Over a decade ago, when Dr. Drew Ramsey was writing a book on a diet that could make people happier, he found himself on the streets of New Orleans looking for a bite after late-night revelry at a wedding. Despite it being morning, he ordered a plate of oysters.
“New Orleans was the first place I ever had oysters for breakfast,” he recalled.
The mollusks became an oft-recommended part of his clinical practice as a nutritional psychiatrist when patients came to him with problems like anxiety and depression. Oysters are rich in vitamin B12, shown to protect against brain shrinkage. They also have omega-3 fats, which promote cognitive function. Elements like zinc and iodine keep brain connections strong.
Dr. Drew Ramsey, a nutritional psychiatrist, is the author of several books on the impact of diet on mental well being.
“A small East Coast oyster has about 10 calories, but for those 10 calories, you just get this incredible buffet of brain nutrition,” said Ramsey.
Ramsey is part of a growing field of practitioners who have added a grocery list to their arsenal of mental health treatments. Nutritional psychiatrists counsel patients on how loading up on foods packed with certain micronutrients can lead to better mental health.
“The problem that most people are having in regards to feeding their mental health is that we’re eating a diet of primarily ultra-processed foods,” said Ramsey. “And these are just missing some of the essential nutrients that we need for optimal brain health.”
The food-brain connection
Although the idea that food can influence mood is new to some, the body of research is growing.
Research has shown that diets higher in saturated fat, refined carbohydrates and processed food led to worse mental health among kids. Another study found that adolescents with low-quality diets are 79% more likely to have depression.
An Australian study found that a Mediterranean diet — focused on vegetables, fruits, fish and nuts — lowered self-reported depression in participants by 45%.
Bistro Salad 2.0, chicken spinach salad with fresh strawberries, candied pecans, feta cheese and pepper jelly vinegarette, at Bistro Byronz which has moved and reopened in the old White Star Market located at Square 46, 516 Moore Street Tuesday Oct. 19, 2021, in Baton Rouge, La.
Another randomized controlled trial found that participants coached to follow a Mediterranean diet for three months had mood improvement and lower anxiety. Members of another group in the study who received general social support did not report such changes.
The impact of diet change in Louisiana could be significant. About one in five adults in Louisiana report frequent mental distress, according to the 2023 America’s Health Rankings. About 40% of residents said they have symptoms of anxiety or depression, according to a 2023 survey.
At the same time, Louisiana residents struggle to eat a healthy diet. About one in seven people — over 680,000 — in the state live with food insecurity. One-third are children.
Without good options for healthy food, many households turn to less nutritious, cheaper options such as fast food that doesn’t keep people full as long, raises blood sugar and drives up cholesterol. Roughly 40% of adults are obese in Louisiana, one of the highest rates in the U.S.
Dr. Annie Yeh, a New Orleans-based integrative psychiatrist, sees a chronic state of stress in many of her patients related to long-standing trauma. She sees patients who are struggling with finances, whose housing is unstable and who have post-traumatic stress disorder from Hurricane Katrina or difficult childhoods. Discussing nutrition is a key part of her early appointments, though it can be overwhelming for people who are just trying to keep afloat.
“Food can be such a charged topic,” said Yeh.
For patients who are ready and able, she asks them to pick one meal per day to make changes. For some, that looks like choosing a bag of potatoes over a bag of chips at the grocery store. The potatoes take a lot more time to wash, cut and cook, but the benefits are immense.
“The difference in the nutrients is that the bag of potatoes is going to have much more fiber, it’s going to have potassium, it’s not going to have gone through the ultra-processed, deep-frying process that the bag of chips go through,” said Yeh.
A diet high in processed food can lead to higher levels of inflammation, said Yeh. That makes people feel sluggish. It can also impact sleep. Over time, inflammation can translate to disease, both physical and mental.
The Antidepressant Food Scale
Armed with more knowledge about what nutrients a brain prone to depression is most starved for, Ramsey created the Antidepressant Food Scale that focuses on 12 nutrients shown to promote recovery.
In good news for Louisianans, oysters topped the list of animal foods with a score of 56%. But plant foods packed a bigger punch.
Foods like watercress, spinach, greens and lettuces, Swiss chard and fresh herbs such as cilantro, basil or parsley all scored over 70%.
Despite a reputation for a poor diet, Louisiana foods like gumbo, red beans and seafood are nutrient-dense and ideal for brain health, said Ramsey.
Clams, shown in this dish from Fausto’s Bistro, are a good source of B12, which is shown to prevent brain shrinkage. (Staff photo by Ian McNulty, NOLA.com | The Times-Picayune)
“Oysters are great, but so are clams,” said Ramsey. “Clams are the top source of vitamin B12. And other crustaceans like crawfish, crab, and other shellfish that are part of the traditional Cajun diet are really amazing foods for us to have in our dietary pattern.”
When researching recommendations, Ramsey and other brain health specialists look to the Mediterranean diet and Japanese diet associated with good mental health. Traditional Louisiana foods may have their place next to such diets.
“People might not automatically put a Cajun diet on there,” said Ramsey. “But I suspect that, done well, it really is a traditional diet that would support the type of robust mental health findings that we’re seeing for a Mediterranean diet.”
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