One of the key messages of our book THE BETTER BRAIN is that nutrition is the foundation of resilience. Very often we hear people say that we live in such stressful times that 20% of our population is now diagnosed with a mental disorder (as opposed to <3% in 1960). This statement is, in our opinion, missing the mark. Our youngest ancestors lived through the Great Depression and two world wars, without antibiotics, without anesthetics and yes - even through a pandemic. Is our life really more stressful ... or ... is our resilience less?
Our current food intake. Current studies show that we don’t eat as healthily as our ancestors did. For example, people in Western societies have reduced their intake of minerals and vitamins (which we will refer to as “micronutrients”) by more than 50% over the past 50 years! Why should anyone choose this?
We don’t think it’s a conscious choice – it’s just that people have gotten used to consuming mostly ultra-processed foods (UPF) – things that look like food but mostly a chemical mix of things like Fats and simple carbohydrates are (sugar) and salt. The problem is that these packaged items contain very few minerals or vitamins. Would that matter to our brain health? YES! In order for our brain to function optimally, they need more than 30 micronutrients per minute every day of our life. And they can’t provide UPFs.
How we deal with stress. A basic premise of the book is that people do not change their behavior just because they are told it will be good for you. A high priority in the first chapters is therefore to explain why we should all avoid UPFs and increase our intake of whole foods and how to do this inexpensively. We also offer a summary of the evidence that the recent move toward UPFs likely explains some of the decreased exercise capacity and increased mental health problems. We support this argument in many ways in the book, and here we focus on only one thing: the dietary management of post-trauma stress.
Post trauma stress. Natural disasters (e.g. earthquakes, floods) and man-made disasters (e.g. terrorism, mass shootings) affect communities worldwide and often cause immense suffering and long-term psychological effects. Julia lives and works in Christchurch, New Zealand, where there has been a lot of trauma, but she also had the opportunity to study the effect of nutrients on our resilience.
For example, on February 22, 2011, Christchurch experienced a devastating 6.3 magnitude earthquake that killed 185 people and destroyed the city center. But as terrible as it was, this trauma gave her Mental Health and Nutrition Laboratory at Canterbury University a chance to see if micronutrients can help people recover from mental injuries rather than physical ones.
Here is the rationale for investigating this question. When we are under high stress, even those of us who avoid UPFs often reach for “comfort” foods (like cookies, donuts), which are usually high in calories but low in nutrients. But what is our brain doing at the same time during this high level of stress? At such times, our natural alarm response system, which is responsible for fight or flight, is activated. Chemicals like adrenaline and cortisol are released, which allows us to get to safety, turn off non-essential functions and ensure that the muscles we need for the flight or flight are activated. Unfortunately, the alarm system can override for long periods of time, and this is a factor that can lead to memories being relived, flashbacks happening, hypervigilant and constantly nervous and feeling anxious and panicked when reminded of the traumatic event. Sleep disorders and nightmares inevitably occur.
But while this high level of stress is occurring and your alarm systems are being activated, your brain and body are using a triage system to redirect nutrients to the urgent, acute needs of fight or flight. In other words, so many ongoing functions can be relatively neglected – like regulating mood, growth, DNA repair, and clarity of perception.
The production of neurotransmitters (like dopamine or serotonin) and hormones (like cortisol) requires micronutrients, which are numerous types of vitamins and minerals, like zinc, calcium, magnesium, iron and all of the B vitamins, vitamin C. This is well established scientific fact. When your body is deprived of these nutrients, either it does not have enough nutrients to make these essential chemicals or it is redirecting all of its resources to the combat flight response (since it is so important to survival) and it will not Much is left to ensure optimal brain function to do things like focus, mood regulation, and sleep.
Earthquake and flood. Perhaps it now makes sense that micronutrients that are depleted at high speed during stressful times need to be replenished in greater quantities from our food (and possibly from other sources). Julie did research on this after the Christchurch earthquake and with Bonnie during the southern Alberta flood, and we want people to be aware of this during the pandemic. Incidentally, in two of our studies we also found that B vitamins in particular can be helpful in reducing stress.
Mass shooting. And then another event happened. In 2019, a gunman entered two mosques in Christchurch, killing 51 people while injuring 40 others. Once again this city and its people have faced a great deal of trauma. As an application of translational science, Julia’s research lab offered donated nutrients to anyone who survived the shootings and monitored their symptoms as both an ethical and standard measure of good clinical care.
Within a few weeks, they clinically monitored 26 people who had come forward, and they saw exactly the same treatment effect that the two of us had seen after the earthquake and flood. Not everyone, but a lot of people got better. These clinical observations have just been published in an APA journal, International Perspectives in Psychology: Research, Practice, Consultation.
Here are some details of the mosque massacre treatment. Before starting treatment, 77 percent of the original 26 participants reached or exceeded a limit value that defines the probable PTSD. After an average of five weeks, this rate fell to 23 percent. In other words, of all people likely to have PTSD, nearly three-quarters showed significant and clinically significant improvement after about a month of micronutrient treatment. Stress is reduced to the normal non-clinical area, similar to controlled earthquake and flood research:
Post Disaster Data Chart: Notice that the three groups of people who received a broad spectrum formula of minerals and vitamins reduced their stress levels to the normal range in just 4 to 6 weeks. In contrast, in the two groups not receiving broad spectrum micronutrients, the reported stress remained in the elevated range.
Summary of the post-trauma studies. The conclusion we draw from this line of post-disaster research is that providing micronutrients to survivors appears to reduce psychological distress to clinically significant levels. These three different examples of traumatic events illustrate the powerful effects nutrients can have on recovery and resilience enhancement. Could these findings apply to challenges related to climate change and pandemics? We think so. Anything that can improve our resilience to dealing with prolonged stressful events must be good to know.
Given the ease of use and large effect sizes, this evidence supports the routine focus on consuming nutrient-rich foods and, in some cases, adding micronutrients as dietary supplements for disaster survivors as part of the state response.
Obstacles. The way to convince governments to help people with micronutrients has been quite a challenge. For example, Julia wrote a description published last year in the New Zealand Medical Journal describing how, after the mosque attacks, she faced great difficulties in disseminating the results of earthquake and flood research and the obstacles that largely prevented translation to practice. She observed an inflexible health system incapable of conducting evidence-based research and ethics committees incapable of reacting quickly to facilitate research into the immediate consequences of a disaster when distress and stress are at its peak.
In Alberta, Bonnie’s experience was similar. After the earthquake and flood results were published, a massive forest fire broke out in northern Alberta in 2016. More than 90,000 people had to leave their homes in and around Fort McMurray. Many lived in student dormitories in the province and were not allowed to return to their homes for several months. Bonnie reached out to various government officials and the provincial health system, demanding that people be given micronutrients to help mitigate the psychological effects of the trauma. While she was able to base her suggestion on local provincial data, all of her suggestions were rejected – even the idea of just telling people to take an inexpensive B-Complex after breakfast each day.
Broader Future Implications. It is important to understand that the post-trauma studies described here are supported by other studies from the UK, Belgium, South Africa, etc., all of which have shown that supplementation can improve resilience. This should come as no surprise to the readers here, as many of you already know the truth about what we said in our first sentence: Diet is the foundation of resilience.
In THE BETTER BRAIN we close with a chapter entitled “A Vision for a Happier and Healthier Tomorrow”. We emphasize food first as the way we should improve our resilience. We adopt a three-tier approach to improving mental health resilience that recognizes that we are not all the same, that individual differences affect the effectiveness of different treatments, and that there is a place for everyone in the Mental Health Management Toolbox is evidence-based treatments: These include whole foods, micronutrients, counseling, family therapy, and medication. And we argue that diet should come first because it is the foundation for everyone else.
The suggested title for our book was Hidden Brain Hunger before it was changed to The Better Brain. We think this aptly describes the modern brain today.
Mad in America hosts blogs from a diverse group of writers. These posts are intended to serve as a public forum for discussion – by and large – about psychiatry and its treatments. The opinions expressed are those of the authors.