He who takes medicine and neglects to diet wastes the skill of his doctors.

—Chinese Proverb

CHAPTER 12

Western Nutrition for Mental Health

Every vitamin and mineral you ingest can impact your mood. Of course, getting enough of all your nutrients is very important to your physical health as well. Balanced hormones, optimal brain function, and the strength and purity of your blood are key factors to improving your state of mind. As you learned earlier, there are certain ingredients to stay away from to avoid energy crashes and moodiness. You also want to make sure you get ample amounts of what you really need to stay calm, cool, and collected. It’s important to know what nutrients to pay attention to when feeling low. Many times, a vitamin deficiency or not enough healthy bacteria in the digestive tract can be major contributors to mental health issues.

Though I am a strong believer in TCM, I have seen many patients who have benefited from simple dietary changes based on Western science. A lack in nutrients can be the main, if not only, cause of many disagreeable moods. My patient Mary was one memorable example. She found herself following every extreme diet ever published for almost twenty years. She did the cabbage diet, the grapefruit diet, the master cleanse for two months instead of ten days, the no-carb diet, the no-fat diet, the HCG (human growth hormone) 500-calorie-a-day diet, and the Special K diet.

Mary took laxatives, fen-phen, amphetamines, and daily enemas and laxatives. She admitted to spending a ten-month period consuming only 1,000 calories a day and working out two hours daily. You name it, she probably tried it. Mary had done so many failed diets, she had thought about writing a book on her yo-yo weight-loss insanity. Her constantly changing attempts to lose weight were particularly sad because Mary wasn’t all that heavy—just about twenty-five pounds overweight.

Every time she did one of these detrimental diets, she felt absolutely horrible, obsessed about food, and usually gained every pound back within a couple of months. Mary told me her mood swings were horrendous, intense fatigue was the norm, PMS made her a raving lunatic, and she was perpetually battling depression. She simply wasn’t consuming enough nutrients. Her body and brain were starving. It’s no wonder her emotional state was so grim.

Most fad diets are lacking in sound nutritional advice and aren’t sustainable—mentally or physically. Depending on which diet Mary was on would determine what she was deficient in. She was always deprived of her B vitamins, calories, and fiber. The no-fat diets always meant she wasn’t consuming enough healthy fat. The no-carb diet lead to an inadequate intake of fiber. Mary wasn’t even allowed to have broccoli on that one. Her doctor at the time told her broccoli contributed to weight gain because it is high in carbohydrates!

Mary would drink a six-pack of diet soda a day for energy. She was so exhausted from malnourishment that it was her only way to function at work. She believed soda, especially diet, couldn’t be that bad. A few doctors even suggested Mary drink it to increase energy and aid in her weight loss.

Once Mary had been on a balanced plant-based diet for a few months, along with acupuncture every two weeks and daily herbs, she became a new person. She was calmer, happier, and achieved her goal weight in just three months. Eight years later, Mary is still doing well.

I could easily write a book on how each vitamin and mineral is used in the body, how they support you emotionally, and how to find them. Every nutrient we consume, or should consume, plays an important part in mood. But I would like to focus on four essential elements in any diet: iron, B vitamins, vitamin D, and healthy fats.

Iron

Iron is a nutrient most associated with beef. Let’s debunk that myth right now. A 100-calorie piece of sirloin steak has 0.8 milligram of iron, while 100 calories of spinach has 15.5 milligrams, and lentils 2.9 milligrams.

There are two forms of iron, heme and nonheme. Heme iron is easier to absorb and makes up 40 percent of the iron in meat, poultry, and fish. Nonheme iron is in all plant food sources and makes up 60 percent of the iron in meats and fish. Vegans and vegetarians don’t have higher rates of iron deficiency than their meat-eating friends, because most fruits and vegetables have a significant amount of vitamin C, which aids in the absorption of iron. Iron-rich foods like kale, bok choy, and brussels sprouts all have an abundance of C. Even C-rich watermelon has iron in it.

Iron makes red blood cells and aids in the transportation of oxygen and cell growth. It does this by helping the blood move oxygen from the lungs to the tissue cells where it is needed. That’s why fatigue and muscle weakness are two of the most obvious symptoms of anemia.

Are you getting enough iron? Your body will probably tell you when it needs you to load up on spinach and lentil soup. Symptoms of iron deficiency include insomnia, irritability, pale skin and nail beds, fatigue, dizziness, weakness, shortness of breath, sore tongue and mouth, light-headedness, brittle nails, decreased appetite (especially in children), and headaches. Other symptoms include heartburn, gas, vague abdominal pains, numbness and tingling in the extremities, heart palpitations, and sores at the corners of the mouth. Women need to pay attention to whether or not any of the above symptoms increase during or right after their periods. That’s usually a sign of anemia.

In Chinese medicine, not having enough blood in the liver is the same as anemia. Most of the time I’m able to diagnose and treat anemia without a blood test. Blood deficiency of the liver leads to blood deficiency in the rest of the body. There are some emotional issues associated specifically with liver blood deficiency. They include panic attacks, insomnia, anxiety, mood swings, emotional sensitivity, and volatility. In TCM it is thought that the soul needs strong, nutrient-rich blood to protect it and to rest. So it makes sense that Western medicine agrees with some of the possible manifestations of iron-poor blood.

Wendy (from chapter 11) had been anemic since her teenage years due to her history of eating disorders. Even though she had been in recovery for bulimia and anorexia for a number of years, she was still anemic. Her digestive tract was so damaged that it had a difficult time taking in the nutrients she was eating. Once Wendy’s digestion was working properly, her insomnia and anxiety decreased right away.

What causes the malabsorption of iron? Along with deficient intake of vitamin C, there are a few other causes. In men and postmenopausal women, anemia is usually due to blood loss associated with ulcers; eating disorders; the overuse of aspirin or nonsteroidal anti-inflammatory medications (NSAIDS); consuming coffee, tea, calcium-rich foods, or vitamins too close to consuming iron-rich foods or supplements; or colon cancer.

Iron is mostly absorbed from the duodenum (part of the intestines) and upper small intestine. So if you have any digestive issues such as gas, constipation, bloating, celiac disease, Crohn’s disease, or food sensitivities, you could be at risk for anemia.

Phytate, which is found in some whole grains and legumes, can limit iron absorption. Soy, which is a good vegetarian source of iron, contains phytate and certain proteins that unfortunately interfere with iron absorption. Other foods that obstruct iron absorption include coffee, tea (including some herbal), cocoa, calcium, and some spices. Keep in mind that only 15 percent of the iron we consume is absorbed. To give you an example, if you eat 15 milligrams of iron per day, your body is only absorbing about 2.25 milligrams.

Some iron loss occurs naturally. The total daily iron loss of an adult is about 1 milligram, and about 2 milligrams in women during menstruation. Children, men, and women have different nutritional needs based on their ages. See the chart below for guidelines.

Daily Iron Requirements

Children

7 months–1 year 11 milligrams

1 year–4 years 7 milligrams

4 years–8 years 10 milligrams

9 years–13 years 8 milligrams

 

Men

14+ years 10 milligrams

 

Women

14–50 years 10–15 milligrams

51+ years 8 milligrams

Pregnant 30 milligrams

Lactating 10 milligrams

 

Sources of Iron

Food (1 cup)	Iron (in mg)	Food (1 cup)	Iron (in mg)
Black beans	7.9	Tofu	4.6
Garbanzos	6.9	Lima beans	4.5
Pinto beans	6.1	Lentils	6.6
Navy beans	5.1	Split peas	3.4
Soybeans	8.8	Fresh peas	2.9
Kidney beans	5.2	Tempeh	2.2
Vegetables (1 cup cooked)
Spinach	6.4	Kale	1.8
Beet greens	2.8	Acorn squash	1.7
Swiss chard	4.0	Brussels sprouts	1.7
Tomato juice	2.2	Potato with skin	1.4
Butternut squash	2.1	Beets	1.0
Fruit
Prune juice, 1 cup	10.5	Dates, 10	2.4
Dried peach halves, 5	3.9	Prunes, 1 cup	1.8
Raisins, ½ cup	2.6	Strawberries, 1 cup	1.5
Grains (¼ cup dry)
Rice bran	10.8	Wheat bran/germ	1.9
Quinoa	4.6	Cream of wheat	8.1
Millet	3.9	Oat- or cornmeal	0.7
Seeds (¼ cup)
Pumpkin seeds	4.0	Sunflower seeds	2.4
Miscellaneous
Blackstrap molasses, 1 tablespoon	3.2	Brewer’s yeast, 1 tablespoon	1.4
Tahini, 2 tablespoons	2.7	Cashews, ¼ cup	2.0

Intro to your B Vitamins

B vitamins, once thought to be just one vitamin, are actually eight very distinct nutrients that promote your mental health. B vitamins, especially B12, are great for the nervous system and supporting the adrenal glands. What does this mean? When you are balanced in your B vitamins and faced with a tough time or high stress at work or home, you’ll feel calmer, more even-keeled. Taking them together, in a B complex, will give you optimal results. All B vitamins are water soluble. This means you pee out what you don’t need every day, and your body doesn’t hold on to any reserves. So getting enough of your Bs every day is key.

Vitamin B1, or thiamine, is vital to balanced mental health and nourishing your nervous system. It improves memory, stabilizes your mood, and converts glucose into energy. Sources include sunflower seeds, flaxseeds, brussels sprouts, navy beans, black beans, pinto beans, lentils, peas, sesame seeds, lima beans, and spinach.

B2 is also known as riboflavin. It aids in the metabolism of carbohydrates and fats, maintains the levels of all the other B vitamins, and protects cells from oxidation. Riboflavin assists in the energy production of cells. Sources include spinach, soybeans, mushrooms, almonds, collard greens, and green peas.

A deficiency of Vitamin B3, or niacin, can lead to depression, irritability, and other mood disorders. It helps optimize the functions of digestion and the nervous system. By helping the release of energy from carbohydrates, niacin can help control blood-sugar levels. Sources include spelt, peanuts, mushrooms, broccoli, brown rice, and tomatoes.

B5, also known as pantothenic acid, enhances the production of healthy fats in the body and improves the immune system. It also helps metabolize fat and carbohydrates to be used as energy. Sources include cauliflower, broccoli, grapefruit, mushrooms, avocado, corn, sweet potato, bell peppers, and asparagus.

Vitamin B6 plays a role in the biosynthesis of important neuro-transmitters: serotonin, epinephrine, norepinephrine, dopamine, and gamma-aminobutyric acid. They are imperative to brain function. For example, low levels of serotonin can cause insomnia and depression. Dopamine is released when we feel happy or experience pleasure, and it is responsible for regulating appetite, sleep, memory, temperature, mood, muscle contraction, and function of the cardiovascular system and endocrine system. B6 is necessary for the brain to produce adequate amounts of dopamine and other neurotransmitters. Low blood levels of B6 have been linked to symptoms of depression. B6 also improves immunity. Sources include peanuts, soybeans, walnuts, bananas, watermelon, bell peppers, summer squash, sunflower seeds, spinach, avocado, and turnip greens.

Biotin, or vitamin B7, is key in metabolizing fat and carbohydrates. It also helps with enhancing mood. Biotin is crucial in processing glucose. This also means that Type II diabetics would benefit from taking biotin to aid in regulating blood sugar levels. Sources include nutritional yeast, walnuts, peanuts, oatmeal, mushrooms, soy, broccoli, cauliflower, and spinach.

Vitamin B9, which is also called folic acid, increases energy. It also protects the heart and brain, helps in the production of red blood cells, prevents cell damage that may lead to certain cancers, and reduces depression and increases efficacy of some antidepressants. Sources include lentils, pinto beans, garbanzo beans, spinach, collard and turnip greens, kidney and navy beans, beets, parsley, broccoli, asparagus, romaine lettuce, and lima beans.

B12, along with helping brain function, has an important role in the formation of blood. It is involved in the metabolism of every cell of the body, especially affecting DNA synthesis and regulation, but also fatty acid synthesis and energy production. B12 is critical in the production of melatonin and serotonin.

If you’re leaning toward going vegan or vegetarian, or are already there, you’ll need to take a B12 supplement. It should be made with methylcobalamin, which is more readily used by your body. I like to cook with nutritional yeast, which is fortified with B vitamins, including B12. Nutritional yeast has a nutty flavor and is delicious in most savory recipes.

B vitamins in general help support and increase the metabolic rate, maintain healthy skin and muscle tone, enhance immune and nervous system function, and promote cell growth and division, including that of the red blood cells that help prevent anemia.

A deficiency in B vitamins may have many causes, including alcoholism, autoimmune disorders such as lupus or Graves’ disease, a lack of intrinsic factor that aids in absorption of B12 (i.e., long-term use of acid-reducing drugs or certain medications, kidney problems, or diseases of the small intestine such as Crohn’s disease, celiac disease, bacterial overgrowth, or a parasite.

Vitamin D: D is for Depression

What is all this hype about vitamin D deficiency? It seems to be the new health trend. Most doctors didn’t test for it or even ask about D until a couple of years ago. It turns out that insufficient vitamin D is a bit of an epidemic: Approximately 40 percent of Americans are vitamin D deficient.

So why is there such a problem? First, if you live north of Los Angeles on the West Coast or Florida on the East Coast, and north of those locations in the middle of the country, you can’t get enough D from the sun in winter. If you work indoors, always wear sunblock, avoid going out in the sun, are obese, have kidney disease, or are over sixty, you are at high risk. (Sunscreens, while helpful for other things, block your ability to get D from the sun by up to 95 percent.)

Vitamin D is responsible for strengthening the immune system, bone and heart health, reducing cancer risk, muscle flexibility, calcium absorption, and mood elevation. Recent studies conclude that seasonal affective disorder (another SAD) may be related to D’s impact on serotonin in the brain. Vitamin D also plays a part in the release in dopamine, another neurotransmitter related to our emotional state.

There are plenty of signs to signal that you might be vitamin D deficient. Some health consequences of not getting enough D include osteoporosis, arthritis, poor memory, easily fractured or broken bones, weak or sore muscles, autoimmune disease, prostate and breast cancer, frequent colds, depression, even the slightest pressure on your sternum is tender to the touch, impaired insulin production, and possibly even schizophrenia.

There are a few sources of vitamin D, but the best is the way nature intended, in the form of sunlight without sunblock for five to thirty minutes per day on the arms and legs; otherwise take a vegan D3 supplement of 2,000 international units (IU) daily. Mushrooms, especially shiitake, and fortified organic soy milk also are good sources. Have you doctors check your vitamin D levels, especially if you’re experiencing any symptoms mentioned above. Keep in mind that it can take months to replenish your vitamin D. Get outside and enjoy a little sun. It does the body good.

Healthy Fats Make You Smarter

You need to eat some fat. Period. You can’t live a truly healthy, well-balanced life without consuming at least some fat. Our organs can’t optimally function without it. Did you know your brain is about 60 percent fat, and that your hormones are made from fat? Sixty percent of your heart’s energy comes from burning fats. Your lungs need fat to work and to keep them from collapsing. Fats help you absorb certain vital nutrients, including fat-soluble vitamins A, D, E, and K.

I know there’s plenty of confusing information out there about what’s healthy to eat and what isn’t. One myth is that all fat is bad all the time. Low-fat and nonfat products became all the rage in the 1990s and still exist today, but not all fats are created equal.

Monounsaturated fats are the healthy kind. The best-known example is olive oil, but don’t cook with it. High temperatures change the chemical makeup of olive oil, which can make it carcinogenic (cancer causing). Eat olives instead. For cooking, I recommend sautéing in just a little vegetable broth. Some research shows that refined oils aren’t a good idea to use at all. I definitely agree to limit the use of them.

There are plenty of tasty sources for healthy fat. These sources include walnuts, flaxseeds, hemp seeds, pumpkin seeds, and avocado. I recommend adding flax-, chia, or hemp seeds, plus some almond butter, to your morning smoothie. A surprising source of healthy fat is seaweed and sea vegetables. Seaweed is an excellent way to get your essential fatty acids. Why do you think fish are considered such a good source of healthy fat? It’s from what they eat.

If you don’t get enough healthy fat, you may experience depression, poor sleep/fatigue, impaired memory, difficulty concentrating, and a lack of mental clarity when you first get up in the morning. Though this is a chapter on nutrition and mental health, it’s worth mentioning the physical symptoms as well, which include infertility, weight gain, brittle fingernails, allergies, arthritis, and dry hair and skin.

My diet-crazed patient Mary attempted eating fat-free for two years when she was twenty-five years old. Guess how she felt during those two years? She had irregular periods, could barely study for law school, her previously gorgeous long nails broke off easily, and she had a difficult time doing her normal routine at the gym. Other factors might have contributed to her symptoms, but eliminating all fat from her diet was a major cause.

Taking Vitamins: Do I or Don’t I?

Even if you have the healthiest, cleanest vitamin-rich diet, you might not be getting all you need. Since our soils are so depleted, most produce doesn’t provide the nutrients we would expect. The end result is that eating only whole foods isn’t a guarantee that you’re actually consuming enough nourishment.

A recent study in England found that the calcium content of modern vegetables is about one-fifth lower than what was measured in the 1960s, and average copper content declined almost 80 percent. Oranges have been shown to have only one-eighth the amount of vitamin A as two generations ago. One US study spanning 1963–1999 proved that, per 100 grams, tomatoes lost 8 milligrams of calcium, 3 milligrams of magnesium, and 22 milligrams of vitamin K. Other vegetables’ numbers dropped dramatically too: iron levels 37 percent, vitamin A levels 21 percent, and vitamin C levels 30 percent.

Unless you’re a locavore (someone who eats only locally grown foods), you’re probably eating at least a portion of each meal from across the globe. Produce loses its nutrient content as soon as it’s been picked—another reason to buy seasonally.

There’s also a proliferation of causes that lead to a lack of absorption of nutrients. High stress, certain medications, food allergies, drinks (like coffee, energy drinks, and soda), irregular eating schedules, antacids, and antibiotics found in nonorganic animal products have wreaked havoc on our digestion. Our stomachs, spleens, and intestines are unable to function to their full capacity. They’re in charge of absorbing all the nutrients we’re taking in. The end result is malnutrition.

If you eat more of a SAD diet (hopefully not after reading this book), you’ll definitely need some added nutritional support. Most, if not all, processed foods are just empty calories, meaning there’s a ton of calories and nothing else. You might be eating 3,000 calories a day, but your body is starving. You crave more food, even though you’re full. Once again, the end result is malnourishment.

With our lives the way they are today, most people probably have some days, weeks, or even months and years when they could be eating better. Of course, my preference is to eat only whole foods for nourishment, but not everyone is going to eat that way or have access to fresh produce. I encourage you to always do your best.

So sometimes you might need some additional support. If you’re experiencing a health issue—thyroid disorder, frequent colds, allergies, chronic fatigue, depression, migraines, female issues—the right vitamins and herbal supplements can help you get back on track, or even help you feel better than you ever have before. Most of my patients and people I know are used to feeling a little bit under the weather, stressed, or exhausted all the time. Usually a natural boost is all that is required to experience major improvement.

I’m frequently asked if I think a certain brand of vitamins is any good. I definitely have my favorites, but there are so many brands on the market now, it would be impossible to research all of them. When I first started studying nutrition in high school, there were only a couple of brands sold at the few health food stores that existed. Now a few rows are dedicated to supplements, even at pharmacies. Unfortunately, buying most brands is like throwing your money away, and many can even make you sick.

Some companies are making some incredible claims. I’m skeptical of any that tout miracle cures: “Take our product for two weeks, and you’ll be in perfect health.” “You can eat and drink whatever you want. Just take these pills to lose weight and feel great.” Usually when something sounds too good to be true, it is too good be true.

Most people just assume that taking any vitamin is a good thing. Unfortunately, this isn’t always the case. Many companies are producing vitamins that can’t be absorbed well, if at all. They can also come from toxic or inorganic (nonliving) sources. Some calcium supplements are just ground-up seashells. The thought is that seashells contain calcium, so they’re a good source of calcium for humans. No, sorry. It doesn’t work that way. What the human body can use and take in from nature is an exact science. Many vitamins even contain iron filings. Iron filings. Can anyone really think this is a good or even safe source for iron? Don’t get me wrong, there are some great products out there, too. They’re just few and far between.

Every nutrient you ingest raises or lowers up to nine other nutrients in your body. For example, taking large doses of vitamin C lowers your level of copper, so if you are already deficient in copper and take high doses of vitamin C, you can actually compromise your immune system. As you will read in the last chapter, vitamin C increases the absorption of iron. So make sure you’re getting enough copper and eat an orange or drink some lemon water with your iron supplement.

What should you look for in a vitamin supplement? Safe sources. I prefer vitamins and supplements from plant-based whole foods. Ideally, they should be organic as well. Not all plants are available as organic just yet. The more consumers demand them, the sooner companies will want to sell them, and the sooner farmers will grow them. The more a plant is chemically processed, the less available the nutrients will be. Sometimes my patients are surprised when I recommend a special formula that requires nine pills per day. This is because the herbs I use aren’t altered to be condensed into one tiny pill. We’re used to this with medications, but this process isn’t beneficial when it comes to herbs.

What should you avoid? If you’re taking a supplement that has been chemically processed and isolated, most likely your body won’t be able to metabolize it. It might even make you sick. A vitamin might claim that it has 100 percent or more of what you need in a day, but if you don’t absorb much or any of it, you’re wasting your money. If a vitamin has extra-high doses, say 200 percent of vitamin A, it can actually become poisonous to your system. Our bodies can’t flush out excess amounts of oil-soluble vitamins A, D, E, and K, so an overabundant amount of certain nutrients will build up in your body and become toxic. Symptoms of vitamin A toxicity include headaches, nausea, dizziness, itchy skin, osteoporosis, joint pain, visual disturbances, and even swelling of the brain. I know the Western mentality is “more equals better,” but when taking supplements, this is rarely the case.

You should also watch out for other ingredients. Are there any animal products in the supplement? Safety regulations aren’t strong enough at this point. Many fish oils come from fish that are loaded with mercury. Bovine (cow) and other animal sources aren’t tested for mad cow disease, other illnesses, or bacteria like salmonella and E. coli. So if you are taking any supplements from animal sources, please do your research on how the company does its quality testing.

Also watch out for dangerous fillers. If at all possible steer clear of vitamins or supplements with any of the words in the list below on the label; these are some of the most commonly used binders and fillers in drugs, vitamins, minerals, and supplements, but unfortunately they’re not always listed. They can all be detrimental to your health.

 

Propylene glycol Talc

Lactose Sucrose

Starch Povidone

Pregelatinized starch Cellulose

Hydroxypropyl Methycellulose

Silicon dioxide Calcium phosphate

Calcium stearate Hydroxypropyl cellulose

Stearic acid Ethylcellulose

Sodium starch Glycolate

BHT Polysorbate 80

Microcrystalline cellulose Tartrazine

Red dye 33 and 40 Peanut oil

Hydrogenated cottonseed oil Fractionated coconut oil

Fractionated cornstarch Sodium benzoate

Partially hydrogenated soybean oil Sodium lauryl sulfate

Sodium laureth sulfate

 

Can you believe these ingredients are in products that are supposed to promote health? Here is some more detail about a few of these ingredients, just so you can begin to get an idea of how bad they really are.

Today, pretty much anyone who follows nutrition knows that hydrogenated oils are harmful, and that long-term consumption will lead to cardiovascular disease and heart attacks. They can even encourage strokes. We know that they cause harm, sometimes irreparable, to the nervous system. Hydrogenated oils interfere with the absorption of the essential fatty acids.

Propylene glycol is commonly used as antifreeze and is an ingredient in windshield washer fluid, brake fluid, and hydraulic fluid. It is also found in cosmetics, deodorants, shampoos, and lotions. It causes liver and kidney damage. Do you really want this in your vitamin?

Sodium lauryl sulfate (SLS) and sodium laureth sulfate (SLES) are used for their cleaning and foaming abilities. These are found in garage floor cleaners, car wash soap, engine degreasers, and personal care products like shampoo. SLS and SLES can form carcinogenic nitrates and dioxins, all of which may enter the circulation with shampooing or ingesting.

SLS can be stored in the liver, heart, eyes, kidneys, and muscles for several years after use and has been known to cause skin rashes, dandruff, allergic reactions, hair loss, and eye irritations. Do you really want to put something supposedly natural in your body if only a chemist knows what it is?

These tips should take you further on your path to wellness. I’ve only given a few examples of mood-boosting nutrients in this chapter. To guarantee good health and a carefree state of mind, make sure to eat a rainbow of food every day. Now you also have more tools when you need some additional guidance in the vitamin and supplement aisle. If you’re unsure what to look for, ask for help from the person who is in charge of the supplement section at your market. Bring the above list with you. Vitamins and herbal supplements should be an addition to your already health-promoting eating plan. They can add to the already strong foundation of a balanced diet.