The Importance of Nutrition in the Pediatric and Adolescent Psychiatric Population
Link to Depression and Nutrition
According to recent research, there is a significant connection between unhealthy eating patterns and poor mental health among children and adolescents. Depression is defined as a cluster of specific symptoms with an associated impairment affecting 7.4% of adolescents (those 10-14 years of age) globally. In any given year, approximately 20 % of children and adolescents globally have mental health difficulties, including major depressive disorder. Self-harm and suicide are the leading cause of death in young people and poor mental health is associated with overall health and developmental concerns among youth, like educational achievements, reproductive and sexual health, substance abuse, and violence. In fact, most mental disorders begin during youth but are detected for the first time in later life. Therefore, it’s crucial interventions like medical nutrition therapy are introduced early, in the pediatric and adolescent population versus waiting until adulthood.
Nutrition and Psychological Disorders
Unfortunately, many studies have reported that young people are eating well below dietary recommendations. Children and adolescents have become increasingly reliant on nutrient-poor, foods high in sugar and saturated fatty acids such as soft drinks, confectionary items, and baked snacks. These dietary patterns are not only significantly related to obesity and non-communicable diseases, but they also critically impact brain development and mental health as well. Consumption of diet and snack-like foods has been linked to behavioral and emotional problems in children, which has been linked to mental disorders in adulthood.
Findings highlight the potential importance of the relationship between healthy dietary patterns or quality and positive mental health throughout the life span. Various nutrition and dietary compounds have been suggested to be involved in the onset maintenance and severity of depressive symptoms and disorders. These nutritional compounds like serotonin and dopamine may assist in regulating depression-associated biomarkers. The chart below illustrates those markers and how they function in our bodies.
Several healthy foods such as olive oil, fish, nuts, legumes, dairy products, fruits, and vegetables have been inversely associated with the risk of depression and might also improve symptoms. However, western dietary patterns which include the consumption of sweetened beverages, fried foods, processed meats, and baked products are associated with an increased risk of depression in scientific studies. The table below better illustrates how each neurotransmitter affects the body and the foods consumed to correct that nutrient deficiency.
The brain has the highest levels of lipids in the body, gray matter in the brain contains 50% polyunsaturated fatty acids (33% are omega-3) and is supplied through diet. The breakdown of functions is as follows:
- N-3 PUFAs modulate the mechanism of brain neuron communication.
- Decosahexanoic Acid (DHA) predominantly constitutes 15% of the brain, DHA concentration affects the membrane permeability of cells in the Central Nervous System (CNS), and deficiency of DHA is linked with the dysfunction and impaired transmission of neurotransmitters; serotonin, norepinephrine, and dopamine.
- EPA constitutes 0.2%.
This illustrates the importance of Omega - 3 fats which have a direct influence on serotonin status by enhancing its production and reception. Research suggests that the depletion of n-3 PUFAs can be an etiological factor in several neuropsychiatric disorders including depression. Lower intake or concentrations of n-3 PUFAs is observed in depressed individuals. Fish intake of >150 g/week is linked to decreased levels of proinflammatory markers like C Reactive Protein (CRP) and cytokines such as interleukin 6.
This supports the hypothesis that eating more fish could lead to reduced depressive symptoms through modification of the inflammatory process. In addition, studies have also concluded that bipolar disorders have a strong relationship between increased seafood consumption and lower prevalence rates. Regular consumption of fish has also been associated with reduced suicidal ideation and better self-reported status of mental health.
A Case Study
A study from London’s Hammersmith Hospital, UK reported a case study of a 21-year-old student who had been on a variety of antidepressants but had shown no improvement. He had a very low sense of esteem, little appetite, sleeping problems, found it hard to socialize, and often thought of killing himself. After 1 month of supplementation with a concentrated form of omega-3, he was no longer having suicidal thoughts and after 9 months of supplementation, he no longer had depression. Thus, illustrating the importance of Omega 3 Fatty Acids.
Folate deficiency and depression are also interconnected, a deficiency of folate can lead to irregularities in methylation and synthesis of monoamine neurotransmitters. Folate can impact the synthesis of dopamine, serotonin, and norepinephrine in our bodies. In addition, Vitamin B12 cognitive changes have been observed in adolescents with borderline levels of vitamin B12 deficiency.
The Healing Journey
Diet and nutrition offer key modifiable targets for the prevention of mental disorders. Evidence is steadily growing for the relationship between nutrition deficiencies, diet quality, and mental health and for the efficacy and use of nutritional supplements to address deficiencies or as augmentation therapies. NEXDINE Hospitality joins our client interdisciplinary team to support pediatric and adolescent patients on their journey to mental and physical health with food as medicine approaches within our services.
Adolescents typically become increasingly independent and make more decisions about the type and amount of food they consume, including ‘junk’ and ‘fast’ foods therefore NEXDINE Hospitality also focuses a lot on education among this population. Our Registered Dietitian Nutritionists spend a lot of time educating patients about food choices and our culinary teams can introduce new fresh healthy foods in a way that would be acceptable to them. For example, if patients are used to eating fast food our culinarians put a totally different spin on healthy foods with increased flavor profiles and how they are presented to the patients. This way they are equipped to make informed decisions regarding their health upon discharge and take back control over their mental health journey. With already having exposure to how healthy foods can be delicious.
Rebecca McCullough, MS RD CDP
SVP Nutrition Health & Wellness, NEXDINE Hospitality
Asbjornsdottir B, Lauth B, Fasano A, Thorsdottir I, Karlsdottir I, Gudmundsson LS, et al. (2022) Meals, Microbiota and Mental Health in Children and Adolescents (MMM-Study): A protocol for an observational longitudinal case-control study. PLoS ONE 17(9): e0273855. https://doi.org/10.1371/journal.pone.0273855
Khalid, S., Williams, C., & Reynolds, S. (2016). Is there an association between diet and depression in children and adolescents? A systematic review. British Journal of Nutrition, 116(12), 2097-2108. doi:10.1017/S0007114516004359
Khanna P, Chattu VK, Aeri BT. Nutritional Aspects of Depression in Adolescents - A Systematic Review. Int J Prev Med. 2019 Apr 3;10:42. doi: 10.4103/ijpvm.IJPVM_400_18. PMID: 31057727; PMCID: PMC6484557.