Mikki Williden: Your kids' mental health
A major health issue facing New Zealand right now is the increasing number of children and teenagers being prescribed medication for mental health issues, including anxiety and depression. Though it’s great that this is being talked about more in the media, increasing our awareness of the problems, the conversation about mental health never seems to include nutrition, an important factor in nurturing wellbeing. There is good observational evidence that dietary choices influence mental health, with poor control of blood sugar increasing depressive symptoms among people, a metabolic environment driven largely by processed refined carbohydrate in the absence of quality protein and fat. Lack of micronutrients in the diet also contributes to poor mental health outcomes.
Research reveals we are consuming more packaged foods than ever before. Seventy per cent of foods that make up our grocery trolley are ultra-processed; defined as formulations of several ingredients which, besides salt, sugar, oils and fats, include food substances not used in culinary preparations. These include flavours, colours, sweeteners, emulsifiers and other additives used to imitate the sensory qualities of unprocessed or minimally processed foods, or to disguise undesirable qualities of the final product. Cereals, soft drinks, biscuits, crackers and frozen food products (excluding frozen vegetables and fruit) would fall under this category. Even if these food products have vitamins and minerals added, as many of the cereals do, the ability of the body to utilise these as effectively as they would if they were eaten as a part of their natural food source has not been established.
Unsurprisingly, the food industry that drives the marketing of ultra-processed food has created a concept of “kids’ food” that wasn’t around when my parents were growing up. We could have an entire supermarket aisle devoted to cereals with cartoon characters or sports people on the front, food that is squeezed out of a tube, and squashed fruit puree in the shape of a bar. Parents often feel guilty if they choose not to offer their children these foods, and I have talked through with clients how they manage their children’s expectations when they often see them in the lunch box of their peers. At home, it is not uncommon for parents to prepare a different meal for their children. This culture extends to restaurants, where there are separate kids’ menus for food options such as pizza, chicken nuggets, fish and chips, macaroni cheese, soft drink and the like. Most items on it will arrive in the familiar shades of golden brown, red, and yellow, or a combination of these; seldom do the options include more nutrient-dense foods. Overall, not only do ultra-processed foods (driven by the food culture) lead to poor blood sugar control — resulting in energy highs and lows, lack of concentration, brain fogginess and cravings for sugar — they crowd the plate, leaving little room for nutrient-dense foods that contain essential nutrients for the gut and brain, both of which are gatekeepers for our overall health and wellbeing.
Children need the same nutrients as adults from the get-go to ensure they are nourished through important windows of development. Rsearch shows if these aren’t taken care of there will be lifelong impacts. Therefore we must ensure these nutrients are accounted for.
Following a Mediterranean eating pattern that incorporates fresh foods as a base has been found in research to positively influence wellbeing and reduce symptoms of depression and anxiety. This pattern incorporates fat-soluble vitamins A, D, E and K. Vitamin E isn’t too hard to come by (avocado and extra virgin olive oil are good sources of this, as are nuts). Vitamin K is present in several forms in our food supply. K1 is the easiest to come by, K2 is more difficult. Though some K1 is converted to K2, foods richest in K2 are organ meats, fermented foods, such as sauerkraut and natto (fermented soy beans), hard cheese, butter (in spring) and egg yolks (also a good form of vitamin A). Cold water fatty fish (salmon, sardines, mackerel) and cod liver oil are good sources of both vitamins A and D. Choline plays an important role in the production and breakdown of neurotransmitters, making it super-important for wellbeing. It is found in egg yolks and cuts of meat that are closest to the bone (such as oxtail, shanks and briskets). Protein in general also contains tryptophan and B vitamins which contribute to the neurotransmitter pathways in the brain, and carbohydrate-based foods (potato, kumara, yams, fruit, legumes) increase the production of serotonin (the feel-good neurotransmitter in the brain).
Iodine, selenium and calcium are involved in both metabolism and the brain’s ability to fight oxidative stress, higher levels of which progress the development of depression. Iodine is primarily found in sea vegetables, such as kombu (added into soups and stews) and nori (though lower in iodine). Using kelp flakes and sea salt as a seasoning is another way to get more iodine. Selenium is found in brazil nuts and seafood, and calcium is found in dairy products (choose low-sugar, full fat varieties), and in smaller amounts in the bones of small fish, sesame seeds and dark leafy vegetables. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are both essential fatty acids, which are crucial to brain development (especially DHA) found in fatty fish and shellfish, which also contain zinc, iron and copper.
With minerals such as those mentioned above, it’s best not to rely on the plant sources as these are not bioavailable to the same extent as they are from animal foods. This doesn’t mean that plant foods are useless. But if animal protein sources aren’t included in the diet then care needs to be taken to ensure there are adequate amounts available, which may mean supplementing.
The phytochemicals and fibre in fruit and veg are very important and including as many of these alongside a source of fat is a good way to ensure that nutrients in the plant foods are well absorbed. Adding greens and berries to a smoothie made with cream or coconut cream, or drizzling olive oil over vegetables are two examples of this. Fibre is important for feeding gut bacteria, and the gut is where 90 per cent of serotonin is produced.
Small changes can make big differences
Mikki recommends this walnut and chia porridge as a healthy breakfast option.
If the above sounds like a really big change in the way your family eats, and almost insurmountable, please don’t panic. The important thing is to have an awareness of how diet affects our brain (and wellbeing) and if necessary, start to make changes to the foods your family buys and prepares. Even small changes can make big differences over time. Start with breakfast, as this affects your ability to maintain stable blood sugar across the course of the day, directly influencing energy, concentration and mood.
1 Add coconut cream, cream, nuts and seeds to a wholegrain rolled oat porridge.
2 Pre-prepare a frittata for breakfast.
3 Saute green cabbage and serve with leftover mince and a fried or poached egg.
4 Add a smoothie alongside the usual cereal or toast, and incorporate a small amount of fruit, nuts or seeds, coconut cream and even a raw egg for more good fats and proteins.
5 Grate vegetables and mix with egg and seeds to make easy breakfast fritters to serve with bacon.
6 Make chia pudding from 3 Tbsp chia seeds and ¾ cup milk or milk alternative, to serve with additional nut butter, chopped nuts, low sugar, Greek yoghurt and sliced banana.
7 Chop and reheat leftover sausages and add to stir-fried spinach and mushrooms.
8 Blend 2 eggs with a small ripe banana and make no-flour pancakes to serve with low sugar Greek yoghurt or coconut yoghurt.
9 Serve 1 cup of cottage cheese with generous handful of chopped walnuts and thawed berries with a sprinkling of cinnamon.
10 Try my walnut and chia porridge recipe (pictured above).