The Council Of European Jamaats

Depression affects one in four adults and could become the world's second biggest killer within twenty years, according to a new report from the Mental Health Foundation. Well over half of Britain's student population exhibits the symptoms of depression, and there has been a 700 per cent increase in the prescription of antidepressants in the last ten years.

The President of The World Federation, AlHahh Hasnainbhai Walji says: Not an easy condition to define, clinical depression is very different from the down feeling that most people experience from time to time. Indeed it will only be accurately diagnosed and treated in fewer than one in three. Along with the diagnosis comes the stigma of this condition. Depression is often viewed by the lay public as evidence of a character defect or lack of will power. All the more so since this patient group is not one which will have the self-image and assertiveness to rise above this negativity, they are already much harder on themselves. I believe that we need to provide support and even become advocates for the patient. An area that is overlooked by the medical profession is the nutrition connection and I append herewith an extract form my book on Depression:

The importance of nutrition for depression is finally being realized. Indeed, some authorities are convinced that not only can depressed individuals relieve depression by carefully selecting foods that change their brain chemistry (neuro-transmitters), some people are maintaining their depressed state with the foods they eat. Several popular books have expressed these concepts quite aptly, such as “Foods and Moods” or “It’s not what you’re eating but what’s eating you”. There are also so-called “Smart Foods”.

Dietary considerations may be approached from either vantage point: how poor diet can contribute to depression, or how depression can contribute to poor diet. This is, of course, an academic distinction for purposes of clarity and the two aspects are inextricably interwoven. The best-known example would be eating disorders; individuals with anorexia nervosa and bulimia nervosa often develop depression. Dietary changes, inevitably, contribute to recovery.

Unfortunately, it is not as easy as simply selecting foods that are good to eat, or even drawing up a list of foods that are good for us. There is a delicate balance. Most of us tend to eat too many calories, derived from a small range of foods, which we repeat, sometimes on a daily basis: the breakfast donut, the burger for lunch, an evening snack of ice cream, etc.

Broadly speaking, protein foods boost dopamine and epinephrine within minutes. This increases alertness and speed of thought. Unfortunately, protein is usually attached to fat, since most people eat meat. Fat clogs the blood circulation and reduces oxygen levels, thereby “depressing” brain function and the work capacity of the heart.

Similarly, complex carbohydrates raise serotonin levels, which improves concentration and a feel-good mood. Simple, or refined, carbohydrates, on the other hand, like table sugar or processed foods that are highly sweetened, may cause a rapid surge in energy and then a “blah” state, termed “insulin-rebound”. Carbohydrates also contribute tryptophan, which is a precursor to serotonin (it is converted to serotonin within the brain). This causes a similar surge and rebound of serotonin levels.

The body reacts to these surges in sugar and tryptophan by producing more insulin in order to restore a sugar balance. As the temporary boost in sugar levels declines, at the same time as insulin increases, glucose levels may even become sub-normal, leading to dullness and fatigue. From a state of “Go, go, go...” you suddenly find that your “Get up and go, got up and left...” Your lifestyle is overtaken by the craving for more sugar and fat snacks, the stereotypical lifestyle of the “Couch potato”. It takes more sugar, more caffeine, and more nicotine to get through the day.

Such imbalances may precipitate a state of depression and, quite literally, continue to feed it, so that it endures.
Tyramine is an amino acid which is found in various foods and affects the sympathetic nervous system (medically, it is an indirect sympathomimetic) that can cause a hypertensive reaction (a rise in blood pressure) in patients receiving MAOI therapy.

Depression can be treated with many drugs, including tranquilizers or monoamine oxidase inhibitors (MAOI's). Monoamine oxidase is found in the gastrointestinal tract and inactivates tyramine; when drugs prevent the catabolism of exogenous tyramine, it is absorbed and displaces norepinephrine and epinephrine from the adrenal glands, disrupting the nervous system. Patients may experience a severe occipital or temporal headache, even cardiac arrhythmias, cardiac failure, and intracerebral hemorrhage have developed in patients receiving MAOI therapy that did not observe dietary restrictions (Brown & Bryant, 1988). Therefore, dietary restrictions are required for patients receiving MAOIs.

The tyramine content of foods varies greatly due to the differences in processing, fermentation, ripening, degradation, or incidental contamination. Foods that normally contain low amounts of tyramine may become a risk if unusually large quantities are consumed or if spoilage has occurred (McCabe, 1986). Because the side effects, from tyramine and MAOIs, are dose-related, reactions can usually be avoided without total abstinence from tyramine-containing foods. Approximately 10 to 25 mg of tyramine is required for a severe reaction compared to 6 to 10 mg for a mild reaction.

Foods to avoid, if taking MAOI's for depression:

• Ripened cheese, Sausage (fermented), Beef liver, Chicken liver, Meats (canned), Soy sauce, Yeast concentrates, Pickled and dried salted herring.
  

The above list consists of foods with sufficient tyramine (in small, or usual, serving sizes) to create a dangerous elevation in blood pressure. Therefore, they should be avoided entirely.

• Bean curd - fermented bean curd (“Tofu”), fermented soya bean, and soya bean pastes contain a significant amount of tyramine.
  
• Broad (fava) bean pods - these beans contain dopa, not tyramine, which is metabolized to dopamine and may cause a pressor reaction and therefore should not be eaten, particularly if overripe.
  
• Cheeses - tyramine content cannot be predicted based on appearance, flavor, or variety and therefore should be avoided except for cream and cottage cheese, which have no detectable level of tyramine.
  
• Fish - Smoked, fermented, pickled (Herring) and otherwise aged fish, meat, or any spoiled food may contain high levels of tyramine and should be avoided. Fresh fish and vacuum-packed pickled fish contain only small amounts of tyramine and are safe if consumed promptly or refrigerated for short periods; longer storage may be dangerous.
  
• Ginseng - some preparations have resulted in a headache, tremulousness and manic-like symptoms. Ephedrine (as in the Chinese herb Ma Huang) is also contra-indicated.
  
• Protein extracts - meat extracts should be avoided. Avoid liquid and powdered protein dietary supplements.
  
• Fresh meat - is safe, however, while there are no detectable levels in fresh chicken livers, a high tyramine content exists in spoiled livers. Sausages contain large amounts of tyramine.
  
• Shrimp paste - should be avoided.
  
• Yeast, Brewer's or extracts - yeast extracts (Marmite) which are spread on bread or mixed with water, should not be consumed. Yeast used in baking is safe.
  

Extract from: Depression, The definitive Guide to Natural Remedies, by This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Kian Press, 1999.