What National Health Surveys Tell Us About Nutrition and Mental Health

Bonnie Kaplan, PhDJulia Rucklidge, PhD
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The two of us have mainly been doing clinical treatment studies in relation to Nutrition and Mental Health. For example, Julia has studied broad-spectrum nutrient treatment of the symptoms of inattention, impulsivity, and mood regulation in adults, including insomnia. However, we have also studied nutrient treatment in groups of people without psychiatric diagnoses who were exposed to the extreme stresses of earthquakes and floods. Those studies have consistently shown general population health benefits from nutrient supplementation.

As a consequence, we have been interested in the broad public health implications of nutrition, such as the findings from national health population surveys. This blog will describe a few recent findings based on data from the Canadian Community Health Survey (CCHS), a large cross-sectional survey that collects information related to health status, health care and health determinants for the Canadian population. The CCHS collects data from participants 12 years of age or older in the ten provinces and three territories of Canada.

In a CCHS study on the economic burden of poor eating habits, Ekwaru and colleagues obtained the responses of 63,964 Canadians to validated questions on the frequency of consuming vegetables and fruit. They summarized the data as a single variable representing the total number of servings of vegetables and fruit consumed daily. First, they found that about 80% of the women and 89% of the men were eating fewer fruit and veggies than recommended by Health Canada (5-9 half-cup servings per day). Then they estimated the proportional reduction in chronic disease that would occur if all Canadians consumed the recommended number of servings of vegetables and fruit. The estimates obtained in the Ekwaru study for inadequate consumption of fruits and vegetables were $3.3 B per year.

It is interesting to compare the Ekwaru results with other findings on economic burden caused by lifestyle variables. In Canada, Krueger et al. compared fruit and vegetable burden to previously estimated annual economic burdens attributable to physical inactivity ($10.8 B), excess body weight ($23.3 B), and tobacco smoking ($18.7 B). So the estimates are that the cost to our societies of physical inactivity, excess body weight and tobacco smoking are greater than inadequate fruit and veggie consumption, but none of these are trivial costs.

And there is another interesting way to examine these data: over the next 20 years an increase of just one serving of vegetables and fruit per day would avoid approximately $9.2 B in health care costs. In a country like Canada, with 1/10th the population of the USA, that is an amazing number.

So far, these findings have related to physical health. But what about mental health? Those figures are not available yet in exactly the same form, but Bonnie and one of her former students Karen Davison published some relevant findings in 2017, again using data from the CCHS.

They examined relationships among three variables: food insecurity, diet quality, and perceived mental health. Data were available from 15,546 adults aged 19-70 years. The measures of food insecurity and diet quality were conventional ones (e.g., the Healthy Eating Index), but the only measure of perceived mental health that was available for analysis was fairly general (good versus poor).

After adjustment for covariates, they found a fairly consistent association with mental health for the two primary variables: both food insecurity and poor diet quality were associated with 60% increased probability of reporting poor mental health. In addition, suboptimal intake of two micronutrients (folate and iron) were associated with about a 50% increased probability of mental health being perceived as poor. Several other nutrients were associated with milder effects (e.g., B1 and zinc).

What conclusion can be drawn from these studies, all of which used the CCHS data in Canada? Improving people’s diets may protect them from experiencing poor mental health. And we already know from much other research that food insecurity caused by low income is a strong predictor of diet quality. All the more reason to ensure everyone earns not the minimum wage, but a living wage.

A study published two years ago emphasizes the importance of all of these findings. Noble et al. reported on brain scans from 1,099 typically developing individuals aged 3-20 years. The research was based in part on the scientific knowledge that income is related to success on a variety of cognitive tests. What the scans showed was that income was logarithmically associated with brain surface area. In other words, higher income was associated with larger amounts of brain development at the cortical level. And as the authors mention, there are multiple variables that might explain their cross-sectional study results, and nutritious food is one of them (others of course are more cognitively stimulating environments which have been shown in lab animals to increase brain development — so this would include both home environments as well as higher-quality child care settings; also the provision of more opportunities for physical activity; and also perhaps less exposure to environmental pollutants and stress).

As always in our blogs, we are not saying that nutrition is the ONLY variable of interest. We are simply trying to raise awareness of the scientific data showing that nutrition is a very important variable with respect to brain and mental health.

18 COMMENTS

  1. Good nutrition is good for one’s health, period, and people with good health feel better. There is no such thing as “mental health,” hence articles such as these are inherently flawed based on their presuppositions.

  2. I want better mental health and happiness for me….and I am looking to healthy eating and healthy exercise for help with my mood disorder…I really like what you are posting here bonnie and julia…I believe that good nutrition is vital for brain health…and I love the bio/psych/soc model for good mental health….and bad mental health

  3. What is it? Brain, or mental health? And this stuff about brain scans is highly suspect. Look, everyone wants to have a better income and to eat better food in order to feel better. No one disputes this. But all this talk of some mysterious entity called “mental health” really needs to be scrutinized. In fact, in many countries, it is the poor people who actually eat good food, while the wealthy consume a lot of junk. Another point to consider is how vitamin mongering actually worsens problems for victims of natural disasters. This is very well documented in Ethan Watters excellent book “Crazy Like Us.” https://www.amazon.com/Crazy-Like-Us-Globalization-American/dp/1416587098

  4. Doctors Kaplan and Rucklidge,

    I have seen quite a few articles here on nutrition for mental health. But instead of so many articles like this, can you write one on what actually to eat in what quantities in simple layman’s terms?

    Like M grams of N fruit per day/week/month—-> Contains A and B nutrients important for Y and Z functions.

        • OK here we go.

          1.Magnesium

          The NMDA receptor is a glutamate receptor. Glutamate is the major excitatory neurotransmitter in the central nervous system. The NMDA receptor is blocked or gated by magnesium ions. Therefore Mg ions control the transmission of glutamate… the major excitatory neurotransmitter in the CNS.

          2.B6 active form PLP Pyridoxal phosphate

          Glutamate and GABA (major inhibitory neurotransmitter in the CNS) are not separate, GABA is synthesized from glutamate by an enzyme called glutamate decarboxylase (it actually comes in two slightly different forms called isoforms but that’s gonna get complex) That enzyme requires a co-factor to work which is the active form of B6 PLP

          You would have to include stopping, all the stuff that will harm or inhibit glutamate decarboxylase such as glutamic acid…. MSG.

          http://www.worthington-biochem.com/GLDP/

          • Great. Text about neurotransmitters and receptors.

            Once again, no mention of what foods to eat in what quantities to gain the right amounts of the aformentioned nutrients.

            2 bananas a day? An apple?

            There is also no need to complicate things beyond what a layman needs to know. Nobody cares about NMDA receptors except those who take an interest in reading about them or do work associated with needing that knowledge.

      • I can’t work in residential substance abuse facilities, because I won’t have second thoughts about using nutrient regimens to get the residents more functional, no matter what the facility’s guiding ideology is. I’ll help you with Oldhead, Streetphotobeing.

        • I have nothing to add to my original post, which is not a complicated statement, nor should it be controversial, especially at MIA. Somehow this is being misconstrued as a debate.

  5. https://uk.reuters.com/article/us-carillion-restructuring/britains-carillion-collapses-after-banks-pull-the-plug-idUKKBN1F40P0

    Now let me tell you something about this. It was on the cards for a long time. Who ever has credit default swaps on Carillion are to blame, and it’s never going to be outright obvious, they will have nudged this into collapse. And I’m thinking Brexit is in the mix as well, being as the UK Govt were – at the end – the only ones backing them, and no doubt thought that would be enough to hold the banksters… and they sure do not want Brexit. Plus we now have a calling for a second vote…. so it can be seen as an attack on the Brexit position.

    Warren Buffet on CDS’s ‘creating your own reality’:

    https://www.youtube.com/watch?v=VUVhto4zC1U

    Why is this relevant to ‘MH’ problems, well if you were just put into a position of suddenly not having a job and going into debt..it’s pretty obvious isn’t it. Sorry but all the good food in the world aint gonna sort this. Blythe Masters… she invented CDS’s by the way, look her up… get a handle on this financial psychotic poison.

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