UC Science Radio transcript: Episode 7

Prof Julia Rucklidge: Micronutrients for the mind

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Molly Magid: Welcome to UC Science Radio, where we conduct interviews with a range of scientists to learn about the big issues facing our world and what science is doing to help. I'm Molly Magid, a Master’s student in the School of Biological Sciences.

Today I’m talking to Dr. Julia Rucklidge. She’s a Professor of Clinical Psychology and she studies how nutrients can help treat mental illness or the stress associated with disaster or trauma. She’s also driven to communicate her research widely to ensure that nutrition is part of the public health dialogue.

Kia ora Julia. Thanks for coming on UC Science Radio!
Julia Rucklidge
: My pleasure, kia ora!

What is your role at UC and what's your research on?
JR:
I was hired in 2000 to teach the child and family component of the clinical psychology program. I came from a postdoc in Canada, and I worked with children there. So that's my teaching component at UC and I continue to do that.

But when I was in Canada I had the fortune, I would say in retrospect, of being able to be at the forefront of learning about families who were using nutrients to treat very serious mental illnesses like, bipolar disorder and depression and psychosis. These are very serious conditions that we often think we can only treat with medications or with psychotherapy. But these families observed and wanted scientists to take note that they were getting well, just making sure that the body had all the nutrients that it needed in order to be able to function optimally. One of the scientists that they approached was my supervisor Bonnie Kaplan at the University of Calgary. And so I heard about all of this because she, like me, took the approach that we’re the critics and conscience of society. And if there are new and crazy ideas that contravene our current way of thinking, it’s still our duty and our role to investigate them. She actually published some very, very preliminary data at the earlier part of the century showing people getting well and staying well with the nutrients.

So I heard about that and was interested. I was moving to New Zealand, and I set up a lab. ADHD was my area of specialty. But I kept hearing about these families and other observations and clinical observations, so by around 2006/2007, I was in a position to be able to start saying, “Okay, well, what is there?” By then I had sadly lost the naïve perspective, which is that that, you know, we have these amazing treatments for people who suffer from mental illness, you know, we have these medications and we have psychotherapy and there are some other options as well. But for the most part, at best 50% of people get better. And if you look at long term recovery rates for medications, it's actually sadly only about a quarter. There are the lucky ones who do benefit from medications and, in those situations, they absolutely often save their life. But sadly not enough people are getting well with these medications. I ended up saying, “Well, what do we have to lose? Let's have a look. Let's see what we can discover.” That's what led to my research, which is all I do at Te Puna Toiora, the Mental Health and Nutrition Research Group, which is my research lab at the University of Canterbury. So there you go, long answer for your question as to what do I do at the University of Canterbury. I teach and do research.

That's wonderful, though, to hear the backstory of how you encountered those families who were treating themselves very early on in this idea of nutrition being able to help mental illness. What kinds of nutrients can you use to help treat mental illness?
JR:
In order to answer that question, we have to kind of just back off a little bit and go to the basics. These nutrients are what we often classify them as micronutrients. That's probably not completely accurate, but it allows us to distinguish them from macronutrients. Macronutrients are what most of your listeners will have heard about. It's fats, carbohydrates, and proteins. I grew up being taught that it's really important that you get a good ratio of these fats and carbohydrates and proteins. If you get that about right, then your weight will be fine, and you'll be fine and healthy.

What that is absolutely missing is that it's completely ignoring the nutrient density of the food. By that I mean the micronutrient density. These are things that people have also heard about. Iron, selenium, magnesium, zinc,  vitamins. Those B vitamins, you know, Vitamin A, D, E.

So talking about what the brain needs, which is what my area of research is all about, is about ensuring that we have good optimal mental health. Then you start to say, “Okay, well, what do these micronutrients do?” We've heard about depression being caused by different deficiencies in serotonin, or we've heard about other neurotransmitters like dopamine, this is within the typical language of our society. What we don't learn is that in order to make serotonin, you need these vitamins and minerals that I just told you about. They act as what we call co-factors along the pathways to make these very important neurotransmitters that are essential for brain function.

Every one of our cells has something that’s called mitochondria and they're the powerhouses of our cells and they make something that’s called ATP. ATP is essential for your energy production. Curiously and interestingly, in order to make ATP, you need these minerals and vitamins. If your body is depleted in those you're going to feel sluggish and you're gonna be slow, and you’re going to have low energy. Other things that these nutrients do are things like combat inflammation, which we know is important; and help our body detoxify: get rid of all these toxins that we're constantly taking in from our environment. And then other things micronutrients will also do, is turn genes on and off. These vitamins and minerals are essential for our DNA to function and to repair DNA. That in itself should be enough for us to all be interested to make sure our food is rich in these vitamins and minerals.

Unfortunately, what's happened alongside this, is that we've had an incredibly rapid change in our food environment. Sixty percent of what’s sold in a supermarket, would be classified as what we call ultra-processed food. That is,  packages that have long lists of ingredients of which some of them, you won't know what they are. There's often a lot of sugar in these ultra-processed foods. We need a certain amount of glucose, we do definitely, to survive, but we certainly don't need the amount that we're currently consuming based on the ultra-processed foods. If you eat you consume a diet that consists mostly of these ultra-processed foods, which the food industry will tell you: “Oh but it's adequate calories” or “It's low in fat. And it's fine.” So “You can absolutely consume as much as you want.” It's giving your brain no nutrients. That's where you should be interested in saying, “Okay, well, what should I do about my diet?” Number one, that any one of your listeners could do, is really start looking at what they're putting in their mouth because you're making a choice every time you put something in your mouth to offer your brain something that's nourishing or nutrient deficient. Where do you get these nutrient-dense types of foods? It's going to be in fruits and vegetables, nuts, fish, grains. That's where you're going to get those vitamins and minerals.

Is it enough for some people to just change their diet in those ways eat more of those unprocessed foods or will some people need those extra supplements, will need to take vitamins or things like that to increase the nutrients of a particular type they need?
JR:
I always say food first. If you can try to get your nutrients from your food, and you can feel well and feel healthy, and you're feeling, vital and energized and all of those things, then you don't need to then consider supplements. But unfortunately, that probably doesn’t describe, a lot of people. I can confidently say that it probably doesn’t describe a lot of people because one in five people are struggling with a mental health issue in any one given year.

The first thing to do would be to look at your food, but there's a number of reasons why that might not be sufficient. One of them is that our food is probably not as nutrient dense as it used to be. There's a number of reasons why that's happening. First of all, we have a lot of mouths to feed and so we're going to favour crops that grow quickly and have a high yield. If your crop grows really quickly, then it's going to have less time to take the nutrients out of the soil into the plant. That selection for food is probably to the detriment of the nutrient density of the food. We also have been using a lot of different ways to try to eliminate pests, using herbicides or pesticides. We call them mineral chelators and that means that they take the minerals out of the plant. Climate change, increase in carbon dioxide in our environment, is great for growth of plants, but it means they grow faster and the nutrients don't get into the plant. Then, also, we don't always remineralize our soil adequately so that can also influence the nutrient density of not getting enough of those trace elements in there. So that's one of the problems.

For some people that might not matter, they can tolerate a much lower nutrient density in their food. There’s a certain percentage of the population who are going to have possibly genetic differences, but also other things that might influence their ability to optimize the nutrients that are coming out of the food. Those genetic differences I would just say, very simply, result in very sluggish metabolic pathways. That means you might have less of the end product, or it just takes longer. Other things that could also influence our ability to use the nutrients in our food would be things like having a leaky gut. There'll be listeners out there who have IBS or just have those gut issues. What's happening in your gut is going to be very important and influence the health of your brain and the bacteria in your gut, in particular, and the diversity of the bacteria in your gut. Then that can also influence the absorption of nutrients out of your food.

Another factor that I think I need to raise in the context of this interview, is that our current environment is incredibly stressful. We've done research on stressful events after the earthquake after a flood, we did some clinical observations after the mosque attacks and what we've learned is that stress really seems to deplete us of our nutrients. It makes absolute sense, your body needs to survive and it's going to prioritize the fight-flight response over anything else that's happening. It needs those nutrients to make the adrenaline. So your nutrients get diverted to make sure you survive, but it's at the expense of everything else that's going on in your body. I'm guessing some people are really struggling with concentration because they're feeling so wound up and on edge, because there's so much uncertainty on at this time, and the uncertainty will drive that anxiety response. Stress can definitely deplete us of nutrients, and so under those conditions, it might be that some people need more nutrients than what they can get out of food.

You mentioned your work on the earthquakes and other disasters and making sure people were provided with these nutrients, looking at what happened when people were taking these nutrients during these big, uncertain, and stressful times. So, are you doing this work right now, which is a pretty stressful and uncertain time?
JR:
Yeah, I mean, you have to be quite creative when you do those studies after a significant disaster, and I wouldn't classify this as that kind of environmental immediate disaster. It's kind of like this chronic oozing unknown thing that’s out there and it's not quite the same. But I suspect the anxiety associated with it is very similar. We don't have, you know, the anxiety for earthquakes and the anxiety for exams and we don't compartmentalize anxiety that way, we just feel anxiety.

We have a study that we were interested in looking at stress and nutrients in undergraduates at University of Canterbury. We had developed the whole study and then Covid-19 became apparent in terms of the impact it's going to have on the stress on the community. Exactly what it’s looking at is anxiety about this great uncertainty that’s happening in the world. And that one’s called the STAR trial, so if people are interested, we don't mind them emailing us. You know, I'm just doing a pitch for our research, because we’ve always got stuff going.

And what did you find when you did this research during other disasters?
JR:
I do end up sadly becoming one of these disaster researchers. Well actually it came from some work we did on the September 2010 earthquake, where we were able to observe people who happened to be taking nutrients at the time of that earthquake, versus people who happened to not be taking nutrients of the time the earthquake. Essentially, we found that people who happened to be taking nutrients at the time of the September 2010 earthquake recovered far more quickly than people who weren't taking nutrients. It was a really interesting observation. And they still got anxious, you know, they were still stressed. We called them one week, two weeks after, but they recovered far more quickly. It was really an interesting naturalistic observation.

When the February 2011 earthquake happened, we then designed a randomized control trial but we didn't use a placebo. It’s totally unethical in that kind of situation to use a placebo. The studies that we're running right now are all placebo-controlled, but I do see it as being a bit of a different type of event. So we found that people who took the nutrients were far more likely to have a reduction of stress into the normal nonclinical range, compared to people who weren't taking nutrients (we had what we call a “treatment as usual” group).

Those are two different observations that really allow us to say, this looks like this is a really important intervention to help people recover from a natural disaster. We also have other data that gives us a little bit more confidence in that conclusion because there's been studies that show B vitamins are better than placebo in just general stress. So I can really say, you know, hand on heart, there's sufficient research out there that it's a really good go-to. To help you just deal with that day-to-day uncertainty and coping go for a B complex, but if you want an even more powerful effect, we’ve observed a stronger effect with the broad spectrum.

I don't want people to go and buy just a multivitamin in the store because it's not going to be adequate, in terms of providing the dose and breadth of the nutrients that your brain requires. Multivitamins in supermarkets are designed to ensure that you don't get a what we call a frank nutritional deficiency. That's things like scurvy. Heard of scurvy, from the sailors? Or rickets, which is something that causes bone fragility. It doesn't do anything in terms of giving the optimal amount of nutrients that your brain needs. It's remarkable, it’s absolutely remarkable, that we ignore the brain, even though it's the hungriest organ and it punches way above its weight: 2% of body weight, 40% of metabolic needs. Why in the world, have we continued to accept that it's okay to consume some kind of multivitamin that really doesn't even adequately give the nutrients that your brain needs? It's one of my pet peeves and things that I would love to see change, at least in my lifetime. We're ignoring the brain at our peril, and we see already the evidence of it in the mental health statistics, in the mental health epidemic.

We've talked a lot about limiting stress and anxiety, and we've mostly talked about people who may not have diagnosed mental illness. I'm interested in, maybe one of your studies or work in a particular community and what sorts of nutrients you’ve given to them, and what you've seen. Could you tell me a bit about your patients with ADHD, since I know that’s some of the work that you've done, what nutrients you’ve given and what you've seen?
JR:
Sure, so on what nutrients we give, we don't differentiate from disorder to disorder. We just take the same approach, which is broad spectrum vitamins and minerals, the full array, usually about thirty or more. I emphasize this because often people think about these disorders as being quite separate. What I can really sort of say is that it's murky, the categories are not as discreet and different as we first thought they were, there's huge overlap in the symptoms.

The approach we take is saying, “Okay, let's give the body what it needs, the brain what it needs, in terms of the nutrients.” And see what happens when you end up being well-nourished. When we've seen people get well, they not only get well in the symptoms that we targeted, which was the ADHD symptoms, but they often come in with mood instability and anxiety and alcohol problems in the adults. We see a levelling-off and improvement across the board, which suggests to me that the treatment is not specific.

In terms of the findings of our ADHD study, we found that about 50% of people did really well about 30% modest, mild and 20%, not at all. The benefits seem to be a little bit more in the concentration side than hyperactivity, I see that as being okay, maybe more a levelling-off but not a complete reduction. We don't have that zombie-ing effect that some of the medications have. What we also notice is a reduction in aggression, and we see an improvement in emotional dysregulation. So that just gives you a bit of a flavor of some of the things that we've observed in those ADHD studies.

I'm curious about what role you see science communication has, in spreading this science view of vitamins and supplements. There are these articles and news, that are more like fluff pieces, don't really have any science to them, just saying “This diet is the diet to do” or “Everyone should be consuming caffeine” or whatever it may be, that it sort of undermines your science, which is backed up by controlled trials and you’re doing good work. But people see that and they sort of equivalate both of those things?
JR:
Oh, I know. I can often get just thrown into the camp of snake oil salesman and that's unfortunate. I certainly experienced that whenever I tried to make any changes in the public health care system. It's just “Oh there's no research on this” or “Vitamins or just expensive urine” and you're like, “Well, actually, if you read our research, you'd know that that was actually incorrect.” Not only is it incorrect because we've shown that nutrients are better than a placebo in many of our control trials. We've shown that we have an influence on turning your genes on and off. We've shown the change in the bacterial diversity. Those are showing biological changes.

It's frustrating when the science ignored, when this research that I've described is published in good medical journals. It's not like I'm publishing in fringe journals. The science is out there, people just need to be curious and want to read it. I've spent a lot of time trying to figure out how to communicate these really complex issues in ways that people understand because that's what you have to do in order for the change to occur. Our education of our physicians, our psychologists, our social workers, of all those front line people has very, very little nutrition in it. So they will automatically assume that it can't possibly be that important, because if it was important, it would be in our medical education system. We have to change the way we've been educating our psychiatrists, our psychologists, to understand that nutrition really is a foundation pillar of health. If you ignore that and you just think, “Okay, I'm going to talk to people about changing their thoughts.” You’re not focusing on what they're eating. Then I think you're going to have a much harder time making a change in their thoughts.

It sounds like the there's a need for those structural changes in the health care system, in the education system, to really make sure that this is something that's valued and that's seen as important, and just as important as taking medicine and other things that we do.
JR:
You know, I've got a really good story that I will sometimes say. We’ve got honey bees—there's the worker bee and there’s the queen bee. Some people don't know that they are genetically identical. And the one thing that makes them phenotypically different, that is that the queen bee, for example, is fertile and the worker bee isn't, it's the different diet that's fed to the queen bee versus the worker bee. If it can have that effect on the honey bee, then it can absolutely have a powerful effect on your brain.

The last question I'm going to ask you is one that I ask everyone, and it's if you could say in one sentence why your work is so important, what would you say?
JR:
You asked me, verbose Julia, to say one sentence of why my work is so important? Because it's going to reverse the mental health epidemic.

That’s excellent! Thank you so much for your time and for talking to me. I really enjoyed our conversation.
JR:
Oh it was my pleasure. Thanks, Molly.

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