| Can you eat your way to happiness? Our diet exerts an effect on our mental well being. Research in recent years has revealed that this effect is in part related to the health of our gut microbiota. As you would have expected, increasing the amount of whole foods (fruits, vegetables, grains, etc.) is an important part of what makes this happen. The net effect is an increase in complex nutrients and reduced inflammation which is a risk factor for depression and other chronic diseases. This is possible because of the synergistic relationship between our microbiota, our immune system and our nervous system. This interaction between diet and mood isn’t news. Over the past decade, dozens of studies have shown that a healthy diet is often associated with reduced depression and overall mental well being. A key step for improving mental health is to reduce or eliminate foods that offer little to no nutritional value. Typically, these are refined foods with a high glycemic index and low nutritional value like chips, candy, cakes, and other snack foods. Most foods with a label fall into this category. The better choice for mental well being is the types of foods suggested by the Mediterranean diet and similar diets that recommend nutritious whole foods that are rich in micro nutrients. A characteristic of these foods is the relatively large amount of micronutrients they pack per calorie consumed. Among the most important in this class of foods are garden greens. Unfortunately, the Standard American Diet (SAD) is often devoid of nutritious garden greens aside from an occasional wimpy piece of iceberg lettuce. Granted, iceberg lettuce is low in calories and definitely not bad for you. However, given a choice, choose dark leafy greens (spinach, mustard, arugula, kale, turnip greens, etc.) for health benefits. Changing our lifestyle to accommodate an improved diet can be challenging. Even more challenging is making the effort when you’re not feeling your mental best. Often the best advice is to begin with simple steps like swapping dense sugar foods (chips, sodas, cookies, etc) for fruit and nuts. While this may not initially make much of a difference in your calorie count there are benefits for mental and physical health. The Pendulum Has Swung In the 1950s, doctors noticed that increasingly saturated fats were clogging arteries. Initially it was assumed that eating too much fat was the problem. As a result the pendulum of advice swung toward advising patients to eat more carbohydrates. Today we know that neither carbohydrates nor fats are necessarily good or bad. It depends on a balance of the two, what kind and how much. While each person is different, numerous studies now point in a common direction – it’s about finding a balance of good fats and good carbohydrates. A recent study, “The Prospective Urban Rural Epidemiology” (PURE) looked at 135,335 people from 18 countries for over 7 years. The peoples that consumed more than 60% of their energy from processed carbohydrates had the poorest health outcomes. The significance of the study was its size, breadth, and that it confirmed findings from dozens of prior smaller studies. Too much sugar was found to correlate with elevated triglycerides, which are made by the liver to store unused carbohydrates (carbs), and is the main cause of fatty liver. It is also associated with low HDL and a high apolipoprotein B (apoB). This study showed that high carbs were associated with a high apoB-to-apoA1 ratio, which can be a better predictor of heart disease than LDL. ApoB is the small dense LDL that is more atherogenic than the larger-sized LDL. And a high apoA1 is associated with HDL levels, which are anti-atherogenic. A high apo B/apoA1 ratio is bad, and it rises with a diet high in sugar and processed carbs. Fats - Choose Wisely This study also showed a protective effect from all types of natural fat. Unfortunately, some may interpret this information incorrectly. For one, fat is dense in calories, and in excess can lead to weight gain. Another problem, animals store toxins in their fat. Eating a lot of animal fat, particularly from red and processed meats, can be a problem. Other fats such as mono-unsaturated fat (olive oil) and polyunsaturated fat (fish, nuts, and avocados) are protective. Carbs Are Not Created Equal Vegetables and fruit are good sources of carbohydrates. Even small amounts of vegetables and fruit (3–4 servings a day) reduced the risk of heart disease by 24% compared with 6 to 8 servings that reduced it by 31%. The good news is that if you eat good carbs from whole foods it’s almost impossible to eat too many if you maintain a proper balance of fats and protein. It’s the dense processed carbs that make overeating too easy. Unfortunately, the United States offers subsidies to farmers that encourage the production and consumption of sugar and high glycemic grains. These subsidies drive down costs, making these carbohydrates more affordable. In turn industry capitalizes on the low cost of these farm products and converts most into low cost packaged junk food. A better policy would be to subsidize farmers for growing foods that are supportive of health. Evidence tells us this can reduce health care cost by reducing the occurrences of many diet- related chronic diseases. Until the root causes of our national healthcare cost are addressed, expect health care cost to rise. Nancy Neighbors, MD Huntsville, Alabama |