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	<title>mood disorders Archives - Amazing Health Advances</title>
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		<title>Urgent: 25% of Pregnant Women Risk Omega-3 Deficiency</title>
		<link>https://amazinghealthadvances.net/urgent-25-of-pregnant-women-at-risk-of-omega-3-deficiency-8103/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=urgent-25-of-pregnant-women-at-risk-of-omega-3-deficiency-8103</link>
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		<dc:creator><![CDATA[The AHA! Team]]></dc:creator>
		<pubDate>Mon, 06 May 2024 18:02:57 +0000</pubDate>
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		<category><![CDATA[Omega-3 deficiency]]></category>
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		<guid isPermaLink="false">https://amazinghealthadvances.net/?p=15548</guid>

					<description><![CDATA[<p>Stephanie Woods via NaturalHealth365 &#8211; Omega-3 fatty acids are vital to a healthy diet and provide many benefits, including brain and heart health. However, a recent study says pregnant women may not get enough omega-3 from their diet or supplements. Getting enough omega-3 during pregnancy can help prevent preterm birth and promote neurodevelopment and overall health of the baby. This gives babies a good, healthy start in life, but almost a quarter of the study participants reported that they did not eat any fish or take any omega-3 supplements during their pregnancy. Research reveals omega-3 deficiency common among expectant mothers A recent study, led by researchers at the Harvard Pilgrim Health Care Institute and published on February 27, 2024, sheds light on omega-3 deficiency in pregnant women. Drawing data from the Environmental Influences on Child Health Outcomes (ECHO) program, the study examined the dietary habits of 10,800 pregnant women regarding fish consumption and supplement intake from 12,646 expectant mothers. After carefully examining the data, the study reveals a concerning reality: many pregnant women are at significant risk of omega-3 deficiency. 25% of pregnant women lack omega-3-rich fish consumption The study’s findings showed that almost a quarter (25%) of the participants reported not consuming any fish or consuming fish less than once a month during their pregnancy. It also showed that just 16% of the women reported taking omega-3 supplements. The findings also showed that women who consumed less fish were also less likely to use omega-3 supplements. This put that group at an even greater risk of not getting sufficient omega-3 fatty acids during pregnancy. Potential risks of omega-3 deficiency during pregnancy There are several risks that an omega-3 deficiency can cause in infants and fetuses. Omega-3 is vital not only for a child’s neurodevelopment after birth but also for fetal brain development. Omega-3 deficiency during pregnancy has been linked to lower behavior and developmental scores. There are also benefits for the pregnant mother. Omega-3 intake during pregnancy has also been linked to regulating inflammation, preventing heart disease, and preventing mood disorders. It can also be beneficial for many medical conditions, such as IBS, cancer, and rheumatoid arthritis. In short, omega-3 intake during pregnancy can benefit both mother and baby. How to make sure you get enough omega-3 While there isn’t a set daily recommended intake for omega-3, guidelines for alpha-linolenic acid (ALA), a type of omega-3 fatty acid, offer insight into suggested amounts: Pregnant women: 1.4 g Breastfeeding women: 1.3 g Children: Birth to 12 months: 0.5 g 1-3 years: 0.7 g 4-8 years: 0.9 g Boys 9-13 years: 1.2 g Girls 9-13 years: 1.0 g Teens: Boys 14-18 years: 1.6 g Girls 14-18 years: 1.1 g Incorporating omega-3 fatty acids into your diet can be achieved through supplements or by consuming foods rich in omega-3s daily, such as: Cold water, fatty fish like mackerel, salmon, herring, and sardines Nuts and seeds such as chia seeds, flaxseed, and walnuts Plant oils like, flaxseed oil Whole foods like organic milk, pasture raised eggs and raw yogurt Bottom line: prioritizing good prenatal care alongside a wholesome diet can benefit both the baby’s and the mother’s health. Fortunately, incorporating enough omega-3 into your diet is relatively straightforward. Take action now – your baby is counting on you. Sources for this article include: Cambridge.org Sciencedaily.com NIH.gov Americanpregnancy.org NIH.gov To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/urgent-25-of-pregnant-women-at-risk-of-omega-3-deficiency-8103/">Urgent: 25% of Pregnant Women Risk Omega-3 Deficiency</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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		<title>Immune System Irregularities Found in Women With Postpartum Mood Disorders</title>
		<link>https://amazinghealthadvances.net/immune-system-irregularities-found-in-women-with-postpartum-mood-disorders-8082/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=immune-system-irregularities-found-in-women-with-postpartum-mood-disorders-8082</link>
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		<dc:creator><![CDATA[AHA Publisher]]></dc:creator>
		<pubDate>Mon, 05 Dec 2022 08:00:03 +0000</pubDate>
				<category><![CDATA[Archive]]></category>
		<category><![CDATA[Emotional Health]]></category>
		<category><![CDATA[Health Advances]]></category>
		<category><![CDATA[Mental Health]]></category>
		<category><![CDATA[Studies]]></category>
		<category><![CDATA[Women's Health]]></category>
		<category><![CDATA[immune system]]></category>
		<category><![CDATA[immune system defense]]></category>
		<category><![CDATA[mood disorders]]></category>
		<category><![CDATA[postpartum]]></category>
		<category><![CDATA[postpartum anxiety]]></category>
		<category><![CDATA[postpartum depression]]></category>
		<category><![CDATA[PTSD]]></category>
		<guid isPermaLink="false">https://amazinghealthadvances.net/?p=15457</guid>

					<description><![CDATA[<p>Cedars-Sinai via Newswise &#8211; LOS ANGELES (Dec. 2, 2022) &#8212; Women with prolonged mental health problems up to three years after childbirth may be suffering from irregular immune system responses, according to new research by Cedars-Sinai investigators. The findings are published in the American Journal of Reproductive Immunology. “We found that women who had clinically elevated symptoms of depression, anxiety, and/or post-traumatic stress disorder (PTSD) two to three years after delivery had genetic evidence of a higher prevalence of immune system defense mechanism activation,”said Eynav Accortt, PhD, principal investigator of the study and director of the Reproductive Psychology Program at Cedars-Sinai. “These women also appeared to have a reduction in the activity of genes related to antiviral immune responses that can offer the body protection from pathogens,” said Accortt, a clinical psychologist. According to the Centers for Disease Control and Prevention, about 1 in 8 women experience significant symptoms of perinatal mood and anxiety disorders that can interfere with overall health, daily activities and family life. Much of the research into maternal mental health to date has focused on the perinatal period and the first year after childbirth. Cedars-Sinai investigators surveyed 33 women about their mental health over a longer period, two to three years after giving birth. Study participants also provided a blood sample, and scientists performed bioinformatic analyses of differential gene expression. “Delayed or persistent postpartum anxiety, depression and PTSD is an area that is woefully understudied,” said Sarah Kilpatrick, MD, PhD, chair of the Department of Obstetrics and Gynecology at Cedars-Sinai and one of the study’s co-authors. “In this preliminary research, we have identified genetic differences related to inflammation when comparing women experiencing prolonged symptoms of mood and anxiety disorders to those who did not report poor mental health. Additional studies will be needed for a deeper dive into the role inflammation may play in postpartum mental illness,” said Kilpatrick. A primary goal of this work is to design a blood test that would detect which women are at the highest risk for serious and prolonged postpartum mood disorders, according to Accortt. “A blood test could help us develop early interventions that provide medical and mental health treatments and support. We want to figure out why some women are at greater risk for depression, anxiety and PTSD. No one should have to suffer for years after childbirth,” said Accortt. To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/immune-system-irregularities-found-in-women-with-postpartum-mood-disorders-8082/">Immune System Irregularities Found in Women With Postpartum Mood Disorders</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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		<title>The Effect of Diet on Mental Health</title>
		<link>https://amazinghealthadvances.net/the-effect-of-diet-on-mental-health-7917/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=the-effect-of-diet-on-mental-health-7917</link>
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		<dc:creator><![CDATA[AHA Publisher]]></dc:creator>
		<pubDate>Fri, 08 Apr 2022 07:00:04 +0000</pubDate>
				<category><![CDATA[Archive]]></category>
		<category><![CDATA[Diet]]></category>
		<category><![CDATA[Gut Health]]></category>
		<category><![CDATA[Mental Health]]></category>
		<category><![CDATA[Nutrition]]></category>
		<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[emotion regulation]]></category>
		<category><![CDATA[food psychiatry]]></category>
		<category><![CDATA[gut microbiota]]></category>
		<category><![CDATA[gut-brain axis]]></category>
		<category><![CDATA[healthy diet]]></category>
		<category><![CDATA[high blood sugar]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[mood disorders]]></category>
		<category><![CDATA[neurotransmitter]]></category>
		<category><![CDATA[regulate mood]]></category>
		<category><![CDATA[serotonin]]></category>
		<guid isPermaLink="false">https://amazinghealthadvances.net/?p=14369</guid>

					<description><![CDATA[<p>Dr. Liji Thomas, MD via News Medical &#8211; The brain controls and regulates most of the body’s vital functions, conscious or not. For this reason, it is essential that the brain receives a steady supply of fuel and oxygen. The fuel is obtained by metabolizing nutrients made available in the bloodstream, originating in the digested food. The brain consumes 20% of the daily intake of calories, that is, about 400 (out of 2000) calories a day. Structurally, about 60% of the brain is fat, comprising of high cholesterol and polyunsaturated fatty acids (PUFAs). Thus, the food one eats is directly linked to brain structure and function, and thus affects the working of the mind. Many studies have found that diets that are too rich in refined sugars are toxic to brain functioning because the high content of simple sugars stresses the pancreas and induces insulin resistance. The high sugar levels with compensatory insulin responses stimulate the counter-reactive surge of autonomic neurotransmitters like cortisol and glucagon. These are known to produce increased anxiety, hunger and irritability. Moreover, they induce inflammatory and oxidative stress. This has been linked to an exacerbation of symptoms of depression and other mood disorders. These findings have led to the emerging field of nutritional psychiatry that traces relationships between food, feelings, gut microbiota, and human behavior. Deficiency Disorders and Mood The deficiency of nutrients like cobalamine, folate and zinc is known to be associated with symptoms of depression and dementia, cognitive decline and irritability. Both overeating and food insecurity are associated with mood and anxiety disorders. Mental illness is ranked among the largest contributors to the global health burden, especially depression, which accounts for the major chunk of disability in the more developed countries, especially in the age group of 15-44 years. Therefore, it is crucial to explore nutritional strategies to ameliorate these conditions. Not only do people eat differently when anxious or depressed, but these changes may occur in either direction. Conversely, depression may be the result, at least partly, of poor eating habits, or may become worsened by the inability of the patient to stop eating comfort foods and choose a healthy diet. Such inability may be financial, psychological, or iatrogenic. Serotonin and the Gut Serotonin is a monoamine neurotransmitter that helps to control sleep and appetite, inhibit pain, and to regulate mood. About 95% of the serotonin is produced in the gut, which is rich in neurons – the enteric plexus contains a hundred million nerve cells. Thus, the gut is intimately involved in emotional regulation, pain perception, and vital physiological functions. Interestingly, the function of these neurons and their secretion of serotonin, and other neurotransmitters, is closely regulated by the metabolic byproducts of the trillion or so bacteria that comprise the gut microbiome. These bacteria ensure epithelial barrier integrity for the intestine, preventing the entry of bacterial toxins and pathogens into the systemic circulation. They also prevent the spread of inflammation beyond the gut lumen, enhance nutrient absorption, and activate gut-brain neural pathways – the gut-brain axis. Monoamine neurotransmitters are synthesized from amino acids in a process that is mediated by mineral-dependent cofactors. Both folate and vitamin B12 are essential for the methylation that occurs during these synthetic processes, also regulating the formation of homocysteine – a metabolite that is strongly linked to cardiovascular risk and depression. Dietary Fats and Brain Functioning Anti-inflammatory fats such as omega-3 fatty acids (FAs) are known to be essential components of neuronal cell membranes, and also play a role in many vital neural processes such as neurotransmission, gene expression, neurogenesis and neuronal survival. They are also known to have antioxidant properties. Omega-3 FAs are used to treat a number of psychological disorders, including attention-deficit hyperactivity disorder (ADHD), depression, bipolar depression and post-traumatic stress disorder (PTSD). A high omega-6 proportion is linked to a higher incidence of these conditions, especially the first two. The standard Western diet is rich in omega-6 but low in omega-3 FAs, primarily because of the consumption of refined flours and sugars, and highly processed foods, and low amounts of seafood (including fish) and grass-fed beef. Some studies have confirmed that diets that are richer in healthier carbohydrates and fats, and lower in refined and highly processed foods, such as the Japanese and Mediterranean diets, are linked to a reduction in the incidence of depression by anywhere between a quarter to over a third, compared to the standard American diet. Inflammation and the Diet Inflammation of the nervous system is also important in the pathogenesis of mental illness, and this is also linked to the diet. Many biomarkers of inflammation, such as C-reactive protein (CRP) and tumor necrosis factor alpha (TNF-α) were associated with a dietary pattern that was linked to a higher risk of depression over the next decade or so. This pattern included high simple sugars (sweetened drinks and refined flours), red meat and margarine (saturated fats), and little green or yellow vegetables, coffee, wine, or olive oil, which are all features of the stereotypical Western diet. The high content of vegetables, fruits, grains, and seafood, with less dairy and meat content, and no refined foods, of the Mediterranean and Japanese diets, compares very favorably with the Western diet. The former uses small amounts of red wine and cheese or yogurt in the daily diet. The mechanism is thought to be via the brain-derived neurotrophic factor or BDNF. This important molecule is implicated in the plasticity and survival of neurons, and neurogenesis. It is reduced in many mental health conditions including depression, PTSD and schizophrenia, and is affected by many antidepressants that are commonly prescribed. Not only so, but the former presents many of the fruits and vegetables in fermented form, which provides probiotics protecting the gut by enhancing the content of health-promoting gut microbes and reducing or preventing inflammation throughout the body. Thus, including more foods with omega-3 FAs in the diet when on inflammation-inducing medications, not only prevents inflammatory changes but also prevents the induction of depression in such individuals, according to recent, admittedly early, work. Again, the Mediterranean diet promotes gut microbes that produce anti-inflammatory metabolites. Of course, depressive tendencies or stressors may prevent the beneficial effects of healthy food from manifesting themselves as reduced inflammation or improved mood. Secondly, only some depressed individuals show this inflammatory tendency, which may mean that diet plays this role in only a proportion of people, perhaps with other inflammatory conditions or due to constitutional factors. Conclusion Many experts would recommend that people pay attention to the relationship between their diet and the foods they eat over a month or at least two weeks. If they could reduce or eliminate processed foods and sugars for this period of time, before bringing back these foods one by one, it would be instructive to notice how they feel. Better eating strategies are essential to promote mental health and recovery from mental illness. It was over 2,000 years ago that the famous Greek physician Hippocrates said, “Let thy food be thy medicine and thy medicine be thy food.” Not only does the Mediterranean (and similar) diet affect the availability of the basic building blocks of the brain and neurotransmitters, including myelin, the neuronal membrane, and monoamine neurotransmitters, but it modulates key chemicals like BDNF to alter neuroplasticity, mutes system inflammation, and determines the health and state of the gut microbiome. Many such traditional diets are known to include mostly nutritious whole foods without much processing. The role of a dietary specialist in helping patients with mentally ill-health to choose approaches that promote the ability to take care of oneself and enhance one’s health is very important and should be encouraged. As one set of authors comment, &#8220;This message supports the idea that creating environments and developing measures that promote healthy, nutritious diets, while decreasing the consumption of highly processed and refined “junk” foods may provide benefits even beyond the well known effects on physical health, including improved psychological wellbeing.&#8221; To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/the-effect-of-diet-on-mental-health-7917/">The Effect of Diet on Mental Health</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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		<title>The Effect of Diet on Mental Health</title>
		<link>https://amazinghealthadvances.net/the-effect-of-diet-on-mental-health-7880/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=the-effect-of-diet-on-mental-health-7880</link>
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		<dc:creator><![CDATA[AHA Publisher]]></dc:creator>
		<pubDate>Wed, 09 Mar 2022 09:31:32 +0000</pubDate>
				<category><![CDATA[Diet]]></category>
		<category><![CDATA[Health Advances]]></category>
		<category><![CDATA[Mental Health]]></category>
		<category><![CDATA[Neuroscience Advances]]></category>
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		<category><![CDATA[Depression]]></category>
		<category><![CDATA[Gut Health]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[mood disorders]]></category>
		<category><![CDATA[neurotransmitter]]></category>
		<category><![CDATA[nutritional psychiatry]]></category>
		<category><![CDATA[nutritional strategies]]></category>
		<category><![CDATA[poor eating habits]]></category>
		<category><![CDATA[serotonin]]></category>
		<guid isPermaLink="false">https://amazinghealthadvances.net/?p=14234</guid>

					<description><![CDATA[<p>Dr. Liji Thomas, MD via News-Medical &#8211; The brain controls and regulates most of the body’s vital functions, conscious or not. For this reason, it is essential that the brain receives a steady supply of fuel and oxygen. The fuel is obtained by metabolizing nutrients made available in the bloodstream, originating in the digested food. The brain consumes 20% of the daily intake of calories, that is, about 400 (out of 2000) calories a day. Structurally, about 60% of the brain is fat, comprising of high cholesterol and polyunsaturated fatty acids (PUFAs). Thus, the food one eats is directly linked to brain structure and function, and thus affects the working of the mind. Many studies have found that diets that are too rich in refined sugars are toxic to brain functioning because the high content of simple sugars stresses the pancreas and induces insulin resistance. The high sugar levels with compensatory insulin responses stimulate the counter-reactive surge of autonomic neurotransmitters like cortisol and glucagon. These are known to produce increased anxiety, hunger and irritability. Moreover, they induce inflammatory and oxidative stress. This has been linked to an exacerbation of symptoms of depression and other mood disorders. These findings have led to the emerging field of nutritional psychiatry that traces relationships between food, feelings, gut microbiota, and human behavior. Deficiency Disorders and Mood The deficiency of nutrients like cobalamine, folate and zinc is known to be associated with symptoms of depression and dementia, cognitive decline and irritability. Both overeating and food insecurity are associated with mood and anxiety disorders. Mental illness is ranked among the largest contributors to the global health burden, especially depression, which accounts for the major chunk of disability in the more developed countries, especially in the age group of 15-44 years. Therefore, it is crucial to explore nutritional strategies to ameliorate these conditions. Not only do people eat differently when anxious or depressed, but these changes may occur in either direction. Conversely, depression may be the result, at least partly, of poor eating habits, or may become worsened by the inability of the patient to stop eating comfort foods and choose a healthy diet. Such inability may be financial, psychological, or iatrogenic. Serotonin and the Gut Serotonin is a monoamine neurotransmitter that helps to control sleep and appetite, inhibit pain, and to regulate mood. About 95% of the serotonin is produced in the gut, which is rich in neurons – the enteric plexus contains a hundred million nerve cells. Thus, the gut is intimately involved in emotional regulation, pain perception, and vital physiological functions. Interestingly, the function of these neurons and their secretion of serotonin, and other neurotransmitters, is closely regulated by the metabolic byproducts of the trillion or so bacteria that comprise the gut microbiome. These bacteria ensure epithelial barrier integrity for the intestine, preventing the entry of bacterial toxins and pathogens into the systemic circulation. They also prevent the spread of inflammation beyond the gut lumen, enhance nutrient absorption, and activate gut-brain neural pathways – the gut-brain axis. Monoamine neurotransmitters are synthesized from amino acids in a process that is mediated by mineral-dependent cofactors. Both folate and vitamin B12 are essential for the methylation that occurs during these synthetic processes, also regulating the formation of homocysteine – a metabolite that is strongly linked to cardiovascular risk and depression. Dietary Fats and Brain Functioning Anti-inflammatory fats such as omega-3 fatty acids (FAs) are known to be essential components of neuronal cell membranes, and also play a role in many vital neural processes such as neurotransmission, gene expression, neurogenesis and neuronal survival. They are also known to have antioxidant properties. Omega-3 FAs are used to treat a number of psychological disorders, including attention-deficit hyperactivity disorder (ADHD), depression, bipolar depression and post-traumatic stress disorder (PTSD). A high omega-6 proportion is linked to a higher incidence of these conditions, especially the first two. The standard Western diet is rich in omega-6 but low in omega-3 FAs, primarily because of the consumption of refined flours and sugars, and highly processed foods, and low amounts of seafood (including fish) and grass-fed beef. Some studies have confirmed that diets that are richer in healthier carbohydrates and fats, and lower in refined and highly processed foods, such as the Japanese and Mediterranean diets, are linked to a reduction in the incidence of depression by anywhere between a quarter to over a third, compared to the standard American diet. Inflammation and the Diet Inflammation of the nervous system is also important in the pathogenesis of mental illness, and this is also linked to the diet. Many biomarkers of inflammation, such as C-reactive protein (CRP) and tumor necrosis factor alpha (TNF-α) were associated with a dietary pattern that was linked to a higher risk of depression over the next decade or so. This pattern included high simple sugars (sweetened drinks and refined flours), red meat and margarine (saturated fats), and little green or yellow vegetables, coffee, wine, or olive oil, which are all features of the stereotypical Western diet. The high content of vegetables, fruits, grains, and seafood, with less dairy and meat content, and no refined foods, of the Mediterranean and Japanese diets, compares very favorably with the Western diet. The former uses small amounts of red wine and cheese or yogurt in the daily diet. The mechanism is thought to be via the brain-derived neurotrophic factor or BDNF. This important molecule is implicated in the plasticity and survival of neurons, and neurogenesis. It is reduced in many mental health conditions including depression, PTSD and schizophrenia, and is affected by many antidepressants that are commonly prescribed. Not only so, but the former presents many of the fruits and vegetables in fermented form, which provides probiotics protecting the gut by enhancing the content of health-promoting gut microbes and reducing or preventing inflammation throughout the body. Thus, including more foods with omega-3 FAs in the diet when on inflammation-inducing medications, not only prevents inflammatory changes but also prevents the induction of depression in such individuals, according to recent, admittedly early, work. Again, the Mediterranean diet promotes gut microbes that produce anti-inflammatory metabolites. Of course, depressive tendencies or stressors may prevent the beneficial effects of healthy food from manifesting themselves as reduced inflammation or improved mood. Secondly, only some depressed individuals show this inflammatory tendency, which may mean that diet plays this role in only a proportion of people, perhaps with other inflammatory conditions or due to constitutional factors. Conclusion Many experts would recommend that people pay attention to the relationship between their diet and the foods they eat over a month or at least two weeks. If they could reduce or eliminate processed foods and sugars for this period of time, before bringing back these foods one by one, it would be instructive to notice how they feel. Better eating strategies are essential to promote mental health and recovery from mental illness. It was over 2,000 years ago that the famous Greek physician Hippocrates said, “Let thy food be thy medicine and thy medicine be thy food.” Not only does the Mediterranean (and similar) diet affect the availability of the basic building blocks of the brain and neurotransmitters, including myelin, the neuronal membrane, and monoamine neurotransmitters, but it modulates key chemicals like BDNF to alter neuroplasticity, mutes system inflammation, and determines the health and state of the gut microbiome. Many such traditional diets are known to include mostly nutritious whole foods without much processing. The role of a dietary specialist in helping patients with mentally ill-health to choose approaches that promote the ability to take care of oneself and enhance one’s health is very important and should be encouraged. As one set of authors comment, This message supports the idea that creating environments and developing measures that promote healthy, nutritious diets, while decreasing the consumption of highly processed and refined “junk” foods may provide benefits even beyond the well known effects on physical health, including improved psychological wellbeing.” To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/the-effect-of-diet-on-mental-health-7880/">The Effect of Diet on Mental Health</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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