Nutritional care and mental health
Nutritional care is a key component of maintaining good mental health and of the treatment of neurological diseases or mental disorders.
Research has consistently shown that diet and nutrition can have a significant impact on mental health.
Poor nutrition and certain nutrient deficiencies have been linked to mental health disorders such as depression, anxiety and schizophrenia. Nutrients dynamically interact with the systems of the body to develop and maintain structural and functional integrity of the body and brain.
Insufficiencies in Omega-3 fatty acids, B vitamins, Vitamin D are for instance associated with depression, anxiety, mood disorders. The brain though one-fiftieth of the body weight by weight uses up to a quarter of the energy requirement of a person at a constant rate1.
Eighty percent of this energy is used up in active signaling process correlated with glutamate cycling.
Brain extracts 50% of oxygen and 20% of glucose from the arterial blood. Its hundred billion neurons and much larger number of neuroglia have cell membranes that are dynamic structures composed of lipids and proteins. Brain has not much energy stores and dependent entirely on aerobic metabolism.
Malnutrition – a condition that occurs whgenb patients are not able to meet their nutritional needs via the normal diet due to diseases, ageing and/or side-effects of medical treatment – is common across a variety of patient groups, e.g., in patients with cancer, gastrointestinal, respiratory, and neurological disease.
Patients with neurological conditions or following a stroke may not be able to swallow or feed themselves.
Malnutrition is found to be common in people with intellectual disability and mental health problems with prevalence of underweight or of malnutrition risk of approximately 19%2,3,. As much as a third of psychiatric patients are at risk of malnutrition4.
A study5 found that the prevalence of malnutrition and its risk in patients in mental health units differed with different diagnoses:
- ~ 12.5% in patients with bipolar disorder;
- ~ 21.1% in patients with schizophrenia;
- ~ 55.6% in patients with major depression.
Malnutrition impacts individuals at all stages of life, from infancy to old age.
It has a negative impact on growth and development impairment in children6. In a dedicated study7 on malnutrition screening in hospitalised children, the highest prevalence of chronic malnutrition was seen in children with neurological disease (31%). Being at risk of malnutrition causes a higher severity of symptoms and lower functioning. It has been recognised that the nutritional status has an impact on recovery from illness, mortality and treatment complications, such as length of hospital stays and the rate of readmissions.
1 Medical nutrition in mental health and disorders, M. S. V. K. Raju, Indian Journal of Psychiatry, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547853
2 Bhaumik S, Watson JM, Thorp CF, Tyrer F, McGrother CW. Body mass index in adults with intellectual disability: distribution, associations and service implications: a population-based prevalence study. J Intellect Disabil Res 2008; 52(Pt 4):287-298.
3 Russell C, Elia M. Nutrition Screening Week in the UK and Republic of Ireland in 2011. Hospitals, care homes and mental health units. Redditch, BAPEN. 2012. Ref Type: Report.
4 Risch L, Hotzy F, Vetter S, Hiller S, Wallimann K, Seifritz E & Mötteli S. Assessment of Nutritional Status and Risk of Malnutrition Using Adapted Standard Tools in Patients with Mental Illness and in Need of Intensive Psychiatric Treatment. International.
5 Tsai AC, Chou YT, Chang TL. Usefulness of the Mini Nutritional Assessment (MNA) in predicting the nutritional status of people with mental disorders in Taiwan. J Clin Nurs 2011; 20(3-4):341-350.
6 Elia M, Russell C. Combating Malnutrition: Recommendations for action. Report from the Advisory Group on Malnutrition, Led by BAPEN. Redditch, 2009.
7 Joosten KF, Zwart H, Hop WC, Hulst JM. National malnutrition screening days in hospitalised children in The Netherlands. Arch Dis Child 2010; 95(2):141-145.
