Dr. Weeks’ Comment: Scientific clinical trials are finally validating orthomolecular psychiatry protocols as taught by Abram Hoffer, Ph.D. M.D. from the past 70 years. I endorse the following article with the exception that I am now entirely convinced that omega 3 fatty acids (i.e. fish and krill oil capsules) are not beneficial (albeit better than rancid, hydrogenated oxidized cooking oils from fast food restaurants). To better understand the benefit of omega 6 fatty acids (seed oils) compared to omega 3 fatty acids (fish oil capsules) – read this LINK
the following is from Dr. Drew Ramsey for Medscape Psychiatry.
Prescribing a Diet to Treat Depression
February 03, 2017
The first-ever randomized controlled clinical trial[1] to test a dietary
intervention as a treatment for clinical depression has just been published. I
am Dr Drew Ramsey. I am assistant clinical professor of psychiatry at
Columbia University in New York City, and I am reporting for Medscape
Psychiatry. I am excited to share the results of this very interesting study
with you.
Two researchers, Felice Jacka and Michael Berk, led a consortium of
Australian Institutions based at the Food & Mood Centre at Deakin University
in Victoria, Australia. Over 3 years, they recruited several hundred patients
with moderate to severe depression and entered 67 into a 12-week parallel
group trial. The treatment group received seven 60-minute sessions of
dietary counselling. The parallel control group received a matching social
support protocol. All but nine of the 67 participants were receiving another
active treatment””either psychotherapy, medications, or both.
In the dietary counseling sessions, participants were implored to increase
consumption of foods in 12 food categories. The food categories, as you may
guess, included whole grains, fruits, vegetables, nuts and legumes, and lean
meats, chicken, and seafood, and to decrease consumption of foods that are
correlated with a higher risk for depression: empty carbohydrates, refined
starches, and highly processed foods. During the past decade, a mountain of
evidence has been building that dietary patterns are strongly correlated with
risk for depression. We have not had a randomized controlled trial like this to
direct our clinical care, however.
Drew Ramsey, MD
The outcome was quite robust. The researchers found a statistically
significant 7.1-point difference on the Montgomery-Asberg Depression
Rating Scale (MADRS) in favor of the treatment group, which was their
primary outcome. The researchers extrapolated that there was a 2.2-point
reduction in the MADRS for every 10% adherence to the healthier dietary
pattern.
They developed that pattern, which they called the Modified Mediterranean
Diet, or the Modi-Medi Diet, by combining recommendations from the
Australian government and the Greek government, and data from an earlier
analysis by Felice Jacka and her colleagues[2] that determined which dietary
factors played the largest role in fighting depression with diet.
In this latest study, the number needed to treat was 4.1. That compares
favorably with data from two pooled analyses of adjunctive aripiprazole[3,4]
in which the number needed to treat was 10. The augmentation effect was
quite robust for an adjunctive treatment. In the treatment group, about 32%
of patients achieved remission, compared with 8% in the control group. In
terms of risk-benefit profiles, a dietary intervention is emerging as a very
safe and effective way for us to engage our patients.
As we know from our experience in our nutritional psychiatry clinic here in
New York, discussing food is a great way to get a conversation going about
aspects of a patient’s life that we traditionally do not discuss. When you
think about all of the information one can get about food and how people
care for themselves, it becomes an intervention that not only helps build a
very strong alliance but also is just a lot of fun””talking about lentil soup and
where people get their seafood, and focusing overall on the food categories
that individuals need to improve. Overall, these good foods tend to be leafy
greens, rainbow vegetables, a variety of seafood, and improving the quality
and amount of meat they consume, and, as the researchers note, reducing
the consumption of foods that increase the risk for depression and other
disorders.
One issue about eating for brain health is the cost, as often the
recommended seafood and organic food can cost more. But the Australian
researchers found that eating for brain health costs less. The average
Australian spends $138 a week on food. Those who were taking part in the
study spent just $112.
The study is called the SMILES Study, which makes me smile. SMILES stands
for Supporting Modification of Lifestyle in Lower Emotional States. We hope
the results of this intervention will be replicated.
For those of you who are incorporating food and nutritional assessments
into your clinical practices, this is more evidence that you are on the right
track. It is not only an engaging and alliance-building conversation, it is also
a very effective intervention. For those who have not incorporated nutritional
and lifestyle assessment into your practices, this study provides a great
impetus to do so. Taking a peek at the paper will show you the methodology,
which revolves around conducting a good dietary assessment.
I should note that the people who entered the trial had a poor dietary
quality. Overall, that is what we also see in our clinic: Individuals who have
the best response to a brain-food intervention are those who are eating a
nutrient-depleted diet, often called the “beige diet” or the “12-year-old boy
diet,” consisting of empty carbohydrates, pizza, pasta, baked goods, and few
of the brain nutrients that we hope patients will seek out based on the
mountain of data we have.
Certain nutrients, such as the omega-3 fats, zinc, magnesium, iron, and
vitamin B12, are very effective in terms of preventing depression and are
readily found if you choose the right core set of foods. These are the foods
that make up traditional diets, the foods that are highly correlated with a
lower risk for depression and dementia. With this new randomized controlled
clinical trial, this set of foods looks as though it can play a role as an
adjunctive treatment for clinical depression and help your patients achieve
full remission.