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A key mental health question: ‘What are you eating?’


Lauren Ball


10/04/2024 3:08:46 PM

GPs must keep nutrition front of mind when working to improve a patient’s mental health, write Dr Terri-Lynne South and Professor Lauren Ball.

Person with big plate of salad
Patients who follow a Mediterranean-style diet have a 30% reduction in the risk of developing depression.

More than one third of all GP consultations each week involve a conversation with a patient around mental health, but how many include the question, ‘what are you eating?’
 
We know lifestyle-based interventions, including nutrition interventions, are recommended as the foundational pillars for working with patients at risk of experiencing mental health disorders.
 
What is perhaps lesser known in our general practice community, is that evidence is continuing to mount about the powerful role of nutrition when it comes to the prevention, management, and treatment of mental health disorders.
 
Dietitians Australia has this week released its latest evidence brief on nutrition intervention and mental health, Nourishing the Mind, Body, and Brain.
 
This brief highlights strong evidence suggesting high intakes of fruit, vegetables, fish, and whole grains may reduce depression risk.
 
People who follow a Mediterranean-style diet, or a diet that includes fruit, vegetables, fish, and whole grains, have approximately a 30% reduction in the risk of developing depression.
 
Meanwhile, consuming a poor-quality diet that is high in processed meats, carbohydrates and other inflammatory foods including alcohol and trans fats, is linked to higher rates of depression.
 
But nutrition is not often front of mind for GPs when supporting patients with their mental health, and it should be.
 
We have a powerful role to play as gatekeepers, not only through establishing supportive allied health referral pathways but by discussing the range of lifestyle-based interventions that may help patients improve their mental health outcomes.
 
As GPs, one way we can reduce the risk of patients developing mental health disorders is by looking closely at their nutritional parameters.
 
We can provide general recommendations grounded in evidence, including a focus on nutrient-dense dietary patterns including increased consumption of fruits, vegetables, legumes, wholegrain cereals, nuts, lean meat, and omega-3 rich foods such as fatty fish, while reducing consumption of processed foods.
 
This will not only reduce patients’ mental health risk, but also their risk of chronic conditions where diet is a modifiable risk factor.
 
GPs are perfectly placed to start a conversation about improving diet quality and nutrition with patients.
 
Evidence shows that if a GP simply asks what types of food a patient is eating, it can elicit behaviour change in that individual.
 
That initial conversation can be powerful enough to have someone walk away and think about examining how healthful their diet really is.
 
GPs can, and should, lean on the accredited practising dietitian community to enhance patient care when it comes to mental health.
 
If we take a step back, and take a holistic view, considering the mind, body, and brain, we can use the tools we have available through Medicare to deliver the best outcomes for our patients experiencing chronic mental health disorders.
 
While we may develop a mental health care plan to provide access to psychologists and psychiatry services, we can also consider simultaneously developing a chronic health management plan to initiate referral pathways to allied health services, including dietitians.
 
Where medications are prescribed to patients with chronic mental health conditions, nutrition support as an ancillary tool can be extremely beneficial, particularly for anti-psychotic medications where metabolic dysfunction is a known side effect.
 
The support of a dietitian can help these patients with individualised approaches, aimed at reducing these side effects, which can include weight gain and changes in appetite.
 
The RACGP’s 2023 Health of the Nation report found psychosocial issues and mental health presentations are the top emerging issues for general practice in Australia, and it is clear GPs are under enormous pressure to support this health challenge.
 
But GPs should not have to feel they are shouldering the load of this challenge.
 
We must enable more avenues for referral pathways to the multidisciplinary approaches, including dietetics, to transform the way we support Australians with their mental health.
 
This week is Dietitians Week in Australia – to connect with an accredited practising dietitian in your local area visit the Dietitians Australian website.
 
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Dr Michel Raymond Hoenig   11/04/2024 10:05:31 PM

Also of interest is that subset if patients whose depression responds to fermented foods. I would love to see more research on this.