NUTRITIONAL CARE IN DEPRESSION
Inadequate dietary intake can never induce depression but there is an important relationship between diet and depression.
Nutritional care of depressed people is to be handled with care. In depression, person’s appetite is reduced and he loses his interest in eating. For the successful compliance of nutritional care plan, proper motivational techniques should be used to reduce the chances of (specific) nutrients deficiency. Different dietary components affect depression in their own way. Let us try to unveil the link between diet and depression.
- Proteins (amino acids)
- Lipids and fats
- Fluid intake
Carbohydrates are one of the macronutrients of diet. Almost 50-60% of total energy required is derived from carbohydrates only. Broadly, they are of two types
- Simple carbohydrates like sugar, jaggery, honey etc.
- Complex carbohydrates like starches, fibers, gums etc.
As far as role of carbohydrates in depression is concerned, it has been observed that depressed people often develop a craving for carbohydrates. Due to this depressed people tries to take more and more carbohydrates (unknowingly) as carbohydrate rich foodsinstantly enhance the production of serotonin (a neurotransmitter). In such situations the type of carbohydrates you are taking is important. Try to reduce the intake of simple carbohydrates specially refined sugars and enhance the intake of complex starches. To further increase the effect of such carbohydrates, incorporate tryptophan rich product in your carbohydrate meal. Usually carbohydrate-rich diet is recommended in depression.
2. Proteins (amino acids)
Proteins are one of the major component of diet. Amino acids(compounds of carbon, hydrogen, oxygen and nitrogen) are the building blocks of proteins. In other words we can say that different amino acids are combined with each other to develop a single (specific) protein. Quality of the protein is usually judged by their amino acids profile(i.e. its constituent amino acids) .Deficiency of certain amino acids may cause depression. These amino acids can be discussed in detail as follows.
Tryptophan is one of the essential amino acids ie. it can not be produced by human body. Therefore it has to be supplemented from outside. Infact dietary supplements of tryptophan are being increasingly recommended in management of psychiatric disorder (mainly depression ; as well as in anxiety and insomnia). Consult your physician before taking such dietary supplements.
How does tryptophan work ?
Tryptophan finally converts into serotonin, a neurotransmitter. Thus the production of serotonin is directly related to the tryptophan concentration in blood. Since the level of certain neurotransmitters (including serotonin, epinephrine, and norepinephrine) is decreased in depression, it is only logical that increase in tryptophan intake would adequately manage depression. Rich sources of Tryptophan are sesame and sunflower seeds, cereals (excluding corn), whole grains with germs, cheese, eggs, milk, turkey fish, banana, dried dates, peanuts and soybeans.
What is the requirement of Tryptophan ?
Estimate of Tryptophan requirements
|Age group||Requirements (mg/kg/day)|
|Infants, 3-4 months||17|
|Children, 2 years||12.5|
|Children, 10-12 years||3.3|
Methionine is also an essential amino acid containing sulphur.
It is converted to S-adenosylmethionine (SAMe), which is known to raise the serotonin levels, thus acting as a mild antidepressant. So, intake of methionine rich products (dietary supplements) can help in treatment of depression by raising the levels of serotonin. Preferably verify the quality of dietary supplement after due medical consultation.
Cereals, whole grains with germ, sesame and sunflower seeds, corn, nuts, seed oils, peanuts, soybeans, eggs, milk and green leafy vegetables are rich in methionine.
It is not an essential amino acid but it can convert to various neurotransmitters like norepinephrine, epinephrine and dopamine, which are implicated in depression.
3. Lipids and fats
Basically Fats are compounds of fatty acids and glycerol (a trihydric alcohol). Fatty acids are of two types. They are-
- Mono unsaturated fatty acids
- Poly unsaturated fatty acids- they are of two types
- Omega-3 fatty acids
- Omega-6 fatty acids
In depression, omega –3 fatty acids, in particular are importantand it is found in some fishes like salmon, mackerel, tuna and herrings.
They are one of the minor components of diet. They are vital in small amounts. They can be classified in two categories depending on their solubility.
- Fat-soluble vitamins like vitamins A, D, E and K.
- Water-soluble vitamins like vitamins B and C.
Water-soluble vitamin B complex plays a major role in depression. Subsequent table can help you in understanding the specific functions of these vitamins along with their common sources, recommended intake and deficiency symptoms. (details… to be done).
A number of minerals are present in the body in small amounts but are essential for the proper functioning of body. They can be of two types
- Macrominerals like Sodium (Na) and Potassium (K).
- Trace elements like Iron, Iodine, Zinc, Copper, Chromium, Cobalt, Molybdenum, Fluoride etc.
Some trace elements like zinc, magnesium, calcium, iron and chromium are important in depression ( and anxiety) so include food materials (in your regular diet), which are rich in these trace elements.
|Calcium||All the dairy products, leafy green vegetables, salmon, sardines and tofu (soyabean paneer).|
|Magnesium||Brown rice, soybeans, nuts, whole grains and legumes.|
|Zinc||Whole grains products, eggs, meat, mushrooms and oysters.|
|Iron||Parsley, spinach and all other green leafy vegetables, shellfish, brewer’s yeast, wheat brans, cereals and dry fruits.|
|Chromium||Whole grain cereals, meat, cheese, molasses and egg yolk.|
Alcohol should be completely avoided in depression as well as anxiety, as it is a mild depressant itself. However, common conception regarding alcohol is entirely different. Generally people take it as a soothing drink during depression. Alcohol causes mild depression bydecreasing absorption of Vitamin-B complex.
People sometimes use caffeine as a sudden stimulant. Ingestion of caffeinated drinks instantly raises the energy levels. Excess of caffeine can cause over-stimulation of nervous system, which can be detrimental in depression and anxiety in the long-run.
8. Fluid intake
In depression, fluid intake should be enhanced in order to reduce the side effects of antidepressant drugs. Dry mouth and constipation are two side effects of antidepressant drugs, which can be reduced by increasing fluid intake. Recommended daily fluid intake is 1.5-2 liters/day. Constipation can be controlled by gradual increase in dietary fiber intake.