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Does a pro-inflammatory diet cause depression?

In December 2018, the journal Clinical Nutrition reported that those with pro-inflammatory diets were 1.4 times more likely to have depression or depressive symptoms.

The finding came from 11 existing studies, involving over 100,000 participants with pro-inflammatory diets. 

Yet, in years of mental health care for diagnosed depression, inflammation was not something that any doctor, at any time, ever mentioned to me or my daughter.

Medical testing to find a potential cause of her depression was limited to a thyroid hormone test and talk therapy. Questions about her diet were binary: ‘Are you eating or not’.

Considering the foods I bring into my home is one of the only things I can fully control in my teenagers’ lives, I did some digging some on chronic low-level inflammation and its link to depression. Here’s what I learned:

Inflammation is both good and bad

Inflammation is our body’s natural response to injury or infection.

If you sprain your ankle, you experience acute inflammation. The injury triggers your immune system. Your immune system releases a microscopic army to fend off infection and intruders. When the war is over, the army retreats. This is good inflammation

Chronic inflammation is bad inflammation. It occurs when there is no injury or infection.

Your immune system still releases the army, but like a group teenagers with nothing to do on a Saturday night, the army gets bored and restless. Looking for excitement, they start doing stupid things like attacking healthy tissue and cells. 

This chronic low-level inflammation seems to be the one common element in nearly every major degenerative disease, including cancer, diabetes, heart disease and Alzheimers. And now depression.

Inflammation affects our neurocircuits in the brain

In April 2018, Modern Medicine Network released a special report on Major Depressive Disorder. It was about the “new inflammatory world in which mental health clinicians and researchers find themselves.”

The report is pretty chock full of science, but I’ll try to sum it up here.

Less than a decade ago, researchers believed inflammation only produced depression when there was some other medical condition was present. A patient with cancer became depressed because they had cancer.

Now, they believe:

  1. Inflammation can produce changes in the brain/body functioning that can contribute to a wide range of psychiatric conditions
  2. Stress can be pro-inflammatory and increase the risk of mental illness
  3. Psychiatric disorders are not inflammatory conditions – meaning there are other ways you can get depressed or manic or psychotic

Through testing they’ve found inflammation affects neurocircuits and neurotransmitter systems in the brain.

When patients are given pro-inflammatory cytokines, proteins important in cell signaling, the cykotines impact neurocircuits in the anterior cingulate cortex (ACC) and the basal ganglia system in the brain.

Researchers believe the ACC is involved with assigning emotions, decision making, and management of social behaviour. The basal ganglia plays a role in emotion, cognition and habitual behaviour and motivation.

You can begin to see why inflammation may activate depressive thoughts and behaviours.

Inflammation in the body is easy to spot

The good news is that you can easily find out the level of inflammation in your body through a simple blood test called a CRP test. It measures the level of C-Reactive Protein in the body, a marker for inflammation.

However, unless there are signs of infection or an inflammatory disorder such as psoriasis, arthritis or Lupus, a doctor’s unlikely to administer a CRP test as part your kid’s annual checkup.  

As a parent, I think I’ll start asking for the test for a few reasons:

  • It’s easy to do and entirely safe
  • If CRP levels are high you can actively try to adjust them through diet
  • The results may be helpful in finding the right antidepressant

In March 2017, Science Daily reported researchers at UT Southwestern Medical Centre found a strong correlation between CRP levels and which drug improved depressive symptoms.

For patients with CRP levels higher than 1 milligram per litre, Escitalopram (Cipralex or Lexapro) plus Bupropion (Wellbutrin or Zyban) together worked better than Escitalopram alone.

In a study at the Emory University School of Medicine in Atlanta, Georgia, researchers found antidepressant treatment resistance is associated with high levels of inflammation.

If a patient’s level is high, drugs that affect dopamine may be more effective than drugs that affect serotonin.

Granted, these are all just studies, but having watched my daughter struggle for years to find medication that worked, I’ll take what I can get.

An anti-inflammatory diet can help lower inflammation

Dark, green leafy vegetables like kale and broccoli are considered anti-inflammatory.
Dark, green leafy vegetables like kale and broccoli are considered anti-inflammatory.
Photo by Mae Mu on Unsplash

Besides taking the test, I’m thinking an anti-inflammatory diet is also a good idea. Not just for my kids, but for me as well.

As you might expect, it’s made up of all the things doctors have been telling us to eat all along for health and longevity:

  • Berries and grapes
  • Dark green, leafy vegetables like kale or broccoli
  • Avacados
  • Fatty fish like salmon and sardines
  • Peppers
  • Mushrooms
  • Tumeric and chilli pepper

And on the avoid list, all the things you’d expect:

  • Added sugars
  • Refined wheat flours found in pizza, cereal, white bread
  • Fried foods like French fries or chicken fingers
  • Vegetable oil
  • Dairy
  • Processed meats like hot dogs, sausages, and lunch meats
  • Grain fed meats such as chicken, pork and beef
  • Alcohol in excess

It will require an overhaul. While we eat a lot of fish and vegetables and not much meat, I have a great love of cheese and wine and my kids practically live on cereal.

But I’m up for the challenge and have this article on the best Mediterranean Diet Cookbooks to help get me started. I’ll let you know how it goes.

Further reading:

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