Ask an Expert: The Future Of Mental Health

Although mental health is important to address all year round, in May we pay particular attention to this topic during Mental Health Awareness Month. This dedicated month serves as a reminder of the pressing need to address the issues our mental health systems are currently facing, and the importance of finding new, innovative ways to support those in need.

In this month’s Ask An Expert article, we spoke to Dr Kathrin Cohen Kadosh, Associate Professor in Developmental Cognitive Neuroscience at the University of Surrey, UK to learn more about the direction that mental health research is currently heading towards, and the surprising role our kitchens might play in improving our mental well-being.

Q: While maintaining good mental health is important for everyone, do we know if there are any groups that could be more vulnerable to experiencing mental health issues?

A:  The transitional period from childhood to adulthood is marked by a multitude of changes in social and cognitive abilities, brain maturation, as well as genetic and hormonal changes. One implication of these many changes is that they increase the risk of developing mental health problems. Moreover, there is the risk that maladaptive behavioural patterns could become persistent while brain networks mature.

Critically, both animal and human research point towards adolescence as a sensitive period when the gut-brain axis is fine-tuned, and when we can use dietary intervention to change the microbiome, with long-lasting consequences for mental health. The gut and the brain are intimately connected via the gut-brain axis, which involves bidirectional communication via neural, endocrine and immune pathways and it has been suggested that the composition of the gut microbiome influences not only initial brain development, but also brain responsiveness and function across the lifespan, with gut microbiota regulating gene expression and the release of metabolites in the brain.

Despite these implications, progress has been slow and one explanation for this is that our current research approach has been missing out on a key player in the changes during this period – the gut microbiome.

Q: We know that consumers are increasingly taking a proactive approach to their health such as maintaining a healthy nutritional diet. Do you think that it’s possible to improve our mental health through nutrition?

A: In recent years, there has been an increased drive to investigate whether diet-based inventions via the gut microbiome could benefit gut-brain health. The importance of a healthy diet on early brain and cognitive development is well-established; however, we’re only now starting to explore how we can use diet actively to improve wellbeing across the lifespan. Several studies have underlined the beneficial effects of psychobiotics (gut microbes used to benefit mental health), such as pre, pro and synbiotics, to enhance mood and improve anxiety symptoms. The evidence is particularly strong in animal models, but there is a handful of encouraging human trials^[1] as well, including some from our lab. We now need more rigorous trials to test this further and to establish personalised intervention protocols across the lifespan, considering the specific needs of each age and sex groups.

Q: What areas of research on mental health is exciting you the most?

A: Nutritional psychiatry is, in my view, the most exciting area in the field of mental health research. These so-called “kitchen table” interventions carry a relatively low stigma, and most people are happy to engage with them. There is also much potential for scalability, which is exciting. It was Aristotle who said that all disease starts in the gut, which just goes to show that we have for a long time been aware of the potential of using dietary interventions to improve our health and well-being. We are now at a point where we systematically research this question.

Q: We can imagine why exploring if what we put on our plate is a key factor to improving our mental wellbeing is gaining traction amongst researchers, as it’s such a fundamental aspect of the human experience. Back on the topic of nutrition – is there anything that you personally eat during the day to support your mental health?

A: As my two sons will readily testify, if something new and suspicious looking appears on their dinner plates, it is likely to be thought off as ‘good for their microbiome’! This could be something like a German sourdough rye bread, sauerkraut, or fibre-rich foods such as leeks, onions and garlic. I certainly try to implement a balanced and varied diet at home, and I am using every opportunity to raise awareness of this fantastic and rapidly expanding research field. Thankfully, I am not alone in this.

Q: The fact that modifying one’s diet could be a (relatively) accessible intervention with a potentially significant impact on one’s wellbeing is encouraging to hear. Final question – how do you envision dietary interventions to be used to improve an individual’s mental health in the future?

For example, women are already doing this for pregnancy and during the immediate postnatal period. It would be good to reach a stage where dietary assessments and interventions become established approaches to maintain good mental health and well-being – for everyone.

More info on Dr Cohen Kadosh

Dr Kathrin Cohen Kadosh is an associate professor in Developmental Cognitive Neuroscience at the University of Surrey, UK where she is head of the Social Brain & Development Lab and the multidisciplinary Brain Nutrition Gut Microbiome group. She read for her PhD at Birkbeck College, University of London, UK and went on to receive postdoctoral training at University College London, King’s College London, UK the National Institutes of Health (USA) and the University of Oxford, UK. A developmental cognitive neuroscientist, she combines behavioural assessments and brain-imaging techniques to understand how improving cognitive abilities and changes in brain function and structure shape the emerging brain network and subsequent behaviour.

Another line of her work investigates the role of the microbiome gut-brain axis on mental health and well-being in development, using psychobiotic interventions such as prebiotics to enhance behaviour and brain function in children and adolescents. She has held a number of national and international research grants and collaborates with industrial partners and charities. Her work has been published in reputed academic journals and textbook chapters and she serves as a reviewer on a number of national and international research panels.

[1]Johnstone, N., Dart, S., Knytl, P., Nauta, A., Hart, K. H., & Cohen Kadosh, K. (2021). Nutrient intake and gut microbial genera changes after a 4-week placebo controlled galacto-oligosaccharides intervention in young females Nutrients, 13(12). doi:10.3390/nu13124384.

Basso, M., Johnstone, N., Knytl, P., Nauta, A., Groeneveld, A., & Cohen Kadosh, K. (2022). A Systematic Review of Psychobiotic Interventions in Children and Adolescents to Enhance Cognitive Functioning and Emotional Behavior. Nutrients, 14(3). doi:10.3390/nu14030614

Johnstone, N., Milesi, C., Burn, O., van den Borgert, T., Hart, K., Sowden, P. T., . . . Cohen Kadosh, K. (2021). Anxiolytic effects of a prebiotic in healthy female volunteers are associated with reduced negative bias and increases in ‘helpful’ bacteria in the gut. . Nature Scientific Reports, 8302. doi:10.1038/s41598-021-87865-w