The Better Brain (2021) is the culmination of two decades of data collection by Professor Julia Rucklidge (Canterbury University) and Bonnie Kaplan (University of Calgary). These two leading nutrition for mental health researchers have been the force behind the growing field of nutritional psychiatry. 

Well-balanced, robust and non-sensationalist, this book is the one to read if you want to understand nutritional psychiatry for mental health treatment or prevention - what it is, how it works, and how to apply it for you or your family.   

As an Integrative Clinical Psychologist, I love that today some clients now come to me with The Better Brain in their hand asking me if I’ve read it and what I think about it - they are informed, interested, and open to nutrition all because of this book. 

There has been a lack of nutritional science in health and mental health training. Doctors, nurses, psychologists and psychiatrists historically receive mere hours of nutrition content in their years of training. Those working in the area of eating disorders (EDs) perhaps learn the most and include the potential for addressing nutritional deficiencies (e.g., Iron and B12). However, even this is limited to the resolution of disordered eating through caloric intake and does not focus on nutrition to alleviate anxiety, depression or other factors that tend to underly or co-occur with EDs - such as using an anti-inflammatory diet or regular multi-nutrients. 

Psychological therapy and psychiatric medications have become the mainstay of treatments promoted and sought. But there is a treatment gap where there is now more demand for services than available or affordable, and many people are left to manage alone. For those who can access services, a number of people find these interventions partially or fully beneficial, although when it comes to medication many adverse effects can occur - such as weight gain, sexual dysfunction, and feeling emotionally numb, not to mention finding it hard to discontinue use. However, a substantial number (the book indicates data suggests it is approximately 50%) don’t find benefits to either therapy or medication. What other options exist for this group? And for those who may wish not to use medication due to side effects. 

Enter nutritional psychiatry! 

While the authors acknowledge the complexity of mental health causes and solutions and don’t suggest that nutrition will cure all mental health ails for all people, they lay out the explanation of what their research has found for various populations.

Here are the key points:

The brain is the most hungry organ accounting for 20-40% of all energy demands - we primarily eat for our brain.

Nutrients are what create our brain's structure and cellular functioning - vitamins and minerals, amino acids found in protein, fats - which line the nervous system and help with nerve conductivity, and other compounds such as flavonoids.

All nutrients are needed by the brain, and so just taking one or two hasn’t often been supported through randomised controlled trials - hence the research focusing on high-quality multi-nutrients. The combination, dose and type matter so common supermarket products won’t cut it in most cases. 

Nutrition impacts for better or worse on bodily inflammation which is now understood to contribute to mental health symptoms like depression via the immune system and cytokines that are released. 

Ultra-processed foods form part of the modern diet which are really non-foods that comprise simple carbohydrates (sugar), inflammatory trans fats, and various chemicals used as additives to enhance appearance and taste or preservatives that extend shelf life. These ultra-processed foods can adversely affect mental health.

Nutrients from food won’t always be enough for various reasons so getting all your needs from food alone in the modern context of ultra-processed foods, changes to soil and nutrient availability, and sprays used agriculturally may not be possible anymore. 

This is especially true for those who experience lots of mental health symptoms that can arise from genetic differences in how the body metabolises some nutrients (e.g., B vitamins) from food or which require a greater level to feel optimal. This is especially true when under any additional stress where demands for nutrients will be increased and mental health relapse may occur.

This is due to the increased demands for nutrients due to the fight-or-flight response - prolonged stress may result in inadequacy or deficiency through the triage theory where these nutrients are prioritised to support the stress response.

Medication use is also a factor as certain medications block the absorption of nutrients - one common example is the oral contraceptive pill which affects several critical nutrients including the B vitamin Folate - which deficiency of can cause depression.  

Those who are pregnant or chronically ill can also be affected by the triage theory - where the body will use up nutrients to prioritise the most important demands - such as growing a healthy foetus or fighting illness - before the brain. Aging is another stage in life when there may be a higher demand for nutrients.

Anyone on a vegan diet - now popular due to concerns about climate change and animal welfare - will also struggle to meet nutritional needs without supplementation. This is because many of the critical mental health nutrients such as B vitamins, Iron and Zinc are abundant in animal proteins but very hard to find in sufficient quantities from plant sources (e.g., B12 is absent unless you consume meat or eggs). This group will have to supplement but if mental health symptoms have arisen or worsened in the months or years following a change to a vegan diet then this is worth exploring further to ensure you meet your nutritional needs for your best mental health.

As a psychologist who has used nutritional interventions alongside therapy for the past seven years, I’ve had a front-row seat to the kinds of profound changes that can occur for people making dietary changes or utilising supplementation to support their mental health. 

Some of the changes people have reported: 

• Deeper and more refreshing sleep

• Emotional regulation becomes easier 

• Clearer brain and reduced brain fog

• Reduced anxiety or panic attacks

• Improved mood and less anger or irritability

• Increased energy and motivation 

• Reductions in alcohol use and cravings

• Less binge eating or cravings for ultra-processed foods

• Increased perceived resilience to cope with stressors

• Reductions in relationship conflict 

• Pre-menstrual syndrome is reduced or gone

• Feeling able to transition off psychiatric medication

• Physical health symptoms have improved - clear skin and disappearance of acne, less joint achiness, weight loss, periods less heavy and painful, and perimenopause symptoms easier.

While my approach usually hasn’t involved the exact products that are used in the research it increasingly has involved a multi-nutrient over single-nutrient approach, or, if single nutrients are used these are combined over the day (e.g, B vitamins in the morning and magnesium taken before bedtime). 

Given that so many people are found to benefit from nutritional interventions for mental health and the overwhelming available data, nutritional change is a safe, empowered and reasonably accessible approach for many people. The Better Brain will help you understand exactly why and how to nourish a better brain whether it’s through dietary changes (with even some shopping and recipe ideas thrown in) or nutritional supplementation and it’s a highly recommended read.

It says on the cover “One of the most important books of the year” - which I would upgrade to “of this century”.