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Leaky Gut & Depression: Is There a Link Between Them?

Jenna Johnston on March 22, 2023

When we think about the cause of depression we often only think about an imbalance of neurotransmitters in the brain. However, new research is beginning to uncover a whole-body connection to depression and gut health may be one of the most important connections. 

More specifically, research has found a link between increased intestinal permeability (i.e. “leaky gut”) and an elevated risk for depression. Knowing more about what a leaky gut is, how it’s related to depression, and what we can do to “seal up” holes or cracks in the gut may be a key component in reversing depression in individuals who struggle with this condition.

What is “leaky gut”? 

Our intestines, which are a part of the gastrointestinal tract (GI tract) beginning after the stomach, are shaped like a tube and have walls or barriers that help to regulate the absorption of nutrients, water, and electrolytes from within the intestines into the body’s circulation. They also help to prevent the entrance of large or undigested food particles, toxic substances, and pathogenic microorganisms into the body.[1]

The intestinal barrier is formed by epithelial cells and a mucus layer that are joined together by proteins called tight junctions. Tight junctions help to regulate what passes into the body from the intestines, but unfortunately, certain conditions can disrupt this system. These junctions can become loose which creates larger openings for unwanted or harmful substances to enter or “leak” into the body.[1]

What causes leaky gut?

The cause of leaky gut isn’t cut and dry. There seem to be many potential reasons and research is ongoing. And many times researchers are left wondering what came first- the leaky gut or the issue related to it. So it’s a bit of a chicken and egg situation. 

However, there are some causes that seem to be well supported by research:

  1. Disruption in the microbiome 
    One important function of the gut microbiome is to develop and maintain the gut barrier throughout our lives.[1] However, disruptions in the microbiome at any point in life from genetic and/or environmental factors (e.g. diet, antibiotics, medications, allergens, stressors, toxins, heavy metals, infections, etc.) can disrupt the integrity of the gut barrier and increase permeability.[1][2]
  1. Food allergies or sensitivities 
    Some individuals have food allergies and/or sensitivities which means they react to certain foods and dietary proteins as if they were toxic or pathogenic. This causes an immune response and leads to inflammation of the mucosal barrier. In turn, this can lead to changes in the formation and function of tight junction proteins within the intestinal wall and lead to a leaky gut.[3]

    A common example of this is Celiac disease which is caused by a gluten allergy. Celiac disease is known for causing structural changes in the small intestinal wall, allowing unwanted substances to leak into the body.[3] 
  1. High blood sugar
    High blood sugar levels or hyperglycemia have been shown to increase intestinal permeability both in mice and human studies.[4][5] This results from the negative impact high blood sugar levels have on the genes expressed by epithelial cells that are involved in maintaining tight junctions in the gut- leading to a decrease in gut barrier integrity.[5]  
  1. Psychological stress
    Studies on humans have shown that situations that cause acute stress can affect gut permeability. For example, when individuals are exposed to public speaking-based stressors, researchers found that small intestinal permeability was significantly elevated but only in individuals who also responded to the stressor with a significant increase in cortisol.[1][6] 
  2. Circadian rhythm disruptions
    The circadian rhythm is the name for the various biochemical processes in our body that follow a roughly 24-hour cycle to regulate normal functions and behaviors. There is a “master body clock” found in the brain and “peripheral body clocks” found in organs (e.g. gut, pancreas, liver). They all need to be working in sync to keep everything they regulate on schedule.[7]

    When disruptions in your circadian rhythm occur such as those seen in shift workers (or parents with babies)- due to abnormal sleep, light exposure, and eating patterns- this has been shown to increase the likelihood of developing a hyperpermeable gut.[7]
  1. Low vitamin D levels
    Studies have found that low levels of vitamin D increase intestinal permeability. However, vitamin D supplementation improves the function of the gut barrier by reducing permeability by modulating the amount and distribution of tight junction proteins.[8]

How are leaky gut & depression linked?

Studies have found that individuals with major depressive disorder have elevated levels of various immune-inflammatory markers when compared to healthy control groups.[9] One reason for an increase in inflammation in these individuals might be due to an increase in intestinal permeability since it’s believed to play a major role in chronic low-grade inflammation in a number of different inflammatory disorders including depression.[1] 

Leaky gut plays a role in inflammatory conditions because various substances from within the intestines including bacteria make their way out of the gut into the circulation and end up in places in the body where they shouldn’t be. When this happens, the immune system is triggered and this leads to inflammation.[9] 

In individuals with depression, one location where inflammation is seen is in the central nervous system (CNS). Inflammation in the CNS has been shown to also change the function and integrity of the blood-brain barrier (BBB)- which is similar in structure to the gut barrier. This can affect the BBB’s ability to prevent unwanted substances (e.g. pathogens, toxins, and chemicals) in the bloodstream from entering the brain- further increasing inflammation in the CNS and elevating the likelihood of CNS diseases and psychiatric conditions.[3]  

Moreover, research has found that the more severe the depression, the higher the inflammation and the greater the permeability of the gut barrier- with patients with a recent suicide attempt having the greatest increases in inflammation and permeability.[10] 

How to test for leaky gut 

Testing for leaky gut is a great way to get a better idea of whether or not it may be at the root of your depression. However, some of these tests can be expensive, so it may be beneficial to work with a Function Medicine or Nutrition Practitioner who can give you a better idea of which one(s) might be the best suited for you.

From a Functional Medicine approach, there are 5 tests that are often used to determine if someone is experiencing a leaky gut:

  1. Measuring Zonulin
    Zonulin is a protein that controls the size of the tight junctions and high levels can indicate that the openings are too large. Checking blood serum levels of zonulin using an enzyme-linked immunosorbent assay test (ELISA) can help determine if gut permeability is too high.  
  2. Intestinal Permeability Assessment 
    This test is an assessment of the small intestinal absorption and barrier function. The test measures the ability of two sugar molecules- lactulose and mannitol- to permeate the gut lining. Learn more here https://www.gdx.net/product/intestinal-permeability-assessment-urine 
  3. Organic Acid Test
    A common problem with a leaky gut is the malabsorption of nutrients which can lead to nutrient deficiencies. Organic acid tests can help to identify any nutritional deficiencies or issues with absorbing and using nutrients- including vitamins, minerals, protein, carbohydrates, and fats. They can also detect antioxidant, bacterial, and probiotic levels which can also be helpful information in relation to leaky gut. 
  4. Stool Test
    Stool tests can help to determine the different levels and types of bacteria in the gut, the state of immune function within the gut, and the overall health of the gut. As well as reveal any inflammation that may be occurring. Reviewing all of these factors can help us know the likelihood of someone having a leaky gut. 
  5. IGg Food Sensitivity Test
    Many individuals who have developed increased gut permeability have also developed food sensitivities. And, as mentioned earlier, food sensitivities may also be a cause of leaky gut or may provoke worsening of it. For this reason, testing for IGg food sensitivities can help someone get a better idea if they are experiencing a leaky gut.   

How to heal a leaky gut

In Functional Nutrition, there is a method for repairing a leaky gut called the 4R approach:

Step 1: Remove 

First, it is essential to remove the things that are having a negative impact on your digestive system. This often includes foods that are causing inflammation such as any food sensitivities or allergies, as well as highly processed foods and/or foods with unwanted additives, artificial flavors, colors, and preservatives. This would also include removing any infections in the GI tract. 

Step 2: Replace 

It’s important to replace any highly processed foods and/or ones with unwanted additives, etc. with whole, minimally processed foods. This also includes adding back in essential components for proper digestion and absorption of food such as hydrochloric acid (HCL), digestive enzymes, and biles acids through supplementation. 

Step 3: Reinoculate

It’s crucial to restore beneficial bacteria in the gut to create a healthy balance of good bacteria to promote optimal function and maintenance of the tight junctions in the gut. This can be done through the combination of prebiotic and probiotic foods and/or supplements.

Step 4: Repair

To repair your gut, it’s important to provide your body with nutrients that will support this process such as vitamin D and zinc. Plus supplemental butyrate and L-glutamine have also shown beneficial effects on improving the health and function of the gut barrier and tight junctions.[11][12]

In addition to this, certain herbs are commonly used to repair the gut such as calendula, plantain, marshmallow root, and slippery elm. As well as herbal supplements like deglycyrrhizinated licorice (DGL) and curcumin. 

Conclusion

When it comes to understanding the connection between increased intestinal permeability and depression, research is still in its early stages. However as time goes on, we will likely uncover more evidence connecting the two and learn more about what is leading to leaky gut in the first place in individuals with depression. Knowing this can further help us understand how to best approach sealing up a leaky gut and ultimately reverse depression.

REFERENCES

. Kelly JR, Kennedy PJ, Cryan JF, Dinan TG, Clarke G, Hyland NP. Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders. Front Cell Neurosci. 2015;9:392. Published 2015 Oct 14. doi:10.3389/fncel.2015.00392

2. Slyepchenko A, Maes M, Jacka FN, et al. Gut Microbiota, Bacterial Translocation, and Interactions with Diet: Pathophysiological Links between Major Depressive Disorder and Non-Communicable Medical Comorbidities. Psychother Psychosom. 2017;86(1):31-46. doi:10.1159/000448957

3. Obrenovich MEM. Leaky Gut, Leaky Brain?. Microorganisms. 2018;6(4):107. Published 2018 Oct 18. doi:10.3390/microorganisms6040107

4. Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in humans. Gut. 2019;68(8):1516-1526. doi:10.1136/gutjnl-2019-318427

5. Thaiss CA, Levy M, Grosheva I, et al. Hyperglycemia drives intestinal barrier dysfunction and risk for enteric infection. Science. 2018;359(6382):1376-1383. doi:10.1126/science.aar3318

6. Vanuytsel T, van Wanrooy S, Vanheel H, et al. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut. 2014;63(8):1293-1299. doi:10.1136/gutjnl-2013-305690

7. Summa KC, Voigt RM, Forsyth CB, et al. Disruption of the Circadian Clock in Mice Increases Intestinal Permeability and Promotes Alcohol-Induced Hepatic Pathology and Inflammation. PLoS One. 2013;8(6):e67102. Published 2013 Jun 18. doi:10.1371/journal.pone.0067102

8. Yamamoto EA, Jørgensen TN. Relationships Between Vitamin D, Gut Microbiome, and Systemic Autoimmunity. Front Immunol. 2020;10:3141. Published 2020 Jan 21. doi:10.3389/fimmu.2019.03141

9. Slyepchenko A, Maes M, Jacka FN, et al. Gut Microbiota, Bacterial Translocation, and Interactions with Diet: Pathophysiological Links between Major Depressive Disorder and Non-Communicable Medical Comorbidities. Psychother Psychosom. 2017;86(1):31-46. doi:10.1159/000448957

10. Ohlsson L, Gustafsson A, Lavant E, et al. Leaky gut biomarkers in depression and suicidal behavior [published correction appears in Acta Psychiatr Scand. 2020 Nov;142(5):423]. Acta Psychiatr Scand. 2019;139(2):185-193. doi:10.1111/acps.12978

11. Michielan A, D’Incà R. Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky Gut. Mediators Inflamm. 2015;2015:628157. doi:10.1155/2015/628157

12. Wang B, Wu G, Zhou Z, et al. Glutamine and intestinal barrier function. Amino Acids. 2015;47(10):2143-2154. doi:10.1007/s00726-014-1773-4

Is Saffron Safe & Effective for Postpartum Depression? Here’s What the Research Says

Jenna Johnston on March 22, 2023

Every year 15-20% of mothers experience postpartum depression (PPD) and that percentage rose up to 36% within the past few years due to COVID.1 And although antidepressant medications are an option for mothers who are experiencing PPD, studies have shown that many women- especially those who are pregnant or breastfeeding- wish to avoid medications due to unknown and/or unwanted side effects.2 

When it comes to alternatives to antidepressant medications, natural remedies can be very helpful for some individuals. However, it’s important to find a solution that is backed by research. Fortunately, more research is looking into natural treatments for PPD and one of these promising treatments is saffron. 

What is saffron?

Saffron is the dried stigma of the plant named Crocus sativus L. It’s commonly known for its use as a spice to flavor food and as a coloring agent for both food and cosmetics. Saffron is also known for its use as a traditional, herbal medicine and for the treatment of a long list of ailments, including depression. In addition to this, it has been shown to create a variety of different actions in the body such as antidepressant, antioxidant, anti-inflammatory, and many others.3

What the research has found

Research has shown that not only is saffron more effective than a placebo in the treatment of mild to moderate depression, it’s also just as effective as some antidepressant medications including fluoxetine and imipramine at various doses.4

For PPD in particular, study participants taking 15 mg of saffron 2 times a day, saw significant improvements in their depression after 8 weeks of treatment without any major side effects.2 

Some researchers believe that saffron’s antidepressant actions come from its ability to reduce inflammation and oxidative stress, protect the nervous system from damage, and modulate the relationship between the nervous system and hormonal systems in the body. This is because depression can be a result of various physical imbalances or disruptions in the body and targeting the root cause can have a positive impact.4

What to consider before taking saffron

Before you begin taking saffron, it’s important to consider a few things:

  1. Talk to your doctor about what might be best for you. This is going to be especially important if you are already taking medication because there may be interactions between saffron and certain medications. Plus it’s important to work with your doctor if you want to go off your medication and try a natural treatment. 

    Also, saffron might not be right for you if your PPD is more severe than mild to moderate PPD, so it’s important to talk with your doctor to determine what level of depression you are experiencing.  
  1. Find a supplement from a trustworthy company. It’s important to investigate a supplement company before you buy from them. Look into:
  • Where they are sourcing the saffron and other ingredients
  • How they are testing their products
  • If the products are being third-party tested
  • If they are GMP certified
  • What other ingredients are in the tablets/capsules
  • If the capsules contain the appropriate amount of saffron so that you are able to take the amount which is proven to be effective  (i.e. 15 mg per tablet, 2 times a day).
  1. Remember that most treatments work best in conjunction with other treatments. When it comes to improving your mood and well-being, there often isn’t one magic cure that will fix everything. Consider other factors in your life that may support your health such as quality of sleep, daily movement practices, a balanced diet, community, and support from others. 

    The more you can improve these areas of your life and create a customized holistic health plan that’s perfect for you, the more likely your mood is to improve. 

Conclusion

When it comes to finding a natural treatment for PPD, it’s important to choose a remedy that is proven to be effective. And for those who are on the lookout for a solution that works- saffron might be the answer they are looking for. Saffron appears to be an effective and safe natural treatment for mild to moderate depression and may be a great alternative for those who do not want to take pharmaceutical antidepressants.

However, before starting any new treatment, it’s always vital to discuss with your doctor what is right for you. Plus it’s important to find a good quality supplement and find other, holistic health practices that will also support your mood and well-being.

REFERENCES
  1. WebMD. 2020. COVID Fuels Depression In Pregnant Women, New Moms. [online] Available at: <https://www.webmd.com/depression/postpartum-depression/news/20201209/covid-fuels-depression-among-pregnant-women-new-moms> [Accessed 24 May 2021].
  2. Tabeshpour J, Sobhani F, Sadjadi SA, et al. A double-blind, randomized, placebo-controlled trial of saffron stigma (Crocus sativus L.) in mothers suffering from mild-to-moderate postpartum depression. Phytomedicine. 2017;36:145-152. doi:10.1016/j.phymed.2017.10.005
  3. Hosseinzadeh H. Saffron: a herbal medicine of third millennium. Jundishapur J Nat Pharm Prod. 2014;9(1):1-2. doi:10.17795/jjnpp-16700
  4. Lopresti AL, Drummond PD. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol. 2014;29(6):517-527. doi:10.1002/hup.2434

Top 11 Nutrients for Supporting Postpartum Mental Health

Jenna Johnston on March 22, 2023

Studies that have looked into dietary patterns that support mental health often come to similar conclusions about which nutrients seem to have the greatest impact on the risk for depression. Researchers have found that depression is usually correlated with almost every micronutrient other than phosphorus and molybdenum.

Below I’ll cover the most common nutrient deficiencies or insufficiencies seen in populations that are at an increased risk for depression and foods that contain high amounts of each.

#1. Vitamin A

Vitamin A plays an important role in immune function and as an anti-inflammatory agent. Studies have shown that deficiencies in vitamin A can result in inflammation and worsen existing inflammatory issues in the body. Since depression is considered to be an inflammatory condition, it’s likely that diets that are low in vitamin A can increase the risk for depression.

Vitamin A comes in two forms: preformed vitamin A or retinol and provitamin A carotenoids such as beta carotene. Some individuals can easily convert beta carotene into vitamin A in the body, while others cannot- this all depends on genetics. It’s important to get both forms of vitamin A from foods if possible.

Examples of foods with retinol: dairy, meat, and organ meats (especially liver)

Examples of foods with beta carotene: sweet potato, spinach, pumpkin, carrots, cantaloupe, red peppers, and mangoes

#2. B-complex

Vitamin B-complex is made up of 8 B vitamins, however, B vitamins that are most commonly deficient in diets of those with depression are folate, B6, B12, and thiamine. B vitamins are vital for making neurotransmitters such as serotonin which have a direct impact on mood.

They are also important for glucose metabolism which is extra important during times of stress because the body uses more glucose when stressed. Lastly, B vitamins are also important for supporting pathways that are involved in reducing the effects of inflammation.

Examples of foods with thiamine: pork chop, trout, black beans, mussels, bluefin tuna, acorn squash, brown rice, sunflower seeds

Examples of foods with folate: beef liver, asparagus, Brussels sprouts, avocado, broccoli, green peas, kidney beans

Examples of foods with B6: chickpeas, beef liver, yellowfin tuna, salmon, chicken breast, potatoes, turkey, banana, bulgur, winter squash

Examples of foods with B12: (only naturally found in animal products) beef liver, clams, tuna, salmon, beef, yogurt, cheese, eggs, and turkey. Common foods fortified with B12 are nutritional yeast and some non-dairy yogurts

#3. Vitamin C

Vitamin C is a powerful antioxidant and it helps to modulate or balance the immune system. This means that it can help to significantly reduce inflammation and improve symptoms or feelings of depression. Vitamin C is also really important for adrenal health which is often negatively affected by chronic stress and this long-term stress is commonly at the root of depression

Examples of foods with vitamin C: sweet red peppers, oranges, grapefruit/juice, kiwi, green peppers, broccoli, strawberries, Brussels sprouts, cantaloupe, cabbage, spinach

#4. Vitamin D

Vitamin D is a key nutrient for your mental and physical health and it plays a vital role in modulating the immune system. Studies have found that low vitamin D levels are linked to depression and certain populations such as individuals who live in northern latitudes, African Americans, and overweight or obese individuals.

Although one of the best ways to get enough vitamin D is through sunlight exposure (e.g., 15-20 minutes per day of skin exposure without sunscreen), there are some foods with smaller amounts of vitamin D. In most cases, it’s important to supplement.

Foods with vitamin D: Fatty fish (such as trout, salmon, tuna, and mackerel), fish liver oils (e.g., cod liver oil), beef liver, egg yolks, and cheese. Mushrooms that have been exposed to sunlight and fortified foods such as dairy

#5. Iron

Deficiency in iron has been shown to negatively impact the proper functioning of neurotransmitters such as serotonin and dopamine which can result in an increased risk for anxiety and depression. Moreover, individuals who develop iron deficiency anemia are also at a significantly higher risk of developing psychiatric disorders including depression and anxiety, as well as sleep disorders.

Women are more prone to iron deficiencies due to higher losses of blood via menstruation. In addition to this, certain dietary patterns such as vegan or vegetarian diets may put individuals at an even greater risk for deficiency.

To improve the absorption of iron, pair iron-rich foods with vitamin C-rich foods.

Foods with iron: oysters, white beans, dark chocolate, beef, lentils, spinach, firm tofu, kidney beans, sardines, cashews

#6. Magnesium

Magnesium is considered to be one of the most essential minerals found in the body and it plays an important role in biochemical actions in the brain as well as in maintaining healthy nerve cell function. Deficiencies in magnesium have been linked to an increased risk of nerve cell damage which may manifest as depression.

Foods with magnesium: pumpkin seeds, chia seeds, almonds, spinach, cashews, black beans, edamame, peanut butter, potatoes with skins, brown rice

#7. Omega 3 fatty acids

Studies have shown that omega 3s have a significant effect on depression in women during and after pregnancy (i.e., perinatal depression). During pregnancy, the demand for omega 3s increases greatly, particularly for DHA which is required for proper brain and retina development for the baby and the need continues while breastfeeding.

For this reason, women are at an increased risk of deficiency and low omega 3 levels can increase the chances of them developing an inflammatory condition such as depression because omega 3’s are strongly anti-inflammatory substances. Overall, studies have shown that EPA has stronger anti-inflammatory effects than DHA, however, both EPA and DHA help to decrease perinatal depression.

There are some plant sources of omega 3s and they contain ALA which can be converted into EPA/DHA in the body, however, some individuals may have very low conversion rates so it’s important to get both EPA/DHA and ALA sources in the diet.

Foods with omega 3: (DHA and EPA) mackerel, salmon, herring, oysters, sardines, anchovies, caviar, (ALA) flaxseed, chia seeds, walnuts, and soybeans

#8. Potassium

Potassium is an electrolyte and low potassium levels have been associated with a greater risk for mood disturbances and depression. In particular, studies have shown that low sodium, high potassium diets led to greater improvements in depression compared to diets with high sodium and low potassium.

Foods with potassium: dried apricot, lentils, dried prunes, acorn squash, raisins, kidney beans, banana, raw spinach, chicken breast, salmon

#9. Selenium

High selenium levels have been associated with a lower risk of postpartum depression and it appears to have a protective role against postpartum depression. It’s believed that it’s important for managing or reducing the risk of depression due to its strong immunomodulatory, antioxidant, anti-inflammatory, and neuroprotective properties.

During pregnancy, there is an increased transfer of selenium from the mother to the fetus and maternal blood levels of selenium are often reduced during pregnancy, especially in the 3rd trimester. Moreover, selenium is also transferred via breastmilk, further reducing selenium levels for mothers and increasing the risk for low levels. For this reason, selenium demand is higher during pregnancy and lactation than for women who are not during these stages.

Studies have shown that supplementing with selenium is more beneficial for increasing selenium levels and therefore it’s important to have selenium included in a multivitamin supplement (which we’ll talk about next. However, it’s still important to include foods with selenium in the diet.

Foods with selenium: brazil nuts (only need 2-3 per day), tuna yellowfin, halibut, sardines, ham, shrimp, beefsteak, turkey, chicken, cottage cheese, brown rice, hard-boiled eggs, oatmeal

#10. Zinc

Zinc is a vital mineral that is required to create the enzymes that are needed in various steps for creating, using, and breaking down neurotransmitters needed in the brain such as serotonin and dopamine. Researchers have found that there is a strong connection between zinc deficiency and an increased risk of depression and that adequate zinc intake (via supplementation) can help improve depressive symptoms.

Foods with zinc: oysters, beef chuck roast, crab, lobster, pork chop, baked beans, dark meat chicken, pumpkin seeds, cashews, chickpeas, oatmeal, almonds

#11. Iodine

Unlike the micronutrients listed above, iodine is not one of the most common nutrient deficiencies or insufficiencies that are seen in studies that look at populations that are at an increased risk for depression. However, iodine deficiency can lead to subclinical hypothyroidism or clinical hypothyroidism which has been linked to an increased risk for depression in some studies. Even more, iodine deficiency has re-emerged in some populations in the U.S.- with women who are pregnant or in postpartum being at a particularly increased risk.

During pregnancy and postpartum, iodine requirements are greater due to an increase in thyroid hormone synthesis, transfer of iodine to the fetus, increased loss of iodine in the urine, and secretion of iodine in breast milk. For these reasons, women who are pregnant or lactating are at an increased risk of iodine deficiency which can lead to poor thyroid function or hypothyroidism and essentially may increase the risk of depression.

Furthermore, more individuals are choosing not to purchase iodized salt and are taking dairy out of their diet- which is two of the main sources of iodine in many Americans’ diets. In addition to this, certain types of seafood is another source of iodine so individuals who choose not to eat seafood are also increasing their risk of deficiency.

It may be recommended for women who are pregnant or in postpartum to supplement with 150 mcg per day of iodine, especially if they are not consuming enough food sources of iodine (we’ll talk more about supplements next).

Foods with iodine: cod, seaweed (nori, kelp), oysters, greek yogurt, cow’s milk, iodized salt (1/4-1/2 teaspoon/day only), hard-boiled egg

Should You Take A Multivitamin-Mineral Supplement To Improve Postpartum Depression?

Jenna Johnston on March 22, 2023

Studies have found that almost all micronutrients (i.e., vitamins and minerals) are needed in adequate amounts to reduce the risk of depression, and depression is often associated with a variety of micronutrient deficiencies.[1] Since pregnancy, lactation, and postpartum healing all increase the requirements for most micronutrients- not getting enough essential vitamins and minerals can greatly increase a mother’s risk of developing postpartum depression (PPD).

Nutrient deficiencies often start during pregnancy

Researchers have discovered that a significant amount of pregnant women are deficient in vitamins A, B6, C, D, E, and K, as well as calcium, choline, folate, magnesium, iron, and potassium. And many may be consuming an excess amount of folic acid and sodium.[2]

Although deficiencies are often more common among individuals who are unable to consume a healthy diet (in which case, even adding an MVM may still not allow them to reach adequate intakes of micronutrients)- it’s still possible and often likely that a healthy diet alone won’t provide enough micronutrients during pregnancy.[2][3]

As a result, many mothers enter postpartum deficient in several micronutrients that are important for supporting mental health and can help reduce the risk of PPD.

Eating a healthy diet may not provide enough micronutrients during postpartum

Even if a woman was able to eat a healthy diet and took an MVM prenatal supplement during pregnancy and was able to enter postpartum without any nutrient deficiencies- if they discontinue the use of an MVM supplement they are still at risk for nutrient deficiencies in postpartum. And therefore, they are at an increased risk of developing postpartum depression. 

During postpartum, there are many factors that make it difficult to get the recommended daily allowance (RDA) for essential micronutrients. 

After birth, nutrient demands are higher for mothers who are breastfeeding because a portion of the micronutrients the mother consumes is used to support the baby’s growth. But even for mothers who are not breastfeeding- the body requires extra nutrients to heal from pregnancy and giving birth. And even more so if you undergo a c-section because the body needs lots of support for wound healing after surgery.[4]

Furthermore, other factors such as high stress, poor sleep, and genetics, as well as possible injuries (e.g., diastasis recti), infections (e.g., mastitis), digestive issues, or chronic health conditions- can all add to the already high micronutrient demands mothers face after giving birth. 

For these reasons, even if you feel like you are eating a balanced, healthy diet it may be very difficult to get all the nutrients you need to support general health and mental health without taking supplements. 

What the research says about multivitamin-mineral supplements for depression

Recent research has found that broad-spectrum multivitamins and multimineral supplements can help to relieve a number of mental health conditions better than single-nutrient supplements. One of the reasons why this is likely is due to the fact that several micronutrients are important cofactors involved in the creation of neurotransmitters. And without adequate amounts of these vitamins and minerals, individuals are more likely to develop neurotransmitter imbalances which can lead to issues such as depression.[5]

One study that looked at multivitamin supplements for postpartum depression found that the occurrence of postpartum depression was significantly lower in the group taking a multivitamin supplement during the first month after birth vs. the group taking a vitamin D and calcium supplement.[6]


Multivitamin-mineral supplements won’t resolve PPD on their own 

In most situations, just taking an MVM by itself won’t completely eliminate PPD. For some individuals, other additional supplementation may be required. This may be because of other factors such as health conditions, genetics, dietary preferences, lifestyle, stress levels, etc. 

Moreover, it may be necessary to add more good-mood foods into your diet and make any necessary lifestyle changes to support mental health. 

For this reason, it can be extremely beneficial to work with a nutritionist to help you determine what supplements are going to be best for you. This can help decrease the amount of guesswork it takes to determine what supplements to choose which can not only save you time and money but can speed up the time it takes you to overcome PPD. 

Conclusion

It’s common for women to experience nutrient deficiencies during pregnancy and postpartum- which can greatly increase their risk of developing PPD. Fortunately, research has shown that taking an MVM supplement can help to reduce the feelings and symptoms of depression. 

Lastly, working with a nutritionist who specializes in nutrition for depression can reduce the time it takes to see improvements in your mood which can help you save lots of time and money!

REFERENCES
  1. Sánchez-Villegas, A., Pérez-Cornago, A., Zazpe, I. et al. Micronutrient intake adequacy and depression risk in the SUN cohort study. Eur J Nutr 57, 2409–2419 (2018). https://doi.org/10.1007/s00394-017-1514-z
  2. Bailey RL, Pac SG, Fulgoni VL 3rd, Reidy KC, Catalano PM. Estimation of Total Usual Dietary Intakes of Pregnant Women in the United States. JAMA Netw Open. 2019;2(6):e195967. Published 2019 Jun 5. doi:10.1001/jamanetworkopen.2019.5967
  3. Gernand AD, Schulze KJ, Stewart CP, West KP Jr, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nat Rev Endocrinol. 2016;12(5):274-289. doi:10.1038/nrendo.2016.37
  4. Ball L, de Jersey S, Parkinson J, Vincze L, Wilkinson S. Postpartum nutrition: Guidance for general practitioners to support high-quality care. Aust J Gen Pract. 2022;51(3):123-128. doi:10.31128/AJGP-09-21-6151
  5. Kimball SM, Mirhosseini N, Rucklidge J. Database Analysis of Depression and Anxiety in a Community Sample-Response to a Micronutrient Intervention. Nutrients. 2018;10(2):152. Published 2018 Jan 30. doi:10.3390/nu10020152
  6. Sparling TM, Henschke N, Nesbitt RC, Gabrysch S. The role of diet and nutritional supplementation in perinatal depression: a systematic review. Matern Child Nutr. 2017;13(1):10.1111/mcn.12235. doi:10.1111/mcn.12235

Postpartum Depression & The Mediterranean Diet: Can Following This Diet Actually Improve Your Mood?

Jenna Johnston on March 17, 2023

It’s very likely that at some point in your life, you’ve heard or read about the countless benefits of the Mediterranean Diet. From helping with weight loss, balancing blood sugar, improving cardiovascular health, and more- it’s no wonder why the Mediterranean diet has received so much attention over the last 30 years and is considered one of the most healthy dietary models around the world.[1]

But, have you ever heard that the Mediterranean diet can help reduce the risk and improve symptoms of depression? Although this is a lesser-known benefit of the Mediterranean diet, it’s still a very valuable way to help ease depression and improve quality of life.

What is the Mediterranean Diet?

The Mediterranean Diet (MD) was first described by Ancel Keys in the 1960s as a dietary pattern that was low in saturated fat and high in vegetable oil (mainly olive oil) and spread throughout Greece and Southern Italy.[1]

More specifically, the MD consists of:

  • A high intake of vegetables, olive oil, fish, and whole-grain bread and cereal
  • A moderate intake of eggs, legumes, fruit, nuts, poultry, and fermented dairy (mainly goat’s milk products)
  • A low intake of red meat (i.e., ~2 times a week)
  • Red wine consumption during main courses

From a nutritional perspective, the MD has a beneficial high ratio of omega 3 to omega 6 and is rich in probiotics, fiber, antioxidants, and monounsaturated fats. It also contains a variety of food groups and types of food which promotes the intake of a variety of vitamins and minerals that can help to support mental health and overall health. 

What does the research say about its success for depression?

Studies have found that Mediterranean dietary patterns are associated with a reduced risk for depression and can help to improve symptoms and feelings of depression. 

In particular, one study found that people with the greatest adherence to the MD had the lowest risk for depression. On the other hand, the researchers found that individuals who consumed an unhealthy, pro-inflammatory diet were at the greatest risk for depression. The authors of the study concluded that following a traditional Mediterranean diet and avoiding a pro-inflammatory diet can reduce the risk of depressive symptoms or clinical depression.[2]

Another study found that consuming an MD that was supplemented with a fish oil supplement led to a significant reduction in depressive scores in individuals with self-reported depressive symptoms.[1]

Although there aren’t any studies that specifically look at MD and its effect on postpartum depression, research has shown that high adherence to a diet characterized by an adequate intake of vegetables, fruit, legumes, nuts, olive oil, fish, and dairy products during pregnancy is correlated with a lower risk of PPD.[3] And greater adherence to this dietary pattern during postpartum is also associated with fewer PPD symptoms.[4]

What makes it so beneficial?

As mentioned above, the benefits of the MD come from a variety of components that work together to help support overall health and mental health. Some of these components include:

  1. High in omega 3’s

Omega 3 is anti-inflammatory and helps reduce inflammation in the body which may be a significant contributor to depression in some individuals.[5] They are found mainly in fatty fish, as well as nuts and seeds like walnuts, chia, and flaxseed.

  1. Fiber

Evidence shows that high intakes of dietary fiber may help to reduce inflammation and severity of depressive symptoms. It’s likely that these results occur due to positive changes in the gut microbiota which can increase the production of neurotransmitters such as serotonin and decrease inflammatory markers.[6] High-fiber foods include vegetables, fruit, whole grains, nuts, seeds, and legumes.

  1. Antioxidants & phytochemicals

A diet high in plants contains antioxidants and phytochemicals which may have anti-inflammatory and antidepressant effects.[7][8] For example. studies have shown that oxidative stress plays a major role in the development of depression and treatment with antioxidant nutrients and compounds has resulted in positive effects on depression.[8]

  1. Probiotics 

Research has found that gut probiotics play an integral role in the two-way communication between the gut and the brain- therefore, probiotics can lead to a significant reduction in depression. This is likely due to their ability to modulate the immune system and, as a result, inflammation in the body, as well as support the production of serotonin.[9] Common probiotic foods include yogurt, kefir, and sauerkraut.

  1. Variety of vitamins & minerals 

Since the MD includes a variety of foods within every food group, it helps supports an adequate intake of all the essential micronutrients needed to support general health as well as mental health. Studies have found that depression is often connected with a large variety of essential micronutrients.[10] For this reason, consuming an array of foods within each food group is the best way to decrease your chances of depression and improve existing depression.

Conclusion 

Although it’s a lesser-known benefit of the Mediterranean Diet- studies have shown that consuming this type of diet can help to reduce the risk and symptoms of depression. Researchers believe this is a result of many components of the Mediterranean Diet that work together to improve mental health such as omega 3s, fiber, antioxidants and phytochemicals, probiotics, and a variety of vitamins and minerals. 

For these reasons, consuming a Mediterranean Diet may play a key role in helping people overcome postpartum depression and relieving unwanted symptoms of depression.

REFERENCES
  1. Ventriglio A, Sancassiani F, Contu MP, Latorre M, Di Slavatore M, Fornaro M, Bhugra D. Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review. Clin Pract Epidemiol Ment Health. 2020 Jul 30;16(Suppl-1):156-164. doi: 10.2174/1745017902016010156. PMID: 33029192; PMCID: PMC7536728.
  2. Lassale C, Batty GD, Baghdadli A, Jacka F, Sánchez-Villegas A, Kivimäki M, Akbaraly T. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry. 2019 Jul;24(7):965-986. doi: 10.1038/s41380-018-0237-8. Epub 2018 Sep 26. Erratum in: Mol Psychiatry. 2018 Nov 21;: Erratum in: Mol Psychiatry. 2021 Jul;26(7):3657. PMID: 30254236; PMCID: PMC6755986.
  3. Chatzi L, Melaki V, Sarri K, et al. Dietary patterns during pregnancy and the risk of postpartum depression: the mother-child ‘Rhea’ cohort in Crete, Greece. Public Health Nutr. 2011;14(9):1663-1670. doi:10.1017/S1368980010003629
  4. Opie RS, Uldrich AC, Ball K. Maternal Postpartum Diet and Postpartum Depression: A Systematic Review. Matern Child Health J. 2020;24(8):966-978. doi:10.1007/s10995-020-02949-9
  5. Firth J, Gangwisch JE, Borisini A, Wootton RE, Mayer EA. Food and mood: how do diet and nutrition affect mental wellbeing? BMJ. 2020 Jun 29;369:m2382. doi: 10.1136/bmj.m2382. Erratum in: BMJ. 2020 Nov 9;371:m4269. PMID: 32601102; PMCID: PMC7322666.
  6. Swann OG, Kilpatrick M, Breslin M, Oddy WH. Dietary fiber and its associations with depression and inflammation. Nutr Rev. 2020;78(5):394-411. doi:10.1093/nutrit/nuz072
  7. Bahramsoltani R, Farzaei MH, Farahani MS, Rahimi R. Phytochemical constituents as future antidepressants: a comprehensive review. Rev Neurosci. 2015;26(6):699-719. doi:10.1515/revneuro-2015-0009
  8. Vaváková M, Ďuračková Z, Trebatická J. Markers of Oxidative Stress and Neuroprogression in Depression Disorder. Oxid Med Cell Longev. 2015;2015:898393. doi:10.1155/2015/898393
  9. Huang R, Wang K, Hu J. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2016;8(8):483. Published 2016 Aug 6. doi:10.3390/nu8080483
  10. Campisi SC, Zasowski C, Shah S, Shah A, Bradley-Ridout G, Korczak DJ, Szatmari P. Assessing the Evidence of Micronutrients on Depression among Children and Adolescents: An Evidence Gap Map. Adv Nutr. 2020 Jul 1;11(4):908-927. doi: 10.1093/advances/nmaa021. PMID: 32193537; PMCID: PMC7360446.