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从饮食角度看心理健康:营养精神病学的作用与可能性

[Considering Mental Health from the Viewpoint of Diet: The Role and Possibilities of Nutritional Psychiatry].

作者信息

Matsuoka Yutaka, Hamazaki Kei

出版信息

Seishin Shinkeigaku Zasshi. 2016;118(12):880-894.

PMID:30620820
Abstract

Disease burden from psychiatric disorders is an important public health issue worldwide, and should be addressed proactively. Because the development of psychiatric disorders involves both genetic and environmental factors, as well as their interactions, lifestyle interven- tion is a feasible treatment and prevention strategy. The human brain uses a substantial por- tion of the body's total energy and nutrient intake. Nutrients strongly influence both brain structure and function, and nutrition also affects neurodevelopment and neurotrophic function. It has been recognized in recent years that diet and nutrition may be an important factor con- tributing to psychiatric morbidity, and that prevention or treatment of psychiatric disorders could be conducted by addressing diet and nutrition. Against this background, in 2013 we founded the International Society for Nutritional Psychiatry Research (ISNPR). The aim of the present paper is to provide a set of practical recommendations for the prevention and treat- ment of depression based on the ISNPR statement and the review by Opie et al. Here, we introduce Opie's five key dietary recommendations and state our hypotheses for improving mental health: (1) follow traditional dietary patterns, such as the Mediterranean, Norwegian, or Japanese diet (2) increase consumption of fruits, vegetables, legumes, whole-grain cereals, nuts, and seeds; (3) consume higher amounts of foods rich in omega-3 fatty acids; (4) replace unhealthy foods with wholesome nutritious foods ; (5)limit intake of processed foods, fast foods, commercial baked goods, and sweets ; and (6) be mindful of probiotic gut bacteria. The pos- sible biological mechanisms by which nutrition might affect mental state are not known in depth, and full associations between nutrition and mental disorders have not been examined in randomized controlled trials. However, the existing evidence suggests that a combination of healthy dietary practices may reduce the risk of developing depression. As dietary practices and lifestyle can be changed by individuals at any time, new integrated approaches to mental health from the viewpoint of diet and nutrition-that is, nutritional psychiatry-could be appli- cable to a wide population. Gathering the findings of high-quality studies and implementing nutritional psychiatry within clinical practice are important tasks for the future.

摘要

精神疾病的疾病负担是全球重要的公共卫生问题,应积极应对。由于精神疾病的发生涉及遗传和环境因素及其相互作用,生活方式干预是一种可行的治疗和预防策略。人类大脑消耗身体总能量和营养摄入量的很大一部分。营养物质对大脑结构和功能有强烈影响,营养也会影响神经发育和神经营养功能。近年来,人们已经认识到饮食和营养可能是导致精神疾病的一个重要因素,并且可以通过解决饮食和营养问题来预防或治疗精神疾病。在此背景下,我们于2013年成立了国际营养精神病学研究协会(ISNPR)。本文的目的是根据ISNPR声明和奥佩等人的综述,为抑郁症的预防和治疗提供一套实用建议。在此,我们介绍奥佩的五项关键饮食建议,并阐述我们改善心理健康的假设:(1)遵循传统饮食模式,如地中海饮食、挪威饮食或日本饮食;(2)增加水果、蔬菜、豆类、全谷物、坚果和种子的摄入量;(3)多食用富含ω-3脂肪酸的食物;(4)用有益健康的营养食物替代不健康食物;(5)限制加工食品、快餐、商业烘焙食品和甜食的摄入量;(6)关注肠道益生菌。营养可能影响精神状态的具体生物学机制尚不清楚,营养与精神障碍之间的完整关联尚未在随机对照试验中得到检验。然而,现有证据表明,综合健康的饮食习惯可能会降低患抑郁症的风险。由于饮食习惯和生活方式可以由个人随时改变,从饮食和营养角度出发的新的心理健康综合方法——即营养精神病学——可能适用于广泛人群。收集高质量研究的结果并在临床实践中实施营养精神病学是未来的重要任务。

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