Right now, most of the research has been done on a Mediterranean diet, with some research showing that people who eat this way (think: cutting out processed junk and loading up on fiber-rich veggies, fruits, fish, nuts, beans, legumes, olive oil, fermented foods, and some meat) have a 30-50 percent lower risk of depression. But many experts agree that there may not be one diet that’s optimal for mental health. A number of dietary approaches, provided they include the right balance of brain-boosting nutrients (e.g. omega-3s, vitamin B12, zinc, iron, magnesium, and vitamin D) may do the trick.
To help his patients cover their nutritional bases, Ramsey guides them toward the nutrient-dense food groups that most Americans fall short in: leafy greens, brightly colored “rainbow” vegetables, seafood, and fermented foods. From there, he’ll talk with patients about what food within those categories they might enjoy and how to prep and cook them in a simple, joyful way. As a useful tool, he and a colleague created an antidepressant food list, featuring the plant and animal foods (oysters, salmon, watercress, and spinach to name a few) that contain the highest levels of nutrients proven to help prevent or reduce depression.
Interestingly, while plant-based diets are often considered the holy grail, they may not actually be ideal for mental health. “There’s some correlational data that people who eat no red meat, or who eat vegetarian diets, are at a much greater risk of depression,” says Ramsey. “This isn’t popular data among the plant-based crowd, but I think it’s important to consider.” But even so, Ramsey believes it’s his job as a nutritional psychiatrist to help you “feed your brain” regardless of the particular diet you subscribe to—whether that’s Whole30 or vegan. So, if you’re passionate about consuming zero animal products, he’ll provide support and make sure you’re eating and supplementing in a way that supports mental wellness.
Other nutritional psychiatrists, like Ede, take a slightly different approach. While she says the most important food rule for mental health is to eat whole foods and avoid modern processed foods (namely refined carbohydrates and refined vegetable oils like soybean and corn oil), she often suggests that patients experiment with eliminating grains, legumes, and dairy as well.
“I generally recommend what I call a ‘pre-agricultural whole foods diet’ made up of whole plant and animal foods as one of the best ways to meet the brain’s nutritional needs,” she says. While nixing all grains and legumes may sound odd, she says these foods contain phytic acid, which can interfere with the absorption of important brain-healthy minerals like magnesium and zinc; and lectins, which can damage the gut lining and aggravate the immune system. This approach is enough for most people, but sometimes Ede will go a step further with patients. “For people who have insulin resistance, I recommend a lower-carbohydrate or perhaps even very low-carbohydrate ketogenic version of this same diet.”
Several years ago, Ede met with a 40-year-old woman who’d had lifelong symptoms of procrastination, poor motivation, low energy, distractibility, and disorganization that interfered with her work and home life. She diagnosed her with ADHD and prescribed Aderall, which definitely helped, but brought uneven benefits throughout the day and caused unpleasant side effects like constipation. She gradually removed grains, legumes, dairy, and most processed foods from her diet, which helped her mood and improved her physical health, yet did nothing for her ADHD. But when she agreed to try a ketogenic diet this year, her symptoms began improving within a few days. “She has since stopped taking Adderall and reports that she functions even better when in ketosis than on Adderall, and without any side effects,” says Ede.
The truth is, every body is a little bit different, and the fact that there are slightly different approaches within the nutritional psychiatry field is likely a really good sign.