We are currently overwhelmed by a mental health crisis, grappling with stress, depression, anxiety, ADHD, autism, OCD, bipolar disorder, schizophrenia and more. But rather than reaching for a pharmaceutical fix, our food should be our medicine in the first instance, says Professor Julia Rucklidge. Jodie Bruning interviews New Zealand’s most popular professor you may never have heard of.
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Professor Julia Rucklidge’s work may be key to alleviating Aotearoa’s mental health disaster. Her Ted Talk ‘The surprisingly dramatic role of nutrition in mental health’ has now been viewed over 1.8 million times. Almost 16,000 people – including medical doctors and psychiatrists – have so far lined up to take her online EdX course. And her new book, The Better Brain (co-written with colleague Professor Emerita Bonnie Kaplan), shows how good nutrition can reverse, heal or lessen many common mental health challenges.
It’s time for health professionals, the Ministry of Health, and indeed all of us, to take on board Rucklidge’s recommendations, for the health of our nation.
The evidence for good nutrition
For some 15 years, Professor Rucklidge has been undertaking clinical trials to understand the efficacy of treatments for mental health. She’s a clinical psychologist, and director of the Mental Health and Nutrition Research Lab at the University of Canterbury. Instead of medication-based solutions, her laboratory explores the positive effects of wholefood and food-based micronutrients on human brains.
It seems that our brains have been starving for nutrients.
Why are our brains starving?
“What our brains are missing are micronutrients, the vitamins and minerals you can get out of real whole foods. Our diet has been changing dramatically to eating more and more ultra-processed food over a very short period of time, at best, a hundred years,” says Professor Rucklidge.
“In addition to that, the micronutrient density of real foods has also been dropping because of poor remineralisation of soils, or use of glyphosate on crops, which can reduce micronutrient density.
“We’ve also selected foods that grow quickly and therefore don’t have the same amount of time for uptake of the nutrients from the soil.”
Nutrients: fundamental brain building blocks
Neurotransmitters – such as the mood-regulating serotonin – are chemical messengers that are essential to brain function. Yet they simply can’t be produced without micronutrients: vitamins and minerals.
For neurotransmitters to be made in our bodies, there’s not just one process or cycle. There are multiple different cycles and cascading, intertwined steps – from our smallest mitochondrial cells onwards. For example, the body converts the amino acid tryptophan to serotonin, our well-being and happiness hormone, and needs several minerals and vitamins to do this.
There’s no silver bullet
The Better Brain articulates that there will never be a silver bullet for mental health – not one food type, nor one nutrient, nor one pharmaceutical. The complexity of the brain means it needs a beneficial cocktail of micronutrients in order to function effectively.
The book details the benefits observed in clinical studies, in which groups of people alter their diets or take multinutrients. Viewers of the Ted Talk have contacted Rucklidge to confirm their own experiences of healing and reversal of conditions, which in many cases could not be helped by psychiatric medication. These testimonies may be anecdotal, but over time add up to form a compelling backdrop to this research.
Trauma, nutrition and resilience
While the Christchurch earthquakes were terrible, they provided an opportunity for Rucklidge and her team to study people who happened to be taking nutrients at the time of the 2010 earthquake, compared with people who were not taking additional nutrients at the time.
“We knew what they were like before the earthquake; we phoned them one week, two weeks, three weeks afterwards and we looked at stress, anxiety and depression.” They found that the stress levels of the people who were on the micronutrients dropped far more quickly than the people who were not taking micronutrients.
“In order to cope with the things that are constantly coming our way, be that financial stress, work stress, health stressors, natural disasters, pandemics, whatever it is, our brains need to be well-nourished… The brain goes: ‘OK I’ve got a stressor, I need to make sure this human survives. Let’s make sure the fight-flight response is well provided for.’”
While this first study involved a relatively small participant sample, this finding has been replicated using nutrient treatment following other traumatic events (Rucklidge et al. 2021, ‘Massacre, Earthquake, Flood’).
The fight-flight response needs sufficient nutrients to operate, but comes at the expense of your wellbeing in terms of sleep or mood, or ability to manage anxiety.
“All of those things are compromised unless your fuel tank is full. And that’s where I think those people who benefitted, their fuel tank was full because they had taken the additional nutrients.”
Diet and stress: past and present
People would have been stressed during the world wars and the depression, but a much greater proportion of the population were eating homegrown food. Does that mean their fuel tank was fuller than it is now?
“Very possibly. And unfortunately, because we have this wealth of ultra-processed food available at our fingertips now, we are lulled into eating those types of comfort foods because we feel good with them for short periods of time, but they’re doing nothing in terms of repleting our brains with the nutrients it needs.
“We’re probably doing it wrong at both ends. One is that we’re not eating sufficient nutrient-dense foods at the time of a fairly stressful event, and then our response to that stressful event is to continue to eat those very low micronutrient dense foods.”
Diverse indigenous diets
Geneticist Professor Tim Spector and neuroscientist Lisa Mosconi have talked about the importance of eating 30 different wholefoods a week, which mimics indigenous and ancient diet patterns.
“This includes the effect of colonisation on the Māori community. Displacement and urbanisation have effectively stripped Māori of their traditional nourishing diets. In the place of traditional food sources, the most affordable food was non-nutritive – crap – Western food,” says Rucklidge.
How important is organic food?
Eating organic food is a ‘no-brainer’ from the perspective of it providing you with more vitamins and minerals, so in itself that should be protective, says Rucklidge.
“There’s data that support that people who eat a whole food, organic type of diet [compared with people on a highly processed Western diet] are less likely to go on to develop mental health issues.
“You can take people who are depressed and eating a poor diet (this is based on the SMILES Trial, Jacka et al. 2017) and then assist them in changing their diet towards more of a Mediterranean style diet, and then that can alleviate their depression – more so relative to a social support kind of group.”
Research with young people
Professor Rucklidge has undertaken extensive research with young people, including those with ADHD, observing the changes that families often experience with improved nutrition. Adequate levels of nutrients are particularly critical for the growing and changing brain, and diets high in ultra-processed foods leave brains effectively starved.
While our brains are only 2% of our bodyweight, our greedy brains consume 20–40% of our energy needs. Energy doesn’t just come from calories – it comes from vitamins and minerals that act as co-factors in a wide range of important bodily processes.
However, right now, ‘normal’ diets in the West are nutrient-poor compared with the diets our grandparents consumed. At least 50% of what we now put in our mouths does not even qualify as food. It is ultra-processed ‘stuff’ made from simple carbohydrates (sugar), salt, trans-fats and chemicals like artificial colouring.
One young person who shares his story in The Better Brain is Isaiah, who had a history of aggression, temper tantrums, serious irritability and meltdowns. He was expelled from kindergarten and primary schools, and his parents were at their wits’ end of how to manage him.
Then Isaiah participated in a randomised controlled trial to study the effects of micronutrients. “He was randomised to the micronutrients. We know that now, we didn’t know that at the time, and even within a week, a couple of weeks, you just saw this stabilisation of his mood.
“One of the things we hear a lot is that when change comes along these kids often just completely lose the plot, but when they’re on the micronutrients they’re better able to adapt and… go with the flow. That’s something the parents start to notice. They go ‘Oh, wow! This is the kind of thing that would have triggered a meltdown in the past.’ But it didn’t happen, they just went with it.”
Healthy diets and micronutrients seem to make stressful situations less acute, less terrible. For young people developing their identity this must be powerful because they’re not developing an identity of that angry reactive person – ‘that ADHD kid’.
“Isiah’s now 17. I caught up with him because he’s in our MOOC (free online course) at the University of Canterbury. He’s really confident… He’s interested in philosophy, in psychology, and he’s got some great [ideas] of where he wants to go… It’s not all about ‘in the moment’, about that anger, about that resentment towards others – the frustrations… It’s about ‘I can see a vision for my life’.”
First step: eat real food
When a child presents with a mental health problem, Professors Rucklidge and Kaplan say the first step for treatment should be through diet, then multinutrients, then at a later stage if needed, through psychiatric medications.
“An obvious place to start is to reduce their consumption of ultra-processed food, and that’s going to be good for their mental and physical health to do that. Increasing the micronutrient density of the foods they are eating may in itself be sufficient. But if it isn’t, then supplement.
“In some cases we would reverse that. If somebody has really low motivation, they can’t cook, and the idea of going shopping is too hard. Some people may need supplements first before changing their diet because… they just don’t have that energy.
Energy and exercise
We’re all told to exercise, but some people can’t get the energy levels for exercise until they change their diet. “Energy does get better when you are eating better food. Increased sleep is certainly something we also see in the groups with nutrients.
Teenagers are more and more aware of their food environment. “Every time the university does Discovery Day (where a whole bunch of university professors or lecturers give a 20-minute talk to year 12 students), the one I do on mental health and nutrition is always [a fully] subscribed one.”
Rucklidge and colleagues have been tracking the side effects of nutrition and multinutrient supplementation since they started their studies, and found any side effects to be mild.
“We’ve never had a serious adverse event, which you do have when you have psychiatric drugs. They’re mild, they’re transient and they happen as much as in the placebo group.” Very few people drop out because of side effects (which can include headaches and stomach aches), whereas with drug trials, says Rucklidge, you tend to have a very high number of people dropping out because of side effects.
Medication is often associated with adverse effects including suicidal thinking, feeling emotionally numb, caring less about others, and loss of libido.
“The one that worries me the most is the effect on sexual function. That’s one that’s not talked about, but… it’s a very well-known and well documented side effect.”
Young people are discovering their sexuality, and medications may have effects on their sexuality. They don’t necessarily know that any change is an effect of the drug, and may well internalise it because that’s where they are in terms of their development.
How quickly can brain health improve?
How long it takes to see positive effects from a change of diet depends on various factors.
A prior history of medication use may slow the response, says Rucklidge.
“But overall yes, you can see some pretty dramatic changes, because you’re feeding their brains. They might be going through puberty and they’re just not adequately getting the nutrients out of their foods.
“With ADHD clients, I can never guarantee it’s going to be quick, but often we hear about slow changes after a couple of weeks.” Families tend to be cautious at first, saying ‘I’m not sure if it’s the nutrients, maybe it’s something else that’s happening’. But they do report that their children are better regulated emotionally. When things come along, they react much better than they would have.
Recipes from The Better Brain
Here are some recipes from The Better Brain: Overcome anxiety, combat depression, and reduce ADHD and stress with nutrition, by Bonnie Kaplan and Julia Rucklidge, 2021. Reproduced with permission of Vermilion, an imprint of Penguin Random House.
Find out more
The Better Brain: Overcome anxiety, combat depression and reduce ADHD and stress with nutrition, by Bonnie J Kaplan and Julia J Rucklidge (Vermilion, 2021). Available via good bookstores and on Kindle
The Ted Talk
The EdX course
Jodie Bruning is a Soil & Health National Council member, and a trustee of Physicians and Scientists for Global Responsibility (PSGR.org.nz) and lives in the Bay of Plenty.