This feature was first published in the weekly colour supplement of Chile's leading national newspaper.
Therapist Sally Baker and co-author of How to Feel Differently About Food (Hammersmith Health Books, London 2017) explain how the value of improving well being and state of mind through nutrition still seems to be not part of mainstream, orthodox medicine.
Medical research over the last couple of decades has, however, highlighted how an unhealthy gut can contribute to depression and low mood along with many physical diseases and these findings are becoming more and more accepted into mainstream medical practice. Clinicians increasingly agree that the gut-brain axis plays a crucial part in emotional well-being, including the development of conditions as diverse as chronic fatigue syndrome, depression and autism.
How your gut influences your well being
The gut-brain axis is a way of describing the inter-relationship between gut health and brain health. The various aspects of digestion are controlled via the vagus nerves by a complex set of neurones embedded in the oesophagus, stomach, intestines, colon and rectum.
The brain sends messages to all the nerves in your body, including the neurones that control digestion. All works efficiently enough until a person is anxious or stressed on an ongoing basis. You perhaps know for yourself that if you are feeling nervous your stomach can feel upset and queasy. The reason for this is that strong negative emotions, stress and anxiety increase cortisol and adrenaline, which then stimulate the sympathetic nervous system and shut down the parasympathetic nervous system, which includes control of digestion and the gut.
In the short term, this allows the body to focus its resources on ‘fight or flight’ – a good survival mechanism. However, with ongoing stress and anxiety, this cumulative slowing down and suppression of the digestive process can, over a prolonged period, lead to a condition called ‘small intestinal bacterial overgrowth’ (SIBO).
As the digestive process is compromised by stress and anxiety, the lack of stomach acid allows the stomach and small intestine – which should both be pretty much microbe-free – to be colonised by unhealthy bacteria, and yeasts, causing foods to be fermented rather than digested. In addition to gas and bloating, compromised digestion leads to declining absorption of nutrients, which contributes to the loss of the cofactors needed for good digestion and consequently further gut problems
Now consider this situation lasting for extended periods of time. The integrity of the gut lining may be compromised, contributing to gut permeability (‘leaky gut’) that may be sufficient to produce chronic low-grade inflammation. The inflammatory process includes the production of cytokines, chemical signals of inflammation that are carried by the blood to the brain. The cytokines can activate cells in the brain called ‘microglia’ – the brain’s immune cells – so that the inflammation originating in the gut thereby causes widespread inflammation in the rest of the body, including in the brain.
The impact of brain inflammation is that the brain has reduced nerve conductance which - guess what - lowers well-being and shows up as depression, anxiety and stress.
This vicious circle can self-perpetuate and requires long-term changes to heal the gut, which in turn will help to heal the brain. This is done through changes in behaviour and improving levels of nutrition through changes to food choices. To improve your natural resilience to stress it is important to increase the amount of healthy polyunsaturated omega-3 oils in your diet, so look for oily fish, grass-fed meats and butter made from the milk from grass-fed dairy herds. Good plant sources include hemp seeds, linseeds, chia and some nuts and nut oils in particular macadamia, almond.
If you consider yourself to have a low mood or be depressed it will be helpful for your recovery to manage your stress levels, improve your sleep patterns and add nutritious and gut-healing foods into your regular eating plan in particular fermented foods.
As Sally Baker has explained, the health of your digestive system is increasingly acknowledged to be the key to your potential to be physically healthy and for general well being. To achieve this requires optimum levels of stomach acid and healthy digestive enzymes which can be encouraged by eating foods most beneficial for this such as including fermented foods in your regular diet.
They can improve gut health, which is linked to enhanced mental health. The practice of fermenting foods goes back hundreds of years as a means of preserving fruit, vegetables and fish for lean times.
The most common fermented food is probably yoghurt, so make sure you buy a good-quality, live, plain, full-fat variety. (If you are avoiding cows’ milk, goat and sheep milk yoghurts may be available, and coconut yoghurt is a delicious alternative to all milk-related yoghurts.) There are other, less well known, fermented drinks, such as kefir made from milk (it can also be water-based) or kombucha, which is fermented from tea. Both are available from health stores. Buy the one with the least ingredients and without added sugars.
Be aware, however, that unfortunately, some people cannot tolerate fermented foods as they are susceptible to the high levels of nitrogen-containing organic compounds called ‘biogenic amines’. These can be a known trigger for headaches and migraines. You may need to experiment and find out what works for you. After all, even the humble olive is a fermented food so it might be easy and palatable to just include a few olives as a pre-dinner appetiser.
A wide variety of vegetables can be fermented at home. The most common is cabbage, which is very simple to ferment and you may know this as ‘sauerkraut’. It can be eaten like a pickle to add healthy enzymes to your meals. Shop-bought fermented vegetables, including cabbage, are available from health-food stores. Just check the label for ingredients and buy unpasteurised where possible to ensure maximum beneficial live enzymes.
It is worth noting that experiencing constipation can impact negatively on your mood and can be a factor in feeling under par and depressed. Along with feeling physically unwell, constipation often causes a loss of appetite, a depletion of energy, irritability and increased unhappiness from the accompanying stomach pain and discomfort. Gently increasing your intake of fibre, which for most adults means almost doubling current consumption levels, can be beneficial to your digestive health and can also improve mood and general well-being.
Examples of soluble fibre include cereals, such as oats, barley and rye, bananas and apples, root vegetables, including carrots and parsnips, and seeds, including golden linseeds. Increasing the levels of soluble fibre consumed should be accompanied by drinking increased amounts of water, which will also be helpful in resolving constipation.
There are simple ways to gradually increase the amount of fibre you eat each day:
Choose whole fruits and vegetables instead of juice.
Make a green smoothie instead of a green juice - A smoothie maker incorporates all the fibre from the vegetables and fruit while a juicer separates out the beneficial fibre to just leave the liquid.
Eat a raw salad or a serving of home-made vegetable soup every day.
If you’re eating bread, choose a whole-grain, artisan loaf made from ancient grains such as spelt flour. Alternatively, buy bread with added seeds and nuts.
Fresh or frozen berries, such as raspberries, make an ideal dessert and are a rich source of fibre.
Over-fed and under-nourished
Noticeable spikes in your hunger levels are an indicator that you are under-nourished for at least parts of the day. Keeping a food and mood diary for a couple of weeks will help to highlight where your nutritional deficits originate.
You may find your mood and appetite feel much more balanced on days when you eat a protein-based breakfast, like eggs, instead of a cereal-based breakfast, or when you have a healthy sized portion of meat, fish or cheese with salad at lunch-time instead of just grabbing a sandwich.
You will also gain insights into the type of foods that leave you feeling satisfied and energised for several hours compared with those that leave you feeling bloated and sluggish. Use your food and mood diary to nudge the creation of your own eating plan to develop new eating habits that support your energy levels throughout your busy day.
A free food and mood diary for you to download and complete is available at www.your7simplesteps.com see Resources.
How to Feel Differently About food is available from www.hammersmithbooks.co.uk or www.amazon.com