The title of this article was inspired by the Roman poet Juvenal and translates to a healthy mind in a healthy body.
If you told me you’ve never heard this phrase, I’d be very surprised. And yet, how many of us know of friends or family who have suffered with mental illness in the past? Better question still, how many were asked about their diet and lifestyle by the healthcare professional they visited? How many of those friends and family members were immediately prescribed medication as their only solution?
If current studies 1, 2, 3, 4 are any indication, the most likely answers are “I know (at least) one”, “they weren’t asked”, and “almost all of them”.
This is not a “taking on Big Pharma” article. Traditional medications can work5. However, they are not the only answer. The fields of exercise and nutrition have entered a cultural economic boom in the last 60 years, at least in the United States and Europe. People are more concerned about their health than ever, and yet the use of exercise and nutrition in helping combat common illnesses, mental or physical, has only recently begun to emerge.
Exercise and proper nutrition is something that has been shown to improve overall mental health in healthy populations6, reduce symptoms and incidence of depression7, 8, improve Bi-Polar Disorder9, Schizophrenia10, and even Attention Hyper-Deficit Disorder11.
So, we know it can help. The next big question is…how?
Exercise, Nutrition and the Brain: The Nuts and Bolts
Other than the fact the symptoms of the above illness manifest as psychological or behavioral, there is really little more justification for deeming depression, bi-polar disorder or any other major mental illness as a mental illness. They are actually as physical as any other ailment.
Take depression. A review of the molecular processes and mechanisms in the brain showed that depressed individuals have, among other symptoms, a smaller hippocampus (the brain’s memory center) than normal, smaller amygdalas (the brain’s emotion-processing center), and lower levels of Brain-Derived Neurotrophic Factor (BDNF – a hormone which triggers brain cell growth)12. The same physical manifestations were found in Bi-Polar patients, with larger activity in the amygdala and reduced activity in the orbitofrontal cortex (which plays a role on decision making)13. Similar physical issues are also seen in schizophrenia14 and ADHD15.
These physiological symptoms have been the basis for a lot of the existing medications that are prescribed today. But how could a 30-minute training session or increasing certain nutrients help improve those problems?
See, exercise is a funny thing. Some tend to think it’s a largely physical activity with physical results, but it’s incredibly psychoactive, meaning it affects the brain in a lot of ways. Training increases the amount of circulating BDNF16, 17, increases blood-flow to the brain18 and neural plasticity (the rate at which the brain can change its signaling network)19. Increasing brain matter growth, blood flow and the capability for the brain to change its communication pathways are just some of the potential benefits in terms of mental health, which could explain the consistently positive findings exercise has on mood and learning20, 21.
Nutrition is the same. Omega-3 intake, through supplementation or fatty fish, has been shown to have therapeutic effects on mood disorders, including bi-polar disorder and depression22, 23. They also help improve mood and anti-social behaviour24, and measures of Autism25. These benefits may come from the fact that omega-3 fatty acids, found in fish and supplements, are quite literally used to hold the brain together, helping forming cell membranes and regulate biochemistry in the brain26. It also helps regulate the immune system by providing materials that make up certain immune cells26.
Vitamin and mineral intake also play a major role in improving behavior and mood24. It’s also shown benefit in stress and mild psychiatric issues27. Mineral intake has also been shown to have a positive effect on psychological functioning in patients with mood disorders28. Vitamins basically act like enzymes, speeding up chemical reactions in the body, which can include energy metabolism, immune systems function, cognition, or a host of other functions. Minerals, on the other hand, usually help nervous system through helping conducting electrical signals29, so it is logical that taking in sufficient amounts can improve overall mental well-being.
The above are all just a few examples of how having a good diet and exercising regularly can help improve mental health.
Putting Theory into Practice
So all the above studies give a pretty clear layout; exercise and eat healthy, right?
Yes, and no. In cases where exercise is used like this, it’s important to stick to what we KNOW works. Here are a few recommendations with that in mind:
- Aerobic exercise and resistance training using moderate repetition schemes, i.e. 3 sets of 8-15 repetitions have been shown to be most effective in terms of exercise.
- There does seem to be a minimum frequency with which resistance exercise is effective30, so if you are using weights, make sure you hit the gym a minimum of 3 days per week, or 2 day per week minimum for aerobic exercise.
- Whenever possible, try to augment this supplementation by getting in a bowl of mixed vegetables and a plate of fish each day also.
- If it’s too difficult to get in enough vegetables and oily fish (like salmon), supplement with a multivitamin and multimineral tablet and 1-2 Omega-3 tablets per day.
- Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980-989.
- Setlik, J., Bond, G. R., & Ho, M. (2009). Adolescent prescription ADHD medication abuse is rising along with prescriptions for these medications.Pediatrics, 124(3), 875-880.
- Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A. B., & Olfson, M. (2007). National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Archives of general psychiatry, 64(9), 1032-1039.
- Olfson, M., & Marcus, S. C. (2009). National patterns in antidepressant medication treatment. Archives of general psychiatry, 66(8), 848-856.
- Olfson, M., Shaffer, D., Marcus, S. C., & Greenberg, T. (2003). Relationship between antidepressant medication treatment and suicide in adolescents.Archives of General Psychiatry, 60(10), 978-982.
- McLafferty, C. L., Wetzstein, C. J., & Hunter, G. R. (2004). Resistance training is associated with improved mood in healthy older adults. Perceptual and Motor Skills, 98(3), 947-957.
- Mammen, G., & Faulkner, G. (2013). Physical activity and the prevention of depression: a systematic review of prospective studies. American journal of preventive medicine, 45(5), 649-657.
- Cooper-Patrick, L., Ford, D. E., Mead, L. A., Chang, P. P., & Klag, M. J. (1997). Exercise and depression in midlife: a prospective study. American Journal of Public Health, 87(4), 670-673.
- Ng, F., Dodd, S., & Berk, M. (2007). The effects of physical activity in the acute treatment of bipolar disorder: a pilot study. Journal of affective disorders, 101(1), 259-262.
- Gorczynski, P., & Faulkner, G. (2010). Exercise therapy for schizophrenia.The Cochrane Library.
- Verret, C., Guay, M. C., Berthiaume, C., Gardiner, P., & Béliveau, L. (2010). A physical activity program improves behaviour and cognitive functions in children with ADHD: An exploratory study. Journal of attention disorders.
- Krishnan, V., & Nestler, E. J. (2008). The molecular neurobiology of depression. Nature, 455(7215), 894-902.
- Phillips, M. L., Ladouceur, C. D., & Drevets, W. C. (2008). A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder. Molecular psychiatry, 13(9), 833-857.
- Lang, U. E., Puls, I., Müller, D. J., Strutz-Seebohm, N., & Gallinat, J. (2007). Molecular mechanisms of schizophrenia. Cellular Physiology and Biochemistry, 20(6), 687-702.
- Tripp, G., & Wickens, J. R. (2008). Research review: dopamine transfer deficit: a neurobiological theory of altered reinforcement mechanisms in ADHD. Journal of child psychology and psychiatry, 49(7), 691-704.
- Church, D. D., Hoffman, J. R., Mangine, G. T., Jajtner, A. R., Townsend, J. R., Beyer, K. S., … & Stout, J. R. (2016). Comparison of High Intensity versus High Volume Resistance Training on the BDNF Response to Exercise.Journal of Applied Physiology, jap-00233.
- Griffin, É. W., Mullally, S., Foley, C., Warmington, S. A., O’Mara, S. M., & Kelly, Á. M. (2011). Aerobic exercise improves hippocampal function and increases BDNF in the serum of young adult males. Physiology & behavior,104(5), 934-941.
- Murrell, C. J., Cotter, J. D., Thomas, K. N., Lucas, S. J., Williams, M. J., & Ainslie, P. N. (2013). Cerebral blood flow and cerebrovascular reactivity at rest and during sub-maximal exercise: effect of age and 12-week exercise training. Age, 35(3), 905-920.
- Cotman, C. W., & Berchtold, N. C. (2002). Exercise: a behavioral intervention to enhance brain health and plasticity. Trends in neurosciences, 25(6), 295-301.
- Arent, S., Landers, M., & Etnier, J. (2000). The effects of exercise on mood in older adults: a meta-analytic. J. Ageing Phys. Act, 8, 407-430.
- Etnier, J. L., Salazar, W., Landers, D. M., Petruzzello, S. J., Han, M., & Nowell, P. (1997). The Inﬂuence of Physical Fitness and Exercise Upon Cognitive Functioning: A Meta-Analysis. Journal of sport & exercise psychology, 19(3), 249-277.
- Parker, G., Gibson, N. A., Brotchie, H., Heruc, G., Rees, A. M., Hadzi-Pavlovic, D., & Psychol, M. (2006). Omega-3 fatty acids and mood disorders.American Journal of Psychiatry.
- Stoll, A. L., Severus, W. E., Freeman, M. P., Rueter, S., Zboyan, H. A., Diamond, E., … & Marangell, L. B. (1999). Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Archives of general psychiatry, 56(5), 407-412.
- Gesch, C. B., Hammond, S. M., Hampson, S. E., Eves, A., & Crowder, M. J. (2002). Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. The British Journal of Psychiatry, 181(1), 22-28.
- Amminger, G. P., Berger, G. E., Schäfer, M. R., Klier, C., Friedrich, M. H., & Feucht, M. (2007). Omega-3 fatty acids supplementation in children with autism: a double-blind randomized, placebo-controlled pilot study. Biological psychiatry, 61(4), 551-553.
- Bourre, J. M. (2005). Dietary omega-3 fatty acids and psychiatry: mood, behaviour, stress, depression, dementia and aging. Age And Nutrition, 16(2), 70.
- Long, S. J., & Benton, D. (2013). Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis. Psychosomatic medicine, 75(2), 144-153.
- Wackerhage, H. (2014). Molecular exercise physiology: an introduction. Routledge.
- Davison, K. M., & Kaplan, B. J. (2012). Nutrient intakes are correlated with overall psychiatric functioning in adults with mood disorders. The Canadian Journal of Psychiatry, 57(2), 85-92.
- Penninx, B. W., Rejeski, W. J., Pandya, J., Miller, M. E., Di Bari, M., Applegate, W. B., & Pahor, M. (2002). Exercise and depressive symptoms a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(2), P124-P132.