George Henderson on a revolutionary study of the link between nutrition and mental health
Tl;dr – the blurb says The Better Brain: How nutrition will help you overcome anxiety, depression, ADHD and stress by Julia Rucklidge, a professor of clinical psychology at the University of Canterbury, and University of Calgary research psychologist Bonnie Kaplan, is “one of the most important books of the year”. But that’s an understatement. There will be readers who will find it the most important book that they, or their caregiver, will ever read.
What is mental illness? Human communities contain a diversity of genetic types – some of us are a bit ADHD, a bit bipolar, a bit anxious, a bit OCD, a bit depressed, a bit schizoid, a bit addictive just by nature; if we were healthy and normally resilient these variations would, in most cases, not cause undue distress to ourselves or others – they would just create the spread of personality types found in Myers-Briggs tests and Tom Sainsbury books.
Our special ways of thinking and sets of priorities should be part of our individual value to the community. But strip us of the nutrition needed to maintain equilibrium, expose us to stresses and adverse experiences, and such traits can overwhelm us, and become distressing for ourselves or others. Brought to the attention of authorities, such behaviours will be pathologised; there is no definition of health in the diagnostic manual except, perhaps, their absence. But mental health disorders are currently being pathologised in the absence of very effective treatments.
As Kaplan and Rucklidge detail in their first chapter of The Better Brain, the mental health establishment is trapped in a dated paradigm where a single brain chemical, or a symptom, becomes the target of a drug, regardless of the biochemical deficits in the pathways surrounding that chemical as a result of poor nutrition or metabolic stress. Consequently the drugs, even when they do work, cannot put these deficits right and can even make them worse, making us take more drugs for side effects, with further risk of toxicity or severe drug withdrawal effects.
It’s Kaplan and Rucklidge’s luck, and ours, that they came across a more accurate paradigm and were able to test it scientifically, between them authoring nearly 300 peer-reviewed publications. It hasn’t been that uncommon for scientists and lay people to discover nutritional formulas that reverse mental illnesses (I’ve known about this field of science for 40 years) but it has been uncommon for them to find support in testing such non-patentable formulas against placebo.
Micronutrients provide relief to almost half of those diagnosed with some common mental health conditions
It’s been easier for many to say “I know this works, and it seems to be harmless, so why should I deny it to anyone” and keep case series that describe recovery in case after case, but this form of medical science does not compete well in the marketplace of ideas with the big numbers generated by drug trials run with drug money; with big numbers indifferent effects can become statistically significant. Kaplan and Rucklidge, separately and together, have managed to produce various types of well-designed experiment, including many randomised controlled trials and including cross-over studies, in which broad-spectrum micronutrients provide relief to almost half of those diagnosed with some common mental health conditions, and have effects that are significant in others.
Living in Christchurch, Julia Rucklidge was also able, after the earthquakes and terrorist attacks, to show that the micronutrient supplements already being trialled for ADHD and other syndromes could protect affected populations without any previous diagnosis of a disorder from the effects of stress and the development of PTSD.
They also cite several studies on improved diet, such as the SMILES study in which 32.3 percent of those with major depression became depression-free within 12 weeks when randomised to a diet with higher food quality, compared with 8 percent of the controls, who were given standard-of-care social support. Their use of multinutrient supplements, useful as these are, is to them a proof of principle – that diet matters, a lot, when it comes to mental health.
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These results speak for themselves, but I want to highlight the research into ADHD, because giving the multinutrient mix to children with an ADHD diagnosis (often part of a more complex developmental syndrome) results in improvements in emotion regulation and aggression, as well as in inattention and overall functioning, with only 20 percent of children not seeing some response to the supplements – despite no change in hyperactivity itself (these kids are still the same people). In a separate study cited, “the 40 children in the experimental group who were given a multinutrient supplement exhibited 47 percent fewer antisocial behaviours requiring discipline than the 40 children who received a placebo. The types of behaviours the researchers monitored included threats, fighting, vandalism, defiance, endangering others, and disorderly conduct”.
The case studies – the stories told about or by individual children, sometimes all grown up and problem-free now – make it clear that these benefits can be seen in some very difficult cases indeed. And, of course, these results are speaking directly to a problem that the New Zealand education system has been unable to cope with for some time.
Gut problems are common in mental disorders…It used to be that the diagnosis would go something like this – “You’re crazy, so you have psychosomatic gut pain, proving how crazy you are”, gaslighting the gaslit.
There’s an intriguing chapter on research into microbes – gut bacteria and probiotics – and mental health. Gut problems are common in mental disorders, for example bipolar disorders are often accompanied by abdominal discomfort and IBS symptoms. It used to be that the diagnosis would go something like this – “You’re crazy, so you have psychosomatic gut pain, proving how crazy you are”, gaslighting the gaslit. Now it’s obvious that it’s the bacteria driving the changes in mood. A trial too recent to have been included in The Better Brain found that giving people with a bipolar diagnosis a specific probiotic alongside their normal meds reduced their rate of hospital readmission to a third of that seen in the control group.
Michael Mosley’s book The Fast 800 has a policy of “harmless compromise” to keep his message as wide as possible, and Better Brain takes the same tack. While dietary guidelines and food star systems are questioned, they are also referred to when needed. (Saturated fat and cholesterol are still supposed to be restricted, yet cholesterol in food – think seafood, organ meats, and egg yolk – is powerfully associated with a great deal of the micronutrition our brains need, and saturated fat in the diet seems to increase the proportion of beneficial, anti-inflammatory fish oil fatty acids – DHA and EPA – likely to reach the brain).
So while the Mediterranean diet is a useful, politically correct (in a Eurocentric way) version of a whole food diet, and a good enough place to start, and is supported here by a whole chapter of interesting recipes, there will undoubtedly be many other whole food dietary patterns out there as nutritious and in some cases more nutritious waiting to be tested, including traditional diets more culturally appropriate for non-Mediterranean peoples.
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Material conditions bring about social conditions. In the last Nutrition Survey for New Zealand, grain was a larger source of iron and protein than all meats combined (grain is not normally a great source of iron, but iron has long been added to white flour; nor is it a particularly rich or balanced source of protein). This can hardly be the same people eating “too much meat” that we hear so much about. The inequality of outcomes in New Zealand is in part an inequality of material factors – a deficiency of the minerals and vitamins, protein and fatty acids we need to thrive, together with an excess of the sugars, refined grains, and heated seed oils that displace these factors and ramp up the metabolic stresses like high blood glucose, high triglycerides, and chronic inflammation that are negative factors in mental health.
For example, according to the 2008/09 Adult Nutrition Survey Māori New Zealanders had higher intakes of white bread, lower supplement use, higher processed meat use (processed meat can be cheaper than fresh meat but has often had its vitamins, minerals and fatty acids washed out), and Māori females at that time had much higher soft drink and fast food consumption than their non-Māori peers.
Yet the latest dietary guidelines published by New Zealand’s Ministry of Health pay very little positive attention to Māori and Pasifika traditional staples; they focus on getting everyone to eat as much as possible of the right kinds of grain, a type of food that didn’t even exist in the Pacific before colonisation, not one particularly rich in micronutrition, and a food that lends itself particularly well to processing and deceptive marketing. The guidelines say half this grain should be whole grains – I say, don’t eat the other half. Replace it with something more nutritious. And eat organ meats – when I was a kid mum cooked us liver every week, because mum had trained as a nurse when nutrition was still taught to nurses, and my school meals would also sometimes feature liver.
For those who think in terms of redistributive justice, the distribution of some material resources may be more important than that of others, and micronutrients and their food sources may turn out to be the most important of all. Material conditions bring about social conditions
For many decades I was addicted to the usual spectrum of recreational drugs in NZ … Then I started using a mutinutrient mix of my own design for the Hep C symptoms I had
Usually reviewing a diet book I’ll cook one of its recipes, or show off my own research skills, but The Better Brain is too important a book for me to clown around as usual. Instead, I’ll give you one of my nutrition anecdotes.
For many decades I was addicted to the usual spectrum of recreational drugs in New Zealand. I never thought I would want to change this, and was only partly aware that I no longer enjoyed it. Then I started using a mutinutrient mix of my own design for the Hep C symptoms I had. They included depression, and after two weeks I woke up one day feeling noticeably more positive. A few weeks later, I noticed I had run out of Valium. I’d been taking 40mg a day more or less for years and would always suffer terribly without it. This time I weighed up the inconvenience of a continued addiction to benzos against the inconvenience of not sleeping for a few nights and thought “how hard can that be”.
And it wasn’t hard at all. I stopped that habit then and there in what seemed like a state of grace where I lay all night in comfort, happy with my own thoughts and feelings. Any hint of cold turkey would have had me running to the dealer – I have no willpower. But no. The same thing happened with my other habits; often it was just a reorientation in my brain to the position of a younger, healthier person – “I don’t enjoy this, why do it anymore?” It was as if a large share of the brain disease of addiction consisted of the set of deficiencies induced by exposure to the drug and its effects on one’s appetite and finances.
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The methods explored by Kaplan and Rucklidge in The Better Brain need development, as they frequently point out. They’ve hit on some supplement mixtures that work here and now, but there is a lot more to learn. But, even so, their evidence is strong enough to justify optimism, despite the economic logic of the medical-industrial complex, which tends to favour the chronic maintenance of illness over health. Kaplan and Rucklidge have gallantly avoided any hint of a persecution narrative in their book, but their work hasn’t been made easy. And therein lies a danger; we know from our work in using low carb to reverse diabetes that people who discover that their illness was unnecessary, and that the experts didn’t tell them the truth about it, are often justifiably outraged, and can develop a jaundiced view of the function of expertise as a result
This sort of effect is an own goal, an unforced error, of the expert community; it’s the fatal flaw in the assumption of expertise. Things don’t have to be that way. A little more humility, a little more intellectual curiosity, less gatekeeping and protection of one’s status, funding, and pet projects and it wouldn’t happen.
But I digress. Food matters to your brain, and its adequacy can determine your moods, your addictions, your reason, your responses to the stresses of existence. Your gut bacteria matter too, so while your thoughts may not always be your own, their source is near to you and within your ability to manage.
Being properly fed makes you more real to yourself.
The Better Brain: How nutrition will help you overcome anxiety, depression, ADHD and stress by Julia Rucklidge and Bonnie Kaplan (Penguin, $40) is available in bookstores nationwide.
