Introduction:

While it is widely known and
accepted that proper nutrition is critical to physical health throughout the
lifecycle 1, 2, the relationship between nutrition and
neurocognition and mental health has been counterintuitively less acknowledged 3. 
However
increasing evidence indicates that malnutrition and micronutrient
deficiencies have deleterious effects on brain development and functionality 3 4 potentially resulting in neurocognitive or
neuropsychiatric disorders and adequate nutrition and micronutrient intake
promotes neurocognition and mental health by potentially preventing,
mitigating, and/or reversing negative effects 5.FI1  

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One of the earliest studies demonstrating
the effects of nutrition on neurocognition and mental health was in 1915 by H. Douglas
SingerFI2 , who found that adults with Pellegra, FI3 caused by niacin (vitamin B-3)
deficiency experienced dementia and negative changes in mental health,
including anxiety and depression 6. A landmark study published in
1992 based on data from the Dutch Winter Famine of 1944-1945 examined a cohort
born to mothers exposed to starvation (400-800 calories per day) during World
War II and found that offspring of those mothers suffered from poor mental health, with females twice as likely to
develop schizophreniaFI4 FI5  7.  Although the
degree of vitamin deficiency and malnutrition were extreme in these studies,
they elicited initial clues about the crucial role of nutrition in neurodevelopment
and long-term neurocognition and mental health, prompting subsequent research
to investigate additional aspects of nutrition and diet and their role in neurocognition and mental
healthFI6 .  While the specific physiological mechanisms
involved FI7 are still not yet fully elucidated, research
suggests that effects are mediated through multiple
interrelated biological processes and pathways including: inflammation processes, the immune system,
oxidative stress, the gut microbiome, neuroplasticity, and epigenetics FI8 8,
9 10-14.  

NeurocognitiveFI9  and neuropsychiatric disorders, often
intergenerational and perpetual, are an enormous emotional and economic burden
to individuals, families, and society.  According
to the World Health Organization (WHO), neuropsychiatric disorders are the
leading cause of global disability and projected to grow exponentially,
potentially becoming a worldwide epidemic 15 16. 
While pharmacotherapy and psychotherapy remain predominate treatment
modalities for neuropsychiatric disorders, they are not always effective and
can be cost-prohibitive.  In addition to
the expense, pharmacotherapy sometimes produces undesirable side effects, both
of which may interfere with compliance and treatment.  Cognitive impairment and dementia are also
increasing worldwide and predicted to increase significantly more in developing
regions 8 17 18, 19. Currently, no medications have been shown to effectively prevent
their progression or conversion to Alzheimer’s disease. Therefore, it is urgent
to focus on alternative preventative and therapeutic opportunities for both
current and future generations. Since increasing evidence supports the
relationship between nutrition and neurocognitive and neuropsychiatric
disorders, it is imperative
FI10 that we
expand our understanding and awareness of these important links to potentially optimize
their prevention, mitigation, and/or treatment. 

This paper will review, analyze, and
summarize the current evidence on various aspects of nutrition including micronutrients,
macronutrientsFI11 , and
overall diet and their effects on neurocognition and mental health throughout
the lifespan.  Mixed and inconclusive findings will be
presented, but the most conclusive evidence will be highlighted for ease of
reading and to enhance awareness of the most significant links to date.  FI12 Detailed
explanations of the involved biological processes and metabolism of nutrients
are beyond the scope of this chapter, however they will be briefly mentioned
when necessary. Implications of the existing evidence, recommendations for advancing
future research, and public health policy matters will also be discussed.

 

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