The Interconnection of Nutrition and Mental Illness

Posted on Tuesday, May 31, 2022

Mental illness may be more common than you think. In 2020, 52.9 million U.S. adults (21%) experienced mental illness, and 14.2 million (5.6%) experienced serious mental illness. In 2019, national spending on mental health services reached $225.1 billion, accounting for 5.5% of all health spending. That number, up 52% since 2009, keeps growing.

Mental illness collectively refers to all diagnosable mental disorders—of which there are more than 200 types. Depression, anxiety disorders, schizophrenia, eating disorders, substance use disorder and bipolar disorder are examples, to name a few.

The Centers for Disease Control and Prevention (CDC) reports 1 in 5 Americans will experience a mental illness in any given year, and more than 50% will be diagnosed with a mental disorder at some point in their life.

According to research, mental health disorders are strongly associated with the risk, management, progression and outcome of serious chronic diseases and health conditions—including diabetes, hypertension, stroke, heart disease and cancer. In fact, mental health disorders often precede chronic health issues, while chronic diseases can magnify symptoms of mental health disorders. This entraps many in a vicious cycle of poor health.

Consider that people with mental illness may experience a range of physical symptoms resulting from their illness and/or treatment (like weight gain or hormonal imbalances), which may make them more vulnerable to a variety of physical conditions. They may develop unhealthy behaviors like poor eating and sleeping habits, for example, which ultimately contribute to negative health outcomes.

Enter nutrition—a critical component to one’s overall health.

According to the CDC, adults who eat a healthy diet not only live longer, but they also have a lower risk of obesity, heart disease, type 2 diabetes and certain cancers. Healthy eating can help people with chronic diseases to manage their conditions and prevent complications.

Over the years, studies have shown the interconnectedness between nutrition and mental illness, and mounting research focuses on how nutrition can improve mental illness.

The Supporting the Modification of Lifestyle in Lowered Emotional States (SMILES) trial was the first randomized controlled trial to show dietary changes can improve the mental health of people with clinical depression. At the end of the trial, 32% of people who received dietary counseling met criteria for remission of major depression, compared to 8% of those who received social support. Similarly, in a recent meta-analysis of 16 randomized controlled studies, researchers found dietary interventions significantly reduced depressive symptoms.

Social determinants of health (SDOH) influence mental illness.

SDOH contribute to wide health disparities and inequities and are known to influence mental health outcomes. Studies show low economic status, unemployment, strained familial relationships and unsafe neighborhoods can strongly impact mental health. People with serious mental illness are also more likely to face poverty, social isolation, residential instability and food insecurity. It's a two-way relationship —as poor mental health can aggravate personal choices and affect living conditions that limit opportunities.

Food insecurity—or lack of consistent access to enough food for every person in a household to live an active, healthy life—is particularly linked with negative health outcomes, puts people at risk for developing chronic diseases, and is associated with an elevated risk of mental illness.

In a study of over 3,500 low-income individuals, researchers found that as the severity of food insecurity increased, the number of reported depressive symptoms among study participants increased. Those with very low food security had three times higher odds of depression compared to those who were food secure.

People with severe mental illness disproportionately suffer from food insecurity. One study found a 71% prevalence of food insecurity and a 44% prevalence of severe food insecurity among people with severe mental illness—rates substantially higher than observed in other populations.

Programs like home-delivered meals are positively impacting the health of people with mental illness.

UnitedHealthcare Community Plan of Wisconsin (UHC WI) and Mom’s Meals recently collaborated on a pilot program to support high-risk, high-cost members with a behavioral health diagnosis by meeting their basic need for nutrition. Ninety-six members received three condition-appropriate, home-delivered meals for 90 days. Results showed a 61% decrease in inpatient costs and a 48% decrease in inpatient admissions. The total cost of care significantly decreased post-period by 44% for program membership, with per member/per month costs dropping from $1,491 to $837.

As growing research connects nutrition and mental health, there are bound to be many future initiatives aimed at meeting the nutritional needs of people living with mental illness. Although eating nutritiously may not eliminate or treat mental illness on its own, a healthy diet must be part of a holistic approach.

Mom’s Meals partners with health plans and payers to help support their members with mental illness and chronic conditions and address food insecurity through home-delivered meals. Learn more about our programs.

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