bigstock-140454893Conventional wisdom is that breakfast is the most important meal of the day. Is that really true, and if not, why is it so often repeated by nutritionists? Is it possible that conventional wisdom about breakfast is counterproductive for depression?

Let’s explore it. 

Conventional wisdom about breakfast states that eat a healthy breakfast to lose weight and avoid cravings later in the day that lead most people to end up going for the vending machine or some other unhealthy snack that’s in the work lounge or refrigerator. As a result, nutritionists advocate for eating a “healthy” breakfast and therefore feel satisfied, making it less likely you will reach for the nearest sugar-packed processed food. 

It is true that most people don’t plan properly and if they skip breakfast that late morning or lunchtime sugar bomb is not a healthy way to go. 

However, what if the assumption about the midday sugar bomb is wrong, and people actually planned properly to have a healthy nourishing meal at lunch? Is breakfast still important, and by skipping it could you actually help your depression symptoms

What if I told you that skipping breakfast, as long as you eat a healthy midday meal, can raise chemicals in your brain that combat depression? Well, it’s true and supported by science. 

The approach I’m talking about is intermittent fasting. Intermittent fasting is defined as having a window daily where you do not eat, that includes the sleep hours. Typically this fast involves 12-18 hours. On the flip side, your eating window is about 6 to 12 hours a day. So for example, you eat your last food at 7pm at night, and your next food item at 11am the next day, that’s a 16 hour fast. 

So, what happens to your body and brain during that 16 hour fast, that might help treat depression? 

Two Important physiologic changes.

First, it’s BDNF, or Brain-derived neurotrophic factor. In a study out of Korea, College of Medicine Department of Psychiatry, BDNF is depressed in patients with major depression. Interestingly, treatment with conventional anti-depressant medications can raise BDNF levels. BDNF is vital for the formation and plasticity of neuronal networks, and of course these networks are involved in depression. A study from the Neurobiology of Disease 2007, showed that BDNF can go up between 50 and 400 percent with alternate day fasting. 

The second, is Ghrelin. Ghrelin is the so-called hunger hormone, and this hormone rises when you are hungry, or fasting. High levels of Ghrelin have been associated with elevated mood. In a study published in the Journal Molecular Psychiatry, Ghrelin has found to be a natural antidepressant that promotes neurogenesis, and also that Ghrelin rises during times of fasting. In another a study from the Journal Nutritional Health Aging, calorie restriction resulted in improved mood and depression among men. 

So, I know you are thinking, ok, it can help, but I’m going to starve to death and pass out. The fact is, humans for centuries have fasted. It’s part of many cultures and also part of alternative treatment plans for cancer patients and even many professional athletes. For many people, they do this for weight control, and to increase lean muscle mass to fat ratios. It has been shown also to improve cognitive function and energy levels.

Also, and most importantly, it’s very simple.

An approach I recommend to people, as long as it’s ok by their doctor is the following. For some people, intermittent fasting may result in a feeling of fatigue, especially early on, but if you can get used to it, it may be a magical elixir for your depression and anxiety.

First, make sure you have plenty of water and you should drink water generously during the fasting period. Second, your last meal of the evening should be high protein and also a fair amount of healthy fats. No carbohydrates, no sugary foods. It’s easiet for most people to start with a 14-hour window and gradually increase it to 15-18 hours, once they get used to it. Black coffee or tea is ok. Water is of course required, and should be drunk regularly throughout the fast.

Most people have a paradoxical experience. After the first couple of days, they stop feeling so hungry and get used to the empty feeling in their stomach, but realize they don’t need to eat to keep working or being active. In fact they have more energy! How, because their body uses fat as a fuel, and also, your body is no longer using energy to burn food in your stomach and can focus on its other energy demands. Lastly, there is no sugar crash mid morning from the morning carbohydrate load that most people consume at breakfast.

Now, here is an equally important factor to make intermittent fasting work for your depression. It is important you have a healthy lunch ready to consumer when the fast is over. It doesn’t have to be anything fancy. It could be a bowl of Greek yogurt, with blueberries, or a lean meat protein of your choice with pita bread. Even a peanut butter sandwich with some additional nuts is fine. The main thing is to have it nutritiously packed with nutrients that can help fight depression and also prevent sugar spikes and valleys.

Now, back to depression and the impact of fasting on it. There are the physiologic changes that I’ve discussed that can have a positive impact on depression, there is also a psychological one. For so many people food is at the center of their life. What will I eat? What can’t I eat? I’m fat? I need to lose weight? I’m in a rush to work, what can I get to eat on the way to work? All of these questions create a focus on food each day that I think is unhealthy.

We beat ourselves up because of all sorts of issues, and depression compounds this stressful focus on food.

By incorporating intermittent fasting into your lifestyle, all of sudden many people find their focus on food is reduced, the pressure to eat something goes away and the ability to focus on other aspects of your day goes up! Your energy improves, and thus your outlook. It’s empowering! Food is not the enemy but for so many people, their depression uses food to cope, and by intermittent fasting, you allow your body’s natural physiologic changes to help combat the depression, and let your mind feel less stressed about food.

I suggest for my patients to try intermittent fasting 2 days a week to start. After the first couple of weeks, and once they get over the initial “hunger” feeling mid morning, and realize they feel better on days they fast vs days they eat breakfast, they often are eager to make it a 3 day a week lifestyle change. They feel better, often lose weight, and their depression and stress improves.

Thanks for reading and please share this link with others you think may find it of help.

References:

N. M. Hussin, S. Shahar, N. I. Teng, W. Z. Ngah, and S. K. Das, “Efficacy of fasting and calorie restriction (FCR) on mood and depression among ageing men,” The Journal of Nutrition, Health & Aging, vol. 17, no. 8, pp. 674–680, 2013.

Kiecolt-Glaser JK (2010). Stress, food, and inflammation: Psychoneuroimmunology and nutrition at the cutting edge. Psychosomatic Medicine, 72, 365-369. PMC2868080

Zhang, Y., Liu, C., Zhao, Y., Zhang, X., Li, B., & Cui, R. (2015). The Effects of Calorie Restriction in Depression and Potential Mechanisms. Current Neuropharmacology, 13(4), 536–542. http://doi.org/10.2174/1570159X13666150326003852