Medical nutrition in mental health and disorders.

Abstract

Byline: M. S. V. K.. Raju Dr. Prasad Rao Garu, distinguished guests and friends, I have been looking forward to this moment with much trepidation for almost a year, because the unwritten law of the society lays down the rule that its presidents must speak on any topic of their liking, or disliking as the case may be, on a day like this. I have been a sort of an up-and-down all-rounder in psychiatry all my life in the armed forces and the “civilized” existence after bidding adieu to uniform. Over the years, I have had the privilege, as a teacher, of putting some brilliant minds through their paces in psychiatry, dabbled in surface-skimming research on a variety of topics ranging from schizophrenia, substance use, imaging, phospholipids, genetics, neuroendocrinology, sleep, and dreams; I have an abiding interest in military psychiatry and I am a clinician with some interest in the currently unglamorous unconscious processes. As I mulled over the looming specter of the speech, several topics clamored for attention. To my utter unease, I was not finding any one of the topics interesting enough to excite my little grey cells. Fortunately, a couple of weeks ago, I traveled to my native village in Odisha to pay obeisance to our family deity. It so happened that I was required to attend to a lady there who was in some distress. Besides some words of comfort, I was obliged to procure and provide the medicines as well to her. She took the proffered pills as if they were an offering of the Gods and then asked me what she should eat. Unwittingly the tribal lady made the unease in my mind cease at that very moment. I decided to speak on food and all the good, and in certain cases bad, it does to a person in sickness and health. It is very common for the patients in India to ask what food substances they should and should not have while undergoing treatment. It is a way of life in traditional homes in India to consider food as the manifestation of the immanent and transcendent unity called Brahma or Atman: “Annam Parabrahma Swaroopam” are the oft-quoted words of the elders to the young. The Taittiriya Upanishad, a treatise of philosophy of more than 3000 years antiquity, states “Annam Bhootanam Jyeshtam tasmat annam sarvaushadam ucyate” which when translated means “Food verily is the eldest born of beings and therefore it is the healing herb for all.”[sup][1] I still remember vividly the surges of energy and sense of luminescent wellness that coursed through my person on eating small cups of cooked rice with warm lentil soup after getting thoroughly shaken and stirred by bouts of malaria in childhood. Intuitively, we all recognize the healing qualities of food but somehow we seem to have lost the way as we started focusing exclusively on molecules. Fortunately, there is a resurgence of interest in nutrition in mainstream psychiatry of late.[sup][2],[3],[4],[5],[6] The World of Nutrition The world is facing a nutritional crisis. Approximately 3 billion people of the world have low-quality diets. Despite the gains of reducing hunger over the past 25 years, malnutrition prevails in all forms affecting one in three people worldwide. Poor diet is responsible for the largest burden of global ill health: six of the top 11 risk factors are diet related. The “double burden” of undernutrition on one side and obesity on the other is a phenomenon of this century.[sup][7] Nutrition continues to be a central health, economic, and sustainable development challenge for every region on the planet.[sup][8] Globally, while 794 million are calorie deficient and 2 billion suffering from micronutrient malnutrition, 1.9 billion are overweight/obese, 161 million children under 5 years of age have stunted growth indicating chronic malnutrition, and 57 million of children