To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This chapter examines the neurobehavioural impacts in adults of both starvation (food restriction/cessation) and energy restriction for life extension. Section 8.2 covers animals, finding that restriction causes hippocampal damage and stress responses. Section 8.3 covers humans. Short-term fasting (<1 week) has limited cognitive effects, primarily increasing attention to food. Long-term fasting (weeks-to-years) has been studied naturalistically (e.g., famines, hunger strikes) and in the lab (e.g., Minnesota starvation study). Findings are convergent, with dramatic increases in appetite, low mood and egocentricity. The neural basis of these effects can be studied indirectly in people with anorexia nervosa, although this is complicated by pre-existing brain changes that may dispose to this disease. The impacts of cachexia and aging are also examined, alongside the longer-term impacts of food restriction post-recovery. Part three examines the animal and human energy restriction literature. While lifespan extension can occur in small mammals, the evidence in primates and humans for beneficial effects is equivocal.
This chapter examines acute and chronic dietary neurotoxins. One group of acute neurotoxins are plant alkaloids, with ergot poisoning from rye the most notable. Others include the marine neurotoxins, which cause hundreds of thousands of poisonings from seafood that have ingested toxic diatoms/dinoflagellates (e.g., amnestic shellfish poisoning) and from seafood itself (e.g., fugu). Acute neurotoxins also arise from processing, flavourants (e.g., absinthe) and contaminants (e.g., milk sickness). Chronic neurotoxins are diverse, common and sometimes lethal. Prions are one group, in the form of kuru, and mad cow disease. Another is BMAA found in cycad seeds, leading to parkinsonian-like diseases. Reliance on cassava can be problematic if poorly prepared, alongside many bush foods eaten during famine (e.g., grass pea and lathyrism). Lead, aluminium, arsenic and especially mercury can all be ingested, with some tragic examples (e.g., Minamata). Interactions between neurotoxins, vulnerability from poor nutrition and the link to neurodegenerative diseases are also considered.
This chapter focusses on addiction to food-related drugs and whether food can be thought of as a drug. Section 7.2 considers alcohol, its behavioural effects and how these might arise in the brain. Consequences of chronic use on brain and behaviour are also examined, both for adult neurological sequelae and for foetal brain development. Section 7.3 explores caffeine and theobromine, the former being the world’s most widely used drug. Whether caffeine’s cognitive-behavioural benefits arise from it ameliorating withdrawal in chronic users or whether it has some cognitive enhancing properties in everyone is examined. The biological basis of these cognitive-behavioural effects are also reviewed, including how caffeine may affect striatal dopamine. Section 7.5 examines food addiction. A number of conceptual issues are discussed, namely obesity as an endpoint of addiction, whether there can be addiction to a biological need, and the appropriateness of parallels to substance abuse and behavioural models of addiction.
This chapter concerns neuroprotective diets, and the use of particular diets and dietary components as an intervention. The first section examines the Mediterranean diet, with its beneficial effects – as prevention and intervention – on cognitive performance, mental health and neurodegeneration. The second section explores the DASH (dietary approaches to stop hypertension) diet, which has shown promise across the same set of conditions as the Mediterranean diet, and with probably a similar set of common mechanisms (e.g., reductions in inflammation and oxidative stress, plus benefits to the cardiovascular system). The third section looks at the ketogenic diet and its variants, with its high fat to carbohydrate ratio, originally and successfully developed for paediatric epilepsy, and its more recent use in other conditions (e.g., multiple sclerosis, brain tumours). The final part of the chapter reviews single nutrients, these being either examples of polyphenols or omega-3 fatty acids, with research focussing on mental health, aging and neurodegeneration.
This chapter concerns neuro-cognitive development, from conception through to childhood. Breastfeeding has been studied extensively using cross-sectional methods, finding cognitive benefits. However, after controlling for confounding variables and with better designs, beneficial effects are at best small. Maternal undernutrition can result in adverse neurodevelopmental outcomes (e.g., enhanced risk of schizophrenia). Undernutrition during infancy and early childhood causes stunting – inadequate growth for age. Stunting is common (around 500 million children worldwide) and is linked to multiple cognitive impairments, imposing lifelong costs on the individual. As stunting involves a complex interaction between nutrition, brain and environment, dietary remediation alone may not be that effective. Maternal overnutrition is also associated with adverse neurodevelopmental outcomes, but here it is unclear if this relates to poor diet quality, maternal body fat or socio-economic factors. Finally, there are a wide range of specific nutritional deficiencies that affect neurocognitive development, many having lifelong impacts (e.g., thiamine, folate iron, iodine).
This chapter examines the impacts of consuming a Western-style diet (WS-diet), rich in saturated fat, sugar and salt. Animal and human data convincingly show that a WS-diet causes hippocampal and prefrontal cortical impairment. Determining which component of a WS-diet is responsible is not currently clear. Several mechanisms may underpin these adverse effects on the brain: (1) reductions in neurotrophic factors; (2) neuroinflammation; (3) oxidative stress; (4) increased stress responsivity; (5) selective vulnerabilities in the hippocampal blood-brain barrier; and (6) changes to gut microbiota. The last one is intriguing as gut microbiota changes may impair the gut endothelial barrier allowing gut material to leak into the bloodstream, subsequently affecting the brain. Eating a WS-diet has also been linked to poorer mental health (anxiety/depression), it may exacerbate multiple sclerosis, and increased risk for Alzheimer’s and Parkinson’s disease. Finally, obesity may be a consequence of these adverse neural changes, leading to appetitive dysregulation and overeating.
This chapter explores the acute effects of food intake. The first part (Section 3.2) deals with whole meals. Having breakfast may have some limited cognitive benefits, but confounds (the link between breakfast and socio-economic status) and absence of a theoretical rationale are problematic. There were few consistent effects linked with other meal-types, except lunch, which is linked to drowsiness. The second part (Sections 3.3–3.4) considers the impact of glucose on the brain and its basis, finding acute administration assists hippocampal-dependent learning and memory and executive function, but with no impact on self-control. Section three examines if dietary manipulation of amino acids can be used to affect specific monoamine neurotransmitter systems, via loading or depletion. Tryptophan (serotonin precursor) is best studied, with loading generating fatigue and depletion lowering mood in at-risk individuals. Tyrosine (dopamine precursor) loading has facilitative effects on working memory, but the depletion findings are ambiguous. There is little data on histidine (histamine precursor).
This chapter’s purpose is to present the aim of the book, its rationale, focus, approach and the basic concepts necessary to make sense of what follows. The first part outlines the aim and approach, focussing on the impact of diet on the human brain and mind, alongside an outline of the content. The second part provides an overview of the core knowledge and methods that underpin research into diet, brain and mind. This starts with basic nutritional (energy needs, macronutrients, micronutrients) and physiological concepts (metabolism, digestion, regulation). It then covers the key issue of dietary measurement (self-report, observation, biomarkers, manipulation) and its limitations (accuracy, demand, stability over days and decades). The latter part examines the measurement of mind and brain – and its limitations – concentrating, respectively, on neuropsychological tests and imaging approaches. The final part describes our study inclusion criteria, and our rationale for favouring those with a whole diet focus.
This chapter examines the implications arising from the book’s content, and draws some general conclusions. Section 10.2 considers implications on a chapter-by-chapter basis, covering the small effect of breastfeeding on cognition, the nature of energy metabolism in the brain, dietary components versus patterns, the gut–brain axis, caffeine and sugar, immorality and hunger, lifespan extension and depression as a common consequence of nutritional deficiency. Section 10.3 presents conclusions and future directions, organised under three headings. First, the necessity to improve dietary recording methods, examining biomarkers for individual foods, active and passive food image collection, and monitoring eating. Second, nutraceutical and nutrigenomics, with the former’s failure so far to deliver concrete benefits – and why – and the latter’s potential to explain this through understanding individual differences. Third, the translation and reproducibility crises in biomedicine, and some consideration of their solutions as they apply here.
This chapter – focussing on adults – concerns the effects on brain and behaviour of deficiencies in vitamins, minerals and macronutrients, which cannot be synthesised in the body. Section 9.2 examines the neurobehavioural consequences of hypovitaminosis (intake below that recommended) and deficiency for each vitamin, including thiamine (Wernicke’s encephalopathy and Korsakoff’s syndrome), NAD (pellagra) and folate (depression). Section 9.3 covers mineral deficiencies, with notable impacts from iodine (hippocampal impairment and links to neurodegeneration in later life), selenium (hippocampal impairment) and zinc (depression). Section 9.4 examines the two essential macronutrient deficiencies. One covers omega-3 and omega-6 fatty acids, with deficiency linked to depression and neurodegeneration. The other covers the essential amino acids and the brain’s unique deficiency detection mechanism. Depression seems to be a common consequence of deficiency, and deficiency in mid-to-later life seems to link to neurodegeneration, but supplementation generally of individual micronutrients has not revealed much benefit in this regard.
Everybody eats, and what we eat – or do not – affects the brain and mind. There is significant general, applied, academic, and industry interest about nutrition and the brain, yet there is much misinformation and no single reliable guide. Diet Impacts on Brain and Mind provides a comprehensive account of this emerging multi-disciplinary science, exploring the acute and chronic impacts of human diet on the brain and mind. It has a primarily human focus and is broad in scope, covering wide-ranging topics like brain development, whole diets, specific nutrients, research methodology, and food as a drug. It is written in an accessible format and is of interest to undergraduate and graduate students studying nutritional neuroscience and related disciplines, healthcare professionals with an applied interest, industry researchers seeking topic overviews, and interested general readers.
The COVID-19 pandemic has disrupted lives and livelihoods, and people already experiencing mental ill health may have been especially vulnerable.
Quantify mental health inequalities in disruptions to healthcare, economic activity and housing.
We examined data from 59 482 participants in 12 UK longitudinal studies with data collected before and during the COVID-19 pandemic. Within each study, we estimated the association between psychological distress assessed pre-pandemic and disruptions since the start of the pandemic to healthcare (medication access, procedures or appointments), economic activity (employment, income or working hours) and housing (change of address or household composition). Estimates were pooled across studies.
Across the analysed data-sets, 28% to 77% of participants experienced at least one disruption, with 2.3–33.2% experiencing disruptions in two or more domains. We found 1 s.d. higher pre-pandemic psychological distress was associated with (a) increased odds of any healthcare disruptions (odds ratio (OR) 1.30, 95% CI 1.20–1.40), with fully adjusted odds ratios ranging from 1.24 (95% CI 1.09–1.41) for disruption to procedures to 1.33 (95% CI 1.20–1.49) for disruptions to prescriptions or medication access; (b) loss of employment (odds ratio 1.13, 95% CI 1.06–1.21) and income (OR 1.12, 95% CI 1.06 –1.19), and reductions in working hours/furlough (odds ratio 1.05, 95% CI 1.00–1.09) and (c) increased likelihood of experiencing a disruption in at least two domains (OR 1.25, 95% CI 1.18–1.32) or in one domain (OR 1.11, 95% CI 1.07–1.16), relative to no disruption. There were no associations with housing disruptions (OR 1.00, 95% CI 0.97–1.03).
People experiencing psychological distress pre-pandemic were more likely to experience healthcare and economic disruptions, and clusters of disruptions across multiple domains during the pandemic. Failing to address these disruptions risks further widening mental health inequalities.
To test the feasibility of using telehealth to support antimicrobial stewardship at Veterans Affairs medical centers (VAMCs) that have limited access to infectious disease-trained specialists.
A prospective quasi-experimental pilot study.
Two rural VAMCs with acute-care and long-term care units.
At each intervention site, medical providers, pharmacists, infection preventionists, staff nurses, and off-site infectious disease physicians formed a videoconference antimicrobial stewardship team (VAST) that met weekly to discuss cases and antimicrobial stewardship-related education.
Descriptive measures included fidelity of implementation, number of cases discussed, infectious syndromes, types of recommendations, and acceptance rate of recommendations made by the VAST. Qualitative results stemmed from semi-structured interviews with VAST participants at the intervention sites.
Each site adapted the VAST to suit their local needs. On average, sites A and B discussed 3.5 and 3.1 cases per session, respectively. At site A, 98 of 140 cases (70%) were from the acute-care units; at site B, 59 of 119 cases (50%) were from the acute-care units. The most common clinical syndrome discussed was pneumonia or respiratory syndrome (41% and 35% for sites A and B, respectively). Providers implemented most VAST recommendations, with an acceptance rate of 73% (186 of 256 recommendations) and 65% (99 of 153 recommendations) at sites A and B, respectively. Qualitative results based on 24 interviews revealed that participants valued the multidisciplinary aspects of the VAST sessions and felt that it improved their antimicrobial stewardship efforts and patient care.
This pilot study has successfully demonstrated the feasibility of using telehealth to support antimicrobial stewardship at rural VAMCs with limited access to local infectious disease expertise.