Food Cures (50 page)

OMEGA-3 FATTY ACIDS

In our diet-conscious society,
fat
has become a synonym for
bad
. But some fat in the body
and
in your diet is necessary for good health. For example, the type of polyunsaturated fat known as
omega-3 fatty acids
make up part of the structure of our brain membranes, and they seem to help brain cells use neurotransmitters more efficiently. So it makes sense that omega-3s seem to help regulate mood.

The relationship between depression and omega-3 fatty acids is complex and not completely understood. Studies have shown that people who are clinically depressed have low blood levels of omega-3s, but their mood did not improve when they took omega-3 supplements.
However…
when depressed people took omega-3s
along with
antidepressants, the supplements reduced depressive symptoms better than the medication alone. If you have been diagnosed with depression and would like to try a therapeutic dose of omega-3s, see the Supplements section, Chapter 13.

For people with milder problems—let’s call them
mood issues
—I recommend going the food route (although you can certainly consider supplements if you can’t get enough omega-3s through food). I believe that foods rich in omega-3 fatty acids could help regulate brain function and level out everyday moods. Omega-3s are most abundant in fatty fish so I recommend eating one serving of fatty fish at least two or three times per week. My list includes only the fatty fish that have been shown to be low in mercury, PCBs, and dioxins.

VITAMIN D

In the past few years, research has suggested that vitamin D might help relieve mood disorders because it seems to increase levels of serotonin, one of the neurotransmitters responsible for mood. In particular, vitamin D seems to help the type of depression called
seasonal affective disorder
(SAD), or the winter blues. More than 10 million Americans are thought to suffer from SAD, leading to anxiety, fatigue, and feelings of sadness for three to six months of the year. Scientists believe this is due to the shortened days and limited sunlight of winter. You see, our bodies can make plenty of vitamin D on their own from sunlight. Just 10 to 15 minutes of sun on the bare skin of your arms three or four times a week is enough to keep most of us healthy. The problem is that sunlight isn’t always safe—too much causes skin damage and premature aging, and may lead to skin cancer—and while using sunscreen protects your skin, it also prevents your body from making its own vitamin D. It becomes important, then, to get healthy amounts of vitamin D from the foods you eat and/or from supplements.

Scientists have discovered that people with SAD have normal blood levels of vitamin D in the summer, but that their levels drop by as much as one-third in winter. No wonder they feel moody and tired! Those who took vitamin D supplements for a year had stable blood levels, and most experienced a significant improvement in their depression. If you would like to try supplementation, see my guidelines for choosing a multivitamin on Chapter 13. But everyone with minor depression and anxiety issues should strive to eat more foods rich in vitamin D to improve their mood profile.

B VITAMINS: FOLATE AND B
₁₂

Two B vitamins—folate and vitamin B
₁₂
—seem to be important for mood. Studies have shown that low blood levels of these vitamins are related to depression, although no one is exactly sure why. Some scientists believe that these vitamins are used by the body to create serotonin, which, as mentioned earlier, is one of the key neurotransmitters that help normalize mood. It would seem logical, then, that low intake of these vitamins would contribute to mood problems.

Research is coming close to showing exactly that. One study found that people who have low blood levels of folate have a higher risk of depression. Other studies tracked people who had been hospitalized for depression, and revealed that about 30 percent were deficient in vitamin B
₁₂
. When researchers tracked 700 women over age 65, they discovered that the women who had low blood levels of vitamin B
₁₂
were twice as likely to be depressed as women who did not have a deficiency. In addition, researchers found that both vitamins seem to help depressed people respond better to antidepressant medications, which means that adding these B vitamin may help people suffering from depression feel better faster.

If you are clinically depressed, it is important to continue to follow your doctor’s treatment recommendations, but you may want to consider taking a multivitamin with appropriate amounts of folate and B
₁₂
(see Supplements section, Chapter 13), in addition to your antidepressant medications. Of course, eating a diet rich in these nutrients is important for maintaining mood, even if you are not clinically depressed.

BONUS POINTS

• Eat consistently throughout the day.
  If your blood sugar flags, your energy will fade and your mood can take a nasty turn, as well. You need to eat at least once every four to five hours in order to keep your brain well-fueled and happy. Some people who are extremely sensitive to frequent blood sugar dips may need to eat every three hours or so to keep from feeling that post-meal letdown. To keep from gaining weight, make absolutely sure the meals and snacks are calorie-controlled. And each meal and snack should contain a mix of high-quality carbohydrates and protein to best stabilize your blood sugar levels (see meal plans, Chapter 13, for examples).
  
• Exercise.
  Too many people underestimate the benefits of exercise—it’s not just for weight loss or fitness (although it is terrific for accomplishing those goals). Exercise can make you feel stronger, more confident, and more self-assured. That alone is enough to improve your overall mood. But exercise exerts other mood-enhancing effects: It raises blood levels of endorphins, those natural body chemicals that scientists believe might induce feelings of well-being. Plus, exercise improves blood flow, which means that the brain gets more oxygen, helping improve its function. Most studies that have looked at the effects of exercise on mood find that nearly any kind of exercise reduces anxiety, tension, stress, and feelings of depression. These amazing results are most powerful after several weeks of regular exercise, but research shows that mood can improve even on the first day of exercise.
  Researchers at the University of Texas Southwestern put people with mild to moderate depression on a exercise program—30 minutes three to five times per week for 12 weeks. The study participants who did a moderately intense workout on a treadmill or stationary bike reduced their depressive symptoms by nearly half, similar to what might be seen after starting antidepressant medications. Less intense exercisers reduced their symptoms by 30 percent—even those participants doing only stretching exercises reduced their symptoms by 29 percent.
  For mood improvement, then, my recommendation is to do some sort of exercise—any sort of exercise—at least three times per week, 30 minutes per session. The more your intense your workout, the more your mood will improve, so do what you can. Happiness really could be just around the corner…as long as you walk there!
  
• Make time for your life.
  Feeling frazzled, crazed, overextended, and overworked is a sure way to end up angry, anxious, or depressed…or all three. As impossible as it may seem, your family and friends may be your best “vaccine” against the daily stresses and strains that can wear us down. But it’s not enough just to
  have
  family and friends, you have to make time to relax with them and enjoy the simple pleasures they can bring. On the same note, you need to find a way to enjoy your work. If you’re like most people, you probably spend a minimum of eight hours a day at your job. That’s one-third of your day, five days a week…and that’s not counting your commute. If you hate what you do, it will eventually affect your emotions. I understand that not everyone can just quit a job or change careers, but everyone can learn to enjoy some aspect of their work (or at least meditate for relaxation). Alternatively, psychological counselors can help you develop a new set of responses to stressful circumstances, or to “reframe” how you think about them so that you can learn to enjoy something that you once found intolerable. If you’re retired, then your challenge becomes finding ways to fill your days that are challenging and emotionally rewarding.
  
• An occasional cup of coffee may perk you up.
  When many people feel low, they often turn to caffeine in cola, coffee, or tea. The problem is that it doesn’t necessarily work. Researchers have studied and studied
  and studied
  caffeine, but there are no consistent results. Some researchers find that caffeine improves concentration and mood all the time. Others find that caffeine works only if you use it periodically, but stops working for mood improvement if you use it every day. Still other studies show that caffeine doesn’t improve mood at all. This means that how you use caffeine is up to you. If you find that an occasional cup of coffee or tea helps you get through the day, there is no reason to deny yourself. But it doesn’t work for everybody—if you find yourself becoming jittery or irritable after drinking caffeinated drink, try decaf instead.
  

SUPPLEMENTS

If you are concerned about mood and want to consider supplements
in addition to
the food fixes, here are some that might be beneficial:

1. A multivitamin.
   For mood concerns, I typically recommend a senior formula multivitamin. These formulations often provide higher amounts of folate and vitamin B
   ₁₂
   compared to regular multivitamins. Simply look for a brand that contains at least 100% DV of vitamin D (400 IU) and folate (400 micrograms), and at least 6 micrograms of vitamin B
   ₁₂
   .
   
2. Fish oil.
   If you find that you can’t eat enough fatty fish or other foods to get your share of omega-3 fatty acids, you can always take fish oil capsules. I recommend taking 650 milligrams of omega-3s. (There are two sub-types of omega-3s called DHA [docosahexaenoic acid] and EPA [eicosapentaenoic acid]. When buying fish oil supplements, choose brands that contain at least 220 milligrams of DHA, and at least 220 milligrams of EPA. The remaining 200+ milligrams can come from either DHA or EPA. Check labels for these details).
   Doses of omega-3s greater than 3 grams (3,000 milligrams) per day are often used along with prescription antidepressants to treat clinical depression. I cannot recommend self-treatment at these doses, however. If you have been diagnosed with depression, talk with your doctor about whether you should add omega-3 fatty acid supplements to your treatment.
   To prevent rancidity, always store bottles of fish oil supplements in the fridge. To lessen the chance of fishy burps or aftertaste, buy enteric-coated capsules, which are digested in your intestines instead of your stomach. Avoid getting omega-3 fats from cod liver oil because it may contain too much vitamin A.
   
3. St. John’s wort.
   This herbal supplement, which seems to prolong the action of mood-stabilizing serotonin and other neurotransmitters in the brain, is a popular treatment for depression. Some scientific studies have demonstrated that St. John’s wort works nearly as well as antidepressant medications for mild or moderate depression, although a few studies failed to find any benefits at all. (It is clear, however, that St. John’s wort does not help people suffering from severe depression.)
   Just because St. John’s wort is a natural herb doesn’t necessarily mean it’s safe. This is not a supplement to be taken casually—it is only recommended for people with documented depression because it has physiological effects that need to be monitored by a doctor. General side effects can include dry mouth, dizziness, fatigue, nausea, diarrhea, and sensitivity to sunlight. Like some prescription antidepressant medications, St. John’s wort can have sexual side effects in some people, including an inability to become aroused or reach orgasm. It can also interact with many other medications, and can weaken oral contraceptives, which means that there may be an unintended pregnancy. So my advice is this: Please don’t try this herb on your own—if you suffer from mild to moderate depression and want to try St. John’s wort, talk with your doctor first.
   
4. SAMe.
   Another “natural” treatment for mild to moderate depression is SAMe (S-ade-nosylmethionine), an amino acid derivative. Because SAMe seems to increase the availability of dopamine and norepinephrine in the brain, it is thought to work similarly to some of the older antidepressant medications known as tricyclic antidepressants. Studies have shown that most people can take SAMe for up to two years with few side effects, and that it is pretty effective. Still, it is important to talk with your doctor before taking SAMe to make sure that your depression is being adequately treated. The usual recommended dose for depression is 400 to 800 milligrams twice a day. Be sure to look for the form of SAMe called
   butanedisulfonate salt
   —it is more stable and can be used more easily by the body. Here’s the big drawback: the cost! SAMe can run $150 per month—much more expensive than a prescription for an antidepressant medication.