Nutrition Science & Clinical Practice
Currently, it takes SEVENTEEN years on average for the results of scientific nutrition studies to be translated into clinical practice. 17 years!!
This means that when something (let’s say diet), has been proven to improve symptoms of something else (let’s say depression), treatment plans won’t acknowledge this potentially life-changing fact for approximately 17 years after the results have been shown.
So, even though there are a bunch of scientists walking around who have seen that diet changes can reduce depressive symptoms, the rest of the world (including the doctors who treat us) continue to follow the old treatment plans, even if they’ve since been proven less effective.
Although it might seem obvious to many that diet is important, our food system still allows opportunistic marketing of energy-dense, high-sugar/high-salt/high saturated fat, conveniently packaged fast food, our doctors still don’t get the nutrition training they need to help lessen the burden of diet-related disease, and our health policies still tend to focus on treatment rather than prevention.
Depression is now the leading cause of disability worldwide, and poor diet is the leading cause of early death in middle- and high-income countries. More energy and far more money need to be allocated to prevent the rising incidence of mental illness and poor diet.
This article will outline why it is important that nutrition research is published, discussed, promoted, and ultimately, translated into clinical practice.
Although the results of studies such as the SMILEs trial are, of course, important to the individual, they also have important implications for improvements in public health policies, health and medical professions, and educational curriculum.
Why?
These results redirect attention away from the weight-centric focus that has dominated health policies for so long, and more towards a focus on eating for the health of the brain, the gut, and the immune system. Focusing on weight alone as an indicator of good health is flawed for many reasons and does not always promote healthy behaviours. A focus on diet to improve brain health, mental health and gut health may be more motivating, is a suitable ‘treatment’ for the whole population with no harmful side-effects, and offers the additional health benefits of eating a healthy diet. Getting this information out to the public is imperative because people often don’t present to doctors until depression is quite bad. If people are starting to feel depressed and they know that changing their diet can help, they might try it and see results before mental health declines further.
Doctors must be given more nutritional training in their medical degrees. Currently, doctors complete very little nutrition training at all, so they may feel ill-equipped to discuss diet with patients. Considering diet-related disease is the leading cause of premature death, it seems incomprehensible that more focus is not being placed on nutrition at medical school. This is not, of course, with the aim of taking work from nutritionists, but giving GPs the ability to recognise when a referral to a nutritionist is appropriate, or feeling more equipped to recognise diet-related issues in a patient.
Alternative strategies to preventing and dealing with mental illness need to be explored further. The SMILEs trial has shown that a Mediterranean-style diet can improve depressive symptoms dramatically. This is exciting news for mental illness research as dietary change is affordable, modifiable, and puts the control into the hands of the patient in a way that other treatments don’t. The publication of these study results helps to explain the exact mechanisms that are affected by dietary change and provides an evidence-based explanation for the reasons that people may feel better on a healthier diet. Evidence-based science is more important than ever in the world of Instagram ‘wellness warriors’ pushing restrictive diets or supplements for personal profit.
These results may give more power to the public health sector to regulate junk food advertising and availability. The current belief that each person is in control of what they put in their mouth is deeply flawed. Currently, the financial enormity of Big Food means that public health policies focusing on reducing the marketing of over-processed foods, decreasing the consumption of sugar-sweetened beverages, and generally aiming to improve the diets of Australians, are being squashed by the powerful Big Food companies. The results from the SMILEs trial shows that a healthy diet offers preventative, therapeutic and economic benefits concerning the leading causes of disability and premature death in Australia. After 12 weeks on the ModiMed diet (a modified Mediterranean diet) 32% of dietary support group, compared to only 8% of the social support group, were considered to be in remission from clinical depression*. On the financial side of things, it was calculated that dietary treatment cost society just over $3000 less per person. These results provide favourable cost-benefit figures that the politicians need to see if they’re to support policy development promoting the use of diet in the treatment and prevention of depression and other mental illness.
These results justify a focus on diet for public health policy with a more preventative approach. Cooking nutritional food needs to be a primary focus in the educational curriculum to empower the next generation to take back control of their health. Cooking and learning about the role of food in health should be a core subject in all school curriculums across Australia.
Although diet is the leading cause of premature death worldwide, not enough is being done to address this problem on any level. The results from studies such as the SMILEs trial support action for more food and health education, more campaigning against the power of Big Food and its detrimental health impact, an increase in the use of diet as an intervention in mental illness treatment plans, more nutritional education for medical students, and a shift away from weight-centric diet culture. Diet really can become a powerful health tool when used in the right way.
