Dietary Inflammatory Index as well as measurements of biomarkers such as C-Reactive Protein) is associated with lower levels of inflammation. The majority of analyses in the review report a positive association between a healthier diet and lower pro-inflammatory marker CRP, indicating less inflammation. These results again means that there seems to be an association between closer adherence to a Mediterranean diet in an adult population and lower levels of a pro-inflammatory cytokine (CRP). One of the limitations in this review and among all of the studies included was that only one inflammatory biomarker (CRP) was assessed and at only one time-point. Future research needs to focus on examining multiple inflammatory markers in order to better understand these complex biological inflammatory mechanisms and how diet influences this. Also, the studies included in the review were mostly cross-sectional, which only allows us to say that there is an association between diet and inflammation, not that diet necessarily causes inflammatory markers to increase. Additionally, there are many different disease states and variables that influence inflammation and hence, measures of inflammatory markers and mediators in the blood. These factors (like chronic medical diseases including Type 2 diabetes and rheumatoid arthritis) were not controlled for in the data analysis. This is important because trying to control for these variables will allow us to better understand the relationship between inflammation and diet alone. Future research needs to focus on longitudinal methods as well as methodological designs that get us closer to seeing if diet alone is enough to cause and maintain chronic inflammation in particular.
Recent Research on Inflammation and Depression
One recent hypothesis is that diet mediates chronic inflammation and that poor diet in some people, may lead to both inflammation as well as contribute to the development of depression. Meaning, that diet directly influences chronic inflammation.
Interestingly, there is some newer research that suggests that certain depressive symptoms may be associated with specific inflammatory biomarkers. For example, one review reports that there is an association between the neurovegetative symptoms of depression and inflammation, such as fatigue, disturbed appetite, sleep problems (specifically hypersomnia), and depressed mood. This review is also interesting because it analyzed data from a very large sample of people. The data was retrospectively analyzed with over100,000 individuals from the UK Biobank and NESDA cohort. The researchers report that CRP and IL-6 levels (two inflammatory cytokines) were associated with specific symptoms of depression including fatigue, sleeping problems, changes in appetite, and depressed mood. This study adds new information to the existing literature and if this is found repeatedly in depressive populations, this may be able to help clinicians tailor treatment based on these assessments. But I think these results need to be interpreted with caution as there is a ton of difficulty involved in helping to determine if certain subtypes of depression are related to inflammation status. There are also some limitations to consider as well in that although this study used elevated CRP as the criteria, a one time measurement of CRP may not be sufficient to identify patients with persistent inflammation.
A recent study from 2020 assessed and measured absolute numbers of 14 immune cell subsets from peripheral blood samples in 206 participants with depression and 77 healthy controls (as defined by not having any history of MDD or other psychiatric illness). Researchers tested the hypothesis that a subgroup of depressed cases would have peripheral inflammation using what’s called a top down analysis, dividing the cases into 2 subgroups based on their immune cell profiles. They then tested for significant differences between the groups in terms of inflammatory proteins and clinical variables. In terms of the characteristics of the participants in the MDD group: 114 had moderate to severe depressive symptoms, of whom 61% were taking an antidepressant medication, 50 with mild depressive symptoms of whom 90% were currently taking medication and 42 with minimal depressive symptoms of whom 100% were currently taking medication.
Results showed that CRP and IL-6 concentrations as well as absolute counts of neutrophils, intermediate monocytes, and CD4+ T cells (various immune cells) were significantly increased in the depressed group. They further defined 4 different subggroups within the MDD patients: an uninflamed group which had low levels of immune cells measured, and 3 other subgroups with elevated levels of different immune cells. The subgroup of cases with increased immune cell counts also had significantly increased inflammatory protein concentrations compared with the second subgroup with decreased immune cell counts. The researchers called this group the inflamed depression group. Cases of inflamed depression had significantly higher severity of observer related depressive symptoms as measured on the Ham-D and self reported depressive symptoms from the BDI, compared with the uninflamed depression cases. Inflamed vs. uninflamed cases had twice the rate of unemployment, were slightly older, and were more likely to be smokers. They still did not differ significantly on other variables like sex, current antidepressant use, alcohol use, and BMI.
Some limitations to consider are the methodological design in that case control designs are vulnerable to the effects of uncontrolled confounding variables, and there are many factors that could have effects on peripheral immune biomarkers. But these results are interesting and help us understand that not all cases of MDD are necessarily driven or are associated with increased levels of inflammation.
Another study published earlier this year that included older adults with late life depression MDD, sought to disassociate the links among depression, medical illness, and inflammation by carefully screening out patients with known inflammatory-associated illness. This approach allowed the researchers to determine, in the absence of known comorbid illness, whether depression was associated with higher rates of inflammation when compared to healthy adults without a diagnosis of MDD. They found that there were very low levels of circulating cytokines and inflammatory mediators in individuals with MDD and in healthy controls, when study participants in both groups were carefully screened to exclude medical causes of inflammation. The researchers report that there was no observable difference in inflammatory markers between patients with MDD and controls, which included levels of 29 different circulating cytokines and chemokines. The authors also note that a large number of patients had to be excluded which highlights the high rates of physical illness in most patients with MDD. In fact, one review estimates that the prevalence of MDD in those with chronic medical diseases is at least twice as high and often more than four times higher than the prevalence in the general population. This is extremely important as other medical conditions that are inflammatory driven (like IBS and rhemutoid arthritis) significantly increase the risk for depression and also will affect the number of plasma inflammatory proteins.
These two recent studies in tandem tell us that inflammation is not necessarily a central component when it comes to the pathophysiology of depression, but that it may be for some individuals. It provides further support that depression is a heterogenous disorder in that there is a lot of variability with regards to how depression develops, it’s time course, as well as ways in which people respond to treatments. Hopefully more research can done to replicate the findings that there may be subgroups of patients with depression where inflammation may be the primary driver. In this way, treatment potentially can be tailored to focus on ways to help lowers these levels of inflammation.
Takeaways
While most of the research on diet and inflammation in humans are from correlational studies, there is growing evidence that dietary patterns influence inflammation. More research needs to be done with more diverse populations as well as with more diverse dietary patterns to help understand the complexity of this relationship and what to relay to the public. Indeed the Mediterranean diet isn’t the only dietary pattern that helps to support our mental health. It’s just that is has been the dietary pattern that has been most studied thus far and therefore has been recommended to promote health more than other dietary patterns.
Food is more than just nutrients, it’s pleasurable, comforting, social, cultural, and emotional. The most consistent finding shown thus far is that it is your dietary pattern that is what seems to matter most when it comes to diet and overall health. Which means it’s not about finding magic brain healthy nutrients, it’s about eating a spectrum of food that both satisfies the soul as well as nourishes our brain. Sticking with sustainable basics like increasing your fruits, vegetables, fiber, and water intake, ensures you are feeding and supporting your mental health as best as you can. And remember, inflammation has not been shown to be a central component when it comes to the pathophysiology of complex mental health disorders, which means you do not need to be obsessive about focusing on lowering inflammation if you have a mental illness. It’s a lot more complicated than that :)
References
Colditz, G. A., Manson, J. E., & Hankinson, S. E. (1997). The Nurses' Health Study: 20-year contribution to the understanding of health among women. Journal of women's health, 6(1), 49–62. https://doi.org/10.1089/jwh.1997.6.49
Hart, M.J., Torres, S.J., McNaughton, S.A. et al. Dietary patterns and associations with biomarkers of inflammation in adults: a systematic review of observational studies. Nutr J 20, 24 (2021). https://doi.org/10.1186/s12937-021-00674-9
Melo, H. M., Santos, L. E., & Ferreira, S. T. (2019). Diet-Derived Fatty Acids, Brain Inflammation, and Mental Health. Frontiers in neuroscience, 13, 265. https://doi.org/10.3389/fnins.2019.00265
Salari-Moghaddam, A., Keshteli, A. H., Afshar, H., Esmaillzadeh, A., & Adibi, P. (2019). Association between dietary inflammatory index and psychological profile in adults. Clinical nutrition (Edinburgh, Scotland), 38(5), 2360–2368.
Zhao, H., Wu, L., Yan, G. et al. Inflammation and tumor progression: signaling pathways and targeted intervention. Sig Transduct Target Ther 6, 263 (2021). https://doi.org/10.1038/s41392-021-00658-5
Omega 3's and your mental
Last week, I highlighted in my latest blog post that research within the last decade has shown that nutritional deficiencies exist in those with mental health disorders and that one of the most common nutritional deficiencies is Omega-3 fatty acids. There are now tons of supplements and headlines promoting the need for Omega-3 fatty acids, but do you know why? Why is this particular kind of fatty acid so important and how does it affect our mental?
Fats have gotten so demonized in our culture and unfortunately it has led many people to not have them in their diets. Fats are one of the three macronutrients (the others being proteins and carbohydrates) that we need to fuel our bodies and our mental. Fats are classified into a few different categories: saturated, unsaturated, monounsaturated, and polyunsaturated. Omega 3 fats are one type of Polyunsaturated Fatty acid (PUFAs). In terms of it’s chemical composition, this class of fats (PUFAs) consist of long chains of carbon atoms with a carboxyl group at one end of the chain and a methyl group at the other end. There are three main types of Omega-3s, Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and Alpha-linolenic acid (ALA). ALA is present in plant oils, such as flaxseed, soybean, and canola oils, while DHA and EPA are found most abundantly in fish, fish oils and krill oils. One of the most important roles in the body that fats play is being a major structural component of every cell in your body (Read that again: FATS ARE STRUCTURALLY PART OF EVERY SINGLE CELL IN YOUR BODY). All of our cell membranes in our bodies are made up of fats (phospholipids). They are important because they separate the cells in the body from their outside (their membrane) and they facilitate the exchange of nutrients between cells. This wouldn’t happen if not for fats.
Following consumption of these fats, omega-3 fatty acids are incorporated into cell membranes in all tissues of the body. Whether the source of these omega-3 fatty acids is fish, fish-oil supplements or food products fortified with the appropriate omega-3 fatty acids, measurable changes in cellular membrane content occur within days of increasing the daily consumption of these fatty acids. Dietary changes that include healthful PUFAs have a significant impact on the cell’s function. These fats help important signaling and communication within and between cells. Specifically, DHA, being the most abundant Omega-3 found in the brain, has been shown to be crucial for maintaining nerve cell structure and function. Both EPA and DHA have been shown to help the brain support healthy memory, cognition and emotional well-being. EPA and DHA also promote healthy blood flow, which is essential for brain function and memory. EPA and DHA are being studied extensively to assess the wide range kind of effects these two Omega-3 fats have on the brain. For instance, a recent meta analysis found that although blood EPA, DHA and total Omega-3 PUFAs are significantly decreased in patients with dementia, only EPA was found to be significantly lower in patients with pre-dementia syndrome, leading the researchers to suggest that EPA may be a biomarker and a risk factor for age-related cognitive impairment. This suggests that your Omega-3 intake, specifically DHA, can help possibly prevent cognitive decline.
Let’s take a look at some studies to see what the research has to say about how Omega-3’s protect the brain. The Easton Center for Alzheimer’s Disease Research report examined levels of DHA in red blood cells in a group of over 1500 men and women aged 67 +/- 9 years who were dementia free. The study measured the size of their brains and evaluated the subjects using a variety of cognitive assessments. Results indicated that those individuals having the lowest DHA levels had significantly lower total brain volume and greater levels of small strokes in their brain compared to those with higher levels of DHA. Additionally, those individuals with lower levels of DHA performed worse on tests for visual memory and executive function. This is more evidence that suggests that DHA protects our brain, allowing for optimal functioning despite the chronological aging process.
There is also evidence that Omega-3’s may be useful as a supplement for the treatment of bipolar disorder related depression and evidence that EPA-supplemented food is helpful in patients suffering depression. More research is needed to make this conclusive, since due to participant recall and diet-related systematic differences, there is complexity in interpreting the literature in order to make specific conclusions.
Although epidemiological research has shown that an increase in the symptoms of depression is correlated with lower intakes of dietary omega-3 fish oil, omega-3 fatty acids have not, so far, proved significant as a monotherapy for major depressive disorder. Individuals experiencing the symptoms of depression were also found to have lower serum concentrations of essential fatty acids, which was also revealed by several studies of EPA and DHA.
Besides treating depression, omega-3 fatty acids may also be useful in treating and preventing dementia. Nine epidemiological studies now support that increased dietary intake of fish is associated with reduced risk for cognitive decline or dementia with several of the studies showing a 40–50% reduced risk of dementia! DHA has also been shown to be specifically protective against Alzheimer’s Disease. One of the ways it does this is by limiting the production and accumulation of the amyloid β peptide toxin that is widely believed to drive the disease. Pretty amazing!
What happens when Omega-3 fats are used in conjunction with medication treatment for depression? Results of one study that evaluated Omega-3 fatty acids with and without SSRI fluvoxamine suggest that the patients treated with a combination of omega-3 fatty acids and fluvoxamine showed a significant difference compared with those treated with fluvoxamine alone in improving depression symptoms. Among women in the USA, depressed symptoms were examined in relation to intake of omega-3 fatty acids and omega-6 fatty acids. Higher intake of omega-3 fatty acids than omega-6 fatty acids was found to be associated with decreased risk of heightened symptoms of depression.
So does this mean that you can use foods rich in Omega-3 to help manage depression and mood disorders? The answer is yes, as a supplement to other forms of therapy that have been shown to be effective (i.e. Cognitive Behavioral Therapy, exercise, stress management techniques). It is important to note that while these studies listed above all have promising and positive results, there are other studies that have been inconclusive or have shown that Omega-3s when compared to medication management for depression (i.e. an SSRI) have not demonstrated significant statistical effects. More research is needed to help clarify these results, specifically with regards to dosing, quality of the Omega-3s being used in studies, and severity of depression or said mood disorder. Other factors that may be responsible for these variable results are differences in sample size, biological and genetic differences among patients, environmental variability, and variability in response to Omega-3 fatty acids. It is also important to note that severity of the mental health diagnosis will dictate what will be necessary in order to manage the disorder. Someone with more chronic mood disorders that also have a strong familial component, might not benefit from the use of Omega-3 fatty acids as much as someone whose presentation isn’t as severe, or whose depression is more caused from environmental or stress related factors. Depression is a disorder that is caused by many different factors and depression due to insufficient Omega-3 fatty acids can be of one type. What this research does demonstrate is that eating nutrient dense whole foods that have a balanced macronutrient profile (fats/proteins/carbs) will have both short term and long term benefits for your mental. Disease accumulates in the body after months or years of “bad habits” i.e. poor diet, poor stress management, lack of exercise, etc. It is much more beneficial to act preventatively and feel the benefits that feeding your mental will have on your day-to-day life. At the very least, you will have improved energy, improved focus and attention, improved overall brain function, and increased satiety. Adding these healthful Omega-3s to your diet will only help protect your brain and other systems of the body (cardiovascular, immune).
The best sources of Omega-3 include fatty fish, such as salmon, mackerel, tuna, herring, and sardines. Other sources include grass fed meat, chia seeds, flax seeds, soybeans, and oysters. In terms of how much to eat? No Recommended Daily Allowance has been set for total fat or individual fatty acids, however, it is estimated that it is healthful to have these healthy fats be between 20-35% of total calories. It’s interesting to note that during hunter-gatherer times, our ancestors ate between 28-58% fat.
According to Dr. Janelle Sinclair, a biochemist and a registered natural medicine practitioner, in order to treat depression with Omega-3, you need to take a considerable amount. In fact, studies show that you need to take between 1000-2000mg EPA per day to treat depression. She further recommends that in order to treat depression, taking EPA over DHA is more effective and that the supplement is most effective when it has twice as much EPA as DHA.
I hope this helped to provide a general overview of how Omega-3’s can affect our mental and how incorporating this powerful nutrient can help provide long lasting benefits.
References
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Marangell L.B., Martinez J.M., Zboyan H.A., Kertz B., Kim H.F., Puryear L.J. A double- blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am J Psychiatry. 2003;160:996–998.
Safa M., Fallah Tafti S., Ghassem Boroujerdi F., Talischi F. Clinical trial in the treatment of 80 Iranian patients with major depression disorder by the combination of omega 3fatty acid and a selective serotonin reuptake inhibitor. Ther. Adv Psychopharmacol. 2013;3:186–190.
Wani, A., Bhat, S., and Ara, A. Omega-3 fatty acids and the treatment of depression: a review of scientific evidence. Integr Med Res. 2015 Sep; 4(3): 132–141.
