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PsychNews Special Report: Nutrition's Role in Mental Health · The Medical Mind

• 0:00
  Dr. Adrian Preda: Hello and welcome to the first episode of Psych News Special Report, a new monthly podcast from Psychiatric News produced for the APA's Medical Minds Channel. I'm Dr. Adrian Preda, Editor in Chief of Psychiatric News and a Professor of Clinical Psychiatry and Human Behavior. Preda, at the University of California, Irvine School of Medicine.
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  Dr. Marta Mudd: Thank you for having me.
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  Dr. Adrian Preda: Let's start by getting to know you a bit better. Where did you grow up and what led you to a career in psychiatry?
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  Dr. Marta Mudd: I'm originally from Poland, um, but I moved to Northern Illinois at a young age and mostly grew up in Northern Illinois, but then moved around a bit for school.
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  Dr. Adrian Preda: That's great. Not during medical school. You worked as a group fitness instructor. Teaching cycling, weight training, and high intensity interval training classes.
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  Dr. Marta Mudd: Honestly, no. I was very studious as a child. And it wasn't until college and graduate school that I really realized the benefits of exercise. I don't think I thought too much about the benefits for mental health and wellness overall, but I think I was inherently drawn to it for those reasons.
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  Dr. Adrian Preda: And you have a Ph. D. in Nutritional Neuroscience. Can you explain what that field encompasses and how it informs your work?
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  Dr. Marta Mudd: Absolutely. So, really what this area of research does is it examines how nutrition can impact the nervous system.
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  Dr. Adrian Preda: So you are a pioneer.
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  Dr. Marta Mudd: Yes, you could say that.
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  Dr. Adrian Preda: So let's, uh, let's talk about your special report, uh, Using Nutrition as a Therapeutic Quantality. What inspired you to write about this topic for psychiatricians?
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  Dr. Marta Mudd: Well, I really love teaching, and I have this expertise in nutritional neuroscience from my graduate work, and I have this interest in lifestyle interventions in psychiatry, and I wanted to start incorporating nutrition management in my own clinical practice, but I also wanted to teach others how to do it.
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  Dr. Adrian Preda: And you know, you point out that there, uh, there are many things that have been done on this topic. Lots of studies that are demonstrating there is a connection between nutrition and mental health. And yet, as you point out, nutrition is readily incorporated into a psychiatric practice. Why do you think this gap exists?
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  Dr. Marta Mudd: So I think that gap really exists because a couple of different reasons. But I think the main one is because we just don't get very good training, um, as psychiatrists and nutritionists. Like I pointed out, only about 40 percent of medical schools are reaching those nutrition guidelines in preclinical curricula.
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  Dr. Adrian Preda: And I realize that I'm asking you to speculate by why do you think that is we have the evidence, but we don't have the guidelines.
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  Dr. Marta Mudd: Yeah, that's a good question. I think, um, Partially, probably because a lot of us don't have training, so no one's doing the translation.
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  Dr. Adrian Preda: So, let's talk about, um, nutritional deficiencies in psychiatric patients. What are some common nutritional deficiencies of certain individuals with psychiatric disorders? And how might these deficiencies exacerbate mental health conditions?
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  Dr. Marta Mudd: Talk about this in two different ways. So one way in which we can talk about this is we can talk about particular nutrient deficiencies in patients with psychiatric illness. So I think the ones we most commonly talk about Vitamin D, vitamin B12, folate, those are the things that we're often checking in our clinical practice to be sure there aren't deficiencies.
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  Dr. Adrian Preda: So you're talking about supplementation through dietary supplements, but then there are whole foods, right?
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  Dr. Marta Mudd: That's right. Dr. Adrian Preda: So whole foods or dietary supplements?
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  Dr. Marta Mudd: The, the question of the out. I mean, I always go with whole foods and I actually think that that's really well grounded in the literature. I mean, there was a long time where we were looking at individual nutrients and the impact of individual nutrients on the brain, but over time we realized that it's actually groups of nutrients that have a more profound impact because as humans, we don't eat nutrients in isolation.
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  Dr. Adrian Preda: How does nutrition interact with other treatment modalities?
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  Dr. Marta Mudd: So I see nutrition as one tool in our toolbox. In the ideal world, we would assess nutritional status in every single patient that comes our way because we know that nutritional status has so many health implications, not only mental but also physical, but in the real world it's not possible. And so I think just like we assess appropriateness and potential benefit of psychotropic medications or psychotherapy.
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  Dr. Adrian Preda: So, um, as you mentioned, um, there is a gap, uh, when it comes to education, right? Starting with medical schools, then also during psychiatric residency. What are the barriers to implementation?
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  Dr. Marta Mudd: Many. Um, I think the first barrier is that medical school curricular already crammed with material and it's simply difficult to, to get everything in there. And I think that unfortunately nutrition tends to fall by the wayside. And then I think once we get past medical school and, and I'm speaking for psychiatrists in particular, we don't, again, we spoke about this earlier.
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  Dr. Adrian Preda: Do you think that there is a role for organizations like the International Society for Nutritional Psychiatry Research?
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  Dr. Marta Mudd: think that these organizations can serve as a body within which the evidence can be collected. Um, and so, so it's a place to go, you know, as a trusted source, if you're looking for the information and maybe that's one place where we can start to create some of these clinical guidelines.
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  Dr. Adrian Preda: So I'm curious with, with your interest and actually expertise, right? And, uh, you. gone through four years of, uh, a traditional psych residency, were you able to bring some of those experiences and then put them to good use and integrate, have an educational component integrated in, in your psychiatry residency program?
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  Dr. Marta Mudd: Yeah, so in, um, because I have this interest, uh, Partially creating this project to teach my psychiatry residents was, was selfish because I wanted the opportunity to really dive into the literature and understand what's there. Um, and so in creating this curriculum, it was a little bit of education for me.
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  Dr. Adrian Preda: How did your colleagues react to that?
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  Dr. Marta Mudd: variably. I'm more enthusiastic than others. Um, I, I think it really depends on the provider's, um, preference for practice, right? Some of us really like using medications and that's the thing that we like to do. And I think some of us like to be, um, think a little bit more outside the box and use medications, but also think about other possible interventions.
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  Dr. Adrian Preda: but it seems that the approach that you're advocating is to, uh, is not one thing in the favor of another, but actually, uh, these are complimentary things and there is value, different type of value coming from the different type of interventions.
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  Dr. Marta Mudd: That's exactly it. I don't see nutrition as. a substitute for our gold standard treatments, um, especially in patients with serious mental illness. I think that actually appropriateness and efficacy of nutrition as an intervention there is still in question.
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  Dr. Adrian Preda: Do you think that, uh, people might, might, might have a different way of approaching sort of nutritional recommendations? I'm talking about psychiatrists, physicians. Because, rightly or wrongly, they would have the perception that the level of the evidence is not similar to the level of evidence supporting some of the other interventions.
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  Dr. Marta Mudd: I think that's a really good point, and certainly, um, a valid one, um, because, um, Like we talked about earlier, this is an emerging area of research and we don't have a lot of really good randomized clinical trials to support, for example, particular supplements or many different kinds of dietary patterns.
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  Dr. Adrian Preda: Let's switch gears and consider a patient's perspective here. So first. Do we have data about how patients perceive, uh, nutritional interventions, and then what's your own experience with how patients
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  Dr. Marta Mudd: You know, to be honest, I'm actually not familiar with the evidence on patient perception on um, nutrition recommendations.
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  Dr. Adrian Preda: What strategies can psychiatrists effectively employ to engage patients in discussions about, uh, nutrition and encourage dietary changes that may benefit their mental health?
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  Dr. Marta Mudd: Yeah. So I recognize many psychiatrists might feel uncomfortable with this idea of using nutrition in their practice and Largely because our training doesn't prepare us to do it, but there are existing resources that we can start using to build comfort and familiarity with this practice, and a great place to start is by assessing diet quality.
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  Dr. Adrian Preda: So let's, you know, we talked about general things.
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  Dr. Marta Mudd: Yeah, so in my limited clinical experience as a resident. I've certainly talked about nutritional interventions with my patients.
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  Dr. Adrian Preda: Two final questions for you. First, What's your favorite food that also happens to have amazing benefits for mental health?
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  Dr. Marta Mudd: I will take a bit of a cop out on this one because I want to stay true to what I preach. So I feel best when my plate is full of colorful whole foods because I know I'm getting all the micronutrients, vitamins, minerals.
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  Dr. Adrian Preda: And finally, if listeners take away just one thing from this discussion, what's one simple change they can make to improve their mental health from nutrition?
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  Dr. Marta Mudd: I wish I could say there was a magic pill, but the good news is the answer is not that complicated. Focus on overall diet quality. Incorporate lots of fruits and vegetables, whole grains, very lean sources of protein, and limit added sugars and saturated fats. And if you're not sure how to do it, check out the USDA MyPlate app.
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  Dr. Adrian Preda: Dr. Matt, this has been a fascinating conversation. Thank you so much for joining us today. And to our listeners for tuning in to Psych News Special Report. If you enjoyed this episode, please take a moment to rate, review, and subscribe. Your support helps us continue bringing you important discussions on mental health and psychiatry.