This episode of “Mad in the Family” discusses the links between nutrition and mental health, and the science that’s showing that diet may help improve or even prevent mental health issues in children and adults.
Julie Rucklidge: “Taking a one-a-day gummy bear might prevent you from getting scurvy, but it’s not meeting the optimal amount that your brain needs.”
Our guest is Julia Rucklidge, Ph.D. Dr. Rucklidge is a professor of clinical psychology at the University of Canterbury in New Zealand, where she leads the Mental Health and Nutrition Research Group and serves on the Executive Committee for the International Society of Nutritional Psychiatry Research.
Julia’s interest in nutrition and mental health grew out of her own research showing poor outcomes for children with psychiatric illness despite conventional treatments. In the last decade, the Mental Health and Nutrition Research Group has been running clinical trials investigating the role of broad-spectrum micronutrients in the expression of issues such as ADHD, mood disorders, anxiety, and stress associated with traumatic events such as earthquakes and mass shootings.
With her colleague Bonnie Kaplan, Ph.D., she is the author of a new book, The Better Brain: Overcome Anxiety, Combat Depression, and Reduce ADHD and Stress with Nutrition, which will be published April 20 by Houghton Mifflin Harcourt.
Listen to the audio of the interview here.
We discuss:
- Â The emerging field of Nutritional Psychiatry, which looks at the relationship between nutrition and brain health. The micronutrients (vitamins and minerals) found in natural, whole foods are essential for regulating brain functions including thinking, feeling, and sleep. They also help moderate our energy levels and DNA expression.
-  How and why our nutritional status potentially affects our mood, behavior, and thoughts. In order for our body to maintain its basic functions and respond effectively to stress, certain chemical reactions must occur so the brain’s neurons can communicate properly. Without adequate reserves of nutrients in our body, which she compares to having “fuel in the tank,” our mental processes don’t function optimally, with a corresponding decline in our mental health.
- The role of ultra-processed foods in declining nutrition. Modern diets are increasingly centered on highly processed foods, which may provide protein, fat, and carbohydrates but lack significant micronutrient content. This means about half of North Americans aren’t getting the nourishment they need. This trend is compounded by modern, massive-scale farming practices that rob minerals from soil and crops.
- Children’s special nutritional needs at different developmental stages. Diet is important even before birth, when mothers-to-be should eat “nutrient-dense, real foods.” Studies show that when pregnant women eat ultra-processed foods, it increases the risk that their child will be more prone to emotional challenges and behavioral problems. Whereas a diet rich in produce and essential fatty acids lowers the risk for those outcomes. The same principles hold during early childhood development and again during adolescence, when kids need extra nourishment as their brains and bodies grow and change.
- Do’s and don’ts to support children’s mental health through nutrition. Rucklidge recommends serving one’s family the Mediterranean Diet, centered on colorful vegetables and fruits, along with lean proteins like fish or legumes and healthy fats like nuts. It’s important to eat at least five to nine daily servings of produce, which most people don’t, and to transition away from sugary beverages. Sweets should not be used as rewards for good behavior.
- The role of supplements in maintaining and improving mental health. While parents should focus on ensuring kids eat a brain-nourishing diet, supplements may be helpful if quality foods aren’t available, or if the child has a higher need for certain nutrients due to genetic factors and/or environmental stressors. But no individual vitamin has been shown to be a “magic bullet.” The most benefit has been found from consuming the full breadth of essential vitamins and minerals –30 in all— often at doses considerably higher than 100% of the RDA.
- Research by Rucklidge and others that supports the use of diet and supplements for treating children’s emotional and behavioral issues. She notes that 80 percent of 50 randomized controlled trials—the “gold standard” for scientific studies –showed a positive effect of nutrients over placebo for symptoms such as aggression, anxiety, stress, and mood issues in people of all ages. Studies at her lab in New Zealand found improvements in children diagnosed with ADHD, who showed better emotional control and concentration and less aggression, and research on kids with autism in the U.S. had similar results.
- The Better Brain, her new book with psychologist Bonnie Kaplan, Ph.D., which is tailored to a non-scientific audience. It gives an in-depth explanation of the importance of nutrition in mental health, the latest science behind it, stories about life-changing improvements in people treated with micronutrients, recipes, and information on using supplements. (She notes that none of her work is funded by nutrient manufacturers.)
- Case studies from Rucklidge’s book where researchers used higher-than-usual doses of broad-spectrum micronutrients to treat severe mental health issues in children who were then tracked over many years. These include the story of Isaiah, diagnosed with ADHD, who had been expelled from multiple schools. His self-control and behavior improved markedly with nutrients and he is still doing well as long as he takes them. Another boy, Andrew, was hospitalized for OCD and psychosis at a young age. No treatments seemed to help him, but he recovered with nutrients and remains healthy as an adult.
- How a nutritional approach to mental health can reduce healthcare costs. Rucklidge notes that the price of Andrew’s supplements was less than 2 percent of the cost of his inpatient stay. She observes, “We think that this is going to save public health care systems and insurance companies a lot of money because we can reduce that cycling in and out of inpatient care that you see often when people are on psychiatric medications.”
- How parents of children with mental health or behavioral problems can implement a therapeutic approach to nutrition. One place to start is by seeking out an “integrative” physician or contacting one of the supplement manufacturers noted in the book for lists of practitioners who use their products. A careful, individualized approach is needed when combining diet and supplements with, or withdrawing from, any psychiatric drugs a child is taking.
- Practical tips for affording and preparing a whole-foods, Mediterranean-style diet. “Any step in the right direction is going to be beneficial,” Rucklidge maintains. Families can shift away from ultra-processed foods and substitute low-cost whole foods, along with eating less meat and more plant-protein sources; buying produce in season; and joining community gardens. She urges people to consider the long-term costs of an unhealthy diet versus paying a bit more for nutritious items.
- Gaining buy-in to a nutritional approach to mental health from pediatricians and other providers. She says that medical professionals have been resistant to considering the effectiveness of a nutritional approach to mental and general health because it is not part of their training, but that the growth of scientific evidence is changing minds.
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Resources
Mental Health and Nutrition Research Group, University of Canterbury
TEDx talk: The Surprisingly Dramatic Role of Nutrition in Mental Health (and her thoughts on “Why Scientists Should Reconsider Presenting with TED”)
Online course: Mental Health and Nutrition (credit or non-credit)
Read Julia’s MIA blogs here.
So- at last, another weirdo like me who believes that your diet plays an important role in maintaining or regaining one’s sanity. I’ve occasionally wondered if I lived on the same planet as some of the other commentators.
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Yes diet does play a role in one’s alleged “mental health.” When I have a bad day, there is nothing better than a peanut butter and jelly sandwich on white bread to bring me to a proper uplifting perspective. But, there is another point to be made here. It is well known that these psych drugs mess up one’s metabolism. Some cause serious weight gain and make it nearly impossible to take the weight off, even if following strict exercise and diet regimens. Another point to be made is that after the drugs, after the withdrawal, one’s eating habits may change somewhat. Of course, during withdrawal, eating can be very dicey and I have seem perhaps no articles that addresses that critical time and diet. But after the withdrawal, the brain is probably damaged and may not be able to process all that is necessary to make allegedly healthy recipes because the foods involved, the techniques, etc. involved could be quite difficult. The other issue is that after years on the drugs what one can eat might be critically diminished and there might be needs not previously known; such as even though the person is no longer on lithium, a salt-restrictive diet would be questionable and damaging. So, in my opinion, given the amount of people introduced to these drugs is probably increasing by an very high amount, especially in light of this virus and the restrictions imposed, and many may hopefully wish to no longer take these drugs at some time, I feel this must be addressed as soon as possible. Thank you.
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That’s a great point, Rebel. Dr. Rucklidge did mention in passing that there’s some evidence nutrient supplements can help with drug withdrawal. I’d like to have her on again to talk about this, or someone else involved with that research.
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That’s interesting. Would any nutritional supplements help after the withdrawal? However, I do see a few problems with any nutritional supplements. Depending on the individual, the body may reject taking any more pills or pill-like substances. A related issue is the anxiety caused into taking these pill or pill-like substances after the horrific experiences with the psych drugs. There are sometimes inert substances in these pills that can cause problems for the individual. As for me, I can no longer take any pill or pill-like substance into my body without some sort of rejection or side effect. I do not even take an aspirin, a tylenol, or OTC medicine at all. I can only use substances that I can safely rub onto my skin: iodine or OTC Pain Healing rubs. The former I use to avoid infection with a cut, because I am allergic to all types of alcohol and the latter I use for pain such as headache or muscle ache. Thank you.
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Rebel – you raise some really important issues that deserve research into what helps with the challenges of withdrawal and what foods and/or supplements may also assist. MAI runs a lot of drug withdrawal workshops and they might have some answers there but at present, while I have seen some research on amino acids – and anecdotal reports of nutrients helping with withdrawal as well as one study we conducted that showed nutrients helped some people quit smoking (another form of withdrawal) – it is definitely an issue that needs research attention – and would need (in my opinion) the prescribers involved. As a non-prescriber, I can’t conduct research on tapering down drugs as nutrients are added so it would be great to see psychiatry step up and find some solutions to this most serious problem.
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Rebel & Julia,
I see discussion on nutrients and withdrawal. There is actually a great deal not only on nutrients through diet and supplements on drug withdrawal, like from tobacco, illegal opiates, and alcohol, but also on prescriptions like benzodiazepines and major tranquilizers. Julia, you reference your group’s study, as well as anecdotal reports, but there is more than meets the eye. Many references can be found in Hoffer/Saul’s The Vitamin Cure for Alcoholism, https://www.amazon.com/Vitamin-Cure-Alcoholism-Orthomolecular-Addictions/dp/159120254X/ref=mp_s_a_1_3?dchild=1&keywords=vitamin treatment alcoholism&qid=1619491639&sr=8-3, and material in The Journal of Orthomolecular Medicine, https://isom.ca/jom/, although there are many others. Is it not good enough, only anecdotal, or should it be forgotten and left behind? Rebel, your difficulty with diet and any type of supplements (at least pills/pill-like) is certainly a difficult challenge in terms of some of this.
Julia, you said you (‘we’) did research on quitting nicotine, and associated withdrawal, yet you said you yourself can’t do tapering studies on drugs, as you are not a prescriber. I assume you refer there to prescription drugs and not legal drugs like nicotine? The references I made above, and many more, have been run, used, consulted, reviewed, and affirmed by and with many prescribers, psychiatric and as physicians.
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You are right as regards taking supplements especially in pill form. As far as my body’s now rejection and adversity to medicine, especially, pills, this may even go back to my teenage days when I was taking tetracycline four times a day for “acne” and then tylenol four times a day for continuous headaches, some migraines during some of my earlier adult years. However, I have learned that if I seem to be short on a particular vitamin or mineral, I found what food has a good concentration of it and then, if I can, incorporate it into my diet until the problem seems to be alleviated. This practice seems to work for me; but each person is thankfully individually different and unique. Thank you.
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rebel,
That makes sense. You at one point mentioned the ‘fillers’ of pills and such. Some capsules either do not have as many or any fillers at all, although the common ones are so often there like magnesium stearate. But other ‘supplements’ have none, like liquids, powders, etc. Then there are herbal methods, like teas or capsules.
I’m all for using dietary strategies and being mindful there. It is especially good for preventing deficiencies or boosting certain nutrients to modest levels. Too many Brazil nuts may lead to too much selenium and what not, but 20 oranges will only give you so much vitamin C, and olive oil only so much vitamin E. I’d be glad to hear from someone who even gets the RDA of magnesium, vitamin E, vitamin A, and iodine, as well as omega-3 fatty acids (which don’t have a formal RDA), in their diet alone. You really have to practice the most radical of diets like the paleo with 9 cups of fruits and vegetables, organ meat, fish, and seaweed, etc. to get either the RDA or the more optimal levels. As someone who has had a lot of jaw popping while chewing (painful if I over did it), then I can appreciate any way to bypass a crunching and masticating festival to get the amounts of nutrients that I would like.
Each person is individually different and unique, however luckily not so much as a whole that we never share commonalities. Basic nutrient deficiency disorders seem to be examples of this.
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I’d note that, sticking with the chemical and biochemical, the Hoffer/Saul book highlights the use psychedelics for addiction, such as as when an orthomolecular approach doesn’t work (as a last resort). Much research went on (while it was legal) going back to the ’50s and ’60s. But there is a great deal over the last couple decades, too. I have benefited from low-dose generic affordable ketamine.
Even though this may seem like replacing one hat for another, it connects to discussion on the differences between ‘addiction’, ‘habit’, and ‘management’. And ‘substance use-abuse’ vs ‘medicine’. Since nutrients are technically chemicals, whether natural or synthetic, I don’t find the use of certain substances to overcome other chemical challenges as innately wrong.
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What you are saying sounds interesting, but, it seems beyond my thinking that a psychedelic type drug could help in the withdrawal from a highly addictive drug like an opiate or a benzo, as both in their withdrawal phases can for some cause “psychotic-like” symptoms. This seems a dangerous area. I think the only way to truly and successfully have a withdrawal from all these various addictive drugs is to stay away from all drugs especially until the most critical time has passed. It seems to me the only drugs that might be used would be that necessary in a “life-threatening” situation. Personally, it should, in my opinion, be the goal of all those who have suffered addiction or similar or other problems due to any drugs, it is stay away from drugs all together, if possible. Thank you.
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rebel,
Thank you for your input. I can sympathize with your views on this. You mentioned in an above-comment that you appreciated our biochemical (etc.) individuality, so this may apply to some degree with this area. Psychedelics have been used (under some conditions, often carefully and attentively) as single experiences, as well as multiple or even daily micro-dosing, which is basically what I do with ketamine (low-dose). I quit using cannabis immediately when starting to use ketamine and radically lowered my dose of major tranquilizer. I’ve actually been off the ‘antipsychotic’/major tranquilizer for going on 2 months now. (I’ve been on ketamine for 14 months, but it has been a process). It’s interesting how the (perceived?) need to take an antipsychotic is diminished when one is not suicidal and depressed. I’m still working on the benzodiazepine, but my main focus right now is to never take an antipsychotic again for the rest of my life. I’m sure you can understand why.
The ‘psychotic-like’ aspects are certainly a complex topic with all this, both from pharmaceutical withdrawal and use of any psychedelic. Ketamine itself has been used for (what I consider dubious) research to ‘understand’ schizophrenia and psychosis. As someone who not only has had labels of schizophrenia and psychosis, but who has been researching what these could or could not be and how they can be viewed and experienced, I am always sensitive when these subjects come up. Perhaps there will be another time for a deeper dive into that, but it should definitely be attended to.
There is research and experience going back at least to the ’50s and ’60s on the use of psychedelics like LSD and mescaline to help alcoholism/alcohol-abuse, and other substance use/misuse, and more recently there is research on psilocybin (magic mushroom active ingredient) for cocaine addiction, ibogaine for heroin addiction, and again, ketamine for certain ‘addictions’. You mention the ‘life-threatening’ situation where drugs may be necessary; given that I was almost as suicidal as one can get before using ketamine (and other wellness modes), I’m sure you could understand why it may have been initiated for me as a ‘life-saving treatment’. But my continued use is an ongoing thing. My impression is that you are more amenable to nutrients as ‘chemical/drug tools’, or simply don’t see them as chemicals, but you mentioned above that you are quite conservative there, too. It’s all so damn complicated, isn’t it?
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Hoffer, and his buddy Humphry Osmond did a lot of that early research while both were in Saskatchewan, back in the 1950’s and early 1960’s. Were it not for the US DEA, psychedelic therapy would likely still be around in Canada.
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One supplement for withdrawals that I know of is the use of mega niacin for alcohol withdrawals, having overseen a couple of them, when the friends of an individual whose style involved going cold turkey and collapsing on the street became worried and contacted me, knowing I had assisted in preventing adverse drug/alcohol reactions in others.
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bcharris,
The other forms of B3 have been used too, but not always in the exact same way. Bill W. of Alcoholic’s Anonymous and his use of B3 has an interesting history. (Perhaps you knew that Dr. Abram Hoffer ‘prescribed’ it to him for his depression and anxiety, after he had long stopped drinking? I think you are familiar with Hoffer.) Bill W. advocated its use and spread pamphlets, but that part of the AA history unfortunately did not stick around like many of the other principles. Interestingly, Bill W. (and many AA members) continued to smoke cigarettes for the rest of his life. I believe he died of smoking-related lung disease.
Large dose vitamin C is useful in many ways, including neutralizing and removing toxins, and even assisting with opiate overdoses if you can get the stuff in the person. Vitamin C IV’s have profound power in terms of toxin exposure. But other nutrients can assist with withdrawal, not the least of which is because of rebalancing and strengthening various parts of the body and their interactions. Magnesium chloride was one thing that helped me get of tobacco. It relaxed and rebooted my muscles, which were in a way verging on catatonia.
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For alcohol related issues, plain old nicotinic acid B3 is the substance of choice, particularly for withdrawals. I don’t know if flush-free B3, (inositol hexanicotinate?) would work as well, as I’m used to flush-filled nicotinic acid after several decades of using it, myself.
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bcharris,
Here is the original Bill W. AA pamphlet. I actually haven’t read it yet, but I notice it does mention niacinamide, as well.
https://aaagnostica.org/wp-content/uploads/2016/05/The-Vitamin-B-3-Therapy.pdf
Hoffer often used niacinamide for children and elders especially, and many women, due to the feeling or cosmetics of the flush. I’ve been using inositol hexaniacinate (no-flush) B3 (7 grams a day!) with great satisfaction. I was on niacin for 4 years, niacinamide for probably 3. I had issues with the those after awhile that I won’t go into here. I do wonder if the niacin caused my rosacea/face acne after 3-4 years of flushing very deeply every morning. My dermatologist doesn’t think so, but I’m not convinced. The orthomolecular literature usually says alternatives to niacin will have to be used if: 1) the flush becomes intolerable or 2) if the flush doesn’t stop or isn’t reduced. Curious. The flush stops or dramatically stops for many who use large doses consistently. Do you still flush at all? Hoffer only had a slight tingle in the forehead.
Hoffer usually mentioned niacin (his favorite) and niacinamide, but he occasionally mentions inositol hexaniacinate, and even more rarely the NAD supplements from research of decades ago, etc. He says things like inositol hexaniacinate is good for ‘schizophrenia’, but not quite as effective (same for modulating cholesterol/triglycerides). I believe the even larger doses of this form compensates for both. I feel he didn’t mention it as much because it has always been more expensive, and he knew that many people he recommended for would not have the budget. It feels very ‘smooth’.
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bcharris,
Correction: the link I gave isn’t the original pamphlet, but seems to be a follow-up and much longer piece designed by Bill W. for physicians.
Also my comment on cholesterol/triglycerides was in relation to niacin, although the one on ‘schizophrenia’ compared to both niacin and niacinamide.
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I’ve been using and studying clinical nutrition and nutritional psychiatry for years. I dedicate part of my website to it. I only read the discussion points and didn’t listen to the audio. However, some points:
This piece invokes ‘The emerging field of Nutritional Psychiatry’: I’m sorry, but nutritional psychiatry and health has been going on for almost a century. (Actually longer than decades, since citrus was used for what was not yet known as scurvy and Ayurvedic and other herbal/dietary medicines were used for centuries/millennia.) Here, I am primarily referring to orthomolecular psychiatry first, then functional and integrative psychiatry/medicine. This includes reliable research, clinical use, and ‘anecdotal reports’. Julia’s interest ‘grew out of her own research showing poor outcomes for children with psych. outcomes for children with psych. illness despite conventional treatments…..In the last decade, the MHNRG has been running clinical trials….’. Well, I beg your pardon, but there is a very rich history that should have been attended to before her ‘practice’, and there should have been recognition of many types of research for many decades. If my points are irrelevant, I would be curious to know how many references from the last 70 years are used in Julia’s new book. Not scientific enough, not rigorous enough, not enough ‘patients’ studied? Hm, I wonder, and I certainly hope I’m wrong. Otherwise, this is putting a new lock on an old door. Maybe the old key was never found.
Supplements can be beneficial not only because ‘quality foods aren’t available, or if the child has a higher need for certain nutrients due to genetic factors and/or environmental stressors.’ But additionally, they may be useful for optimizing health, prevention, and treatment, regardless of these factors that are mentioned. Also, there is at least one exception to the comment on no ‘vitamin’ being a ‘magic bullet’, although I believe there are others. And that is micro-nutrient deficiencies, whether essential vitamin, mineral, fatty acid, or amino acid. D3 IS a magic bullet for preventing and treating Rickets, B3 for pellagra, B12 for beri beri, and C for scurvy. No? Sure, there may be additional needs if someone already has rickets or scurvy, but I don’t think that is my point. Although, obtaining the ‘consortium’ of nutrients does have a synergistic and holistic effect.
‘Nutrient psychiatry’ or nutrients for mental/(and physical) health can save system costs like insurance companies and hospitals, but only in the big picture. They should cover the costs some way, and incorporate this into the entire field, but right now, mostly the customers, the citizens that already choose these methods, pay out-of-pocket for the food, supplements, educational materials, time learning, etc. My insurance company covers a bit of supplements, but only 1 or 2 brands/products, usually of cheap quality with unnecessary ingredients. Some nutrient products are even patented and used in normal prescribing practices like vitamin B9 (as folic acid) used for MTHFR gene variants. They are more expensive with unnecessary ingredients like red dye #5 (or whatever it’s called). The psychiatrist I had would use THAT (since I tested positive for heterozygous MTHFR), yet she warned me against using most of other supplements. Being FDA-approved seems to be a magic halo for many prescribers. My psych. nurse practitioner asked his consulting doctor if I could use nutrient supplements in the psych. hospital (because I asked in case I needed to go), and they said ‘no, because they are not FDA-approved’. I don’t need to say here what I really think about that response.
I mention these things because I care. 🙂 By all means, continue the many decades long (and longer) movement of using nutrition in psychiatry, overall health care, and healthcare systems. Prove more, network more, educate more. Just don’t make it seem like you are starting from the beginning, or middle for that matter.
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I see that I have probably misused the word ‘practice’. I don’t believe this word is used for clinical psychology professors or administrators of research organizations. Sorry about that.
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Duplicate comment
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B1 is for beriberi.
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bcharris,
Yes, thank you for correcting me on that, both the nutrient and the spelling of beriberi. I’ll be the first one to say that I will need editing, revision, multiple drafts, and more homework for the rest of my life.
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Oops.
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Evan1, great contributions!
In calling Nutritional Psychiatry an emerging field (my words, not Dr. Rucklidge’s), I mean field of formalized scientific study or branch of psychiatry. Her blogs and book with Dr. Kaplan do point out how ancient the use of food-as-medicine is and how today’s research builds on that.
In any case, I was excited to find their work because, among many other reasons, it so validated my own experience. When I had my own “mental breakdown” some years ago, I stumbled into a functional medicine practitioner who was also a psychiatrist. Nutritional supplements were an important part of my individualized “treatment” plan, which addressed previously undiagnosed nutritional issues. It was part of a much broader approach but I do recall immediately being put on high doses of a multivitamin as well as getting B12 shots for a bona fide deficiency and also high doses of fish oil for brain health. At the time, no other psych pro I consulted even brought the issue up…just wanted to write me a drug script.
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Miranda,
Thank you. I can readily see how the ancient uses of food-as-medicine would naturally be recognized. My main point is that nutritional psychiatry is not new, as scientific research nor as a branch of psychiatry. Perhaps you are emphasizing the size, popularity, and amount and types of research that have been growing over the last decade or so? More integration into schooling, more practitioners, more well-funded and longer research projects, perhaps with more sophisticated testing technologies, etc.?
One famous example is Dr. Linus Pauling and his Linus Pauling Institute that started in the ’70s under a different name. He not only coined the term orthomolecular (the ‘field’ of which has had a pioneering and profound influence on all these areas today), but he first learned about the science, clinical use, and basic ideas from Drs. Hoffer and Osmond’s book called How to Live with Schizophrenia, which included clinical research, and the first few randomized double-blind placebo-controlled studies in psychiatry involving vitamin B3. (Hoffer later criticized the trend of these ‘gold-standard’ methods for justifiable reasons I won’t go into here.)
I can understand that much of the early ‘pioneering’ work was based on practical clinical experience and, to some extent, research that would be lacking in the complexities of technologies and accumulated (sometimes only apparent) knowledge that modern research would prefer. However, research and the development of the nutritional and nutritional psychiatry fields have taken many forms and turns over the decades. So my impression is that you are either requiring a certain threshold of ‘formality’ to be made to consider it formal scientific research and a new field, or you are disregarding the work and research of the last 70 years and more. Thank you. I am certainly glad you found benefit with this stuff in your own history.
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