Every person’s mood fluctuates, and their experience of it is unique and depends on numerous factors.
These include external factors, such as the environment or situation they are in or have been in, and internal factors such as fluctuations in hormones, neurotransmitters and nutrient availability.
Therefore, no one mechanism can explain all the clinical manifestations of depression.
In recent years, research has focused on modifiable factors that support brain health and mood, as well as risk factors for depression.
Nutritional psychiatry is an emerging field of research that investigates how specific nutrients can benefit mental health conditions.
When you feel depressed, it can be difficult to find the motivation, appetite or energy to eat.
Malnutrition is associated with depression and loneliness, particularly among elderly people.
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In addition, eating foods high in sugars and only a limited variety of food contributes to symptoms of depression.
Poor nutritional choices, reduced day-to-day functioning, and emotional changes, can all exacerbate one another, resulting in a vicious cycle.
Regular exercise can be very beneficial, especially if it is done outdoors in a green environment.
Even a mindful stroll through the park or by the river is thought to be beneficial.
Moreover, you may benefit from receiving support from your doctor, as well as from psychologists, therapists and nutritionists.
It is important to consider nutrition with regards to depression.
This is especially as the essential building blocks – macronutrients (eg carbohydrates, proteins and fats) and micronutrients (eg vitamins and minerals) – that the body needs to make neurotransmitters and hormones that are responsible for a balanced mood, come from food.
Low mood is associated with deficiencies in one or more B vitamins.
Depression in children and adolescents is also linked to low vitamin B12 and vitamin D levels, as well as increased homocysteine levels.
Vitamin B-rich foods include whole grains, beans, nuts, seeds, fruits and vegetables.
Green vegetables, beans, lentils, nuts and seeds contain folic acid (vitamin B9), while meat, fish, eggs and dairy products contain vitamin B12.
A multivitamin with optimal levels of B vitamins or a specific B vitamin may also be helpful if you don’t get enough in your diet.
Any new supplements should always be discussed with your doctor before you start taking it.
We synthesise around 90% of our vitamin D through the action of sunlight on our skin.
Depression and panic disorders may be caused by vitamin D deficiency, particularly if you don’t get enough sunshine.
The risk of vitamin D deficiency increases with age (as your skin is less able to make it), dark skin (as dark-skinned people require six times more sunlight to produce vitamin D than those with light skin), weight (as their vitamin D may be stored and inaccessible within the fat tissue) and avoidance of the sun (eg people who always cover up their entire body or use sunscreen).
In contrast to some other substances, omega-3 fatty acids cannot be manufactured by the human body, even though they are essential to brain function and cell growth.
The diet is therefore essential to obtain them.
Among the richest sources of omega-3 fatty acids in foods are oily fish such as salmon, sardines, mackerel, pilchards, herring and trout.
There is evidence that the more fish a country’s population consumes, the lower its incidence of depression.
EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the two most important omega-3 fatty acids.
For vegans and vegetarians, seaweed and algae are good sources of omega-3 fatty acids as they contain DHA and EPA.
For example, chlorella and spirulina can be mixed with water or added to smoothies.
Nori is another type of seaweed that is common in Japanese cuisine.
It is also possible to take EPA and DHA supplements.
Chromium is essential for maintaining a stable blood sugar level as it is required for insulin to function.
Insulin is the hormone responsible for removing glucose from the blood.
Broccoli, turkey, liver, whole grains, seafood and green beans are good sources of chromium.
It is also possible to take chromium picolinate, which is a supplement form of chromium.
But this should be done under the supervision of a doctor, especially if you are also on diabetes medications such as metformin.
Proteins are built from amino acids.
Among the 20 amino acids, nine are essential, meaning that the body cannot manufacture them and we must get them from food.
They are histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine.
Energy is made from tryptophan, as are serotonin and melatonin, which are neurotransmitters.
There are many protein-rich foods that contain tryptophan, such as meat, poultry (particularly turkey), fish, beans, eggs, lentils, nuts and seeds.
With each meal, the body needs a portion of protein to perform many vital functions.
When we are under a lot of stress, either psychologically or physically, tryptophan can be converted into quinolinic acid instead of serotonin.
In some individuals, quinolinic acid is found to increase depression symptoms.
Depression is associated with lower levels of tryptophan (and higher levels of quinolinic acid) in some groups.
A magnesium deficiency is linked to a wide range of systemic diseases, including depression and anxiety.
This is as magnesium plays an essential role in a wide range of bodily functions.
It is the second most commonly deficient mineral after zinc.
High levels of sugar and chronic stress also deplete magnesium levels.
Depression symptoms seem to be reduced by higher intakes of dietary magnesium.
There are some foods that are associated with mood problems.
A recent study involving women with celiac disease found that 37% of the participants suffered from clinical depression.
Another study that involved children with celiac disease found that the rates of depression among the participants ranged from over 8% in boys to nearly 14% in girls.
It is important to note, however, that people who are very sensitive to gluten may experience mood symptoms relating to gluten consumption, even without a diagnosis of celiac disease.
A gluten elimination diet may still be appropriate in such cases.
Such a diet should be conducted under the supervision and with the guidance of a qualified nutritionist.
In addition, you can perform a food intolerance test to determine whether you have elevated antibody levels against specific foods in your blood.
You shouldn’t make any drastic changes to your diet or eliminate entire groups of food without first seeking professional guidance.
Ensure that your diet continues to be balanced and provides your body with the full range of nutrients.
This is particularly critical for children, individuals who live with chronic illnesses, and the elderly.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email firstname.lastname@example.org. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.