Friday, Oct. 28
14:30 – 15:30 (1 hr)
Meeting Room: Chestnut (Mezzanine)
Stephen Wiseman*, MD, FRCPC; Leslie Wicholas, MD, FRCPC
- Medical Expert
- Health Advocate
At the end of this session, participants will be able to: 1) Be familiar with the possible roles of inflammation, gut permeability, microbiome, and neurotransmitter synthesis in the onset and maintenance of clinical depression; 2) Understand the ways in which dietary and related factors can have modulating effects on these mechanisms, both positive and negative; and 3) Describe a novel group-based treatment program for depression, using dietary and other antiinflammatory interventions, and consider how these approaches can be potentially adapted to routine psychiatric practice.
The burden of depression remains disturbingly high, despite a range of standard treatments, including pharmacological intervention and various psychotherapies. Particularly in chronic illness with comorbid lifestyle and medical pathologies, our treatments are too often seen in the clinic to have frustratingly modest effects. Recently, the study of biological mechanisms possibly influencing depression has identified immune system activation and associated neuroinflammation. Drivers of this are thought to include trauma and chronic stress and increased gut permeability, leading to a systemic pro-inflammatory response. The gut microbiome has also been implicated as playing an important role in the synthesis of neurotransmitters key to maintaining a healthy mood state. We now understand that dietary factors may play a significant role in determining the internal inflammatory state, influencing gut permeability and characterizing our microbiome. The new field of nutritional psychiatry provides evidence for diet quality as a modifiable risk factor for depression and opens up the possibility for active intervention with dietary changes and other antiinflammatory approaches, on a clinical basis. In this workshop, we will review the biological mechanisms described above and explore why dietary intervention might be a key missing piece in our efforts to better address depression in our patients. In doing so, we will also introduce the Food as Medicine program at the Mood Disorders Association of British Columbia and suggest ways in which its dietary approach and emphasis on inflammation might be adapted more universally.
- Marx W, Moseley G, Berk M, et al. Nutritional psychiatry: the present state of the evidence. Proc Nut Soc 2017;76:427–36.
- Jacka FN, O’Neil A, Opie R, et al. A randomised controlled trial of dietary improvement for adults with major depression (the ‘Smiles’ trial). BMC Med 2017;15:23.