Changing your diet to improve mental health is easier than it sounds

by Jennifer Bowden / 26 November, 2017

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QUESTIONI’d like to try the Smiles Trial diet, but I can’t see how I’m going to fit all the recommended food into my diet. Do you have any suggestions?

ANSWER: A Mediterranean-style diet significantly improved mental well-being in the recent Australian Smiles Trial, thanks to a serious effort by participants to swap many less-healthy foods for more nutritious ones.

The Smiles (Supporting the Modification of Lifestyle in Lowered Emotional States) Trial was a 12-week, randomised controlled trial involving 67 Australian adults, of whom 69% were taking antidepressants and 45% were receiving psychological therapy. The participants were randomly assigned to either a dietary support group, who were counselled to stick with a modified Mediterranean diet (see box), or a social support group who acted as a control.

After 12 weeks, the effect on mental health was pronounced: a third of the dietary support group showed remission of depressive symptoms, compared with just 8% of the control group.

At first glance, eating all the foods listed in the modified Mediterranean diet may seem unachievable, but consider how many foods you’ll be removing from your diet.

The trial participants were asked to limit “extras”, such as sweets, refined cereals, fried food, fast food, processed meats and sugary drinks, to three a week. And they did a great job, reducing their unhealthy “extra” foods by 22 servings a week. That made room for the extra whole grains, fruit, vegetables, dairy, olive oil, pulses and fish.

New Zealanders also tend to eat too many “discretionary foods” that are nutrient-poor and high in saturated fat, salt or added sugar. According to the 2008/09 New Zealand Adult Nutrition Survey, more than a quarter of our energy intake came from extras such as non-alcoholic and alcoholic beverages (about 5% each), sugar and sweets (4.2%), cakes and muffins (3.7%), biscuits (2.7%), pies and pastries (2.5%), snack bars and foods (1.3%) and puddings and desserts (1%). And that doesn’t include fast foods.

So, start by cutting out as many of those “extras” as possible, then the Smiles food targets will be easier to meet.

For breakfast, try one serving each of whole grains, fruit and dairy. You could have fresh fruit on muesli with greek yogurt, for example, or a smoothie made with fruit, oats and milk.

Then have nuts and a piece of fruit for a morning snack. Add a milk-based drink to your morning or afternoon snack if you like.

For lunch, aim for a protein-rich food, such as meat, fish, egg or legumes, and two servings each of veges and whole grains. I suggest having at least one fish-based lunch and two legume-based lunches a week, and eggs can be added on the other days. So, for example, make a green salad and toss through tinned tuna or salmon, then add a couple of slices of wholegrain bread.

For an afternoon snack, try a serving of vegetables – vege sticks and hummus is a great idea. Or, if you’re still hungry, add a wholegrain item, such as a bran muffin.

Aim to have chicken (two), red meat (three), fish and legume-style vegetarian (one each) meals each week. Add three servings of vegetables and one serving of whole grains to each dinner. Have a fresh salad with wholegrain pasta, for example, or stir-fried veges with brown rice. Reduce the serving of whole grains if the recommended size is too big.

Finish with either fresh fruit salad or stewed fruit. Add a dollop of greek yogurt and a sprinkle of seeds if you’re particularly hungry or didn’t have a milk-based drink during the day.

If you have a small appetite, keep the proportions of the food groups the same, but reduce the serving sizes. If you have a bigger appetite, increase your servings to the higher end of the trial recommendations.

This article was first published in the October 14, 2017 issue of the New Zealand Listener.

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