Before September 2005, Scott Gooding was a competitive athlete who could run 10 kilometres in under 33 minutes (i.e. really fast).
Then he ruptured disks in his lower back and, after a lifetime of sport and being known to friends and family as “the fit guy”, exercise was off the cards.
“It got so bad that I couldn’t do one push-up or one squat,” says Gooding, now 41. “I was in constant pain and discomfort.”
Apart from the physical pain and the mental struggle with his new identity – “fitness was so much a part of who I was” – he had lost his outlet.
“I couldn’t tap into the therapeutic and meditative effects of running and exercising,” says the former My Kitchen Rules star, personal trainer and health coach. “I dipped in and out of pretty dark periods for the best part of seven years.”
During that time, Gooding began exploring nutrition and how it might help reduce some of the inflammation in his body.
“I think the diet really helped with my back condition and slowly I started to reintroduce exercise,” says Gooding, who adds that moving again helped him shift out of “feeling pretty blue and shit about myself”.
While many individuals intuitively understand the link between how we fuel and move our bodies and how we feel, the medical community is in the midst of a paradigm shift.
“This mind/body dichotomy that has informed psychiatry for at least the last 50 years or so, we know that is erroneous and is not based on evidence because we are increasingly understanding that the whole body is involved in mental health,” says Professor Felice Jacka, head of the Food and Mood Centre at Deakin University. “Psychiatry is really starting to understand that we need to get back to treating the whole person, not just bits of their brain.”
Jacka, who is also a Black Dog Institute external fellow, is referring to the mounting evidence that our immune system plays a central role in depression and other mental health problems.
“We’re increasingly understanding that the gut and its resident microbiome has a leading role in prompting immune function and is very much involved in brain health,” she explains.
“We have extensive evidence from animal studies, showing when you manipulate diet, you manipulate the function of the hippocampus, which is a key area of the brain involved in learning and memory, but also in mood regulation.”
The hippocampus is a “central target” in antidepressant treatment, but Jacka says the impact of diet and exercise on its functioning (as well as the immune system and gut health) helps to explain its pivotal role in influencing mental health.
In fact, she says, in adults and older adults, the size of the hippocampus is linked to the quality of diet.
“Diet and nutrition are as relevant to brain and mental health as they are to physical health. This should be no surprise because nutrition is fundamental to every process of the body and brain,” says Jacka, whose latest study found that improving the diets of those with major depressive disorder had a “substantial beneficial impact” on their mood.
Despite this, Jacka stresses she is not suggesting that diet, or lack of exercise, is the only reason why someone might be depressed – or that diet and exercise are the only solutions to depression.
“Depression – and any other mental illness – has many causes and many drivers, but the key thing with diet and exercise is that they’re modifiable,” Jacka says. “So many other risk factors that lead to depression, such as early life trauma, genetics, poverty, disadvantage; these things are very difficult to change.
“If we know that we can change diet and exercise and very quickly, according to the evidence, have an impact on mental health, we believe that this should be a fundamental starting point for treating mental health problems and it can go along with psychotherapy and antidepressant treatments but it should be underpinning all of these treatments.”
This recommendation has been adopted in the latest update to the clinical recommendations for the treatment of mood disorders by the Royal Australian and New Zealand College of Psychiatrists and is significant given that depression is one of the most common reasons people visit their doctor.
“They are now recommending that the first thing that happens when a doctor has a patient with a mood disorder, is to address diet, exercise, smoking cessation and sleep,” Jacka says.
Which is great, except that doctors do not receive any nutritional education during their degrees.
“I attended and spoke at a big conference of psychiatrists on the weekend – psychiatrists and psychologists are still quite astonished to learn that nutrition might be important to mental and brain health,” Jacka says. “They will always say to me: ‘it’s because we never learnt anything about it in our medical degrees’.”
Until nutrition training is introduced to medical degrees, Jacka suggests that a quick and easy option is to include dietitian referral services in the Better Access initiative as part of mental health care.
Through the Food and Mood Centre, Jacka and her team are also in the process of developing a nutrition resource that people can use at home.
While Jacka thought getting people to change their diet “would be very difficult” because of the fatigue and reduced tendency to self-care associated with depression, she found the opposite.
“People really, really like this approach because it’s something that’s under their control,” she says. “It doesn’t have to be complicated – you can do a big pot of veggie and legume stew in the crockpot which you can get for $20 from the op-shop – and you can have that for the whole week. You can use frozen vegetables, you can used tinned fish … this idea that it has to be more expensive is not true, the idea that it has to be complicated or time-consuming is not true either.”
Scott Gooding says that he has come to see his “really negative” experience as a positive because it has transformed the way he understands fitness and nutrition and its impact – both physically and mentally.
“The way I see fitness now is simply a tool to improve my mood and make me feel good about myself,” says Gooding, who is also a Blackdog Exercise Your Mood ambassador. “I also realised you can have this sustained energy and cognitive alertness all day if you’re eating the right food. At no point now is my mood, energy or cognitive function impaired by what I’ve eaten.”
The Black Dog Institute’s Exercise Your Mood campaign is challenging Australians to improve their diet and physical activity this September. Visit the website for tips and more information.