The subject of mental health is becoming ever more prominent in everyday discourse, and with good reason. Stigma attached to mental illness still prevents many from opening up about issues such as anxiety and depression, despite them being so commonplace. According to mental health charity Mind, one in four people each year will experience mental health issues in the UK.
We’ve discussed before how lifestyle and work habits can have a significant effect on mental wellness. However, many experts are now also starting to link mood with what and how we eat, and a consensus is emerging that nutrition may play a pivotal role in our mental wellbeing.
To explore about this further, we spoke to Rachel Kelly, writer, mental health campaigner and ambassador for SANE, Rethink Mental Health and Young Minds.
Rachel was diagnosed with depression during her early thirties, and has since gone on to write and campaign extensively on the subject of mental health: among her works are the Sunday Times Bestseller Black Rainbow, in which she recounts her experiences of serious depression; and Walking on Sunshine: 52 Small Steps to Happiness, in which she discusses her holistic approach to recovery.
Her latest book, The Happy Kitchen: Good Mood Food, is about using nutrition and positive diet choices to maintain good mental wellbeing.
‘I was first intrigued by food’s medicinal power about eight years ago. I took our then ten-year-old son George to see a nutritionist about his persistent eczema at a well-known clinic in west London. I was delighted when his symptoms began to clear up within a few weeks of changing his diet.’
It was a few years later, Rachel explains, when she began to wonder if nutrition could improve mental health as much as it could physical health. She started to experiment, making a note of which foods made her feel calm, helped her sleep, and improved her mood.
‘Some were thanks to my GP.’ During a routine checkup to see how she was coping with her anxiety, Rachel’s doctor said there was compelling evidence to suggest a link between mood and food, and issued a list of ‘happy foods’ that she could try to help her stay calm. ‘Included were green leafy vegetables, dark chocolate and oily fish.’
Like may of us, Rachel wanted to learn more but found herself stymied by the sheer amount of conflicting nutritional advice on offer. So, she reached out to Alice Mackintosh, a nutritional therapist who at the time was working for a clinic on Harley Street in London. With Alice’s help, and advice from dietitians and psychiatrists, Rachel set about giving her diet an ‘overhaul’.
‘I swapped processed foods for healthier ones, learnt to eat certain foods at certain times for certain symptoms, and started to eat slowly. Together, Alice and I developed recipes based on more than 140 scientific studies for my symptoms, whether it was finding it hard to sleep, feeling anxious, or feeling blue. I felt so much better, and felt inspired to share what I had learnt with others.’
Of course in recent years, the subject of mental health has come to the fore in both the media and in regular discourse; it's a subject which now, fortunately, increasingly more people are aware of and willing to openly talk about.
We asked Rachel what she thought the main instigators were behind this change.
‘Two main factors have caused this welcome change in my view. The first is the seriousness of the problem.’ Rachel tells us. ‘We are facing an epidemic of mental illness, with the number of those affected increasing year on year. We couldn't ignore the scale of the problem any longer.’
‘The second is that a shift in understanding of the reality of mental illness has happened.’
Rachel explains that people have become accepting of the fact that mental illness is exactly that: ‘An illness, in which something goes wrong with your brain. It's not something that people imagine or make up. This is particularly true of those who don't seem to have any reason to suffer a mental illness. They may have a good job, a loving family, and plenty of support but they still become unwell. A privileged life doesn't necessarily mean privileged health; mental illness is no respecter of background, and this is now being understood.’
However despite this new level of understanding, Rachel explains, stigma can still often be an obstacle.
‘My own experience running workshops for mental health charities like Depression Alliance and Mind, and being an ambassador for Sane, Rethink and Young Minds, as well as working in schools and businesses, is that the worst obstacles are to be found among young people, and also those who have good jobs.’
‘When I give talks in schools and we discuss stigma, few young people want to admit they have a problem. There is a pressure to appear as if your life is perfect.’
‘Equally, those who work in professional services, bankers, accountants, lawyers, doctors, journalists, and those who are running their own businesses are reluctant to talk about their experience of mental illness as they feel it would threaten their jobs. Luckily, businesses and schools are beginning to change to increase awareness, but there's more to be done.’
The importance of nutrition in mental health
The concept of using diet to help boost mental wellbeing is a relatively new one, which many might not be familiar with.
Rachel argues that nutrition ‘plays a very significant and underestimated role in good mental health. It is a key tool in my holistic approach to staying calm and well alongside meditation, mindfulness, the healing power of poetry and exercise.’
‘Nutrition is an especially exciting field of new hope for those who live with mental illness. There's plenty of new research happening in the field of nutrition and mental health right now.’
Doctors are increasingly starting to question theories around depression and chemical imbalances, and low serotonin; and a new theory, Rachel tells us, is that low mood may be linked to low levels of chronic inflammation. Unhealthy foods, such as processed items and trans fats, generate fatty or ‘adipose’ tissue, which in turn contributes to inflammation.
‘Carmine Pariante is a professor of biological psychiatry at King's College London. The link between inflammation and depression is the central focus of his research.’ Rachel explains.
‘In a 2014 study, in which 152 patients with high levels of inflammation participated, omega-3 fatty acids were shown to reduce the rates of depression.’
Pariente noted that it was now ‘established that increased inflammation plays a role in causing depression in at least a subgroup of patients.’ The study demonstrated, he summarised, that ‘even a short course of nutritional supplement containing one type of omega-3’ lowered new-onset cases of depression to 10 percent; down from the ‘30 percent we usually see in this group.’
‘We believe that this nutritional intervention restores the natural protective anti-inflammatory capabilities of the body,’ Pariente went on to say, ‘and thus protects patients from new-onset depression when inflammation occurs.’
Further evidence from animal studies, Rachel tells us, seems to indicate a link between an inflamed gut and low mood.
‘Some of the small proteins that control this inflammation are known as cytokines: important molecules for several bodily processes, but if too many escape into the rest of the body from the gut, they may cause inflammation elsewhere. Heightened levels of cytokines have been linked with depression, and this theory is known as the Cytokine Hypothesis.’
‘One way to reduce inflammation is to encourage healthy bacteria to flourish in our digestive systems. It is thought that an increase in the levels of unhelpful bacteria that emit chemicals can compromise the lining of the intestine. Given this inseparability between good mental and good physical health, taking care of our digestive systems should be a priority for all of us.’
‘I think we will see more research in these areas in the coming years, and if anything the importance of nutrition will grow.’
Nutritional keys to good mental health
So what food choices can we make to help maintain our mental wellbeing?
‘The key elements of a diet which promotes good mental health is to return to 'real' food which looks like the food our ancestors ate. I slowly swept my kitchen clean, eliminating processed foods and focusing on ‘real foods’ instead.’
Rachel increased her probiotic and fermented food intake, as she ‘learnt about the links between staying calm and a healthy microbiome, otherwise known as gut flora.’
Probiotic yoghurt is a particular favourite Rachel holds up as an example: ‘Women given yoghurt containing probiotics were found to have a calmer response to certain stimuli, according to a 2013 study reported in Gastroenterology.’
‘Fish oil,’ she adds, ‘can also be highly beneficial to our mood, due to its powerful anti-inflammatory effect. I eat plenty of oily fish (at least four times a week) such as salmon, tuna, herrings and anchovies, as well as hemp seed, and green leafy vegetables which also contain omega-3 fatty acids, such as broccoli.’
Getting the maximum nutritional benefit from our diet, Rachel adds, doesn’t just lie in what we eat, but also how we eat.
‘While eating we also need to stay in the moment and remain conscious of what we’re doing. Learning how to cook has been key to adopting a slower pace and appreciating food. Cooking now feels like an extension of my normal meditation routine. I can lose myself in the process. Standing still at the stove and preparing food grounds me. I become rooted in the moment and stop worrying.’
So what about the bad stuff? Which types of food does Rachel think are the major contributing culprits to mood and anxiety?
‘Avoid processed foods, trans fats, and preservatives and additives as much as possible.’ she advises. ‘Sugar has also been linked to low mood and anxiety in several studies. It can increase the less healthy bacteria in our guts, and also trigger the release of stress hormones.’
Beating the convenience trap
As we’ve written before, poor dietary choices can often be a consequence of a hectic lifestyle. Sometimes a heavy workload might push someone towards convenience food, which isn't always the healthiest option, and in turn amplify feelings of stress related to work.
With this in mind, what advice does Rachel have for those who would like to eat healthily, but struggle to find the time to prepare their own meals?
‘The best ways I've found to eat healthily is to learn to love my liquidiser! If I'm in a rush, and I often am, the quickest and easiest way to eat with your mood in mind is to make a green smoothie: some green leafy kale or spinach for iron and good digestive health, some nuts for protein to help the production of neurotransmitters or chemical messengers in our brain and to slow down any sugar rush, some nut milk for variety (perhaps almond) or maybe oat milk, bananas for serotonin and energy, and maybe some live yoghurt for good digestive health and to boost the healthy bacteria.’
‘In each chapter of The Happy Kitchen, we have a recipe for when you're feeling fragile and don't feel up to cooking: most of them can be made in less than ten minutes and I promise you they will boost your mood!’
You can find out more about Rachel, The Happy Kitchen, and her campaign work, by visiting her site.
Recipe: Cecilia’s Purple Risotto With Goats Cheese and Beetroot
To whet your appetite, Rachel has been kind enough to give us a sneak preview of her new book, by sharing this deliciously tempting risotto recipe with us.
From The Happy Kitchen by Rachel Kelly and Alice Mackintosh
Short Books £14.99 paperback
‘This recipe was given to us by Cecilia, a friend and an accomplished cook, who helps develop healthy recipes for mothers with small children. You can make it with brown rice, but it takes a little longer, and the risotto won’t be quite as creamy. If you are cooking the beetroot from raw, use gloves when peeling it.’
‘Beetroot can boost blood flow to the brain. The walnuts provide omega-3s.’
- 300g cooked beetroot (raw or pre-cooked)
- 2 tablespoons of olive oil
- 1 large onion, finely chopped
- 3-4 garlic cloves, finely chopped
- 200g risotto (or brown) rice
- 600ml vegetable stock
- 60g soft goat’s cheese
- 100g walnuts, chopped
1. If you are using fresh beetroot, wash and trim them, but do not peel them. Place them in a large saucepan and completely cover with water. Bring the water to the boil then reduce the heat, put the lid on and simmer until they are just tender.
This should take around 30 - 40 minutes depending on their size.
2. Leave the beetroot to cool and then peel and dice them. If you are using pre-cooked beetroot, simply dice them into small chunks.
3. Heat the oil in a medium-sized saucepan and sauté the onion and garlic until they have softened, then stir in the rice and cook for a further 2-3 minutes. The grains should go slightly translucent.
4. Add a splash of water to the pan and stir, then turn the heat down and add the hot stock, ladle by ladle, stirring the rice regularly to ensure it doesn’t stick – a lovely soothing process I find. This is what releases the starch and gives the risotto its creamy consistency.
5. When the stock is almost used up and the rice is cooked – this should take 15-20 minutes – stir the diced beetroot and half the goat’s cheese into it. Leave it for about 5 minutes before switching the heat off.
6. Toast the walnuts in a frying pan over a moderate heat for 2-4 minutes, tossing them regularly to prevent them from burning.
7. Serve the risotto with a scattering of chopped toasted walnuts, the remaining goat’s cheese and a crisp green salad.
Copyright Rachel Kelly 2016