Health re­port: Can you treat anx­i­ety with... yo­ghurt?

To nutri­tion-con­scious food­ies, the mind-gut con­nec­tion is noth­ing new. But a grow­ing strand of neu­ro­science called psy­chobi­otics is ex­plor­ing the ways that feed­ing your mi­cro­biome could hold the key to com­bat­ing men­tal ill­ness

Women's Health Australia - - CONTENT - By Nikki Os­man

Psy­chobi­otics might help our mind the way pro­bi­otics help our di­ges­tion

In the dark depths of my un­der­wear drawer, be­hind the date-night bra and the grippy socks, sits a pack of pills. Pop­ping one with my cof­fee is as much a part of my morn­ing rou­tine as the dou­ble snooze – it’s mus­cle mem­ory. They’re an an­tide­pres­sant I take for anx­i­ety that, for the past few years, has made it­self known when­ever I’ve been look­ing the other way. I have no shame in the con­tents of my top drawer, but I’m be­com­ing in­creas­ingly cu­ri­ous about the re­cent raft of re­search that’s ex­plor­ing a new al­ter­na­tive, the likes of which I might find in my fridge. Turns out the lat­est fron­tier of neu­ro­science isn’t re­ally about the brain. It’s all about the gut. In ex­cit­ing news, the gut mi­cro­biome is now thought to be just as in­flu­en­tial as our genes in de­ter­min­ing who we are, and the study of psy­chobi­otics – broadly de­fined as any in­ter­ven­tion that af­fects the brain through the trig­ger­ing of gut bac­te­ria – is piquing the in­ter­est of all those clever folks in white lab coats.

“We’ve seen this area of re­search evolve so much over the past five years, driven not only by ad­vances in tech­nol­ogy but also strong pub­lic in­ter­est,” says Pro­fes­sor John Cryan, prin­ci­pal in­ves­ti­ga­tor at APC Mi­cro­biome Ire­land and co-au­thor of The Psy­chobi­otic Revo­lu­tion (he’s ba­si­cally the

CEO of psy­chobi­otics). “There’s huge ex­cite­ment: peo­ple want to know what they can do with this in­for­ma­tion about how the gut in­flu­ences the brain, and we’re strug­gling to keep up,” he adds.

Let’s, for a sec­ond, put a pin in this en­thu­si­asm and back up a bit. The term ‘psy­chobi­otics’ was coined by Cryan and his co-au­thor, Pro­fes­sor Ted Di­nan, to re­fer to the in­flu­ence of pro­bi­otics – the bac­te­ria found in foods such as live yo­ghurt and miso – on the brain. It was the work of their team that led to the sem­i­nal study in this area, which has since been cited in re­search papers more than 1000 times (sci­ence gone vi­ral). In 2011, the team fed one group of mice a strain of the bac­te­ria Lac­to­bacil­lus rham­no­sus, and an­other a bac­te­ri­afree broth. Af­ter sev­eral stress tests, the team ob­served an ar­ray of changes in the bac­te­ria group, in­clud­ing al­ter­ations to neu­ro­trans­mit­ter re­cep­tors in the brain, such as GABA – the same re­cep­tor tar­geted by anti-anx­i­ety drugs. But the real clincher? They also ob­served fewer anx­ious and de­pressed be­hav­iours in the mice. “We pro­posed that if this could be re­pro­duced in hu­mans, it would lead to a psy­chobi­otic ef­fect,” ex­plains Cryan. “And when we did some test­ing on healthy adult vol­un­teers, the po­ten­tial psy­chobi­otics that we found did in­deed have a sig­nif­i­cant ef­fect in low­er­ing stress re­sponse and chang­ing brain ac­tiv­ity.” Wow!

BRAIN AND GUT TALK

In ad­di­tion to pro­bi­otic foods like yo­ghurt, psy­chobi­otics also in­clude pre­bi­otics (foods that feed your mi­cro­biome, such as as­para­gus, leeks and legumes) and other in­ter­ven­tions such as ex­er­cise. The con­vic­tion with which the mind-gut con­nec­tion is per­ceived would sug­gest that the brain and the gut are in con­stant com­mu­ni­ca­tion, the likes of which you wit­ness only in your most pro­lific group What­sapp chats. “The body is so

in­cred­i­bly com­plex that there are many dif­fer­ent mech­a­nisms that could ex­plain how the bac­te­ria com­mu­ni­cate with the brain,” says Dr Me­gan Rossi, re­search as­so­ciate at King’s Col­lege Lon­don. “We do know that there are three main path­ways: one sends mes­sages through the blood­stream by pro­duc­ing chem­i­cals in the gut; the sec­ond is through the ner­vous sys­tem; the third is like an alarm sys­tem, via im­mune path­ways.”

While it’s one thing know­ing these con­nec­tions ex­ist, prov­ing how and why eat­ing gut-friendly fare could make you feel less anx­ious is an­other chal­lenge. In 2013, re­searchers from UCLA used func­tional MRI scan­ning to prove that when healthy women in­gested a pro­bi­otic twice daily for four weeks, it af­fected ac­tiv­ity in re­gions of the brain that con­trol emo­tion and sen­sa­tion. More re­cent stud­ies have ex­plored the po­ten­tial for ma­nip­u­lat­ing this com­mu­ni­ca­tion not only for anx­i­ety treat­ment but also for post­na­tal de­pres­sion, schizophre­nia and PTSD. Though hu­man stud­ies have been small so far, find­ings sug­gest that the im­pli­ca­tions ex­tend far beyond our cur­rent com­pre­hen­sion. This could be huge. We’re in the midst of a men­tal ill­ness epi­demic. The num­ber of Aussies tak­ing an­tide­pres­sants has more than dou­bled in the past 20 years. Could it be that the re­search be­ing car­ried out to­day is paving the way for the use of psy­chobi­otics – yo­ghurt in­cluded – as a men­tal health treat­ment?

Yes, say those knee-deep in the sci­ence. “I think we are head­ing to­wards a sce­nario where in five years’ time every­body will be get­ting their mi­cro­biome mea­sured in the same way that you get your choles­terol mea­sured to­day,” says Cryan. “In this sense, I think we could re­ally see a shift in pre­ven­ta­tive care but also in treat­ment.” Just one ex­am­ple? A team in Canada is cur­rently re­search­ing dif­fer­ent strains of bac­te­ria with the hope of be­ing able to use mi­cro­biome anal­y­sis to pre­dict risk but also to cre­ate be­spoke treat­ment for men­tal health con­di­tions. Cryan’s team is also in the early stages of de­vel­op­ing a psy­chobi­otic that could be used to treat the symp­toms of mild de­pres­sion.

Yep, pretty mind-blow­ing stuff.

THE FU­TURE OF PSY­CHOBI­OTICS

But oth­ers are more cau­tious when I ask if this re­search can be trans­lated into tan­gi­ble treat­ment.

“In or­der for psy­chobi­otics to have a clin­i­cal ap­pli­ca­tion, we need more hu­man stud­ies,” says Dr Philip

Bur­net, as­so­ciate pro­fes­sor in the Depart­ment of Psy­chi­a­try at the Univer­sity of Ox­ford. “The prob­lem we have is that in or­der to de­ter­mine if they alone can treat some­one who has de­pres­sion, you would need to deny that per­son med­i­ca­tion. You can’t do that, which makes it very dif­fi­cult to test.” In­stead, Bur­net sees psy­chobi­otics as sup­ple­ments that can help med­i­ca­tion to work bet­ter in peo­ple who don’t re­spond well to treat­ment or for those who have low mood but no de­pres­sion di­ag­no­sis.

Ad­ding an­other layer of com­plex­ity to psy­chobi­otics?

The care that has to be taken in dis­cussing the po­ten­tial of some­thing other than tried-and-tested med­i­ca­tion for men­tal health. The worry is that we risk ad­ding to the stigma that con­tin­ues to sur­round med­i­cally treat­ing your mind.

“Med­i­ca­tion has a re­ally im­por­tant role and peo­ple should never be afraid to take it if other fac­tors aren’t work­ing,” says Rossi. “But per­haps, ul­ti­mately, when some­one goes to their GP and re­ports symp­toms of anx­i­ety or de­pres­sion, doc­tors will pre­scribe both ex­ist­ing med­i­ca­tion and psy­chobi­otics.”

As to whether pre­bi­otics or pro­bi­otics play the big­gest role in in­flu­enc­ing men­tal health, ex­perts agree that we need more re­search. While it’s too early to tell every­one to go out and stock up on pro­bi­otic sup­ple­ments, Lac­to­bacil­lus and

Bi­fi­dobac­terium are among the most re­searched strains of bac­te­ria, and sup­ple­ments should con­tain up­wards of 5 bil­lion bac­te­ria per cap­sule. But eat­ing a diet rich in pre­bi­otics is also im­por­tant. That in­cludes legumes, Jerusalem ar­ti­chokes, leeks, onions and as­para­gus. Cryan sums it up: “If you look at the Mediter­ranean diet, which is rich in pre­bi­otics, it has been proven to be ben­e­fi­cial for brain health. The miss­ing link thus far has been that this is down to your mi­cro­biome. We need to join the dots, but my gut in­stinct tells me that, if you want to build up your stress re­silience, a psy­chobi­otic ap­proach would be use­ful.”

So, what does all this mean for peo­ple like me? While the link be­tween pre­bi­otics and brain health might need more hu­man stud­ies to de­liver con­crete proof, up­ping my in­take of pre­bi­otic foods can only be a good thing. And it’s re­as­sur­ing to know that di­etary steps could fu­ture-proof my men­tal health should I reach the point of com­ing off my med­i­ca­tion. As for where this re­search is headed, I’m ex­cited – and I’m not the only one. “We are in the early days of un­rav­el­ling the se­crets of this sys­tem,” says Dr Emeran Mayer, au­thor of The Mind-gut

Con­nec­tion. “I think we cur­rently know about 10 per cent. But, in the next 10 to 20 years, this could rev­o­lu­tionise so many dif­fer­ent ar­eas of medicine.” Now, there’s some real food for thought.

A DOSE FOR YOUR BRAIN

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