depression

Migraines, anxiety, depression and gluten: on the Chronic Headache & Migraine Summit

June 26, 2017 By Trudy Scott 5 Comments

The goal of a 2015 Russian study titled Gluten Migraine, was to study the prevalence of migraine among patients with celiac disease and to assess the efficacy of a gluten-free diet in its treatment. There were 200 celiac disease (CD) patients and the

CD group had migraine syndrome four times more often than the control group. The attacks were more frequent in CD patients who were older than 50 years old.

The migraines disappeared in 25% of patients with migraines who were on the gluten free diet and the reduction in the intensity and/or frequency of attacks was observed in 38% of patients.

This is the study conclusion:

We revealed the clear association between migraine syndrome and CD and the high efficacy of gluten FREE diet in the treatment of migraine symptoms.”

I would suspect similar results if you have gluten sensitivity. And here is some gluten-migraine feedback from 4 different women in my community:

HUGE decrease in my migraines now that I eat more cleanly. I used to start to get headaches immediately upon eating gluten-y meals
I had them frequently from teenage years right up until my Celiac diagnosis in my thirties. Once gluten was gone so were the migraines
Stopping gluten stopped my migraines
My migraines always came from gluten and dairy

Of course there is also an anxiety-gluten and the depression-gluten connection so getting the gluten out of your diet will help with both anxiety and depression most of the time too.

I talked about all this on The Chronic Headache & Migraine Summit.

The other topic I covered is the autoimmune condition called Antiphospholipid Syndrome (APS) which is one of many possible contributing factors for both migraines and anxiety. Of course, with any autoimmune condition gluten removal is key.

I also cover low serotonin as one possible cause of migraines (and anxiety) and the use of tryptophan (instead of SSRIs). An amino acid like tryptophan or GABA also helps you break the gluten addiction so you don’t have to rely only on willpower!

Have you got questions or comments? Please post in the comment box below.

Prozac Nation Is Now the United States of Xanax in New York Times Magazine: my response

June 23, 2017 By Trudy Scott 11 Comments

This is the title of a new article recently published in the New York Times Magazine: Prozac Nation Is Now the United States of Xanax. In other words, depression has been surpassed by anxiety and the antidepressant Prozac has been replaced by Xanax (and other benzodiazepines /anti-anxiety medications) by the US population!

It’s an excellent read for creating awareness about anxiety and benzodiazepines but also sad because there is so much we can do and no solutions are offered. Here are some startling stats shared in the article:

According to data from the National Institute of Mental Health, some 38 percent of girls ages 13 through 17, and 26 percent of boys, have an anxiety disorder. [Note: this was quoted in the article. I’m trying to track down the source because an article in Time Magazine last year says this: ‘About 30% of girls and 20% of boys–totaling 6.3 million teens–have had an anxiety disorder, according to data from the National Institute of Mental Health’ as of 2015.]
On college campuses, anxiety is running well ahead of depression as the most common mental health concern, according to a 2016 national study of more than 150,000 students by the Center for Collegiate Mental Health at Pennsylvania State University. [Both anxiety and depression have shown slight but persistent increases each year for the past six years]
Meanwhile, the number of web searches involving the term [anxiety] has nearly doubled over the last five years, according to Google Trends. (The trendline for “depression” was relatively flat.)

I’m the optimistic type, I’m proactive and I like to give hope as well as solutions – and I have quite a bit to say about this article so here goes.

#1 Too many people are prescribed benzodiazepines without knowing what they are getting into

The article does not address the issues with benzodiazepines: how too many people are prescribed benzodiazepines without knowing what they are getting into, with many suffering dreadfully and never offered nutritional solutions. When I shared the article on my facebook page, someone in my community shared this (and gave me permission to share it further in the hope someone else will be spared her suffering)

Been totally disabled by benzo for 3.5 years. I have been off meds for 17.5 months and the impact of these meds makes any anxiety I ever felt a cake walk. Please run from the poison. Find healthy foods, nutrition and take the break your body is begging you for. We need to listen to our bodies! If it is screaming with anxiety maybe you need to make some life changes. I wish I did instead of taking a med that has almost destroyed me.

I asked her what symptoms she was experiencing, and as well as suffering from severe motion sickness (so badly she can’t even leave her home) she also shared this:

I have locked shoulder muscles, neck, jaw; I have internal vibrations, I get bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks, my teeth all feel like they will fall out but they are not lose, it feels like adrenaline or cortisol rushes through the body. Sometimes arms go numb. I am pretty tortured every day. These meds are truly causing chemical warfare on some of us.

I believe this will be the next big epidemic and I hope I heal somehow to help others

She had been on a variety of benzodiazepines, SSRIs and other medications for over 17 years and you may think this is an isolated incidence. I assure you it is not – just read the list of the most common psychological and physical symptoms of benzodiazepine withdrawal.

Here is some useful information about the risks and dangers of benzodiazepines:

#2 Let’s help anxious individuals like you find solutions

Scott Stossel, journalist and author of My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind was quoted as saying this in the article:

The silver lining for those with nervous disorders is that we can welcome our previously non-neurotic fellow citizens into the anxious fold.

My first response to the article is this: I say NO to Scott Stossel and instead I say let’s think bigger and instead let’s invite the anxious citizens into the calm and no-more-anxiety fold!

Scott’s book is well-written book, offers an excellent understanding of what it feels like to experience anxiety and panic attacks, and has many compelling stories. But as a number of his Amazon reviewer’s say the big question is this: what is the answer or solution? Unfortunately it’s not provided in his book (or the New York Times Magazine article).

The New York Times Magazine article provides another anxiety resource that has helped “bring anxiety into the open, and allowed its clinical sufferers to band together in a virtual group-therapy setting”: The Sarah Fader on twitter, creator of the hashtag #ThisIsWhatAnxietyFeelsLike and a mental-health advocacy organization called Stigma Fighters.

Again, these are wonderful resources for support, awareness and advocacy but they don’t offer solutions if you suffer from anxiety. With nutritional solutions we can change this to #ThisIsWhatCalmFeelsLike.

#3 Too few people know about nutritional solutions

Too few people know about nutritional solutions and that has to change. Clinically we know it works and there is now SO much research supporting this approach.

Here are a few of many blog posts on my site that share powerful anxiety nutrition solutions:

Here is one of the latest food and mental health studies – A modified Mediterranean dietary intervention for adults with major depression: Dietary protocol and feasibility data from the SMILES trial

This and other dietary and nutritional approaches for both depression and anxiety will be presented at the upcoming International Society of Nutritional Psychiatry Research conference in Bethesda, MD next month)

Here are two book resources too: my book The Antianxiety Food Solution and integrative psychiatrist Kelly Brogan’s book A Mind of Your Own.

I’d love your feedback

Which nutritional solutions topics do you have questions about and in what areas do you still need help?
What ideas do you have for getting this nutritional solution message out in a bigger way?
What do you wish you’d known when you were first diagnosed with anxiety and prescribed medication (such as a benzodiazepine or SSRI)?
How do we convince the naysayers that this does work and is worth implementing?
How do we get the mainstream mental health community on board?
What anxiety resources do you have to share

Depression as a black dog that comes in and lays down beside you at night

May 26, 2017 By Trudy Scott 18 Comments

Trevor King’s interview about his journey with depression – on That Vitamin Summit – is not to be missed if you are depressed, have ever suffered with depression or if you have a loved one or friend with depression. He shares how he feels a sense of complete hopelessness at times:

It descends like a black cloud that makes me almost sort of retreat into myself. And my eyes will know and I don’t want to take the world in. I don’t want to get out of bed at times. Actually, that’s one of the things that … one of the only things that actually helps me, is going to bed and lying down.

Winston Churchill famously described it as this black dog who’d come in and lay beside him at night.

“From the moment my eyes opened in the morning, I am engaged in a battle. I must protect myself with armor against ongoing, negative, intrusive thoughts that flood into my brain, while sending my prefrontal cortex, which is the home of logical thought, the green light to make decisions and take charge of my brain’s limbic system. That is, before the fear center completely spazzes out. I spend more time and energy chasing and maintaining good health than I do in any other aspect of my life. My marriage, family or work. Because I know that everything meaningful and good around me depends on a stable base. And I hope and pray that one day, I don’t have to fight so hard for my sanity.”

He talks about how he is affected by sugar and low blood sugar, and how he’s found some benefits with niacin, chromium, magnesium and tryptophan (when he’s consistent with taking them!).

Trevor actually talks about the GABA interview I did with him a few days earlier and how he’s very interested in what he learned. He is planning to do a trial of GABA to see if it can help him further.

Here is a snippet from my interview on GABA (so do tune in to this interview if you’re new to my work and the targeted amino acids):

GABA is really quite profound. When I had my anxiety, GABA was my lifesaver. It completely turned my life around. Within three days of using GABA, the panic attacks stopped and the anxiety started to go down, and then I had to look for all the other root causes. It worked immediately so I’m a complete believer, just because I’ve experienced it myself. You’ll hear a lot of people say GABA won’t work. It doesn’t cross the blood/brain barrier so it’s not going to have an impact.

We’ve now got research showing that there may be ways that it crosses the blood/brain barrier. We’ve also got research showing that we have GABA receptors in various parts of our body. We’ve got a lot in our muscles, and with low GABA symptoms you’ll have physical tension.

The beautiful thing is it works. It works quickly, and if you have these low GABA symptoms, which is the physical anxiety, which could be panic attacks. It could be stress eating, it could be drinking to calm down. If you are the kind of person who needs wine to wind down at the end of the day, that’s a big sign that you may need GABA. You take the GABA and you just feel this physical tension release from you, you know you’re onto something good.

I just wish I’d known about his struggles with depression at the time of our interview – I would have talked more about tyrosine for dopamine support (for curl up in bed depression) and DPA for endorphin boosting (for low endorphins weepy depression).

I did discuss gluten and would consider this especially since his daughter has issues with it. I talked about low serotonin and mentioned Lidtke tryptophan. If someone doesn’t do well on another brand I’d have them trial the Lidtke brand. I’d also look into SIBO – I have SIBO and rice and grains make me feel flat and low and I see this often with clients. Finally I’d look into lithium orotate for keeping an even mood.

Trevor shares these wise words at the end of his interview:

You do find that when you actually bite the bullet and share it with people,

people are very, very understanding. And actually, you’re amazed that many people have been there themselves.

I could not agree more which is why I’ve always shared my journey with anxiety. I appreciate him for being willing to share his story with depression!

If you’re not already registered here is the registration link for That Vitamin Summit

Feel free to post questions or feedback below – and share your story with anxiety or depression if you feel drawn to do so

Anxiety, depression, GABA and cortisol: effects of Lactobacillus ingestion

April 14, 2017 By Trudy Scott 23 Comments

We now know that good bacteria or probiotics have the potential to alter brain chemistry and have an impact on anxiety and depression. You may recall my interview with Professor Ted Dinan on a prior Anxiety Summit – Microbes in the gut and psychobiotics as a potential treatment for anxiety and depression. He shared his paper and this definition of Psychobiotics: a novel class of psychotropic.

…we define a psychobiotic as a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness. As a class of probiotic, these bacteria are capable of producing and delivering neuroactive substances such as gamma-aminobutyric acid and serotonin, which act on the brain-gut axis.

Research published by Dinan, Cryan and their teams also found benefits of Lactobacillus rhamnosus on stress, anxiety and depression type behaviors in mice. This is older research (published in 2011) but it’s the first time I’ve shared it on the blog. I talk about this paper in the upcoming Microbiome Medicine 2 Summit so I like to share study excerpts and links to the study.

The write up in Science Daily is a good one – Mind-Altering Microbes: Probiotic Bacteria May Lessen Anxiety and Depression

…mice fed with Lactobacillus rhamnosus JB-1 showed significantly fewer stress, anxiety and depression-related behaviours than those fed with just broth. Moreover, ingestion of the bacteria resulted in significantly lower levels of the stress-induced hormone, corticosterone.

The part that I find fascinating is the effects of Lactobacillus on GABA receptors in the brain (GABA is your main calming neurotransmitter):

The researchers also showed that regular feeding with the Lactobacillus strain caused changes in the expression of receptors for the neurotransmitter GABA in the mouse brain, which is the first time that it has been demonstrated that potential probiotics have a direct effect on brain chemistry in normal situations.

In this paper the authors discuss the vagus nerve and the three-way communication:

…the vagus nerve is the main relay between the microbiome (bacteria in the gut) and the brain. This three way communication system is known as the microbiome-gut-brain axis and these findings highlight the important role of bacteria in the communication between the gut and the brain, and suggest that certain probiotic organisms may prove to be useful adjunct therapies in stress-related psychiatric disorders.

What is even more fascinating is this:

the neurochemical and behavioral effects were not found in vagotomized mice

What does this mean? When the researchers severed the vagus nerve in the test mice – removing the communication between the gut and the brain – they found that the behaviors and stress hormone levels reverted back to the way they had been i.e. the vagotomized mice were more anxious, more stressed, more depressed and had higher corticosterone levels.

You can find the abstract of the paper here: Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve.

What does this mean for you? It means that good bacteria in your diet could well improve your anxiety and depression symptoms and even have an impact on your adrenals and cortisol levels. This could be in the form of a good probiotic and should always include fermented foods like sauerkraut, kimchi, kombucha, yogurt and kefir (if dairy is tolerated), water kefir (if dairy is not tolerated).

Have you observed an improvement in your anxiety and stress levels since adding a probiotic or fermented foods into your diet?

Paleo and grain free diets: anxiety and depression success stories

March 31, 2017 By Trudy Scott 16 Comments

I recently reached out to my community to hear your diet-depression or diet-anxiety success stories in anticipation of the new SMILES diet depression trial, published last month and which I covered in a blog post last week. In that post I promised to share some real-life success stories on how an anti-inflammatory and anti-anxiety diet i.e. nutritional psychiatry people’s lives for the better!

I also shared that everyone who responded with success stories was following a more “evolved” diet than those who participated in the SMILES trial, the first randomized controlled diet depression study where ONE THIRD of the dietary intervention group saw improvements in their depression symptoms by switching from processed/junk food to real food with no specific dietary restrictions!

What do I mean by a more evolved diet? Each of them was eating a real foods or traditional non-processed diet that was gluten-free, mostly or all grain-free and various permutations of the Paleo or cave-main diet.

The anxiety and depression success stories

Alice from Cape Town shared this about banting, a Paleo-type dietary approach that does include dairy products and has been popularized in South Africa by Professor Tim Noakes:

Three days after I stopped eating grains, my chronic depression lifted and has never returned (it’s three years later now). I had been a vegetarian most of my life, discovered in my early 50s that I was gluten intolerant, went off grains, started banting (Cape Town craze!) and have never felt better. Gut, mood, bones, energy, skin … all better!

Andrea shared this about her diet-mood results, also with a grain-free and high fat diet:

I happened upon a fat loss diet that had me cut out grains, most dairy, and sugar while focusing on mostly meat, fish, fats from nature such as butter, olive, and coconut oils. Nuts, seeds, and legumes were allowed too. These rules made it so I had to avoid processed foods. There was one day a week of eating anything.

Within 6 weeks I was shocked that I got much much more than fat loss. My depression, anxiety, mood swings, sleep issues and all but one pesky health symptom was left disappeared. I was stronger, faster, and felt energy I never remember having.

Holly shared how she healed severe depression and anxiety by changing her diet:

Over the course of a year and a half, I was given 10 different psychiatric diagnoses and cycled through 10 different medications. I discovered the healing power of diet completely by accident, and it changed my life. I now live with no diagnoses and no symptoms.

I started with the Whole30 (strict paleo), then went paleo, dabbled with a ketogenic approach, and now I eat a modified paleo diet, with some rice and goat dairy.

Krysti shared how diet reduced her severe mood swings and panic attacks:

I was dx with bipolar at 18 years old. Suffered panic attacks and the random severe mood swings that made absolutely no sense. I was sad for days to weeks only to be followed with unrealistic overly-exuberant highs where I had the energy of a toddler on sugar and the signature grandiose thoughts that I could simultaneously fly and conquer the world and do all the things! For a day. Then the next day felt numb. And resorted back to “cutting” just to feel something. I never cut for attention. In fact not even my closest friends knew I did it. It was for me and I hid it.

…my oldest sister introduced me to Paleo. I was soon dx celiac, cut out grains and have been med and *mostly* mood swing/manic free ever since. No panic attacks. I have never felt more emotionally stable. Even through the death of my youngest sister and big life events, my emotions have been that of a normal person. Explicable. Expected. Level. No extremes.

You can read their entire inspiring diet-depression stories and other ones in the comments on this blog.

Thanks to Alice, Andrea, Holly and Krysti for sharing your wonderful and very hopeful stories! It warms my heart and I know it inspires my community!

And here is my story again:

For me it was anxiety and panic attacks that resolved when I made dietary and other nutritional and lifestyle changes. I had been eating a vegetarian diet for a few years and I suspect the non-organic/GMO processed soy products (soy milk, soy yogurt, soy “butter” etc) were a big issue for me and damaged my gut. When I added back quality animal protein (grass-fed red meat, wild fish, pastured eggs and chicken), switched to organic produce, added healthy fats and removed gluten my mood improved dramatically. Now I eat a combination of a Paleo/SCD /low FODMAPS/low oxalate diet.

During the severe anxiety and panic attacks I also needed additional support in the way of the targeted amino acids GABA (this was a life-saver and stopped the panic attacks in a few days) and tryptophan, plus zinc, vitamin B6, evening primrose oil, a good multi and B complex and adrenal support. I still continue with some of these basic nutrients today.

My health issues have been complex as I’ve also had to deal with heavy metals, poor gut health and much more so I had what I call “a perfect storm” and yet diet has had such a huge impact for me!

Getting off medications

Lead researcher Professor Felice Jacka was quoted in an ABC article saying this in response to the SMILES trial:

people suffering from depression should not replace therapy and drug treatments with the Mediterranean diet.

Based on my experience working with clients and feedback I receive on the blog, finding the ideal diet and addressing all nutritional deficiencies often allows my clients to work with their doctors on eliminating all their depression and antianxiety medications. Other medications also go by the wayside: pain meds, high blood pressure meds, allergy meds, reflux meds etc.

What is Paleo?

I had the pleasure of hearing Australian Chef Pete Evans at an all-day Sydney event earlier this year, in celebration of the launch of his new book The Complete Gut Health Cookbook, with co-author Dr. Helen Padarin. He is a big time Paleo advocate and this is what he said on stage at the start of his presentation and wonderful day of cooking demos:

Paleo is basically a meat and 3 vegetables – it’s that simple!

To expand on this a bit…this means quality animal proteins like grass-fed red meat, wild fish, pastured eggs and chickens, organic vegetables (typically lower carb) and fruit, soaked nuts (if tolerated), bone broths, fermented vegetables and broths, and health fats like coconut and avocado. Many in the Paleo community say no to dairy and butter but I do find that some of my clients do fine with small amounts and some people do better with fermented dairy like kefir and yogurt or goat/sheep and even camel milk rather than cow’s milk.

I also got to meet both Pete and Helen at the book signing – they are both wonderful and very down-to-earth!

Meeting the famous (and very down-to-earth) Chef Pete Evans at the book signing

Can you imagine my surprise when Pete invited me on to stage to welcome me to Australia and share a bit about my work with diet and anxiety!?

Here is a 5 minute clip of me on stage with Pete and Helen where we talk about:

How what we eat has a direct impact on our brains and how we feel
How our gut bacteria make some of our brain chemicals like serotonin and GABA when we consume fermented foods [and other foods rich in amino acids and organic produce]
The term “psychobiotics” coined by Dr. Ted Dinan ie. good bacteria that improve our mood
Kelly Brogan’s wonderful work around depression and diet and medication tapering, and her great book A Mind of Your Own
How quickly can diet lead to anxiety and depression symptoms improving and allowing you to get off medications? …biochemical individuality, diet alone, addressing gut health, adding fermented foods, addressing low zinc and other root causes, looking at gene defects
Real food, liver, rooibos tea, herbs
My story of anxiety and panic attacks and changing from a vegetarian diet to a modified Paleo diet
The Anxiety Summit and my book The Antianxiety Food Solution as resources

As you’ve read with these success stories and heard me say on Pete’s stage, many people can do it with diet alone (even if their anxiety is very severe), many need additional nutritional support, and many need the targeted individual amino acids to get immediate relief from their anxiety or depression while they are looking for all their root causes. Many also need the amino acids to break their gluten and sugar addictions. But making the dietary changes are the foundation!

Stay tuned for more about Pete Evans, some of his recipes and gut healing protocols and the unfortunate grilling he’s been getting in the Australian media for advocating a Paleo diet! In the meantime, I will say that all his books come highly recommended!

In case you’re wondering about the research on the Paleo diet, while we don’t have a study that’s looking directly at anxiety and depression, we do have these papers on the overall benefits of a Paleolithic diet:

And in this paper co-authored by Professor Felice Jacka – Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch, they mention

a potential evolutionary mismatch between our ancestral past (Paleolithic, Neolithic) and the contemporary nutritional environment.

We do, of course, have many studies supporting a diet-mood connection:

And Professor Felice Jacka shared this during our interview on The Anxiety Summit: The Research – Food to prevent and treat anxiety and depression?

One of the hypotheses that I had during the Ph.D. was that increased intake of animal foods would be toxic and would be associated with more mental disorders.

This did not turn out to be the case: In our study, out of every single dietary food grouping that I looked at including vegetables, fruits, salads, beans, etc the strongest correlate of mental health was red meat intake [grass-fed red meat of course.]
Consistently, women who have less than the recommended intake of red meat seem to be in an increased risk for common mental disorders [like anxiety and depression] and bipolar disorder.

She was referring to the results of her Ph.D. paper that was published in the American Journal of Psychiatry in 2010: “Association of Western and Traditional Diets with Depression and Anxiety in Women.”

Have you changed your diet to a Paleo way of eating and observed a reduction or elimination of anxiety or depression? Was a dietary change enough or did you need to address brain chemical imbalances and other nutritional deficiencies too?

If you’re a practitioner, have you seen results like this with your clients or patients?

SMILES diet depression trial: reduced depression and anxiety

March 24, 2017 By Trudy Scott 16 Comments

The SMILES trial, A randomised controlled trial of dietary improvement for adults with major depression was recently published BMC Medicine. It is the first randomized controlled trial to test whether dietary improvement can actually treat depression. Yes, we’re using dietary improvement and treat in the same sentence!

The objective was to determine if “structured dietary support, focusing on improving diet quality using a modified Mediterranean diet model” would have an impact on mood. The outcome is very exciting:

‘SMILES’ was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length.

The results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities.

These encouraging results were seen in participants who switched from a junk food diet to a real foods diet. Of the 67 who were enrolled in the study, the majority were using some form of therapy: psychotherapy and medications combined or psychotherapy only or medication only. There were 31 in the diet support group and 25 in the social support control group. Participants had to have been eating this diet in order to be accepted into the study:

a poor (low) intake of dietary fibre, lean proteins and fruit and vegetables, and a high intake of sweets, processed meats and salty snacks.

The dietary approach followed by participants in the study intervention group was the ‘ModiMedDiet’ which is based on the Australian Dietary guidelines and the Dietary Guidelines for Adults in Greece.

The primary focus was on increasing diet quality by supporting the consumption of the following 12 key food groups (recommended servings in brackets): whole grains (5–8 servings per day); vegetables (6 per day); fruit (3 per day), legumes (3–4 per week); low-fat and unsweetened dairy foods (2–3 per day); raw and unsalted nuts (1 per day); fish (at least 2 per week); lean red meats (3–4 per week), chicken (2–3 per week); eggs (up to 6 per week); and olive oil (3 tablespoons per day), whilst reducing intake of ‘extras’ foods, such as sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks (no more than 3 per week). Red or white wine consumption beyond 2 standard drinks per day and all other alcohol (e.g. spirits, beer) were included within the ‘extras’ food group. Individuals were advised to select red wine preferably and only drink with meals.

The dietary composition of the ModiMedDiet was as follows: protein 18% of total energy; fat 40%; carbohydrates 37%; alcohol 2%; fibre/other 3%.

Here are the reasons I’m excited about this research:

It’s the first randomized controlled diet depression study and ONE THIRD of the dietary intervention group saw improvements in their depression symptoms. This was just diet alone and switching from processed/junk food to real food with no specific dietary restrictions!
Participants also reported improvements in anxiety symptoms.
The authors even addressed the cost factor, stating it was more affordable to eat this way ($112 per week vs $138 per week).
The authors address the fact that the dietary intervention group was able to make these dietary changes “despite the fatigue and lack of motivation” that we so commonly see with depression.
I’m optimistic about it paving the way for making dietary approaches part of the standard of treatment for mental health conditions. The paper suggests the addition of “clinical dieticians to multidisciplinary mental health teams.” I’d like to add that these dieticians, together with nutritionists and health coaches would need to be well versed in functional medicine approaches.
According to an article on ABC, one participant continued the Mediterranean diet after finishing the study and is now doing a diploma in health science. How inspiring is this? When we get results like this we want to share them with everyone!

These are very encouraging results and we applaud the positive results of this SMILES study which are truly groundbreaking.

Let’s also be aware of where we are headed with future research and how we can improve on the trial diet. The researchers conclude with this comment about future research:

The scaling up of interventions and identification of the pathways that mediate the impact of dietary improvement on depressive illness are also key imperatives

Professor Jacka recently shared this paper on how personalized dietary interventions successfully lower post-meal glucose i.e. how certain foods can affect two people quite differently because of our unique gut bacteria. She said that she wants to do a similar personalized nutrition study for depression if they are successful in obtaining NHMRC funding.

Here are some questions I’ve been asked about this SMILES trial (and I’m sharing here in case you have similar questions):

why did only one-third of the study intervention group see improvements?
why was wheat and other grains included?
why was low fat dairy and lean meats emphasized?
why was there no mention of grass-fed meat, wild fish, healthy fats like butter and coconut oil, pastured eggs or chickens or quality organic fruits and vegetables?

The ideal dietary approach for anxiety, depression and any health condition is always one that high quality, is personalized and takes into account biochemical individuality. With the removal of gluten, grains and the inclusion of the other dietary changes mentioned above, plus addressing all nutritional imbalances I expect we will see more than one-third of the dietary group experiencing improvements in depression in future trials.

I truly appreciate the work of Professor Felice Jacka and her team and look forward to seeing more studies like the SMILES trial, using a personalized approach and quality foods that include grass-fed red meat and wild fish, plus pastured eggs or chickens, and healthy fats; and organic produce as a baseline.

And then future trials that also look at the impacts of these dietary changes on anxiety and depression: gluten and/or grain removal; removal of high histamine foods and high oxalate foods; a low FODMAPs diet; the specific carbohydrate diet/SCD; a Paleo diet and so on – all based on biochemical individuality. We know these diets works in clinical practice and now we just need the research to back this up. In part 2 of the blog, I share some incredibly inspiring diet-depression and diet-anxiety Paleo success stories.

In summary:

a simple change like switching from junk to real food can have a major impact on your depression and anxiety – ONE THIRD of the dietary intervention group saw improvements in their depression symptoms and many also saw reduced anxiety. This is profound!
you may need to make additional dietary changes (gluten-free, grain-free, low FODMAPs i.e. avoiding or adding certain foods based on your biochemical individuality) and always add healthy fats and focus on quality
you may also need to address brain chemical imbalances with amino acids supplements, address gut health, adrenal issues, low zinc, low vitamin B6, low vitamin D etc. too

Are you encouraged by this research?

And have you made similar dietary changes to those done in the SMILES trial and seen a reduction in your anxiety and depression?

Have you removed gluten or grains and made additional dietary changes, and added supplements and seen even more benefits?

Note: to avoid confusion I’ve used the Australia spelling of “randomised” and “fibre” in the quoted sections and the US spelling “randomized” elsewhere in the blog.