“I eat, therefore I am”: Should Mental Health Enter the Food Policy Debate?

If the old parable is true and you are what you eat, does food affect who we are and what we think? I have previously written about the visible problems associated with poor diets in the world such as obesity, diabetes and food related cancers and the possible starting points for individual and public policy solutions. However, one notable health aspect generally missing from discourse on food policy is that of mental health problems associated with diet. These can include depression, with associated human cost of suicide, and health problems due to malnutrition associated with eating disorders. For example, according to the World Health Organisation “in low-income countries, depression represents almost as large a problem as does malaria (3.2% versus 4.0% of the total disease burden)” and every year 844,000 people commit suicide globally, a staggering 60% rise in the last 45 years. It is a pricey omission too since mental health issues are highly costly to: societies overall through their national health and medical systems; to the private sector through lost days of work; and to individuals through the suffering of depression or the silent, and often unreported and untreated, psychological and physical suffering associated with eating disorders. Mental health disorders cost the UK National Health Service, for instance, an estimated £77bn ($120bnUSD) annually and 77,000 people currently out of work due to mental health problems.

So what does mood have to do with food? Well, increasingly, these rising mental health issues are being linked to the change in diets experienced all over the world in the last 50 years according to a 2006 report by two UK charities. In countries with low fish intake, for example, the report finds higher rates of depression, whilst deficiencies in essential fats and anti-oxidant vitamins are found to contribute to schizophrenia. The global change in diets towards highly processed, nutritionally deficient foods and increasingly meat-based diets, known as the nutrition transition, has been driven by the global food system as much as anything else. Yet solutions to these rely on heavy use of psych-medication, leading many to criticise the UK, US and others for becoming true ‘Prosac Nations”. In the mean time, ground-breaking nutrition-based mental health therapy in the UK is producing incredible results. Reported in the Guardian, a nutrition centre in Rotherham has found that, upon arrival, mental health patients have the worst observable diets compared to other patients requiring nutrition therapy. This includes high levels of sugar and carbohydrate intakes and very little fruits and vegetables. After significantly altering their diets at the centre, some bipolar patients (such as manic depressives) showed improvements to the extent that they were able to come off anti-psychotic drugs altogether. As much of an incredible feat as this represents, it is important to remember that food is of course but one component in the complex milieu of mental health, which includes intricate interaction of individual, societal, environmental and nutritional/biological factors in the same way that obesity and other forms of malnutrition do. Nevertheless, given the increasing evidence of the effect simply changing what you eat can have on your psychological well being, it is imperative that mental health should feature in discussions about food policy. This is especially the case for developing countries with much larger public health budget constraints since to treat someone in a psychiatric hospital, a purely curative measure, is incredibly costly, whilst a change to a healthier diet is cost-effective and has both curative and preventative value.

Do you think that mental health should be part of the food policy debate? Share your thoughts in the comments below.

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