Which Foods Are Best for Brain Health?

Since 2010, annual meetings of the American Psychiatric Association have included a new session on how diet may affect mental health: “Food and the Brain”.

In one presentation, psychiatrists Dr. Drew Ramsey and Dr. Emiliy Deans suggested that oysters are particularly good for the brain.

Dr. Ramsey is developing a standard “brain diet”. He said, “We want to help our patients develop more resilient brains by moving away from processed foods and refined white carbohydrates.”

The Evolution of Diet

We began by eating plants, insects and larvae, but added meat approximately 2 million years ago, contributing to brain development. Then, 1 to 2 million years ago, various roots and bulbs entered our diet. Agriculture developed approximately 6000-10,000 years ago, adding grains, dairy products and legumes.

Question 1: Which food group is most closely associated with brain evolution in Homo sapiens sapiens (modern humans)?

Answer: Shellfish.

Early humans evolved in Africa’s Rift Valley near a coast. Part of what makes us human is the omega-3 fatty acids and cholesterol in our brains, which are particularly abundant in oysters (the brain is 60% fat).

Oysters and other mollusks are rich in micronutrients, including B12, essential for myelin and neurotransmitter function and often deficient in people following vegan or vegetarian diets.

Question 2: Which dietary pattern is associated with greater anxiety during pregnancy?

Answer: Vegetarian and high-sugar diets.

Dr. Ramsey said, ‘Foods such as seafood, greens, nuts and beans improve people’s energy, confidence and engagement in self-care.’

Which Foods Are Best for the Brain?

How does Dr. Ramsey encourage patients to eat better for their mental health?

He asks what they have eaten for breakfast, lunch and dinner and requests meal photographs for a few days. He identifies healthy foods they enjoy and tries to incorporate them into their diet. “We should help patients choose more nutritious foods according to their resources and traditions. We should ask about allergies and childhood mealtimes, explore how people eat, and identify where we can make improvements.”

Seafood: Seafood is rich in brain-healthy omega-3 fatty acids. These fats are also abundant in plants such as chia and flax, but plant sources are not efficiently converted into docosahexaenoic acid (DHA), a key structural component of neuronal membranes. DHA also affects brain-derived neurotrophic factor (BDNF), which may benefit people with mood and anxiety disorders. Bivalves such as mussels and oysters are excellent sources of vitamin B 12 and zinc. Six oysters, each only about 10 calories, provide 240% of daily recommended B12 and 500% of recommended zinc. Seafood is also a leading dietary source of vitamin D, iodine and chromium. To address mercury concerns, Dr. Ramsey recommends small fish such as sardines, anchovies and herring, which do not accumulate toxic levels.

Greens: These provide fiber, folate, magnesium and vitamin K. Perhaps surprisingly, kale, mustard greens and bok choy provide more absorbable calcium than milk. Greens also contain flavanols and carotenoids with beneficial epigenetic effects. A cup of kale provides 600% of daily vitamin K, 200% of vitamin A and more than 100% of vitamin C.

 Nuts: Nuts once had a poor reputation because of their high fat content, but they are rich in healthy monounsaturated fats and help absorb fat-soluble nutrients. A serving of 22 almonds, only 162 calories, provides 33% of recommended vitamin E, plenty of protein and minerals including iron.

Legumes: Although Dr. Ramsey supports eating meat, he acknowledges that nuts and legumes are excellent alternative sources of protein and nutrients. Red beans are a naturally abundant source of antioxidants; 1 cup of lentils contains 18 grams of protein and 90% of daily recommended folate.

In conclusion, it is no coincidence that the Mediterranean Diet, containing all the foods above, has for years been chosen as the healthiest eating plan .

Are Plant-Based Diets Healthier?

Some data associate vegan and vegetarian diets with better mood. However, these patterns can cause B12 deficiency, which is associated with brain atrophy (shrinkage) and developmental delay. Supplementation is therefore important for vegans and vegetarians.

The average American consumes more than 200 kilograms of meat and fish annually. Dr. Ramsey commented, “This is not sustainable for the planet, particularly considering how much beef we consume. We want to help patients use meat and seafood more as additions to a plant-based diet.”

Small amounts of meat have benefits: hemoglobin-derived iron can be absorbed up to 40% more than plant-based iron. Unlike most plants, meat provides all amino acids needed for protein synthesis. Dr. Ramsey stressed choosing lean, grass-fed meat when possible.

What About Gluten?

According to Dr. Deans, gluten is one of today’s most popular health concerns.

Most people tolerate whole grains and gluten well. Approximately 2% of Americans have celiac disease and are allergic to even tiny amounts of gluten. Gluten sensitivity is more controversial: it is reportedly present in up to 6% of adults, but 11% now buy gluten-free foods. Gluten allergy is therefore being exaggerated.

People with schizophrenia have been shown to have significantly elevated antigliadin antibodies (gliadin is a gluten component). More than 23% had moderate to high levels, compared with only 3.1% of controls.

Dr. Deans said, “Perhaps we should screen our psychotic patients for celiac disease.” She described a very thin 37-year-old woman without a psychiatric history who became increasingly paranoid and psychotic over 1 year. She lost her job, became homeless and grew estranged from family and friends. Numerous medication trials were unsuccessful. When she eventually came to hospital, an endocrinologist suggested celiac disease because of her weight. Initially skeptical, she agreed to a gluten-free diet for 3 months and stabilized. After a gluten-heavy meal, her antigliadin antibodies rose again, and she returned to hospital. Dr. Deans said, “They called me and asked about medications.” She continued, “But I said, ‘No medication; just keep her gluten-free.’” The patient again improved quickly. “If we are going to recommend things such as brain MRI for first-episode psychosis, celiac screening is much cheaper and may be worth considering, ” she said.

Fermented Foods and the Microbiome

Compared with the 23 thousand genes in human DNA, our resident microbiota contain more than 1 million genes, known as the microbiome. These organisms benefiting from us also account for 90% of the cells in our bodies. Among other roles, gut bacteria help build immunity and aid digestion, making them critical to health. Understanding of their contribution to mental and physical health is advancing rapidly. Diet is one of the most powerful interventions for changing our microbiome.

There are 260 million neurons linking the gut and brain. Many resident gut bacteria also produce neurotransmitters and communicate with the brain through the vagus nerve.

Although probiotic therapy is relatively new, these resident organisms have clearly evolved with us and adapted to our diets.

 To the question, “What should we eat to build a better brain?”, Dr. Ramsey believes the focus should be on dietary patterns rather than isolated foods here and there.

Question 3: Which is healthier: raw or cooked food?

Cooking increases nutrient availability and reduces toxins, but vegetables may be healthier raw.

Question 4: Should we worry about recommending too many high-cholesterol foods such as oysters, especially to people with high cholesterol?

Dietary cholesterol does not affect blood cholesterol levels very much. A major cause of heart disease is high triglycerides, largely resulting from glucose and fructose consumption—in other words, sugar. However, patients with high cholesterol or other cardiovascular disease should ask their doctor or dietitian about nutrition.

Question 5: We hear a great deal about healthy spices. Can you comment?

Spices matter for flavor and possibly health. Studies suggest potential benefits from capsaicin in chili peppers. Others associate greater curry consumption with less dementia, and suggest rosemary extract may help prevent cognitive impairment. Dr. Ramsey commented, “Many spices seem to have healing properties.”

Question 6: Is drinking coffee and tea healthy?

Dr. Ramsey said, “I had a patient drinking nine diet colas daily. I switched him to coffee. It is still low-calorie, but now he gets healthy flavonoids. Tea is also one of my favorite ways to move people away from soda; many teas have antioxidant properties. Earlier this year, a Japanese study linked green tea consumption with a lower risk of dementia or mild cognitive impairment.” In short, coffee and tea are much healthier choices than carbonated sugary drinks.

Question 5: Is milk healthy for the brain?

Dr. Ramsey explained that milk is very nutritious and that he is neither for nor against dairy products.

Question 6: How Does Fasting Affect Health?

Fasting helps maintain a healthy weight and induces ketosis. Ketone metabolism has been shown to benefit the brain and improve cognition in people with mild cognitive impairment or Alzheimer’s disease. Medical advice is needed because fasting may pose risks for some people, especially those with diabetes.