Let’s talk about nutrition and bipolar disorder because there’s a new review that just came out that goes over all of the literature that’s ever been published about nutrition and bipolar disorder. My latest book Eat to Beat Depression and Anxiety focuses on mood disorders and anxiety disorders but I get asked a lot about how nutrition relates to other mental health disorders like bipolar disorder. Bipolar disorder is a mood disorder and along with depression, it includes periods of mania or hypomania. When people feel activated and really energetic, there’s a decreased need for sleep and there’s an increased speed in thinking and speaking and overtime it can escalate and can cause a variety of problems. When it comes to the treatment of bipolar disorder, nutrition and nutritional therapies are adjunctive, meaning that the mainstay of treatment for most patients is going to be medications like lithium, depakote, or some of the new mood stabilizers.
This paper is by Beny Lafer and Fernanda Gabriel from the bipolar division at the University of Sao Paulo and they’re joined by two big names in the nutritional psychiatry field, Felice Jacka and Michael Burke from the Mood and Food Center in Australia. The findings show that nutritional therapies are quite important when it comes to thinking about the overall management of bipolar disorder for a few reasons. First of all, patients with bipolar disorder often have an increased risk for metabolic disorders such as obesity, and diabetes, or having challenges with lifestyle. The researchers state that nutrition is a non-negotiable foundational treatment and that’s important as we think about nutritional psychiatry being an intervention or a set of interventions and ideas that can be critical for patients with a variety of brain-based disorders like mental health disorders.
The authors found that there was a significant correlation between mood and mood stability and the intake of a few different types of foods. Seafood and namely long-chain omega-3 fatty acids, zinc and folate or folic acid are correlated with mood stability. So let’s talk a little bit about where you can find them in your diet and safe ways to get them. The first category is seafood and there are a lot of different types of seafood so it’s important to get the seafood that has the most long-chain omega-3 fats with the fewest concerns. This is fish like anchovies and sardines, wild salmon and rainbow trout. These are foods that have a reasonably high amount of omega-3 fats. I also like to include the bi valves such as mussels, clams, and oysters when we think about seafood, because they’re high in many of the nutrients, particularly omega-3 fats, zinc, and many of the minerals that are quite important for mental health.
The other two nutrients that have a significant evidence, according to this most recent review of bipolar disorder and nutrition are folate or folic acid. Oftentimes we think about these related to prenatal vitamins, but folate is a very important nutrient when it comes to mood and mood stability. You’ll find folate in leafy greens. In fact, the word folate comes from the Latin word for foliage. Leafy greens are a great place to find folate, folic acid as well as beans, sunflower seeds, and liver. Those are some good choices when you’re looking for folate.
In terms of zinc, top choices are going to be oysters. Just 6 small East coast oysters have over 500% of your daily need of zinc. That’s about 60 calories. Another great source of zinc are pepitas or pumpkin seeds. Dark chocolate is another great source of zinc.
It’s great to see a review come out about nutrition and bipolar disorder. For individuals interested in this, it provides you a great resource in terms of all of the studies that have been done. They include over 60 trials.
There are two other trials that come to mind that are important when it comes to nutritional moves that individuals with bipolar disorder can make. The first was a study done by Robert Yolkens group at John Hopkins that looked at a correlation between nitrated meat products and the risk of mania and hospitalization for mania. They found an increased relative risk of about three times the risk when individuals had a daily meat stick or other nitrated meat products. So avoiding these highly processed foods, which meet sticks often are, is one move to think about.
The other study that was quite interesting came from Faith Dickerson and it looked at an adjunctive probiotic. These were individuals who have bipolar disorder and were hospitalized with mania. They received treatment as usual, usually this was lithium or depakote, and then took either a placebo or a probiotic with it. This group found that individuals who took the probiotic had a greatly reduced risks of being re-hospitalized. In fact, out of 33, people in the control group that got the placebo, 24 were re-hospitalized over the subsequent six months. When you looked at the intervention group that took the probiotic, only eight of the 33 in that group were re-hospitalized. So this is a very interesting and excited finding. Of course, in nutritional psychiatry, we try and translate this into food and this would indicate that individuals who perhaps are concerned with mood cycling and want to improve their microbiome, may want to consider something like yogurt, kefir, sauerkraut, or kimchi. Those are great fermented foods that according to the most recent research we need to eat to improve the diversity of our microbiome.
Please remember this blog is for educational purposes and should not be mistaken for clinical treatment or medical advice if you’re in treatment for bipolar disorder. I hope this review helps remind you and remind us all that nutrition is an important part of treatment for all mental health disorders and I hope that some of this evidence and ideas help.