Nourishing the Mind: Integrating Evidence-based Nutrition into Mental Health Support

June 19, 2024

There are a lot of ways to express the connection between the mind and nutrition:

  • Comfort food
  • You are what you eat
  • Eat your feelings
  • Brain food
  • Good mood food
  • Healthy body, healthy mind

These well-worn clichés touch on a deep, intuitive connection between what we eat and mental and cognitive health. And while the science backs it up, there’s still so much to learn. Health practitioners like you turn research into practical dietary recommendations, but scientists are still working to delve deeper into dietary approaches to mental health. 

Recent studies show the benefits of the Mediterranean diet and variations of that diet on mental health conditions like depression and cognitive health. These studies show that nutrition isn’t just a nice add-on to a mental health treatment plan (although it can play that role); it’s a powerful intervention in its own right. 

Mental health: Turning research into recommendations

As wellness practitioners, you can support and inspire your clients to achieve their best mental health with evidence-based strategies that involve easy, doable healthy food swaps. 

In this post, we’ll explore some studies digging in to the links between nutrition and mental health, including the SMILES trial, the PREDI-DEP trial, and the MIND Diet. Then we’ll discover some new ways to empower your clients to put these new findings to work in their life.

First, let’s meet your research guide, Alyson Roux.

Meet nutrition expert Alyson Roux

Alyson Roux is a certified nutrition specialist with an MS in Nutrition and Integrative Health. She uses nutrition therapy for chronic dieting and eating disorder recovery, behavioral and mental health, gastrointestinal and digestive health, as well as fertility support for those in recovery from eating disorders. 

In the Mental Health Masterclass Series, Alyson walks through the latest research on dietary approaches to mental health. 

Her opening thought: “Dietary guidelines have to be simple: nutrition is not simple.”  

Fortunately, Alyson made her literature review simple. The practitioner’s goal is to make healthy dietary changes simple, too. 

A headshot of Alyson Roux, CNS, MS

So what does the research say about nutrition and mental health? Let’s look at the three latest trials on dietary interventions for mental health: the SMILES Trial, the PREDI-DEP Trial, and the MIND Diet Trial. 

Mental health and nutrition: An overview of the evidence

All of these trials used variations of the research-backed darling of nutrition science: the Mediterranean diet. This diet is full of plant-based foods, with vegetables and fruit, whole grains, legumes, and olive oil as the stars of the show, plus fish and nuts, and some low-fat dairy as well. 

While most studies on the Mediterranean Diet focus on its heart-health benefits, the studies below tout its uses for mental health, too. As an intuitive eating coach, Alyson focuses on adding these heart-and-mind-healthy foods to clients’ diets rather than restricting their intake of other foods. However, some of these studies recommended reducing other foods, such as refined sugar.  

SMILES trialPREDI-DEPMIND diet
Whole grains5-8 servingsNo recommendation>3 servings
Vegetables6 servings>2 servings
> 2 servings sofrito
>1 servings
> 6 servings of green leafy vegetables weekly
Fruit3 servings> 3 servings> 2 servings/week berries
Legumes3-4 servings/week> 3 servings/week> 4 servings/week
Dairy2-3 servings low-fat, unsweetened< 1 serving of butter or cream< 1 serving/week of cheeses
< 1 tbsp/week of butter
Nuts1 serving of raw and unsalted> 3 servings/week> 5 servings/week
Adapted from Alyson Roux’s session “Collaborative Meal Planning for Clients with Mental Health Nutrition Needs” for the Mental Health Masterclass Series.

The SMILES Trial

The SMILES trial was the first intervention study to test nutrition as a treatment strategy for depression, vs. previous research that observed trends between dietary habits and mental health.

The trial was a 12-week intervention in which the control group followed their usual eating habits. At the same time, the treatment group followed a variation of the Mediterranean diet and received several appointments with a registered dietitian. Study participants had to have a diagnosis of depression to qualify for this study. 

The dietary intervention emphasized:

  • No calorie limit
  • Emphasis on whole grains, veggies and fruit
  • Recommended fish twice weekly
  • Olive oil: three tablespoons a day
  • Raw nuts daily

In addition, they were recommended to reduce sweets, sugary drinks, and highly processed foods.

The results: Participants in the treatment group had a significant decrease in depressive symptoms at the end of the 12 weeks, as measured by the MADRS scale, a validated tool. 

The PREDI-DEP Trial

Next on Alyson’s list is the PREDI-DEP trial, the first ongoing randomized clinical trial to explore the Mediterranean diet in the prevention of recurrent depression. 

The PREDI-DEP trial is a long-term study in which dietitians coached the participants in the intervention arm to follow a Mediterranean diet, including a big push for olive oil each day. The PREDI-DEP also encouraged the cultural favorite sofrito, a sauce made with tomato, onion, leek, or garlic and simmered with olive oil.

The dietary intervention emphasized:

  • Olive oil as the primary fat – at least four tablespoons/day
  • Limited animal protein – focus on chicken, turkey, or rabbit over veal, pork, or beef.
  • Nuts: at least three servings per week
  • Fish: at least three servings per week
  • Sofrito: two servings per week 

The delicious results: Participants in the treatment group experienced significant improvement on several validated measures, including the mental domains of HRQoL, a surge in quality of life, and physical health and vitality (with no known adverse effects, to boot). 

The MIND Diet Trial

The MIND Diet explored how the Mediterranean diet can help to slow cognitive decline with age. Participants were 65 to 84 years old. 

The dietary intervention emphasized:

  • Whole grains: three servings per day
  • Veggies: lots, including one serving of leafy greens each day
  • Fruit: lots, including two servings of berries each week
  • Fish: once per week
  • Nuts most days
  • Olive oil as the main cooking fat

The MIND Diet de-emphasized sweets, pastries, red meat, and butter.

The delicious results: After three years, researchers found a marked improvement in cognition scores for the study participants. 

With the results of these three mental health dietary interventions, let’s explore how we can empower our clients to put these goals into practice. 

Putting the evidence to practice: Nutrition for mental health

You need to get to know your clients before you can create a personalized plan that’s helpful and achievable for them. 

Alyson advocates for providing “validating care,” which means accounting for a client’s barriers, lifestyle, and, of course, their favorite foods.

Assessing your client’s nutrition and culinary skills

In your client assessment, Alyson encourages learning about your client’s needs and preferences. Knowing what is going on with their life right now helps you best support their needs with your recommendations. She suggests asking about:

  • Their favorite foods
  • Foods they do not like
  • Their grocery budget
  • Space available for food storage
  • How much time they have to prepare food
  • Energy levels
  • Dietary restrictions, allergies, or food sensitivities
  • Preference for batch cooking and one-pan meals

Alyson also recommends asking your clients about their learning styles so you can teach them effectively. If they’re visual learners, having recipes and menus with pictures helps them understand what you’re teaching. Even better, when the recipe photos look delicious and doable, your clients will feel excited to try them, even if they’re outside of their normal routine. 

Identifying opportunities to teach

With a thoughtful assessment, you’ll be able to identify opportunities to teach your clients the best steps to achieve their wellness goals. 

With the proper understanding of where your clients are and where they’d like to be, you are well-equipped to provide them with personalized meal plans (that don’t take all day to create).

An example of a selection of heart health-y nutrition plan templates from That Clean Life in the Practice Better platform, including a creamy apple pie smoothie, almonds, penne with bursted cherry tomato sauce.
A selection of heart-healthy nutrition plan templates from That Clean Life in the Practice Better platform.

For example, suppose you already know your client prefers sheet pan meals that exclude beef, emphasize salmon filets, and take under 30 minutes. In that case, you can filter your recipe library by those criteria and make a plan your client will use and benefit from. 

Supporting mental health with meal plans 

The studies in this article offer a glimpse into just how powerful nutrition can be. But recommendations can feel abstract to your clients, and figuring out how to incoporate them into a daily eating plan can be a lot.

For example, clients don’t exactly shop for magnesium and fiber at the grocery store. They shop for and eat food: peaches, leafy greens, and their favorite cookies. 

Thoughtful meal plans match your client’s preferences, culinary skills, budget, and interest in cooking. With these personalized plans, your clients will be well-equipped to nourish their best mental health. And with the right technology, you can support lots of clients with those personalized, helpful tools.

Achieve personalized planning perfection with software

Personalized nutrition planning takes time; the right tools make this work streamlined but still impactful. 

To maximize your impact without maximizing your time investment, look for software that:

  • Offers filters to find meals quickly, based on taste and culture
  • Integrates seamlessly with your Electronic Health Record (EHR)
  • Provides helpful protocols and templates to save you time
  • Uses client assessment tools to help you nail your personalized protocols 

Address mental health confidently with science-backed nutrition

The studies in this blog show there are many good mood foods out there, but nutrition has never been one-size-fits-all. The better we understand our clients, what they’re struggling with, their favorite foods, interests in cooking, budget, and lifestyle, the better we can serve them with personalized plans that empower them.

The future is collaborative, and so is mental healthcare. Much like a Mediterranean recipe, the results can be simple and tasty.

For evidence-based guidance on health and wellness strategies for mental health, check out Alyson’s talk and other educational sessions at the Mental Health Masterclass Series.

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