After being hospitalised with anxiety and depression, Rachel Kelly discovered how what she ate could transform her mood — and her family life
This January I am not pining for the last of the mince pies, nor am I mournfully spearing a mouthful of kale. Being lean in 15 is not for me, nor do I practise “clean eating”.
It’s not that what I eat doesn’t matter to me. It does, very much. For the past five years my daily fare has been a key tool in my battle to stay calm and well after a long struggle with anxiety and depression for which I have spent time in hospital.
My diet is not about losing weight, but about food being my medicine. It’s a prescription I take seriously. Good mood food has made me calmer, energised and more balanced — and a sensible weight without even trying. Like happiness, weight loss has come on unexpectedly.
While we’ve long accepted that what we eat affects physical illnesses, especially heart disease and some cancers, it is less commonplace to believe that our diet can also affect maladies of the mind. For years doctors looked to medication as the sole solution for mental illness. These days there is a growing sense that drugs are just one part of the answer.
Good psychiatrists now give advice on exercise, mindfulness and nutrition alongside prescribing medication. Despite these advances, nutrition is hardly taught at British medical schools. That seems strange to me. Although I’m the first to recognise that those suffering from severe mental illness may need access to strong medication, who wouldn’t want, if at all possible, to rely on their own ability to eat and exercise well when combating depression? Since my last serious depressive episode just over a decade ago, I have sought to make lifestyle changes gradually and to embrace a holistic attitude to my mental health.
I was first intrigued by food’s medicinal power when, about eight years ago, I took my son, George, who was ten at the time, to see a nutritionist at a well-known clinic in west London about his persistent eczema. I was delighted when his scaly red skin healed within a few weeks of reducing his intake of wheat and dairy.
It wasn’t until several years later that, given my struggles to stay steady and well, I wondered if nutrition could help with mental as much as physical health. I began to experiment, noting which foods made me feel calm, which helped me sleep and which cheered me up.
Some ideas were thanks to my GP. At a routine check-up to see how I was dealing with my anxiety, she told me there was compelling evidence about the links between mood and food. She wrote down a list of “happy foods”. The main ones were green, leafy vegetables, dark chocolate and oily fish. I wanted to learn more, but was confused by the conflicting nutritional advice. So I got in touch with Alice Mackintosh, a nutritional therapist who at the time worked for a nutritional clinic in Harley Street in London. Alice holds degrees in nutritional therapy as well as biomedical science. With her help, and advice from other doctors, dieticians and psychiatrists, I began to overhaul my diet. I began to eat a lot more vegetables, a much greater variety of them, and a lot less processed food.
Alice gave me practical tools in the form of meal planners, and we began to develop recipes for my symptoms, leading to our book, called The Happy Kitchen: Good Mood Food. Studies show that a diet marked by processed vegetable fats, sugar, preservatives and a host of other chemicals may make us more prone to low mood. The jury is out as to the exact causes of depression, but some doctors are questioning the “chemical imbalance” theory that we are depressed largely because of low serotonin levels. A more nuanced explanation emphasises the social, psychological and biological aspects of the illness.
I slowly swept my kitchen clean, eliminating processed foods and focusing on “real foods” instead. These included fresh fruit and vegetables, eggs, unprocessed carbohydrates, fish, and nuts and seeds. I don’t rule out red meat — I have a history of anaemia, so I eat it regularly. I also eat animal fats from meat and dairy in moderation, rather than processed or manufactured fats, as well as plenty of omega-3 fats, which are important given that our brains are made up of 60 per cent fat.
I learnt what to eat and when — a handful of roasted pumpkin seeds if I’m feeling low, or some green broth made from broccoli, kale and cabbage if I’m anxious (the ingredients are rich in calming magnesium).
I also increased the amount of probiotics and fermented foods I ate as I learnt about the links between staying calm and a healthy microbiome, otherwise known as gut flora. A modest portion of creamy yoghurt so thick it stands up in the bowl suits me well. Women given yoghurt containing probiotics were found to have a calmer response to certain stimuli, according to a 2013 study reported in the journal Gastroenterology.
Our gut is now being thought of as our “second brain”. The enteric nervous system, which is the part of the nervous system embedded in our gut, contains as many neurotransmitters as our brain. There are eight neurotransmitters that affect our happiness, including serotonin and dopamine, sleep-inducing melatonin, and oxytocin. In fact, as much as 90 per cent of serotonin is made in our gut and about 50 per cent of dopamine.
Today scientists are discovering that there may be links between gut microbiota and anxiety-related behaviours, as well as many other illnesses. Given the inseparability of good mental and physical health, looking after our digestive systems should be a priority for all of us.
It turns out that, for maximum nutritional benefit, it’s not just what you eat that matters, but also how you eat it. While we eat, we also need to stay in the moment and remain conscious of everything we’re doing — the opposite of scoffing on autopilot, which was my previous default setting. We ate fast when I was growing up — a hangover from the war and rationing I suspect.
In contrast, my half-French husband has always savoured his food — maybe because he was partly brought up in Spain and learnt a more languid, Mediterranean approach to mealtimes. In the past I would be itching to load the dishwasher almost as soon as we sat down. You can imagine how relaxing our family meals were.
I learnt what to eat and when — a handful of pumpkin seeds if I’m low, green broth if anxious
Now, at 51, I’ve learnt to eat more slowly. Alice explains: “It all begins when we learn to chew our food slowly. The saliva production triggers digestive juices, sending a signal to our stomach that food is on its way.”
In addition, slow and steady chewing — ideally 30 to 40 chews for something tough, such as red meat — chops up the food into the kind of small, semi-soft pieces that are easier for our stomachs to digest, thus optimising our absorption of the nutritional content of the food.
There are other benefits to a slower pace. It gives us time to assess properly if we are hungry. Before I swing open the fridge door, I now ask myself if I am hungry, or bored, or stressed? If I’m actually hungry, I then have time to reach for a healthy snack, and one that might help my mood.
Yet if, after a moment, I realise that I just need a break or am feeling anxious, I can go for a walk or do some gardening. This slow pace is especially relevant for those who feel low or anxious; naturally, they are drawn to sugary treats to cheer themselves up.
I’ve found eating more slowly has given me more time to reflect. More time to reflect makes us appreciate our food and how lucky we are to eat it. Saying grace, or just a few words of thanks, is a good example of how we can develop this sense of gratitude that in itself is important for good mental health, as numerous studies have shown. One good device is to eat with your non-dominant hand. Equally, rest your fork on the table after every bite.
Learning how to cook in a different way has been the most important aspect to adopting a slower pace and appreciating that food is my friend. Rather than seeing it as something that has to be ticked off a list and got on the table, it now feels like an extension of my normal meditation routine. I can lose myself in the process. Standing still at the stove, preparing food, grounds me. I become rooted in the moment and stop worrying.
Cooking has changed my relationship with my children too. As a busy mother of five, whose ages range from 13 to 21, it has only been possible to change my diet by changing the family’s diet too. Cooking is now something we often do together. Standing side by side chopping onions elicits revelations about the latest best-friend saga or exam drama in a way that a face-to-face chat doesn’t seem to. One daughter is now a more inventive and talented cook than me.
Some of my happiest memories as a child were watching at my mother’s knee while she whisked a mousse or painted a glaze on an apricot tart. Instilling in my offspring the value of good mood food as they begin to learn to cook has been important to me. I only wish I had spent more time cooking with our older children sooner.
Like me, I feel that the children have learnt the pleasures of a happy kitchen. Even on days when my mood is fragile, the achievement of chopping an onion or slicing an avocado makes me feel that little bit better. It is as much about the warm atmosphere in my kitchen as the cooking itself.
So now, if I do eat a mince pie, I do so consciously and with enjoyment and I don’t beat myself up about it. If I follow my good mood food rules 80 per cent of the time, that’s good enough. And good enough is what I’m aiming for this new year; it’s certainly an attitude that’s at the heart of my own happy kitchen, and I hope it will be at the heart of yours too.
The Happy Kitchen: Good Mood Food is published by Short Books (£14.99).
What to eat to be happy
By nutrition expert Ian Marber
Dried apricots for iron
Iron has multiple roles in the body, including helping with the manufacture of neurotransmitters and myelin, the fatty layer that covers and protects nerves so that they can transmit signals from the brain. A healthy iron intake can reduce the risk of anaemia, which causes fatigue and low mood. Dietary iron is found in meat, vegetables, dairy and dried apricots, which also contain vitamin C, which helps the absorption of iron in the digestive system.
Salmon for omega-3 fats
Salmon contains omega-3 fats, which have an important role to play in maintaining mood and combatting depression. Two of these omega-3 fats, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are found in the brain cells, where they encourage the flow of signals between the cells. We eat less oily fish than we should — one portion a week, when two is the minimum recommended. There are about 2.6g of omega-3 fats in 100g salmon.
Asparagus for vitamin B1
Asparagus is a rich source of vitamin B1, or thiamine, which helps to boost mood. Research suggests that reduced levels of B1 coincide with feelings of anxiety and depression, probably because B1 is directly involved in the creation of glucose, the primary source of fuel for the brain. B1 is required for the first step in a complex process of deriving energy from food; without it the process is impaired. Signs that you are deficient in B1 include irritability and confusion.
Sunflower seeds for vitamin B6
Vitamin B6, also known as pyridoxine, helps to manufacture neurotransmitters involved in mood and anxiety, including dopamine, serotonin and gamma-aminobutyric acid (GABA). The latter can counteract anxiety and agitation, and has been shown to rise after yoga and meditation. B6 is available in many foods, but notably sunflower seeds. A 28g serving sprinkled on a soup or over vegetables supplies almost a quarter of your daily needs.
Pumpkin seeds for magnesium
Low levels of magnesium are associated with increased production of adrenaline, which causes anxiety as well as poor sleep quality. We need 375mg of magnesium a day and eating 28g of pumpkin seeds will supply 20 per cent of this. Magnesium is also found in green vegetables, beans and cocoa.
Lentils for folate
In supplement form folate is known as folic acid, but it is available in many foods, notably lentils. A member of the B vitamin family, folate is sometimes referred to as vitamin B9. Low levels are generally found in people with depression, but increased levels can help to improve mood and to enhance the actions of some types of antidepressants. Furthermore, folate is closely connected with the production of dopamine and serotonin, which are the chemical messengers in the brain that help to maintain mood. Eating 100g of cooked lentils will supply 45 per cent of the recommended daily intake.
Broccoli for chromium
Broccoli is especially rich in chromium, a mineral involved in enhancing the sensitivity of cells to insulin, which in turn boosts the uptake of glucose from the blood. The brain requires a consistent supply of glucose and studies show that low mood is more likely to occur when glucose levels are inconsistent. The levels of chromium in broccoli remain high even after cooking.
Oats for tryptophan
Low levels of the amino acid tryptophan can lead to reduced levels of serotonin and thus low mood. While tryptophan is found in many protein foods such as nuts, dairy, poultry and eggs, it is also found in oats. As the brain doesn’t absorb tryptophan easily unless complex carbs are eaten at the same time, oats are the better choice because they contain tryptophan and complex carbs.
Shiitake mushrooms for vitamin D
Vitamin D levels are lower in people with depression, although there is continued debate about whether this is as a result of the depression, or responsible for it. What is more certain is that increased levels of the vitamin are linked to higher concentrations of the neurotransmitters serotonin and dopamine in the brain, which boost feelings of wellbeing.
Vitamin D is made naturally by the body in response to sunlight and occurs in food. Shiitake mushrooms are a good source of D2 and D3.