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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 25  |  Issue : 2  |  Page : 72-79

Functional foods for mental health promotion


1 Department of Home Science (Food and Nutrition Division), University of Calcutta, Calcutta, West Bengal, India
2 Department of Food and Nutrition, Women's College, Calcutta, West Bengal, India
3 Department of Psychiatry, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India

Date of Submission09-Feb-2020
Date of Acceptance12-Jun-2020
Date of Web Publication15-Dec-2020

Correspondence Address:
Mr. Soumam Dutta
Department of Home Science (Food and Nutrition Division), University of Calcutta, 20E, Judges Court Road, Kolkata - 700 027, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmgims.jmgims_15_20

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  Abstract 


Mental health problems and morbidities are increasing day by day. The etiology of mental health disorders is extremely complex and encompasses a range of genetic, dietary, emotional, and social as well as lifestyle factors. Finding adequate therapeutic and preventive strategies for mental health promotion is a great challenge. India is a country which is famous for its flora and fauna, many of which possess functional and medicinal properties. This article summarizes the mental health role of some selected functional foods of Indian origin, namely, brahmi (Bacopa monnieri), ashwagandha (Withania somnifera), turmeric (Curcuma longa), garlic (Allium sativum), and pumpkin seeds (Cucurbita maxima). Relevant article searches were conducted in PubMed, Google Scholar, and Google to identify the scientific articles highlighting the role of the functional foods on various mental health problems such as neurodegeneration, Alzheimer's disease, Parkinson's disease, depression, epilepsy, stress, and anxiety. The eligible articles were reviewed to gather information. These functional foods were found to be highly beneficial in treating and preventing mental health disorders mainly due to their antioxidant and anti-inflammatory properties as well as their ability to prevent mitochondrial dysfunction and degrade abnormal protein aggregates. These functional foods were also found to be effective in the improvement of the activities of various neurotransmitters such as acetylcholine and monoamines. These foods can be incorporated into the diet as well as can be used to develop drugs and nutraceuticals for treating various psychiatric problems.

Keywords: Antioxidant, functional food, mental health, neurodegeneration, protein aggregates


How to cite this article:
Dutta S, Roy S, Roy S. Functional foods for mental health promotion. J Mahatma Gandhi Inst Med Sci 2020;25:72-9

How to cite this URL:
Dutta S, Roy S, Roy S. Functional foods for mental health promotion. J Mahatma Gandhi Inst Med Sci [serial online] 2020 [cited 2021 Jun 21];25:72-9. Available from: https://www.jmgims.co.in/text.asp?2020/25/2/72/303414




  Introduction Top


A sound mind in a sound body is a social ideal. According to the World Health Organization, mental health has been defined as “a state of well-being, in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and can make a contribution to his or her community.”[1] The all India prevalence of mental morbidity (lifetime), mental morbidity (current), intellectual disability, epilepsy, and suicidal risk are 13.9%, 10.5%, 0.6%, 0.29%, and 6.4%, respectively.[2] It is estimated that in India, over 3.7 million people (aged over 60) have dementia, which is expected to be double by 2030.[3] The etiology of mental health disorders is extremely complex and encompasses a range of genetic, dietary, emotional, social, and lifestyle factors. This article targets to focus on the mental health-promoting properties of some selected functional foods of Indian origin. The roles of brahmi saag, ashwagandha, turmeric, garlic and pumpkin seeds have been discussed.

Objective

The aim of this study is to explore the existing scientific literature on some selected functional foods of Indian origin, which have an effective role in mental health promotion.


  Methodology Top


Functional foods that have been studied extensively in the scientific literature for their mental health-promoting properties were identified through literature search. Initially, eight items were identified, namely brahmi, ashwagandha, turmeric, shankhpushpi, mandukaparni, guggulu, garlic and pumpkin seeds.[4],[5],[6],[7] Out of these those which are easily available and commonly used at the household level were selected for this review, namely brahmi, ashwagandha, turmeric, garlic, and pumpkin seeds . The searches were performed in PubMed, Google scholar, and Google. Search items like “functional food,” “mental health,” “neuroprotection,” “neurodegeneration,” “neuroinflammation,” “oxidative stress,” “antioxidant” were used. Relevant research and review articles were identified for this narrative review.

Mental health-promoting effects of some selected functional foods

“Brahmi Saag” (Bacopa monnieri)

Brahmi is a popular creeping herb from the plant family Scrophulariaceae found in India. It is classified in Ayurvedic texts as “medhya-rasayana” (memory enhancer and rejuvenator) and “aindra-rasayana” (increasing longevity). In “Charaka Samhita,” it is recommended for the management of various conditions such as anxiety, lack of concentration, and cognitive impairment.[8] It can be taken in various forms such as ghrita (medicated ghee), fresh juice, paste, milk decoction, tea, powder, and pill. It is found to possess nootropic, anti-convulsant, analgesic, anti-depressant, anxiolytic, anti-inflammatory, anti-oxidant, and adaptogenic properties.[9] The dammarane types of triterpenoid saponins, also known as Bacosides are present in Bacopa monnieri (BM) extract as the main nootropic agents. The Bacoside A is most extensively studied and has four types: Bacoside A3, Bacopaside X, Bacopaside II, and Bacopasaponin C. These Bacosides are present as aglycone units with jujubogenin or pseudojujubogenin. They regulate translation of mRNA and expression of various neuroreceptors namely α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor, N-methyl-D-aspartate (NMDA) receptor, and gamma-aminobutyric acid receptor in the brain.[10] BM mainly acts by anti-oxidant neuroprotection, inhibition of acetylcholinesterase and/or activation of choline acetyltransferase, reduction of β-amyloid, increased cerebral blood flow, and modulation of neurotransmitter acetylcholine, serotonin, and dopamine.[9]

In vitro studies

BM extracts significantly inhibit the release of pro-inflammatory cytokines (tumor necrosis factor-α [TNF-α] and interleukin [IL]-6) from the microglial cells and thus may be beneficial in the treatment of central nervous system inflammation.[11] A standardized extract of BM is found to inhibit three enzymes, namely poly (ADP-ribose) polymerase (PARP), catechol-o-methyl transferase, prolyl endopeptidase and act as an antagonist of serotonin 6 and 2a receptors leading to memory enhancement.[12]

In vivo animal studies

Supplementation with BM extract (50 mg/kg/day for 15 days) is found to improve oxidative stress, inflammatory markers and reduce amyloid beta plaque formation in colchicine induced dementia in male Wistar rats.[13] BM increases GABAergic neurones in the brain of rat models of schizophrenia and enhances cognitive performance.[14] In epileptic rats treatment with BM extract improves alterations in 5-hydroxytryptamine (5-HT2 C) receptor, NMDA receptors, metabotropic glutamate receptor 5, glutamate and aspartate transporter, inositol triphosphate (IP3) content and thus shows anti-epileptic properties.[15] BM extract also reduces depressive like behavior in rat models of depression induced by chronic unpredictable stress.[16]

Clinical studies

Oral administration of a standardized extract of BM at a dosage of 150 mg twice daily for 6 weeks has been shown to improve cognition and performance in certain neuropsychological tests namely digit span backwards and logical memory test in the intervention group among medical students.[17] Standardized extract of BM is also found to be effective in reducing the symptoms of attention deficit hyperactivity disorder and is well-tolerated by children.[18] Although another study with healthy adults (35–60 years) found that BM extract at a dosage of 450 mg/day for 12 weeks leads to a lower anxiety level in the intervention group but does not improve cognitive status.[19]

Ashwagandha (Withania somnifera)

Ashwagandha (Withania somnifera [WS]) belongs to the plant family of Solanaceae. In Ayurveda it is classified as a “rasayana” (rejuvenator). In “Charaka Samhita,” “Susruta Samhita” and “Nighantus” it is recommended for various conditions such as “vataroga,” “kustha” (leprosy), “pachan” (digestion), “jwara” (fever), strength and is praised for its anti-inflammatory, immunomodulatory properties and its influence on the endocrine, nervous, cardiopulmonary, and reproductive systems.[20] It is usually consumed in the form of churna or powder with honey, ghee or milk. It possesses adaptogenic or antistress, antioxidant, anxiolytic, anti-neuroinflammatory, and GABA mimetic effects. The ashwagandha leaf extract is found to reverse the pathology of Alzheimer's and Parkinson's disease, enhance memory and protect against environmental neurotoxins.[21]

In vitro studies

The neuroprotective properties of WS extracts and their bioactive compounds were evaluated by using cultured glioblastoma and neuroblastoma cells. It was observed that the extract and one purified component named withanone at a low dose protected the glial cells and the neuronal cells from oxidative damage and glutamate insult as well as induced their ability to differentiate.[22] Alkaloids and steroidal lactones are found to be present in the methanol: chloroform (3:1) extract of dried ashwagandha roots. Withanolide A is the prominent one and is found to be neuroprotective against beta-amyloid-induced cytotoxicity.[23]

In-vivo animal studies

WS extract has been found to ameliorate the level of Bisphenol A (major endocrine disruptor and xenobiotic) intoxicated oxidative stress and thus treating cognitive functions.[24] Water extract of ashwagandha leaf containing triethylene glycol as a major component has been shown to induce non-rapid eye movement sleep significantly with a slight alteration in rapid eye movement sleep in experimental rat models. It indicates that WS can be used potentially for insomnia therapy.[25] An active metabolite of Withanoside IV called sominone was found to phosphorylate RET (“rearranged during transfection”), a receptor for glial cell-derived neurotrophic factor. Thus it increased the morphological plasticity of neurones and enhanced memory in normal mice.[26]

Clinical studies

WS root extract at a dosage of 300 mg twice daily for 8 weeks is found to be effective in mild cognitive impairment (MCI) and also in the improvement of attention, executive function, and information processing speed in adults with MCI.[27] WS extract supplementation at a dosage of 120 mg/day along with selective serotonin reuptake inhibitors (SSRI) for 6 weeks is beneficial and safe in the treatment of obsessive compulsion disorder.[28] Similarly, WS extract at a dosage of 1 g/day for 6 weeks along with SSRI is found to be effective in the treatment of generalized anxiety disorder.[29] WS may also be beneficial for the improvement of cognitive dysfunction associated with bipolar disorder.[30]

Turmeric (Curcuma longa)

Turmeric is a very popular native South Asian spice which belongs to the plant family Zingiberaceae. In “Charaka Samhita” and “Susruta Samhita” it is recommended for curing skin diseases (“kustaghna”), antidote to poisoning (“visaghna”), anti-obesity (“lekhaniya”) and anti-parasitic (“krimighna”) effects. “sayana” mentioned turmeric as a nootropic agent (“medhya”) when consumed with honey and ghee.[31] It can also be consumed with milk, as herbal tea or added to food while cooking. Turmeric is popularly known for its anti-inflammatory and antioxidant properties. A well-recognized compound present in turmeric is curcumin (diferuloylmethane) which is found to possess potent neuro-protective properties. Other compounds like phenolic and flavonoid antioxidants, curcuminoids, and some other functional monosaccharides have also been characterized.[32] Curcumin may be highly beneficial in the treatment of various brain-related disorders such as Alzheimer's disease, Parkinson's disease, autism, multiple sclerosis, and aging-associated neurodysfunctions.[33]

In vitro studies

Curcumin is found to inhibit beta-amyloid fibril formation from amyloid-beta peptide as well as destabilize preformed beta-amyloid fibrils in a dose-dependent manner.[34] Macrophages of Alzheimer's patients when treated with curcuminoids have shown significant increase in the uptake of beta-amyloid fractions. Such immunomodulatory effect of curcuminoids helps in the clearance of beta-amyloid plaques.[35]

In vivo animal studies

Curcumin is found to enhance postsynaptic electrical reactivity and viability of cells in intact neural circuits with antidepressant-like effects by up regulating brain derived neurotrophic factor (BDNF) and reducing inflammatory factors in the brain of chronically stressed rats.[36] Tetrahydrocurcumin, a major metabolite of curcumin, increases the activities of catalase, superoxide dismutase, glutathione peroxidase, reduced glutathione and glutathione-S-transferase in brain tissue of diabetic rats and prevents lipid peroxidation.[37] Curcumin decreases polyglutamine-induced cytotoxicity, neuronal dysfunction and neurodegeneration in the Drosophila model of Huntington's Disease.[38] It also reduces seizures and hippocampal neuronal loss in rat model of temporal lobe epilepsy.[39] Curcumin prevents cognitive-deficits associated with alcohol consumption in a dose-dependent manner.[40] It increases the production of docosahexaenoic acid (DHA) from its precursor compound, alpha-linolenic acid (ALA) and also increases the levels of enzymes which are found to be involved in the synthesis of DHA such as elongase 2 and fatty acid destaurase 2 (FADS2) in both liver and brain tissues of rats.[41] Elevation of brain DHA levels may be possible pathway through which curcumin results in cognitive improvement.

Clinical studies

Curcumin supplementation (360 mg/day) for 8 weeks may improve BDNF levels in patients with schizophrenia. Genetic expression of BDNF may be increased via phosphorylated cAMP response element binding protein by Curcumin leading to such effect.[42] Supplementation of curcumin is also found to increase brain-derived neurotrophic factor (BDNF) levels in women having premenstrual syndrome (PMS) and decrease the symptoms of PMS.[43] Curcumin at a dose of 1000 mg/day for 6 weeks is found to decrease depressive symptoms, pro-inflammatory cytokines (IL-1β and TNF-α) and salivary cortisol and increase the efficiency of anti-depressant treatment in adult male patients having major depressive disorder.[44]

Garlic (Allium sativum)

Garlic is a medicinal herb which is used in different traditional systems of medicine. It belongs to the plant family Amaryllidaceae. In “Kashyapa Samhita” it is mentioned as a “Rasayana” (rejuvenator). According to “Kashyapa” it is an appetizer, aphrodisiac, clarifier of memory and intellect and is recommended for various conditions like “vataroga,” cough, skin diseases, menstrual disorders, seminal disorders, increasing longevity etc.[45] It can be eaten in fresh form or added to food preparations. Garlic has been used extensively in the prevention and treatment of different cardiovascular diseases. Cerebrovascular disorders and metabolic syndrome are frequently associated with the development of dementia, Alzheimer's disease, cognitive impairment and other mental health morbidities. The well-known risk factors involved in the development of cardiovascular as well as cerebrovascular diseases are high blood cholesterol, high homocysteine, hyperglycemia, inflammation, hyper tension, atherosclerosis, and oxidative stress. High cholesterol level is associated with cognitive dysfunction, increased neuroinflammation, and amyloid precursor protein processing. Garlic is found to possess hypotensive, hypoglycemic, hypocholesterolemic, hypolipidemic, anti-thrombotic, and anti-atherosclerotic properties.[46] Thus, it also improves cerebrovascular health and may show neuroprotective properties. The bioactive principles present in garlic are the organosulfur compounds (OSCs), especially allicin (diallyl thiosulfinate) which is produced from alliin by an enzyme alliinase when crushed.[47]

In vitro studies

Raw garlic is found to possess potent anti-neuroinflammatory properties and this is due to the alliin derived OSCs (like allicin, diallyl trisulfide, diallyl disulfide). These compounds, especially diallyl trisulfide, and diallyl disulfide, decrease the production of TNF-α, lipopolysaccharide (LPS) induced nitric oxide, monocyte chemoattractant protein-1 and IL-1β in LPS stimulated microglial cells.[48] Similarly, a sulfur containing compound named thiacremonone decreases LPS induced activation of glial cell and inflammatory mediators, which are involved in amyloidogenesis.[49] These compounds inhibit the activation of nuclear factor (NF)-κB pathway and thereby reduce inflammation. Aged garlic extract and S-allyl-cysteine also have neuroprotective properties and reduce amyloid-beta peptide-induced apoptosis in pheochromocytoma (PC12) cells possibly by improving the endogenous antioxidant defense mechanisms.[50]

In vivo animal studies

Raw garlic and low temperature aged garlic administration (500 mg/kg) to stressed mice were found to reverse the levels of stress related hormones (e.g., cortisol, corticosterone, adrenocorticotrophic hormone, corticotropin releasing factor) and changes in the neurotransmitters of the brain (e.g., epinephrine, nor-epinephrine, dopamine, serotonin).[51] Garlic improves learning and memory impairment associated with lead exposure in juvenile rats by preventing oxidative damage and decreasing lead content.[52] Garlic also reduces anxiety and depression-related behaviors in diabetic rats.[53] In depression, the levels of monoamine oxidase enzyme (MAO) in the brain are found to be increased, which in turn reduce the levels of monoamines, namely nor-epinephrine, serotonin and dopamine. Garlic extract reduces the levels of monoamine oxidases (MAO-A and MAO-B) in the brain, thereby showing anti-depressant like activity.[54]

Clinical studies

Clinical studies have shown mixed results regarding the effect of garlic on lipid profile and other markers of metabolic syndrome which are associated with mental health disorders. Supplementation of aged black garlic (6 g/day) for 12 weeks is found to increase high density lipoprotein (HDL) levels and decrease apolipoprotein B levels in patients having mild hypercholesterolemia.[55] Some studies have found no significant effect of garlic therapy on lipid profiles and psychopathologic parameters.[56] Although a recent meta-analysis of clinical studies has confirmed the beneficial effect of garlic on reducing total cholesterol, low-density lipoprotein, triglyceride, fasting blood sugar, glycated hemoglobin (HbA1c) levels and increasing HDL levels.[57] Such improvements may have highly beneficial effects on mental health.

Pumpkin seeds (Cucurbita maxima)

Pumpkin seeds are usually considered as agro-wastes and are discarded in spite of their high nutritive value and medicinal properties. Pumpkin belongs to the plant family Cucurbitaceae. The plant is widely grown in India and is conventionally used in Ayurveda. Pumpkin seeds are classified under the nuts and seeds group. It is 'tridoshic' and can be recommended in the “ahara” (diet) of “kapha Prakriti,” “vata prakriti” and “pitta prakriti” individuals based on the principle of “viruddha guna” (selection of food items having qualities which are opposite to the dominant qualities of the individuals).[58] They can be consumed in the fresh form, roasted form or can be added to food preparations. Pumpkin seeds contain high amounts of L-tryptophan (576 mg/100 g) and choline (63 mg/100 g).[59] L-tryptophan is widely used in the management of various medical conditions such as depression, anxiety, insomnia, hyperactivity, mood disorders, pain, and eating disorders.[60] Tryptophan can be converted to serotonin in the body which in turn may regulate various neuropsychological processes. Choline is known to be the precursor for the formation of the neurotransmitter acetylcholine in cholinergic synapses that provide stimulatory transmission in the nervous system. Choline also helps in brain development.[61]

In vitro studies

Pumpkin seed extract scavenges 2,2-diphenyl-1-picrylhydrazyl free radicals and inhibits lipoxygenase enzyme due to its phenolic content.[62]

In vivo animal studies

Oral administration of pumpkin seed oil (100 mg/kg and 200 mg/kg for 5 days) is found to exert anti-amnesic effects against scopolamine-induced amnesia in adult male Wistar rats. It inhibits acetylcholine esterase, decreases TNF-α expression in the hippocampus and increases glutathione levels in the brain.[63] Pumpkin seeds are also found to reduce depression[64] and improve memory[65] of experimental rats.

Clinical studies

Daily supplementation of 40 g of pumpkin seed (nutrient balls) to school-going children (6–8 years)[65] and bread prepared from germinated pumpkin seeds (100 g bread containing 1 g of tryptophan) to moderate depressive adults (20–50 years)[66] for one month were found to improve memory function and symptoms of depression, respectively.


  Discussion Top


Neurodegeneration and neurodegenerative diseases are becoming more prevalent day by day. Brahmi, ashwagandha, turmeric and garlic are found to be effective in the reversal of such diseases. [Table 1] summarizes their effect on the etiological factors of the neurodegenerative diseases. Anti-acetylcholinesterase activity is also shown by brahmi,[85] ashwagandha,[86] and turmeric[87] which may improve cholinergic neurotransmission in the brain and may compensate for the decreasing amount of functioning brain cells associated with various neurodegenerative diseases. Monoamine oxidase inhibitory properties are shown by garlic,[54] brahmi[88] and turmeric.[89] Pumpkin seeds show their anti-depressant properties mainly due to their L-tryptophan content and antioxidant effects. [Table 2] summarizes the dosage ranges and compositions of brahmi, ashwagandha, and turmeric for their neuroactive properties suitable for human subjects. Crushed garlic at a dose of 100 mg/kg body weight improves the components of metabolic syndrome.[96] Pumpkin seeds have shown positive effects on depressive symptoms and memory at a dosage of 35–40 g/day in human subjects.[65],[66] These dosage ranges can be safely used in humans.
Table 1: Effect of Bacopa, Withania, Curcuma and Allium on factors associated with Neurodegeneration

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Table 2: Dosage ranges for neuroactive properties of Bacopa, Withania and Curcuma

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These functional foods can either be incorporated in the daily diet (raw or cooked) or be used in the development of newer drugs. Different cooking methods also alter the bioavailability of certain active compounds. Brahmi and ashwagandha are not generally cooked. The total antioxidant capacity of cooked curcuminoids is decreased slightly depending on the cooking method. Boiled curcuminoids are stronger than the roasted form and the fried form is the weakest.[97] Cooking decreases the allicin content of garlic. Crushing garlic prior to cooking is found to minimize such losses.[98] Antioxidant content of pumpkin seeds is also decreased by cooking.[99] The losses of active compounds can be compensated by increased consumption.


  Conclusion Top


Mental health promotion is the need of the current era. Using functional foods can be a well acceptable way to promote mental health, although further research is needed in areas which are not evaluated so far. Although further research works are required in the unevaluated areas. Moreover, knowledge regarding the benefits of these functional foods should be disseminated to the public.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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