Recognizing the ongoing stress and mental health crisis in our field, this article focuses on the consequences of poor nutrition and its biological impact through its effects on first responders. It presents a brief review of the biological mechanisms in layman descriptions and its impacts on EMS culture.
Mental health in EMS is unfortunately overly stigmatized and, to change that, it’s important to keep discussing it along with new ideas to reduce or eliminate it.
This article takes recent studies and applies them to EMS and our culture. It utilizes multiple references citing the biological mechanism through meta-analysis and observational studies completed in the past few years, including a study that illustrated a lower risk of depression when a Mediterranean diet was followed.
What Is Nutritional Psychology?
Nutritional psychology is a new field emerging in the scientific community; a field that studies the effects of nutrition on the brain. Until recently, studies conducted in the field of nutritional psychology haven’t received much attention due to their lack of statistical significance in their data. However, a recent study showed that a Mediterranean diet compared to that of a western diet can lower the risk of depression, showing a correlation between nutrition and mental health.1 This is an important finding because of the potential that this has for reducing stress and depression in emergency responders.
Zeroing in on the Body’s Bacteria
We all have bacteria living in our stomach that are sensitive to the foods we eat. When we ingest foods that promote growth of these bacteria into our stomach, our digestive system is able to produce the molecules we need for our body.
When we don’t take care of our body’s microbiota, we have a decline in many of the molecules our bodies need. What’s important for responders to recognize is that, many of the molecules that are produced in the gastrointestinal (GI) tract from the microbiota have a function directly related our mood.2
Research has now shown that a lack of these important molecules being produced in our GI tract can lead to increased anxiety and depression among animal and human models. (See Figure 1.)2
Diets such as the Mediterranean diet and other non-Western diets are high in antioxidants, anti-inflammatory components and omega-3 molecules, which all play a role in “gut” health.5
So, what this research suggests is that what we eat is not only important for our physical health but also our mental health, and it can have an impact on our job performance, our ability to act under pressure and our ability to prevent work-related injuries.
Luckily, nutrition is something that’s controllable in the emergency responder culture.
Why You Should Care
First responders are in the midst of a mental health crisis, with many in our field suffering from depression and anxiety, and many exhibiting the signs of post-traumatic stress. However, little has been said about our diets or the way our body processes and is affected by what we eat
Although it’s becoming less taboo to discuss and ask for help, the problem isn’t going away anytime soon. Therefore, to really take control of the issue, we have to analyze every angle—including analyzing our dietary nutrition.
Fast food has unfortunately become a large part of the culture of first responders. Although there’s no current study on nutritional psychology specifically looking at first responders, we can apply the previously cited studies to the first responder community.
When first responders aren’t receiving adequate nutritional value, they become part of the cycle mentioned earlier. Lacking proper nutrition, we’re at risk for developing depression just like the civilian population is. However, the important difference is that first responders have the added burden of dealing with the high stress of the job and low pay culture on top of it, which can exacerbate the field’s mental health crisis.
Fast-food chains and “gas station meals” are all high in preservatives and refined ingredients that have been linked to worsening mental health problems.3
The GI tract and psychology are very closely linked together, so when you have a whole population of individuals like first responders who are putting detrimental ingredients into their GI tract, it begins to make sense why the population’s psychological health is below par and negatively impacts mental health. Studies involving children have also shown that a poor diet can affect the biological mechanisms that are associated with depression.4
Although there’s a strong possibility that eating habits are contributing to the crisis first responders are facing, it would be unreasonable to say that eating better would solve our mental health crisis. However, we do need to take into consideration that, due to the levels of depression in the community at large, application of these studies may assist us in battling the current situation confronting many in our ranks.
Eating healthier isn’t going to cure post-traumatic stress or depression, but it has the great potential to reduce depression and anxiety.
More research needs to be done, not just on the overall population but on high-risk populations such as first responders, in particular, to understand the correlation more in depth and better learn how we can apply these findings.
Although the long hours, irregular schedule and reduced days off due to elected or forced overtime shifts can make it a challenge to control our source of nutrition, it’s one of the few things we have control over. Small steps in the right direction are important, whether its prepping healthier meals, getting a salad at a fast-food chain instead of a burrito or a burger and fries, or even analyzing our own diets.
Reducing inflammatory foods and those that cause oxidative stress (i.e., a disturbance in the balance between the production of reactive oxygen species, or free radicals, and antioxidant defenses) can improve mood disorders.2
These differences may seem insignificant when we look at our own personal lives, but the collective data is important.
We need to be able to criticize culture to progress in a positive manner. Also, we must able to understand how first responder culture affects us.
Although our nutrition isn’t the sole factor in determining the diagnosis of a mental health problem, it may be a contributing factor that needs to be taken seriously. And, it’s important to remember that nutritional adjustment isn’t meant to take the place of prescribed medications, but to be an adjunct to work in coordination with them.
1. Lassale C, Batty GD, Baghdadli A, et al. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry. 2018 Sep 26, 2018. [Epub ahead of print.]
2. Sandhu KV, Sherwin E, Schellekens H, e al. Feeding the microbiota-gut-brain axis: diet, microbiome, and neuropsychiatry. Transl Res. 2017;179:223–244.
3. Selhub E. (Nov. 16, 2015.) Nutritional psychiatry: Your brain on food. Harvard Health Blog. Retrieved March 18, 2019 from www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626.
4. O’Neil A, Quirk SE, Housden S, et al. Relationship between diet and mental health in children and adolescents: A systematic review. Am J Public Health. 2014;104(10):e31–e42.
5. Mediterranean diet: A heart-healthy eating plan. (Jan. 26, 2019.) Mayo Clinic. Retrieved March 18, 2018, from www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801.