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Rosemary Ann Ogilvie talks to renowned researcher Jerome Sarris PhD about his ground-breaking work into diet, nutritional deficiencies, and mental health.

A Senior Research Fellow (CR Roper Fellow) at the University of Melbourne, Jerome Sarris PhD moved from clinical practice as a natural therapist to academic work after completing a doctorate in psychiatry at the University of Queensland. Post-doctoral training was undertaken at the University of Melbourne, Department of Psychiatry; the Centre for Human Psychopharmacology, Swinburne University of Technology; and Harvard Medical School’s Depression Clinical and Research Program. Jerome’s particular interest lies in mood and anxiety disorder research pertaining to nutraceutical psychopharmacology, and in complementary and integrative medicine, and psychotropic plant-medicine research.

Your research shows the growing relationship between diet and mental health. Can you discuss? This particular paper, published in The Lancet Psychiatry, brought together some of the leading academics and clinicians in the field to advocate for a position supporting the importance of both quality of diet and select nutrient supplementation to potentially prevent mental health disorders, to enhance mental health, or to use as an adjunct alongside pharmaceutical medication to better treat people with psychiatric disorders. It was, in a sense, a collaborative perspective on this emerging area. We also published in the World Psychiatric Journal a consensus statement advocating our position, which is to encourage greater discourse about the importance of diet and nutritional supplementation to improve people’s mental health, and for this to become a mainstream part of psychiatry – just as it is in other fields, like cardiology and gastroenterology.

How is today’s generally poor-quality diet impacting Western mental health? A combination of supplements with antidepressants may actually have a stronger mood-elevating effect than the antidepressant alone. We do know there are data drawn from cross-sectional* and longitudinal* studies showing the relationship between a poor-quality diet and an increased level of depressive or anxiety symptoms. Further, the quality of the person’s diet may determine whether they have a greater or lesser likelihood of developing depressive or anxiety symptoms in the future. It should be said that not all data affirms this. However, it makes sense theoretically that if a person has a very poor diet, and they’re not consuming the minerals, vitamins, phytochemicals, proteins and essential fatty acids required for proper brain function, then inevitably this is going to impact their mental health.

What about the influence of maternal and early-life nutrition? This is nascent research: we’ve only just started to explore the quality of a pregnant woman’s diet, and its relationship to the child’s mental health down the track, as well as early life nutrition for children and how this impacts mental health. But certainly some preliminary research shows a relationship exists. One of my colleagues, Associate Professor Felice Jacka, is interrogating this particular relationship.

Do some supplements show particular promise in treating mental disorders? There’s actually a range of quite encouraging evidence. In respect to depression, there’s solid evidence around SAMe (S-adenosyl-l-methionine) and the EPA component of omega-3 essential fatty acids. There’s also research on zinc, and an active form of folic acid called 5-MTHF (methyltetrahydrofolate) or folinic acid. A combination of these supplements with antidepressants may actually have a stronger mood-elevating effect than the antidepressant alone.
There’s also a range of supplements for obsessive-compulsive disorder (OCD), bipolar disorder and schizophrenia. This field is complex, but just in terms of general mood improvement there are certainly examples of some encouraging supplements. Another promising supplement is the amino acid derivative NAC (n-acetylcysteine), a relatively inexpensive nutrient that improves mood in people with bipolar disorder and schizophrenia. Australia’s National Health and Medical Research Council (NHMRC) is funding work looking at this particular nutraceutical and its role in treating bipolar disorder, schizophrenia and OCD.

What prompted you to start investigating nutrition and mental health? Before completing my doctorate and post-doctoral qualifications, I practised as a naturopath, nutritionist, and acupuncturist. These days I mainly do academic work in mainstream psychiatry and no longer work in clinical practice. My broad background is the reason I enjoy this work so much. Many people from the medical field are studying this, which is great, but coming from the natural-medicine background means I provide a different perspective, not least on the way many of these approaches are used traditionally.

How do you see treatments for mental health conditions changing in the future? It depends really on the psychiatric condition, but my position is actually an integrative one: I believe we should use the best of both worlds where possible.

*Both longitudinal and cross-sectional studies are observational: researchers do not interfere with their subjects. However, in a longitudinal study, researchers conduct several observations of the same subjects over a period of time, sometimes lasting many years, while a cross-sectional study is a ‘snapshot’ at one time point.

And if any of our readers would like to take part? Currently we have several NHMRC-funded clinical trials investigating the effects of natural supplements on a range of mental disorders. So it’s quite exciting and encouraging in terms of the interest in this area. Obviously diet is important for mental health, and there’s a place for supplementation. However, we also have to consider – from an integrated-model perspective – the influence of psychological care, along with other lifestyle aspects such as making sure people have good levels of physical activity and exercise; social support; quality sleep; and cut down on the vices in their life.
But certainly nutrition is one of the mainstay elements of this model, and we have ongoing clinical trials that hopefully will produce more exciting results in the near future. And on this note, I’ll mention that we’re recruiting for clinical trials that will be ongoing for the next couple of years, one based in the University of Melbourne, the other at the University of Queensland in Brisbane. So anyone interested in being part of them should contact www.nutrientsdepressionstudy.com.

Jerome Sarris PhD was a presenter at the Second Annual Blackmores Institute Symposium.