One of the key messages of our book THE BETTER BRAIN is that nutrition is the foundation of resilience. Very often we hear people say that we live in such stressful times, which must be why 20% of our population is now diagnosed with a mental disorder (in contrast to <3% in 1960). This explanation misses the mark, in our opinion. Our recent ancestors lived with the Great Depression and two World Wars, without antibiotics, without anaesthetics, and yes — even through a pandemic. Is our life really more stressful….or.…is our resilience lower?
Our current dietary intake. Recent studies show that we are not consuming as healthy a diet as our ancestors did. For example, in the last 50 years people in western societies have cut their intake of minerals and vitamins (which we will call “micronutrients”) by more than 50%! Why would anyone choose to do that?
We don’t think it is a conscious choice — it’s just that people have become used to consuming primarily ultra-processed food (UPF) — stuff that sort of looks like food but is mainly a chemical mix of things like fats, simple carbs (sugar), and salt. The problem is that these packaged items have very few minerals or vitamins. Would that matter to our brain health? YES! For our brains to work at their best, they need more than 30 micronutrients every minute of every single day of our lives. And UPFs cannot provide them.
How we handle stress. One underlying premise of the book is that people do not change their behavior just because they are told “it will be good for you.” So a high priority of the first few chapters is to explain why we all should avoid UPFs and increase our intake of whole foods, and how to do that inexpensively. We also provide a summary of the evidence that proves that the recent move toward relying on UPFs likely accounts for some of the reduced resilience and increased mental health problems. We support this argument in many ways in the book, and here we will focus on just one: nutritional treatment of post-trauma stress.
Post-trauma stress. Disasters, both natural (e.g., earthquakes, floods) and human-made (e.g., terrorism, mass shootings) affect communities worldwide, often causing immense suffering and long-term psychological effects. Julia lives and works in Christchurch, New Zealand, which has had its fair share of traumas, but then has also provided her with the opportunity to study the effect of nutrients on our resilience.
For example, on February 22nd 2011, Christchurch experienced a devastating 6.3 magnitude earthquake that killed 185 people and destroyed the city centre. But as awful as it was, this trauma gave her Mental Health and Nutrition Lab at the University of Canterbury the chance to learn whether micronutrients could help people recover, not from the physical injuries, but from the psychological ones.
Here’s the rationale for exploring that question. When we are under high stress, even those of us who avoid UPFs often reach for “comfort” foods (like cookies, donuts) which are usually calorie-rich but nutrient-poor. But what is our brain simultaneously doing during that high stress? At such times, our natural alarm response system responsible for fight or flight is activated. Chemicals like adrenalin and cortisol are released, enabling us to get to safety, shut down non-essential functions, and make sure the muscles we need for flight or flight get activated. Unfortunately, over extended periods of time, the alarm system can go into over-drive, and this is one factor that can lead to re-experiencing memories, having flashbacks, being hypervigilant and on edge all the time, feeling anxious and panicky when reminded of the traumatic event. Inevitably, sleep disturbance and nightmares become common.
But while this high stress is occurring, and your alarm systems are being activated, your brain and body use a triage system to divert nutrients to the urgent, acute needs of fight or flight. In other words, so many ongoing functions may be relatively neglected — such as regulating mood, growth, DNA repair, and clarity of cognition.
Making neurotransmitters (like dopamine or serotonin) and hormones (like cortisol) requires micronutrients, which are numerous kinds of vitamins and minerals, like zinc, calcium, magnesium, iron, and all the B vitamins, vitamin C. This is a well-established scientific fact. If your body is depleted of these nutrients, then either it won’t have sufficient nutrients to make these essential chemicals, or it will redirect all resources to the fight-flight response (as it is so vital for survival) and there won’t be much left for ensuring optimal brain function to do things like concentrate, regulate moods and sleep.
Earthquakes and a flood. Perhaps it makes sense now that as micronutrients get depleted at a high rate during times of stress, we need to replenish them in greater quantity from our food (and perhaps other sources). Julie studied this following the Christchurch earthquakes and with Bonnie during the Southern Alberta flood, and we want people to be aware of it during the pandemic. And by the way, during two of our studies, we also found that B vitamins in particular can be helpful in reducing stress.
Mass shooting. And then another event happened. In 2019, a gunman walked into two mosques in Christchurch and killed 51 people while wounding 40 others. Once again that city and its people were dealing with huge trauma. As an application of translational science, Julia’s research lab offered donated nutrients to anyone who was a survivor of the shootings and monitored their symptoms as both an ethical and standard action for good clinical care.
Within weeks, they were clinically monitoring 26 people who had come forward, and they saw the exact same treatment effect that both of us had seen after the earthquakes and the flood. Not everyone, but many people got better. These clinical observations have just been published in an APA journal, International Perspectives in Psychology: Research, Practice, Consultation.
Here are a few of the details from the mosque massacre treatment. Before starting the treatment, 77 percent of those original 26 participants met or exceeded a cut-off score defining probable PTSD. After an average of five weeks, this rate dropped to 23 percent. In other words, of all the people who likely had PTSD, almost three quarters showed substantial and clinically significant improvement after about a month of micronutrient treatment. Stress reduced into the normal nonclinical range, similar to the controlled research after the earthquakes and a flood:
Summary of the post-trauma studies. The conclusion we draw from this line of post-disaster research is that providing micronutrients to survivors appears to reduce psychological distress to a clinically significant degree. These three different examples of traumatic events illustrate the powerful effect nutrients can have in recovery and improving resilience. Could these results apply to challenges associated with climate change and pandemics? We think so. Anything that can improve our resilience to coping with ongoing stressful events has to be a good thing to know about.
Given ease of use and large effect sizes, this evidence supports the routine focus on eating nutrient dense food and in some cases, additional micronutrients as supplements for disaster survivors as part of governmental response.
Obstacles. The road to convincing governments to help people with micronutrients has been quite the challenge. For instance, Julia wrote up a description published in the New Zealand Medical Journal last year, describing how, after the mosque attacks, they faced huge difficulties in disseminating the results of the earthquake and flood research, and the barriers that largely prevented it being translated into practice. She observed an inflexible health system unable to implement evidence-based research, and ethics committees unable to respond quickly in order to facilitate research in the immediate disaster aftermath, when distress and stress is at its height.
In Alberta, Bonnie’s experience was similar. Following the publication of the earthquake and flood results, there was a massive forest fire in Northern Alberta in 2016. More than 90,000 people had to leave their homes in and around Fort McMurray. Many lived in university dormitories sprinkled around the province and were not permitted to return to their homes for several months. Bonnie approached various officials in government and in the provincial health care system, asking that people be given micronutrients to mitigate the psychological impact of the trauma. Even though she was able to base her proposal on local, provincial data, all her suggestions were rejected — even the idea of just mentioning to people that they might want to take an inexpensive B complex after breakfast every day.
Broader future implications. It’s important to understand that the post-trauma studies described here are supported by other studies from the UK, Belgium, South Africa etc, all of which showed that nutritional supplementation can enhance resilience. This should not surprise the readers here, as many of you already know the truth of what we said in our first sentence: nutrition is the foundation of resilience.
In THE BETTER BRAIN we conclude with a chapter called “A vision for a happier, healthier tomorrow.” We emphasize food first as the way in which we should improve our resilience. We lay out a three-step approach to improving mental health resilience which acknowledges that we are not all the same, that individual differences will influence efficacy of different treatments, and there is a place in the “mental health treatment tool box” for all the evidence-based treatments: these include whole-foods diets, micronutrients, counselling, family therapy, and medication. And we argue that nutrition ought to come first, because it provides the foundation for all the others.
The proposed title for our book was Hidden Brain Hunger before being changed to The Better Brain. We think this aptly describe the modern brain today.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.