Rethinking mental health: Is nutrition the missing piece?

In her concluding comments on a BBC Podcast – What can we do about the world’s mental health problems – in November 2019, Grace Ryan a researcher at London’s Global Mental Health Centre said –

“What excites me about the sector I work in is that there are more answers out there that we have not come up with and that by looking further afield we might discover something really exciting and transformative that could improve mental health care all over the world.” [1]

While the benefits of nutrition on health and wellbeing are not new, emerging research on nutrition which involves the use of multinutrients is gaining a foothold in various part of the world and is possibly the transformational key the mental health sector has been looking for to address the rising rates of mental health we see today. ”

I refer to the book – The Better Brain, co-authored by psychologists Julia Rucklidge and Bonnie Kaplan, and found it to be a compelling and insightful read and now summarise some of key points from the book.

Why This Book Is So Important

For decades, treatment for depression and anxiety has been dominated by pharmaceuticals. Yet this body of research suggests the real key to better mental health might be found not in a pharmaceutical pill bottle—but in broad spectrum nutritional supplements.

In their groundbreaking book, Dr. Julia Rucklidge and Dr. Bonnie Kaplan argue that nutrition, long ignored in psychiatry, is central to preventing and treating mental health conditions. Rich in evidence-based science, the book makes a strong case for broad-spectrum nutritional supplements to be available through mainstream medicine as an effective and cheaper alternative to psychotropic medications (primarily antidepressants) to treat mental health disorders. Interwoven throughout the book are powerful personal stories of individuals who have experienced significant improvements in their mental health and overall well-being through the use of multinutrients. Their work draws from global studies and their own clinical research in New Zealand and Canada, challenging the widespread reliance on antidepressants and advocating for a return to good nutrition as medicine to assist people in the recovery process.

SSRIs: Little More Than Placebos?

Despite their popularity, antidepressants such as SSRIs (Selective Serotonin Reuptake Inhibitors) are now facing serious scrutiny. According to Rucklidge and Kaplan, evidence shows these medications often perform no better than a placebo—except in the most severe cases of depression.

More concerning, the process of coming off antidepressants has been downplayed by the psychiatric community. While often labelled “discontinuation syndrome,” the reality is stark: 56% of patients experience withdrawal symptoms, and in 46% of cases, these symptoms are severe. [2]

A Case for Nutritional Psychiatry

Instead of quick pharmaceutical fixes, The Better Brain promotes a nutritional approach. At its core is a simple truth: the brain, like the rest of the body, needs a full range of nutrients to function properly. Deficiencies in multiple vitamins and minerals can severely impact emotional regulation, cognitive function, and resilience to stress.

“We wouldn’t expect a car to run without fuel or oil,” says Dr. Rucklidge. “Why do we expect our brains to function without the nutrients they need?”

The authors point to the Mediterranean diet—rich in vegetables, fruits, legumes, herbs, spices, —as an anti-inflammatory powerhouse that’s consistently linked to lower rates of depression.

Furthermore, it’s been known for some time now that eating fish on a regular basis lowers the risk of the onset of depression and other mental health disorders. Research has found that a diet low in seafood consumption is associated with 65 times greater lifetime risk for depression 50 times greater risk for postnatal depression and a 30 times greater risk for bipolar disorder. [3]

Doctors Receive Almost No Nutrition Training

The authors highlight a troubling fact: the average medical student receives just 20 hours of nutrition education over five years. Meanwhile, pharmaceutical companies continue to influence clinical guidelines and education, leading to scepticism about supplements and dietary interventions.

“Advertising and industry messaging have convinced people that only psychiatric pills can fix mental illness,” the book notes. “But good science now tells a different story.”

Youth and Mental Health: Diet Matters

The impact of diet on children and teens is particularly compelling. Studies across multiple countries—including New Zealand, Canada, and Australia—have shown a strong link between poor diets and mental health issues like ADHD, mood swings, and depression.

An Australian study of 3000 adolescents (2011) revealed when reviewing their diets that a higher intake of unhealthy foods was related to poor mental health, while a diet of healthy foods i.e. a balanced diet of fresh fruit and vegetables served with lean meat and seafood was related to higher mental health functioning. [4]

Across the Tasman research reveals similar trends. A study in New Zealand (2018) revealed that the raw fruit and vegetable intake was more strongly associated with improved wellness as compared to tinned or cooked fruit and vegetables. The top ten raw foods were – carrots, bananas, apples, dark leavy greens like spinach, grapefruit, lettuce, citrus fruits, fresh berries, cucumber and kiwifruit. [5]

And:

In a 2019 Canadian study involving over 3,000 children aged 10 and 11, researchers assessed positive behaviour traits, primarily focusing on diet, physical activity, and daily screen time on computers and mobile devices. Two years later, follow-up findings showed that children who practiced these healthy behaviours maintained better mental health and experienced a 15% reduction in the need for medical treatment for mental health issues compared to those who did not participate in the study. [6]

Nutritional Supplements Show Promise for ADHD in Children

A 2018 New Zealand study involving 93 medication-free children aged 7–12 with ADHD found that those who took a broad-spectrum multinutrient supplement for 10 weeks showed greater improvements in inattention and overall functioning compared to those on a placebo. Parents, teachers, and clinicians also reported better emotional regulation and reduced aggression in the supplement group. In contrast, those who switched to medications like Ritalin were more likely to experience mood or anxiety issues at a one-year follow-up, often influenced by the lower cost of government-subsidised medications. [7]

Addressing Depression in Vulnerable Populations

A 2018 Canadian study showed promising results using broad-spectrum nutrients to treat depression. Pure North, a non-profit in Calgary, Alberta, has offered comprehensive nutritional and holistic support—including vitamins, minerals, amino acids, probiotics, and omega-3s—since 2007. Their programmes are free for low-income and homeless individuals.

In a one-year review of over 16,000 participants, published in 2018, about 50% reported improved mood. Notably, over 90% of those with severe or extreme depression or anxiety showed significant improvement. [8]

Pregnancy and Depression: The Nutrimum Trial

One of the most compelling pieces of evidence comes from the Nutrimum Trial in New Zealand, a large double-blind study examining the effects of multinutrients on antenatal depression.

The trial ran between 2017 and 2022 and recruited 88 women in their second trimester of pregnancy. Participants were randomly allocated to receive either 12 capsules (four pills, three times a day) of a broad-spectrum multinutrient supplement or an active placebo containing iodine and riboflavin over the 12-week period).

• 69% of pregnant women taking the supplements showed major improvements in mood, sleep, and day-to-day coping, compared to just 39% in the placebo group.
• Their babies also benefited—showing better emotional regulation, lower stress, and improved motor function, compared to infants exposed to antidepressants in utero.

“This is a safe and effective alternative for women who want to avoid medications during pregnancy,” Dr. Rucklidge noted. [9]

The Christchurch Case Studies: Multinutrients in Crisis

In the aftermath of the 2011 Christchurch earthquake, researchers from Canterbury University launched a study to see whether micronutrients could help traumatised residents. Ninety-one people took part in the trial and were randomised to one of three groups – (Berocca a B-complex formula, EMP (Mutinutrient Supplement) high dose, EMP low dose). An additional twenty-five people served as a non-randomised control group (they received the typical care being offered to Christchurch public at the time. The study ran for three months during which the city continued to be rocked by aftershocks.

The results were striking – people who took broad-spectrum nutritional supplements reported better mood, reduced anxiety, and lower rates of PTSD.

Participants on the higher dose of EMP Supplement showed the greatest improvements in mood, energy, and anxiety—consistent with findings from the 2010 earthquake study—and were five times more likely to continue the nutrients post-trial compared to those on Berocca. Among all treated groups, PTSD rates dropped from 65% to 19%, while the untreated group saw no change, remaining at around 50%. [10]

A similar intervention took place following the tragic 2019 Christchurch Mosque Shootings, in which a white supremacist gunman killed 51 and injured 40 people of Muslim faith at two mosques in Christchurch.

In just five weeks, rates of probable PTSD among traumatised participants dropped from 77% to 23%—with no adverse effects reported. [11]

Significant Government Savings Through Nutritional Psychiatry

The studies listed reveal that there is a strong and growing weight of evidence supporting the effectiveness of multinutrients in alleviating symptoms of depression, anxiety, trauma, and stress. Despite this, many individuals are forced to rely on publicly subsidised psychotropic medications—not due to preference, but simply because they cannot afford the ongoing cost of supplements.

If multinutrients—clinically proven and cost-effective—were made available by prescription through the primary health sector, the potential savings to the government could be substantial. Not only would this reduce reliance on more expensive pharmaceutical interventions, but it could also decrease hospitalisations, emergency responses, and long-term disability support caused by untreated or poorly managed mental health conditions.

In 2019, the Labour Government ring-fenced $1.9 billion over five years for mental health services—a commendable initiative, but one that pales in comparison to the $20 billion annual cost of mental illness to the New Zealand economy, as highlighted by Auditor-General John Ryan in his February 2024 report Meeting the Mental Health Needs of Young New Zealanders. Ryan stated:

“The human and economic costs of inaction are high. It is estimated that mental illness costs New Zealand about 5% of gross domestic product annually. In 2023, this meant more than $20 billion.”

By investing a fraction of that amount into making multinutrient treatments accessible, the government could unlock dramatic cost savings while also improving health outcomes for thousands. This is not just a matter of public health—it is a sound economic strategy for a healthcare system already under immense strain.

Changing the Conversation

To conclude, The Better Brain is more than a book—it’s a call to action. With anxiety and depression on the rise, and medications often falling short or causing harm, Rucklidge and Kaplan are urging both the public and the medical community to rethink mental health from the inside out.

Their message is clear: food isn’t just fuel—it’s medicine. And in the fight for better mental health, what we eat may be our most powerful tool yet.

Notes

[1] The Inquiry – What can we do about the world’s mental health problem? – BBC Sounds. Running On Empty: Antidepressants and Youth Suicide – A New Zealand Review -84, Vernall., R.W, – The Copy Press (2021).

[2] The Better Brain – How Nutrition Will Help You Overcome Anxiety, Depression, ADHD and Stress– Rucklidge., J. PhD and Kaplan., B, PhD – Penguin Random House UK (2021)

[3] Ibid p.107

[4] Ibid p.108

[5] Ibid p.105

[6] Ibid p.108

[7] Ibid p.119

[8] Ibid p.130

[9] For women with antenatal depression, micronutrients might help them and their babies – new study

[10] The Better Brain – How Nutrition Will Help You Overcome Anxiety, Depression, ADHD and Stress – Rucklidge., J. PhD and Kaplan., B, PhD – Penguin Random House UK (2021) – 168 -169

[11] Ibid p.174

Image credit: Umit Bulut