Jono (00:16)

Welcome back to the Bite Me Nutrition podcast. I've got Jenna here again with me today. Now I'm sure regular listeners, which is a strange sentence, but regular listeners and followers along would already know who Jenna is and definitely probably know her as the CrossFit person, the Eat Before You Train person, the Gym Myth person, and all of these other areas. But we're going to talk about something a little bit different today. And I'm very excited because it's a very important topic. We're going to be sort of talking more about

diet and its impact on, we'll say mood disorders, acknowledging that that's a very, very broad spectrum will be focusing primarily on anxiety and depression. But I think there's probably going to be at least a few nuggets in here for people who might be struggling with other struggles on that spectrum. But I guess why are we not talking about CrossFit today? Why? Why are we talking about?

this topic wise is important to you.

Jenna (01:17)

Yeah, yeah. I guess, you know, it is strangely, it's something that you'll find in a lot of professions, the things that impact us most in our own personal lives, and maybe the people around us is the things that we are more excited about. I like why I like to talk about CrossFit. I love CrossFit. And so mental health is something definitely in the last kind of five years, I've gotten more, I guess, passionate about more in, you know,

going through my own mental health journey as well has definitely encouraged that. And it is something that I do believe that as dieticians, we have a massive role in this space and helping to support people with mood disorders and even other kind of psychiatric conditions as well through food. Yeah, so I mean, I guess without making this a bit of a therapy session.

I won't trauma dump on you too much. But no, I do feel, especially like I said, in my own journey with mental health, one thing that I have discovered is that the more vulnerable we are, the more we talk about our experiences, the more we can connect with people. And it's often a space that is very isolating. So to, I guess, fill you in on my own personal experience. So I...

received a diagnosis, generalized anxiety disorder and major depressive disorder would have been about this time last year. I've known that I've got anxiety and depression for a very long time. I really didn't need the diagnosis. And it has been something that I personally have struggled with, especially like looking back from a teenager, early twenties. My mother also had her own mental health struggles. Wasn't

the most emotionally intelligent person. And obviously, you know, that kind of stuff gets passed on. So I, my anxiety is probably the biggest thing that I struggle with, mainly coming from, you know, you wouldn't think it now, I'm not very good at communicating my feelings. A lot of people pleasing a lot of feeling like I'm not good enough. So I'm sure that there's plenty of people out there that can probably relate to those feelings. And so that's a

through my journey, I've discovered that that's that's my massive trigger. And so I guess like fast forward to the last five years, where I really kind of started my journey, really need to find a different word for journey, but it doesn't matter. It's the only word it really is. I found myself in a long term relationship, you know, in hindsight, dating someone.

Jono (03:52)

It's the only word. It's the only word.

Jenna (04:03)

that was very similar to my mother that treated me in a very similar way to my mother. And from there, I think I kind of hit my rock bottom. It was very controlling and emotionally abusive and a lot of a lot of those kinds of things. And from there ended up in couples counseling. And I believe within like the first five minutes of meeting my psychologist, he was like, we need to work on some things. So from there was really engaged with

therapy for every two weeks to monthly to now I'm kind of on an as needs basis. But spent a lot of time doing CBT. I always want to say AMDR because it's a nutrition acronym, but EMDR, hypnotherapy. So I like, I've done it all in therapy. And so, kind of got a handle on a lot of.

that situation ended up leaving that relationship was in a far better place from there. And then, you know, life kind of carried on and it wasn't really until, and I don't know if I've shared this with you, wasn't really until I started working with ByteMe Nutrition that my anxiety reared its head again. Definitely, you know, I'm sure a lot of people can relate starting a new job, the imposter syndrome.

Again, not feeling like I'm good enough. The social media side of things, it can be a lot. And that sort of first couple of months, I was definitely running on pure anxiety. And so from that point, I kind of decided also around that same kind of time, my mother did pass away and her mental health was definitely a contributing factor to that. And so that was kind of a bit of a, I guess, a wake up call for me in that.

cool, all right, I maybe need to be doing a little bit more than what I'm currently doing. And that's when I went to my GP, I got the diagnosis and I started taking Lexapro, the good old fashioned SSRI. And so I guess, thank you for letting me indulge in my own personal story, but I guess it's a nice kind of segue into what we're gonna talk about today because I really wanna highlight to people,

You know, being a dietician, one could argue that I know how to eat, what to eat, you know, that kind of thing. I've also exercised, you know, five to six times a day, I've done some kind of movement in, if anything, for a number of years. I engaged in therapy, I take an antidepressant, and there are still some days where my anxiety and my depression are, you know, level eight, level 10 on a whole.

a lot better. But I think it's just important to recognise that mental health is complex. There's so many things that go into it. And to be wary of any of these kind of, you know, messages, especially influencers, social media that talks about curing your mental health or your mood disorder. Because what you might find is you try one of those things and it doesn't necessarily work for you.

And then you're left kind of feeling more vulnerable, more isolated because, you know, there must be something wrong with you. And there's definitely not. Um, so I guess the whole goal of this podcast, um, is to really dig a little bit deeper into the diet side of things and some things that we do know that work, um, and help give you, I guess, a few more tips and understanding around how diet has a, has a role in all of this.

Jono (07:47)

Yeah, yeah, absolutely. And exactly like you said, like, if it was just a case of knowledge, you kind of got it all, like you've been doing all of the right things, right?

Jenna (07:59)

I mean, maybe I should like start selling my own. No, it wouldn't. It wouldn't be ethical. But yeah.

Jono (08:04)

We would need to talk, but... Well, no, no. So yeah, thank you for sharing your journey. Quest is another word that I've heard, but that's a bit... But no, I realize I'm making light of a very serious situation. So thank you. Yes.

Jenna (08:20)

Yeah, if you can't laugh about these things then you know it's it's a part yeah.

Jono (08:23)

Yeah, sure. But no, thank you. And like you said, understandably why this is an area that is, I mean, I think it's going to be relevant for all of us because we've got clients struggling with this. But like you said, you've got that really personal connection to it. Let's say you weren't a dietician and you decided you were going to Google, Google, what can I do? Right? Because as we know, that's definitely the safest and best way. Yeah.

Jenna (08:42)

Mm.

Good old Gecko.

the first step.

Jono (08:51)

What would, what sort of like, what are the things, what are kind of the, I guess, the main few dietary interventions that we might find there?

Jenna (08:59)

Yeah, so the big two things that are going to pop up, number one, good old fashioned Mediterranean diet. We love the Mediterranean diet. We'll probably spend more time talking about that one. And then the other more emerging research now is coming up around that sort of gut brain axis and the role that our microbiome can play in our brain health. So they would be the two big things to be paying attention to. Anything else is...

probably stuff that you can ignore. Yeah.

Jono (09:35)

Yeah. So I mean, I think part of the law of being a dietitian is you have to love and support the Mediterranean diet or like, so, um, what is the Mediterranean diet? What is, yeah. What is it?

Jenna (09:50)

Yeah. So the Mediterranean diet is I guess a diet protocol that we recommend. It follows more of an emphasis on fresh fruit, fresh vegetables, whole grains, legumes, nuts. A really big solid foundation of it is things like extra virgin olive oil in our fatty fish, in our, you know, the healthy fats, steering away from...

processed foods and red meat consumption. So it really has an emphasis on those whole foods and the omega -3, our healthy fatty acids as well. So from a mood disorder or a mental health kind of lens, it's a diet that we know is rich in a couple of key ingredients. So zinc, magnesium,

B vitamins and like I've already said, like your healthy fat. So they're the big four contributors and we know that each one of those kinds of individual nutrients, so omega -3s in specific EPA impacts what we would call these neurotrophic factors. So they promote the growth of new brain cells. They're really important in our cognition and emotion, zinc and to...

similar kind of extent magnesium are really important in modulating some MDMA, MDMA, MD, NMDA, oh, it's a tricky acronym, receptors in our brain. And they're very important in regulating mood, serotonin uptake, all of that kind of stuff. So that's the reason why we're interested in those, those nutrients specifically, but also on the flip side, kind of bringing back in this gut microbiome.

side of things, it's a diet that's high in fiber. If we're consuming more fresh fruits, more vegetables, more whole grains, legumes, nuts and seeds, we're going to be getting more fiber. We know that fiber is great for our gut microbiome. They're going to ferment them into other products that are going to be able to cross that sort of blood brain barrier and influence our brain health as well. So that's kind of why we kind of are interested in the Mediterranean diet. We also know that

Like you said, dietitians, if you don't love the Mediterranean diet, then we'll take your badge away because it also, it reduces your risk of a lot of other chronic diseases. So things like cardiovascular disease, type two diabetes, and people who suffer from mental health disorders are at greater risk of a lot of these conditions as well. So it's kind of two burns, one stone, which is amazing for like a diet protocol.

Jono (12:39)

Yeah. Yeah. It does seem to do it all. Hey, which I guess could probably talk about the smile, smiles, smiles. I should know that we're talking about it just before the smiles trial. Uh, do you know what the acronym is offhand? I'm putting you super on the spot. It's okay if you don't study Mediterranean something. Yeah. Yeah. It doesn't matter. Everyone. Yeah. Yep. Yep.

Jenna (12:45)

Mm.

Oh, no, I don't. It's got something to do, yeah, yeah. We just know it as a smiles trial.

Jono (13:09)

For those who don't know studies often get big funny acronyms that they sometimes work, sometimes don't that design that explains the purpose of the study. And then they just call it the SMILES trial, which is also ironic with the mental health. I'm sure that's no accident. Well done. Well done. So yeah, let's talk through that trial. Why is that? Why is that the one we always talk about when it comes to this? What happened? What could we take away from it?

Jenna (13:23)

Conveniently, I think that they worked that acronym.

Yeah, so the SMILES trial, there is another trial as well. It's a kind of a very similar one. It was a very similar protocol. So there's two big ones out there. But the SMILES trial was a research trial that was conducted here in Australia. And it is our best evidence to date of a causal role of diet improving depression symptoms. So it sounds incredibly promising.

And so what they actually looked at was they used a modified version of the Mediterranean diet. So the principle was still very much the same that focus on the fresh fruit, vegetables, fatty acids and all that kind of, sorry, Omega -3s. But they also included a moderate intake of red meat. And this is because red meat is a good source of iron, also zinc and our B vitamins, which we know, already talked about are important for our brain health. So.

What they did is they collected a group of participants that had a diagnosis, and this is really important too, because there is tons of research out there. This one looks specifically at people that had a diagnosis of major depressive disorder, understanding that depression has a spectrum. So you can have mild to moderate to major depressive. And so all of these participants had that diagnosis and they also had a self -reported poor intake.

of the things like fiber, lean proteins, fruits and vegetables. So the things that they weren't including in their diet were the things that we were going to add in. And so lo and behold, what they found was there was a improvement in the depressive symptoms. So yeah, improvement in depressive symptoms with the dietary intervention. Sounds pretty good. Sounds like another gold star for Mediterranean diet.

Jono (15:34)

wish three points. We're done here. Right. Just, just you depressed Mediterranean diet. Yep.

Jenna (15:40)

Yeah. Yeah. And I mean, I guess if we dig a little bit deeper into that SMILES trial, and this is by no means a dig at, you know, anyone that uses the Mediterranean diet as a way of helping to support people with mood disorders. As dietitians, I think that we get excited by this kind of stuff. Like we see the nutrition science, we see, you know, okay, well, we know that these nutrients are going to have an impact. And so we can we

can kind of cling to that. And if we dig a little bit deeper, especially into these studies, there are some other things that start to pop up. And so when we look at the two groups that were in this study, so both groups had the major depressive disorder diagnosis. One group specifically received individual advice from a trained dietician. You and I know that a big part of our study,

is not just the food, it is the counseling side of things. So techniques around like motivational interviewing, goal setting, this other, you know, patient centered care. So essentially what this means is that we're sitting down, well, these, these, this group sat down with a dietician, talked through, well, what does your life look like? What does your food preferences look like? How can we make food work for you? Gave them a lot of skills around time management.

how to make recipes, how to adapt recipes, label reading, created meal plans for them, made it a very comfortable and confident environment. And then on the flip side, the control group was what they called a social support or a befriending condition. So these this control group received no dietary intervention, and they didn't receive the same

I guess, counselling that you would from seeing someone like an APT. And so they still visited on the same schedule. So they were visiting, I believe, bi -weekly for every half an hour to an hour, depending on where they were. So they still visited the exact same frequency, but those sessions, instead of being, I guess, semi -counselling through nutritional strategies, were more focused on talking through neutral topics of like,

sports and the weather. And if we couldn't have those conversations, then they were going to do play games and things like that. So it was very much, you know, the conversation was not around depression, your symptoms, your experience. It was just very surface level. So immediately there is a major difference in that control group to the our intervention group, not only from the dietary things that they were eating, but from, I guess, a

a personal level and a personal connection. And so it highlights a really big aspect into what we're doing in that, you know, we have other research that shows that when we just look at dietary interventions alone, so without the kind of counseling, diet really only has a very small effect on...

you know, the symptoms of depression and anxiety. So there is a lot more to it than just the kinds of things that you're eating, which, you know, leads us kind of into, okay, well, does that mean we shouldn't be doing the Mediterranean? What should we do? Like, you know, where do we go through, go from here? It's kind of like the next steps.

Jono (19:25)

Yeah, yeah. Just if anyone from dietitians Australia is listening, we do love the Mediterranean diet. And we're not saying we're not saying anything bad about it at all. No, I think we've all been guilty. Well, maybe not all, but a lot of us have been guilty of yeah, just sort of just slap a Mediterranean diet on it, right? Or just like, that that that will solve everything without thinking about the application of that there's significant barriers in the way of being able to

stick to the Mediterranean diet. And then like you said, in this trial, what how much of the benefit was specifically the nutrients from that diet versus the very different counseling, goal setting, behavior change, motivational interviewing kind of, you know, techniques that were used. So it's almost like this is really complex and nuanced. And there's a lot of different factors at play.

Jenna (20:21)

Yeah, yeah, yeah, yeah. It's, yeah, I mean, you start to understand now why like you, there is no one size fits all. And we say this about everything, no one size fits all. You can't cure these things because there is so much, yeah, like nuance to a lot of these complex conditions. And that's not just, you know, mental health, I could, you know, relate to tons of other conditions as well. But yeah, we can get deep.

Jono (20:25)

Probably not.

Well, so in terms of, let's say that we all agree that the Mediterranean diet is good. Like we're not saying it's not helpful, but maybe there's a big gap between suggesting someone follows it versus it actually coming to help. And exactly like you said, let's just reiterate for the, continue to reiterate, this is to support your overall mental health journey in conjunction with many other treatments, whether that be cycle, like,

counseling based with a psychologist or psychiatrist or other counseling professional, or whether that be medication like pharmaceutical intervention, or both. Right, those are still always going to be our frontline things and then diet can come along and help out, right? Not cure stuff. Just have to say that. But on that, so instead of just saying, Oh, do the Mediterranean diet, what are some like sort of practical because I know you see lots of clients that are like kind of navigating this quest.

Jenna (21:32)

Absolutely.

Jono (21:47)

And, you know, help them, like, what are some of the strategies that you find really helpful? Some of the more practical ones.

Jenna (21:47)

Mm.

Yeah, absolutely. I think, you know, not to completely rule out the Mediterranean diet, I think definitely when you're in those, you know, the ups of your mental health and your mood, when things are going good, you've got that routine, that structure. Absolutely. We know that, you know, following the Mediterranean style diet is not going to do you any harm if anything, you know, we've seen that there could be some slight improvement. So when things are going great.

That is what we should be focusing on those whole foods, our mega three fatty acids, eating regular meals, all of that kind of stuff. Flip that on its head. What do we do if and when we go through another depressive episode or our anxiety starts to creep up? I can tell you from personal experience, I ain't eating like some smoked salmon. I'm sorry. That's the last thing that I feel like doing. So a lot of people...

especially that struggle with mood disorders, we have to think about the symptoms of what occurs in that episode. And so motivation can often be low. We start to see a change in our appetite. And then there's some pretty, look, I'll call it scary statistics out there that 55 to 97 % of people with mood disorders will also experience an eating disorder.

or some other kind of disordered eating behavior. And so that's huge, whether that comes from a restriction due to lack of appetite or other coping mechanisms or binging. So we have to understand what is that person experiencing? What can we then do to help them navigate that time in their life to help support them to get to that other end where we can then cuddle them with the Mediterranean diet? So a few things that I...

Jono (23:49)

I want that on a t -shirt. Cuddle me with the Mediterranean diet. Sorry.

Jenna (23:50)

Just wrap me up in a salmon fillet. So there's a few things that I work with a lot of my clients is working through some structure. So we've got the structure of when things are going great. This is what we're focusing on. Now what happens when things are going great? Can I fall back on my usual structure? So my meal planning, what are my usual breakfast options? What is my usual lunch options? Grocery shopping. So.

having that baseline to start with is always key. And then from there, we've got the other nuances of like, okay, well, what do I do when my appetite is low? I know that, you know, the baked beans and toast that I eat 99 % of my life, it's not gonna change today. The only thing that has changed is that I feel anxious. I don't have an appetite. These beans, you know, cut it every other day, so they'll cut it again today. So it's reminding yourself of like,

You don't still need to eat. I enjoy these foods. Sometimes that's not often enough. And so it's working through those barriers of, okay, well, why don't I have an appetite? Something is always better than nothing. How do I create these meals that are, you know, good enough? Because at the end of the day, a piece of toast is far better than, you know, two cups of coffee and nothing else for the rest of the day. Yeah, yeah, yeah.

Jono (25:15)

I hope everybody heard that.

Jenna (25:18)

And then from there, the, oh, I'll tell you what. Anyway, that's another rant for another day. So outside of, I guess, like the appetite side of things, it's then working through, OK, well, what plan B options do I have? What things can I keep in my pantry that I can keep in my freezer that, you know, non -perishable? So when my motivation is low and say I haven't gone grocery shopping for a week, I still have options that can tick boxes.

Jono (25:19)

and feels attacked.

with love.

Jenna (25:48)

I can still put together an assembly style meal when my brain power is low because no one wants to be cooking this big elaborate meal. It's a struggle just to get out of bed to do your daily functions, let alone cook a massive meal. So if I've got something that I can throw a few ingredients together, microwave it, that's going to help set me up better than trying to force myself into cooking this massive meal. And then I guess the final kind of

piece of this is understanding that, you know, you can't rationalize with a hungry brain. It's something that we know and even specifically in treating, you know, eating disorders. The first step for a lot of those severe eating disorders is getting the brain back into function. So getting food back into the system so that we can start to make rational decisions. You're not going to be able to

pull yourself out of your depressive episode or your anxiety if you're not feeding your body and giving your brain the nutrients that it needs to function properly. So it's kind of combining a lot of those tips and tricks together to get you, I guess we could call it your survival kit of how do I survive my depressive episode or my anxiety episode to get me through to the other side. That's where the value lies with seeing a dietitian.

to help you come up with those strategies that work best for you around your personal food preferences, all of that kind of stuff. So that's the thing that we need to be focusing on more than the Mediterranean diet, in my opinion. In my opinion.

Jono (27:32)

Yeah. Yeah. Yeah. Or I don't know if it's just an opinion. I think it's stronger than that. You can claim more than that. No, I am. I was talking actually literally with like three clients in a row today about making, um, making your bad days better. I feel like that's more important in nutrition than like really fine tuning the good days because like, you know, that's important to, like you said, like absolutely when you're having a good run, like focus on the Mediterranean diet, try and maximize nutrient intake, et cetera, et cetera.

Um, but the reality is, unfortunately, there's going to be some low days or a string or, you know, low periods. So, um, yes, having a survival kit can really save you and, um, shorten those load ones as well. Like you said, you can't rationalize with a hungry brain. So the quicker we can get something in, you know, the shorter those episodes are potentially going to be in conjunction with talking to your mental health professional and medication.

Jenna (28:15)

Absolutely.

Jono (28:30)

I'm going to keep driving that home. Yeah. Yeah. Yeah. Yeah. Um.

Jenna (28:31)

Yes, absolutely, absolutely. Yeah, yeah. Diet alone, like diet is great, but diet alone is not the answer for everyone.

Jono (28:41)

100%. Yep. And this is two dieticians who obviously care enough about food to go back and devote way too much of our life and finances to studying this. Right. So like when we say food's not the first line of defense here, please trust us. Awesome. That was so good. Yeah. Huge red flag. Huge red flag. That's a yes. Yes. So look.

Jenna (28:52)

You

And don't trust anyone that doesn't say that. I guess is the other. Yes.

Jono (29:12)

really good nuggets in there. That is a horrible word actually, nuggets, but some excellent diamonds, gems. So make sure you go back and listen through that with a pen and a paper, build your survival kit, look at some of the strategies that Jenna was talking through. As always, if you need help, you want a third brain, a second brain to help you build that toolkit. And I know I've seen your toolkits. There's a lot of...

Jenna (29:21)

Gems.

Jono (29:41)

cool products out there on the shelves and in the freezers and stuff that we can, you can build a really awesome meal with really low effort these days. It's where we're really lucky. So yeah, if you want any help with that, either flick general message at Jenna Stein, of course I'll link on Instagram. If you got to be following her right now. So I'm not even gonna, I'm not gonna link her. There you go. Yeah. Figure it out. Nah, I will.

Jenna (29:47)

Mm -hmm.

Surely, surely.

Jono (30:04)

But you know, if you want to have a chat further, make sure you chat to her or you flick us an email. Otherwise, I hope this was helpful. We'd really appreciate if it was helpful. We always like seeing it out in the wild in the stories. So throw it up there and tag Jenna and myself, mostly Jenna. She did the valuable bit. And, or just as importantly as well, if you found it was valuable or there's someone in your life who you feel could really help, really benefit from hearing this, we'd love for you to share it with them. So on that note.

Jenna (30:27)

Mm -hmm.

Absolutely.

Jono (30:33)

Thanks so much, Jenna. Thanks for your open and honest discussion today. Thanks for giving me the phrase, cuddle you with the Mediterranean diet. That is gold. Love it. I'm there. I'm so there. I'm so there. Wrap me up in some smoked salmon, like you said. So yes, thank you so much for the lines, but also the valuable information. And yeah, we'll get you back on to chat about some other stuff further down the line.

Jenna (30:40)

We're going to have to bring out a line of t -shirts. It's just, it's happening.

Not a problem.

Jono (31:03)

Cool. Thanks. Bye.

Jenna (31:05)

Bye.