Did you know that an estimated 14% of children aged between 4 & 17 experience mental health disorders? As a clinical nutritionist who works mainly with children, what I’m hearing from parents right now is that they’re concerned about the effect the pandemic is having on their children’s mental health. Children are dealing with lockdown, school closures, physical distancing, no community sport and new routines & it is probably no surprise, then, that many children are showing signs of experiencing mental illness - anxiety, social anxiety, disordered eating, or OCD. Witnessing these symptoms is extremely concerning for parents, and with around 13 million Australians in lockdown right now, this is affecting so many Australian families.
So, what can we do to help? Many emotional symptoms are now regarded to be, in part, related to the influence our diet has on our body - dysbiosis of our gut microbiome, chronic inflammation, oxidative stress or impaired mitochondrial energy function are all at the fore of the latest nutritional neuropsychiatry studies. It’s been discovered that children with coeliac disease have a 1.4 greater risk of developing psychiatric disorders, and that the incidence of coeliac disease is also much higher among those diagnosed with anorexia. Nutritional psychiatry is one of the newest area of research and looks at the effect nutrition and micronutrients have on our mental health.
What we eat absolutely matters when it comes to mental health outcomes. Large population studies have reported better mental health in people who consume a whole foods diet which includes lots of fruits, vegetables and nuts. For optimal mental health & wellbeing, we want to aim to base our child’s diet around whole foods, with plenty of colourful fruits and vegetables, sufficient protein and lots of high fibre foods. Think whole grains, legumes, nuts, seeds, fish, eggs, meat, vegetables & fruits. Foods that don’t tend to come from a packet and haven’t undergone a lot of processing in a factory. Basically, aim for the famous Mediterranean Diet! Rest assured, though, within that healthy, wholefood framework, there is always space for treats – aim for the 80/20 principle J
On top of a general wholefood, Mediterranean style diet, there are some specific micronutrients that have been identified to be to be important in supporting mental health outcomes. These can depend slightly according to the specific nature of the mental health issue (& any underlying driver), but it’s a great idea to make sure we’re including adequate amounts of these micronutrients in our child’s diet as well;
Zinc - found in oysters, red meat, nuts & seeds
Vitamin D - the sunshine vitamin! But also found in mushrooms (sit them in the sun before you cook them to up their D content), egg yolk, grass-fed butter, cod liver oil, oily fish like sardines & mackerel, liver
Magnesium - leafy greens such as arugula & kale, nuts & seeds, cacao, legumes & whole grains
Omega-3 fats – found in oily fish like salmon & sardines, oysters, anchovies, cod liver oil, hemp seeds, flaxseeds & chia seeds
Folate - leafy greens such as spinach & kale, asparagus, beets, brussell sprouts & broccoli, legumes, nuts & seeds & beef liver
B vitamins – leafy greens, whole grains, eggs, legumes
Choline – beef liver & beef, eggs, chicken, fish & soybeans
Strain-specific Probiotics - Lactobacillus plantarum 299v & Lactobacillus paracasei Lpc-37
One area that has garnered a lot of interest is the gut-brain connection in mental health and mood disorders. A bi-directional communication pathway called the vagus nerve, connects our brain with our gut. Signals sent along the channel include microbial metabolites produced by our gut bacteria, neurotransmitters released by cells within our gut, and inflammatory cytokines produced by immune cells within the gut. There have been a few studies that indicated simply altering the microbiome composition led to reduced mental health symptoms and improved stress response. Unfortunately, our microbiome has been shown to be shrinking in diversity in recent generations, and is basically under fire from just about every aspect of our life – antibiotics used in food production, our overly-hygienic lifestyles, treated water, stress, alcohol, and the low fibre/high processed food Western diet. We can support a healthy microbial population in our children's gut by including various fermented foods like yoghurt and sauerkraut, and eating a high fibre diet by including lots of vegetables, fruits, legumes and wholegrains.
We also know that there’s a type of food that doesn’t support our child’s mental health, and that is a diet made up predominantly of processed food and sugary food. Eating too much highly processed food doesn’t promote a healthy gut microbiome or stable blood sugars, it doesn’t give your body the amino acids or minerals it needs to build neurotransmitters and it contributes to inflammation and oxidative stress – all of which play a role in our mental health, and our overall health and wellbeing. Foods to avoid here are just about any packaged snack, processed breakfast cereals, store bought biscuits and cakes, soft drink, lollies, packaged sauces and marinades. The thought of reducing highly processed convenience foods can be daunting for a busy family, but you don’t have to overcomplicate it - just eating a piece of fruit with some nut butter is a fantastic wholefood & highly nutritious snack! And switching from regular pasta to a wholegrain spelt option and popping a piece of broccoli (or veggie of choice) on the side is an easy way to improve a simple pasta meal. There are also plenty of wholefood convenience packaged snacks that are nutritious – look for things made with nuts, grab a packet of seaweed, or simply throw some frozen berries through some Greek yoghurt with half a teaspoon of honey & a dash of cinnamon. When you do buy something in a packet, always read the nutrition panel and buy the option with the least amount of food additives, strange ingredients and vegetable oils.
In addition to our what our child eats, there are also some lifestyle strategies that we can put in place to support our children’s mental health.
Exercise has proven mental health benefits. When we exercise, “happy” hormones like dopamine and serotonin are released, and exercise has also been shown to improve insulin resistance and blood sugar control, which is also so important for our mood. I find my children are far more amenable to home learning if they’ve been out for some sunshine and exercise in the morning (& research supports this, showing that children who walk to school have better learning outcomes than children who don’t). If we get out in the morning, before we all jump on our screens to do school/work, we all work more efficiently, and we feel in a more positive mood throughout the day.
Unfortunately, it’s all too easy to let many of our rules and routines slide in lockdown. But routine provides important boundaries for children, and keeping to a routine can help support our children’s mental health by giving them some security in a world that’s changed dramatically. Keeping a routine around similar waking time, eating time and bed time can help the whole family – and, of course, this also supports a healthy sleep habit, which is critical to our mental health as well. In our house, we’ve definitely let a few rules slide (no screen time during the week flew out the window early!), but we’ve kept regular bedtime and eating times, and we have a few set things we do in the week (like Olive does netball training with a friend on Thursday afternoons and we walk with a friend on Friday mornings). We also added in Frozen Yoghurt Friday so we had something to look forward to, a fun ritual to punctuate the end of another week of home learning.
Maintaining our child’s connection to other people is also so important. As humans, connection really is a pretty basic biological need, so extended lockdowns can feel so tough if you’re feeling isolated from your social group of friends. If your child is old enough, let them take a walk with a friend in the morning or afternoon each day. If your child is younger, take them on a scooter ride with a friend. One positive thing I’ve noticed during our lockdowns is that younger kids seem to be gaining more independence and are out on the street climbing a tree, or scootering with a neighbour – things that I did as a child! This lockdown, we’ve found ourselves drawn to our tiny patch of grass at the front of our house, where we can sit in the sun, and have a chat to whoever comes walking past. (It’s a great way to get to know all our neighbours!)
Connecting to nature is another part of this, as well. Simply being in green spaces has been shown to reduce symptoms of inattentiveness and increase mental wellbeing in children. Get the kids to a park for a bike ride, or take a bush walk if you have one nearby on the weekend.
And, of course, you can’t be expected to give everything over to support your child’s mental health if you aren’t also looking after your own! And there’s no doubt about it – parents are facing a mammoth load right now in lockdown. Managing work commitments, supervising home learning, looking after the emotional wellbeing of the household and, quite often, a large domestic load to boot. Take the time to get some space each day for yourself to recharge, if that’s a walk, a bath, listening to music with the headphones on – whatever makes you feel good! For me, I find I need to get some exercise every day - even better when it’s taken outdoors and followed by a cold swim J
If you are concerned about your child’s mental health, your GP is a great place to start for a chat and, if needed, a referral to a psychologist. With a referral from a GP, you should be able to access 6 (or more, as needed) free or discounted psychologist appointments for your child through Medicare. (I personally know two excellent child psychologists in Sydney if you need a trusted referral!) And as I've described here, there are lots of tools a natural medicine practitioner can support your child with, as a powerful adjunctive therapy, as well. I’m here to chat anytime you’d like to know how we could support your child’s mental health through dietary interventions and nutrient therapy.