Lifestyle Medicine: A holistic approach to mental health is important
Just as heart disease, cancer and auto-immune diseases are strongly affected by diet and exercise, so too brain health is influenced by our choices.
In our last article we spoke about the increasing awareness that the brain, accounting for consumption of 20-25% of energy ingested, is very sensitive to lifestyle behaviours.
Just as heart disease, cancer and auto-immune diseases are strongly affected by diet and exercise, so too brain health is influenced by our choices. Let me hasten to add that mental illness is the result of multiple factors, and it would be simplistic to emphasise only diet or exercise.
It is now established practice, reflected in various national guidelines around the world, to incorporate lifestyle interventions as an important part of therapy for mental illness and mood disorders.
This in no way downplays the important role of medications and well-trained psychiatrists/psychologists in managing the very real risks of severe depression and anxiety.
The role of lifestyle medicine is to ‘flesh out’ the lifestyle interventions and provide support and coaching in implementing these.
Dietary interventions focus on replacing highly processed, fast foods with plant-rich whole foods – abundant fruits, vegetables, whole grains and legumes, some nuts (particularly almonds, walnuts, pecan nut) and seeds (particularly pumpkin seeds, chia, and ground linseeds).
It is helpful to limit significantly red meat; even white meat, fish, and dairy to be used moderately. A poor diet works in many ways to inhibit brain health – through such things as excess blood cholesterol and saturated fats, excess sugars, insufficient dietary fibre, inadequate antioxidants, and insufficient vitamins, minerals, and phytonutrients.
Exercise is an important contributor to mental health. It improves sleep and mood, improves brain function and brain oxygenation, offers pleasurable experiences, improves self-esteem, and increases opportunities for interaction with other people.
The best exercise is the one that you are willing to regularly perform. Both aerobic (like walking, running, cycling, and swimming) as well as resistance exercises (lifting weights and working out on machines in the gym) are effective for managing depression and anxiety.
Exercise of the large muscles also increases the production of a protein in the brain called brain-derived neurotrophic factor (BDNF) which promotes the survival, and growth and differentiation of nerve cells.
Adequate sleep is another vital intervention for mental health. Sleep allows for the housekeeping of the brain, allowing the microglial cells to detoxify the brain and get rid of free radicals – by-products of brain function. Sleep also promotes orderly filing of information gathered during waking hours. Lack of sleep causes moodiness, anxiety, lack of concentration, forgetfulness, and poor choices. Sleep deprivation results in weight gain from cravings for junk foods and energy dense foods.
According to Courtney Ackerman, positive psychology focuses on positive life experiences – like happiness, joy, inspiration, and love; positive states and traits – like gratitude, resilience, and compassion.
Finally, mental health is enhanced by cutting out destructive habits such as excess alcohol, tobacco, recreational drugs, pornography, and addictive behaviours.
Dr Dave Glass
MBChB, FCOG(SA), DipIBLM
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