TEEN MENTAL HEALTH AND NUTRITION

Anxiety and depression continue to rise among adults and teens around the world. Prior to the pandemic, mental health issues were already escalating. Teens have been hit the hardest and need the support of their community, family and school. On 3/31/2022, the Centers for Disease Control (CDC) released new data highlighting the rise in mental health issues among United States high school students during the pandemic.

• 37% of all high school students report poor mental health status
• 44% felt sad or hopeless
• More than 55% reported emotional abuse by a parent or another adult
• 11% reported physical abuse by a parent or other adult
• 36% experienced racism
• 1 in 10 high school students stated they tried to take their life in the past 12 months
• 1 in 5 had seriously considered it
• > 29% reported a parent losing their job

“This worsening crisis in child and adolescent mental health is inextricably tied to the stress brought on by COVID-19 and the ongoing struggle for racial justice and represents an acceleration of trends observed prior to 2020,” according to the declaration from the pediatric groups (American Academy of Pediatrics, the Children’s Hospital Association and the American Academy of Child and Adolescent Psychiatry). When it comes to suicide in particular, the groups point to data showing that by 2018, suicide was the second-leading cause of death for people between the ages of 10 and 24. According to the CDC, data shows that in 2020, the percentage of emergency room visits for mental health emergencies rose by 24% for children between the ages of 5 and 11, and 31% for those 12 to 17, compared with 2019. Girls are the highest among suicide attempts and up to 51% for ages 12-17.

As you can see, numbers were already rising prior to the pandemic. Then the pandemic hit. “Young people have endured so much throughout this pandemic and while much of the attention is often placed on its physical health consequences, we cannot overlook the escalating mental health crisis facing our patients,” according to the American Academy of Pediatrics’ President, Dr. Lee Savio Beers. Teens were faced with virtual school and social isolation. This caused an increase of reliance on electronics.

Social media played and continues to play a huge role in the rise of mental health issues in teens. Researches have looked at Instagram, Snapchat, and Tiktok, and the negative influence it has on teens and their mental health. In an article by The Child and Mind Institute, some experts state teens mental health has worsened due to social media and texting. Based on their data, and my observations among teens:

• Instagram allows teens to filter their pictures. You can make your skin clear and/or your body thinner for example. Other teens look at these filtered pictures and think, “why can’t I look that skinny?” Could this be a reason for the rise in eating disorders among teens (this is another topic for discussion)?
• Snapchat allows teens to see where their friends are all of the time. Were they included? Were they not invited?
• According to a report on CBS and a New York Times article, teens turn to Tiktok to diagnosis their mental health struggles, often getting misinformation. This information can be very misguided and dangerous to their mental health.

Therefore, teens are highly affected and have front row seats to the world news, politics, mass shootings, racism, etc. So why are they affected more than adults are? There is a biological explanation! The human brain is not fully developed until we are about 25 years old. Teen’s process information with a part of the brain called the amygdala, the emotional part of the brain. Adults process information with the prefrontal cortex, the rational part of the brain. This is why teens may take things harder, act on impulse and/or engage in risky behaviors (sex, drugs, disordered eating). Adults are more likely to think things out and think about long-term consequences (not all adults of course and we all have our moments)!

This is why teens need the entire support of their community, family, and school. The CDC reports only 47% of teens felt supported by their schools during the pandemic. “These data echo a cry for help,” according to the CDC. “The Covid-19 pandemic has created traumatic stressors that have the potential to further erode student’s mental well being. Our research shows that surrounding youth with the proper support can reverse these trends and help our youth now and in the future.” Data demonstrates that a teen feeling connected to their school and teachers, were less likely to experience feelings of sadness. It takes a village to support our teens and not discount what they are going through to, “they are just being teens.” What else can we do as parents to support our children? We need to provide continuous education and support. We need to be in close communication with their schools and make sure that the schools are providing all resources available. The schools should be able to provide our teens with outside resources for additional support as well as their own. And as parents, we need to advocate for our teens, and make sure they are getting this support. The numbers show that school support is critical for our teen’s mental health!

In a recent article, Brigid Garvin, Clinical Director of Psychology at St. Christopher’s Hospital for Children, stated that the data from the CDC “reinforces what decades of research have told us: that a supportive and safe adult in a child’ life is the most important factor contributing to positive mental health outcomes and positive life outcomes.”

FOOD AND MOOD

Did you know that food effects our mood? We all need to understand the role that nutrition plays in our brain health. We require the proper nutrients, vitamins and antioxidants to fuel our brains. It is very important for teens to eat healthy since their brains are still developing. Choosing whole, fresh foods and cooking at home as much as possible, is the best way to ensure our teens are getting the nutrients they need for healthy brain growth. Their bodies require a rainbow of fruits and vegetables daily (they provide antioxidants to fight off free radicals and many other nutrients), healthy fats, lean proteins, omega-3 fatty acids, low fat dairy (as long as they don’t have an intolerance) and whole grains (unless their is a gluten allergy or sensitivity). They are at an age where they should be involved in meal prep and planning. They should know how to choose a balanced meal and snack, but do they?

FOODS TO CHOOSE:

• Omega-3 Fatty Acids: salmon, canned sardines, ground flaxseeds, chia seeds, walnuts
• Vitamin D3 – Our sunshine vitamin! Sources include cod liver oil, salmon, swordfish, tuna fish, fortified products, sardines, beef liver, egg yolk.
• Whole grains – brown rice, quinoa, whole wheat or whole grain bread and pasta, oatmeal
• A rainbow of vegetables and fruits – choose different colors for all of the different benefits. They are filled with powerful antioxidants that our brains need to function.
• Healthy fats in proper portions – avocado, nuts, all-natural nut butters, avocado and olive oil
• Lean protein – chicken, turkey, fish, eggs and plant based proteins such as beans, all-natural nut butters nuts, tofu, and quinoa
• Common vitamins supplement for mental health – B vitamins, D3, Vitamin C, Zinc, Magnesium and Omega-3 fatty acids (speak to a dietitian nutritionist to see if you may need to supplement your diet with these vitamins/minerals).

FOODS TO AVOID THAT PROMOTE INFLAMMATION (inflammation leads to chronic illness and disease and worsening mental health)

• Fast food
• Fried foods
• Processed foods
• Sugar
• Caffeine and energy drinks
• Refined carbs
• Soda
• Foods you may be sensitive to, such as gluten or dairy?

The best plan for improving your brain health: Choosing whole, fresh, foods!

Nutritional Psychiatry is becoming more popular and an area of nutrition I have started using in my practice. It is the practice of using food and food supplements as alternatives to mental health disorders (versus using prescription medications). To determine which foods are healthiest for you and which ones are causing inflammation. I use functional testing in my practice. I am able to test my patients for food sensitivities through a Mediator Release Test. Your blood is challenged against 176 different foods and food additives. The test identifies which foods are optimal foods for YOU and which foods could be causing adverse symptoms such as gut health issues, brain fog, fatigue, anxiety or depression, acne, joint issues, migraines, etc (which are all causes by inflammation). Blueberries may be anti-inflammatory for you but may cause inflammation in me. There is no “one size fits all” or one anti-inflammatory diet that works for everyone. That is where functional nutrition testing comes in.

FOOD AND GUT HEALTH

Did you know that 90% of serotonin is produced in the gut? This is your feel good hormone. Serotonin plays a pivotal role in your mood, amongst other functions. Imagine if your gut health is inflamed, imbalanced, or if you have leaky gut? I know most of you have heard of the gut-grain connection. Toxins can cross over the gut-brain access (leaky gut) and cause symptoms of insomnia, brain fog, depression and/or anxiety. Through genomic stool testing, we can determine if you have enough beneficial bacteria, too much bad bacteria, leaky gut, inflammation, digestive compromise, and/or food sensitivities that may be breaking your gut barrier down (allowing the good bacteria out, bad bacteria in). Once I find out where your imbalances are, I provide you with nutritional guidance and natural supplement recommendations to improve your gut’s immune health and overall well being.

In general, foods that can boost your gut health include: yogurt with live cultures, kimchi, kambucha, sauerkraut, whole grains and kefir. Some people take pre- and probiotics to better balance their gut health and improve adverse gut symptoms. Avoiding or limiting refined carbohydrates, sugar, and saturated fats will also benefit your gut health. Improving your gut health, can improve overall mental and physical health! If eating healthier can improve our teens’ mental health, we need to educate them and provide them with the proper resources.

Here are some statistics that prove we need to better educate them:

• According to the 2020-2025 Dietary Guidelines For Americans, more than 80% of Americans’ diets are low in vegetables
• According to an April 2017 study in the Journal of the Academy of Nutrition and Dietetics, 8.5% of high school students met fruit recommendations and 2.1% met vegetable recommendations
• Teens eat fruit 0.2 times per day and vegetables at 0.1 times per day according to the Journal of Academy of Nutriton and Dietetics Study
• Obesity doubled among adults, tripled in adolescents and quadrupled in children ages 6-11 in the United States between the 1970s and 2010, according to the 2011 Dietary Guidelines for Americans
• About 40% of American children and adolescents are overweight or obese, and the rate is increasing according to the 2020-2025 Dietary Guidelines for Americans
• According to the CDC, a median of 44.8% of middle and highs schools offer a salad bar for students
• And… according to the CDC, American students receive fewer than 8 hours of required nutrition education every school year. 40-50 hours of education are needed to change behavior!

In Summary, as a Registered Dietitian Nutritionist, Functional Medical Nutrition Specialist, and mom, I see first-hand, the rise of anxiety, depression and other mental health concerns among teens. My role is to educate parents and teens on how to choose the best foods possible for their brain health and gut health. The best advice I can give is to eat whole, fresh foods as much as possible and get your teens involved in the kitchen. Eat at home as much as possible and cut back on take out and dining out. Educate your teens to NOT jump on the latest diet fad and to not believe everything they hear or see on social media. Challenge them to take a break from social media and be proactive in stress management. Stress management and good sleep hygiene also play a role in mental and physical health! Guide them and provide them with the right resources to create the healthiest lifestyle possible!

Please reach out to me with any questions or concerns!

Joanne Gibson, RDN, FMNS, CLT, LDN

Nutrition and Wellness, LLC