13 Feb 2023 Children’s Mental Health Week – Start sowing the seeds of mental health early
Using diet and nutrition to foster good mental health in childhood and adolescence.
The triggers for mental health are multifactorial and most experts agree that early lived experiences are crucial to sowing the seeds for mental health in adulthood. Place2Be’s Children’s Mental Health Week 2023 took place from 6-12 February with the theme of ‘Let’s connect’, and in this article BANT Registered Nutritionist ® Vandana Chatlani connects the dots between diet, nutrition, and lifestyle interventions as prevention and support for children’s mental health. Eating a healthy balanced diet and installing healthy habits from a young age can help foster the terrain and empower children, adolescents and their families to make healthy choices to take forward into their adult lives.
There has been a resurgence in the focus on mental health among children and young adults in recent years, propelled by the covid pandemic.
This month, a report published by the UK’s Department of Education on children and young people’s wellbeing underlined elevated levels of probable mental disorders and eating problems following the pandemic; a rise in emotional difficulties; and a higher percentage of children and young people reporting low happiness with their health (1).
In addition, the paper says young adults experienced worse rates of anxiousness over the past academic year despite a return to regular schooling after the pandemic, and notes that disadvantaged groups in schools such as those from a minority background or with special educational needs report significantly lower wellbeing scores (2).
Spending by the NHS on children’s mental health has increased by 4.4% since 2019/2020 according to the Children’s Commissioner for England (3).
Meanwhile, statistics from UNICEF state that in 2019, an estimated one in seven adolescents experienced mental health disorders. This is the equivalent of a staggering 166 million adolescents globally (4).
The number could be substantially higher today. Experts who studied recent and past health epidemics confirm that children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic (5).
Children exposed to conflict and violence, natural disasters, financial difficulties, and consistent familial discord face an additional mental health burden.
Mental health during a child’s formative years can also be impacted by a cocktail of peer pressure, academic stress, and social media use where content is carefully curated to showcase a perfect reality.
The role of diet in mental health
Nutrition and diet also play a huge role in the mental state of children and young adults. Cultivating good eating habits early on is vital as part of an overall healthy lifestyle, particularly given that mental health struggles in adulthood often begin in childhood and adolescence (6).
We know that good nutrition is an essential component for early brain development and cognitive function and performance (7). High quality protein, long-chain polyunsaturated fatty acids, iron, zinc and iodine are crucial to shaping the brain’s structure and capacity in childhood (8).
This extends to emotional, behavioural, and mental health. Researchers have found compelling evidence of the relationship between unhealthy dietary patterns and poorer mental health in children and adolescents, while also observing a correlation between good quality nutrition and better mental health (9,19,11,12).
Studies have also highlighted that high levels of ultra processed food and refined sugar can contribute to low mood, behavioural disturbances, and anxiety, and can increase the risks for depression (13).
Diets low in fruits, vegetables and healthy sources of fats and protein will almost certainly be missing micronutrients such as folate, zinc and magnesium, which could exacerbate mental health problems such as depressive disorders.
A western dietary pattern laden with sugary drinks, fried foods and processed meat has also been associated with an increased risk of depression (14). Similarly, excluding foods rich in omega-3 fatty acids, such as salmon, mackerel, flaxseed and walnuts, can exacerbate anxiety disorders (15).
Mental health disorders among younger populations are not limited to depression, anxiety and other severe conditions. Diets lacking in essential nutrients which are packed with additives, can also contribute to emotional and behavioural struggles (16).
A study of Norwegian children showed that those who consume a varied Norwegian diet (rich in unrefined plant foods, fish and regular meals) were less likely to exhibit indications of psychiatric concern or hyperactivity disorders, while children who recorded a diet high in junk, convenience food and habitual snacking showed some signs of inattention and hyperactivity (17).
Key nutrients
So, what should children be eating?
The nutritional deficiencies frequently found in those with mental disorders include omega-3 fatty acids, B vitamins, minerals, and amino acids that are precursors to neurotransmitters (18).
Eating enough high-quality protein is important for healthy brain function and mental health. Amino acids are the building blocks of protein and lay the foundations of the chemicals that help regulate our mood, motivation, and happiness. Amino acids such as tryptophan (found in foods such as turkey, chicken, beef, tofu, fish, oatmeal, and soybeans) and tyrosine (found in cheese, pork, lamb, chicken, eggs, dairy and whole grains) for example, are the raw materials needed to make the neurotransmitters serotonin and dopamine which combat depression and insomnia and have mood-enhancing effects on the brain (19,20).
Omega-3 fatty acids have often been hailed for their anti-inflammatory properties and contribution to a lower prevalence of mental health problems. Brain lipids are made up of fatty acids and are constituents of membranes. These fatty acids enhance neuron communication, neurotransmitter function and serotonin production and reception.
Clinical trials have shown promising results in the alleviation of depression with omega-3 supplementation. The conversion of the omega-3 fatty acid, eicosapentaenoic acid (EPA) into another omega-3 fatty acid, docosahexaenoic acid (DHA), has demonstrated anti-depressant effects in humans. And daily supplementation of omega-3 fatty acids in trials have resulted in mood elevation (21).
Micronutrients such as zinc, B vitamins, and magnesium are also important in maintaining good mental health.
Zinc is vital for many biochemical and physiological processes related to brain growth and function. Several studies have illustrated that zinc levels are lower in patients with clinical depression, while separate trials have demonstrated the benefits that oral zinc brings to anti-depressant therapy (22). Foods high in zinc include red meat, oysters, crab, and pumpkin seeds.
The B vitamins are composed of eight water soluble vitamins that help regulate cellular functioning, act as co-enzymes in enzymatic reactions, and help with energy production, DNA/RNA synthesis and repair and other tasks (23). Research has shown parallels between B vitamin deficiencies and neurological and psychiatric symptoms such as depression and cognitive decline (24).
Magnesium works as an activator for over 300 enzymatic systems, many of which are responsible for adequate brain function. Magnesium-rich foods include dark green leafy vegetables, nuts, seeds, and whole grains. Magnesium depletion can be related to a number of health conditions including attention deficit hyperactivity disorder and depression (25).
In addition, a diet, rich in colourful fruits, vegetables, whole grains, and legumes is also beneficial because of its biodiversity, antioxidants, and vitamins. The Mediterranean diet is widely used as a model for a healthy and vibrant pattern of eating; however, this can easily be achieved in culinary preparations rooted in Asia, the Middle East, Africa and Latin America.
Creating an environment of support
To some extent, children and young adults may find it difficult to recognise symptoms of mental health disorders in themselves; feel embarrassed to seek help because of the social stigma attached to mental health problems; or simply lack the structures needed to point them towards the best systems of support (26).
With this in mind, how can we improve our ability to care for children and young adults?
Healthcare practitioners, teachers, parents, care workers and other guardians may wish to better understand and look out for common signs and symptoms of mental distress.
For example, researchers point out that many easily noticeable food patterns that precede depression are identical to those that occur during depression. This could include poor appetite, skipping meals and a dominant desire for sweet foods (27).
Other common signs and symptoms of mental distress include:
Apathy
Lack of motivation
Irritability
Consistent fatigue
Low self-worth
Difficulties concentrating
Anxiety
Insomnia
Low mood
Palpitations
Sweating, trembling, or shaking
Suicidal thoughts
Identifying these and other symptoms early on would allow adults to raise concerns with appropriate healthcare specialists, and provide a holistic system of support at home, in school and within the wider community.
Lifestyle interventions
Educational institutions, community organisations, charities, publishing houses and healthcare experts are increasingly investing resources to promote better mental health among children.
Nutrition is one component, but environmental and lifestyle measures are equally important. Children are now being taught how to recognise and understand their emotions. In times of stress and anxiety, children can use grounding exercises, such as focusing on their senses to see, hear, smell and touch objects as a technique to restore calm and pull them back to the present moment.
There are several other strategies and tools that children and young adults can use to promote balance and improve mental wellbeing.
Meditation and mindfulness activities can foster feelings of hope and optimism. In-person community activities such as urban gardening or volunteering can create a sense of purpose and connection. Capped screen time and regular digital detoxing can provide relief from information overload. Time in nature can be very soothing. And sport and movement are brilliant ways to release endorphins, our happy hormones, elevate our mood and reduce anxiety (28).
Author – BANT Registered Nutritionist ® Vandana Chatlani, NT Dip, mBANT, CNHC
REFERENCES:
- State of the nation 2022: children and young people’s wellbeing https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1134596/State_of_the_nation_2022_-_children_and_young_people_s_wellbeing.pdf
- State of the nation 2022: children and young people’s wellbeing https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1134596/State_of_the_nation_2022_-_children_and_young_people_s_wellbeing.pdf
- Briefing on Children’s Mental Health Services – 2020/2021 https://www.childrenscommissioner.gov.uk/report/briefing-on-childrens-mental-health-services-2020-2021/#:~:text=Spending%20by%20the%20NHS%20on,investment%20is%20making%20a%20difference .
- Mental health https://data.unicef.org/topic/child-health/mental-health/
- Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038056/pdf/ijerph-18-03432.pdf
- Lifetime Prevalence of Mental Disorders in US Adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946114/
- Review of the evidence linking protein and energy to mental development https://www.cambridge.org/core/services/aop-cambridge-core/content/view/DF57A891D5A7167CBCE47DB3CB354B83/S1368980005001436a.pdf/repdf
- The Role of Nutrition in Brain Development: The Golden Opportunity of the “First 1000 Days” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981537/
- Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167107/
- Eating patterns and mental health problems in early adolescence – a cross-sectional study of 12–13-year-old Norwegian schoolchildren https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173131/#ref2
- Nutritional Aspects of Depression in Adolescents – A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484557/
- Understanding nutrition, depression and mental illnesses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
- Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167107/
- Nutritional Aspects of Depression in Adolescents – A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484557/
- Food for Mood: Relevance of Nutritional Omega-3 Fatty Acids for Depression and Anxiety https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087749/
- Food Additives and Child Health https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298598/
- Eating patterns and mental health problems in early adolescence – a cross-sectional study of 12–13-year-old Norwegian schoolchildren https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173131/
- Understanding nutrition, depression and mental illnesses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
- Nutritional Aspects of Depression in Adolescents – A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484557/
- Understanding nutrition, depression and mental illnesses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
- Understanding nutrition, depression and mental illnesses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
- Understanding nutrition, depression and mental illnesses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
- B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772032/
- B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772032/
- Zinc, Magnesium, Selenium and Depression: A Review of the Evidence, Potential Mechanisms and Implications https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986464/
- Symptoms of Mental Health Problems: Children’s and Adolescents’ Understandings and Implications for Gender Differences in Help Seeking https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540163/
- Understanding nutrition, depression and mental illnesses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
- Exercise for Mental Health https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/
NOTES TO EDITORS:
BANT is the leading professional body for Registered Nutritional Therapy Practitioners in one-to-one clinical practice and a self-regulator for BANT Registered Nutritionists®. BANT members combine a network approach to complex systems, incorporating the latest science from genetic, epigenetic, diet and nutrition research to inform individualised recommendations. BANT oversees the activities, training and Continuing Professional Development (CPD) of its members.
Registered Nutritional Therapists are regulated by the Complementary and Natural Healthcare Council (CNHC) that holds an Accredited Voluntary Register (AVR) for the Professional Standards Authority for Health and Social Care (PSA). A report by the Royal Society for Public Health and the Professional Standards Agency made a key recommendation that AVR practitioners have the authority to make direct NHS referrals, in appropriate cases, to ease the administrative burden on GP surgeries. BANT nutrition practitioners are the key workforce asset to harness 21st century lifestyle medicine to tackle the rising tide of stress-related fatigue, obesity, Type 2 Diabetes, dementia and other chronic diseases.
To find a BANT nutrition practitioner, please click here
BANT WELLBEING GUIDELINES:
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