There’s growing evidence that the trillions of bacteria in our gut, known as microbiomes, could play a critical role in mental illnesses like schizophrenia. To help us understand the connection between what we eat and our brain, we invited Dr. Amedeo Minichino, a clinical academic psychiatrist and researcher at the University of Oxford, onto the latest episode of our podcast Look Again, titled The Gut-Brain Connection: Can Diet Influence Mental Illnesses?
The gut microbiome is a complicated system of all the bacteria and bugs that live in our gut. In addition to helping us metabolize food, they also help us regulate a bunch of other bodily functions—including brain health.
Dr. Minichino explains that there are several different steps in this connection. First and foremost, diet affects the microbiome, and the microbiome affects the host. Bacteria degrades a lot of the food that we eat, like complex carbs and medications.
For instance, if you take medication orally, the bacteria in your gut can trap the drug in your bacterial wall and reduce how much of it gets into your bloodstream. Your microbiome can also directly metabolize drugs, essentially acting as your liver. Thus if diet can influence the bacteria, it can affect mental health.
“Basically, they have enzymes that can degrade that specific drug—for instance, antipsychotics—and they can reduce how much of it gets into the blood and also produce toxic molecules out of it that can cause some of its side effects. That’s one direct implication of how things you ingest go through bacteria and affect mental health.”
Dr. Minichino
Dr. Minichino noted that while we have developed very good tools for detecting serious mental illness over the last 30 years, we still have work to do in finding treatments and interventions that actually prevent the transition to psychosis.
“It’s not that we cannot really prevent psychosis, it’s that the standard of care has become so high that we have to find something that is better than what we already provide to justify using something more specific for the prevention.”
Dr. Minichino
Faydra and Dr. Minichino also discussed the possibility of personalizing treatments for people with serious mental illness in the future. Due to the specificity of each person’s microbiome. Minichino says it’s very likely we’ll discover that the microbiome can tell us who will (and won’t) respond to or tolerate certain medications.
“There are studies that clearly show that your microbiome can cause abnormalities in the brain and can cause dysfunction in brain networks. The issue is identifying the specific mechanism and then using that specific mechanism to inform treatments. That’s the link that we are missing out to translate these findings into actionable things that can be of benefit to patients.”
Dr. Minichino
The two also discussed the potential for future research on the connection between gut health and serious mental illnesses like schizophrenia. Certain diets, like the ketogenic diet, have also shown promise and garnered a lot of interest, but there is still a lot of work and research to be done in the field to prove a link. Dr. Minichino himself recently conducted the first randomized controlled trial on the ketogenic diet for treatment-resistant depression at Oxford and is currently waiting for the results.
Despite these promising potential avenues, Dr. Minichino cautions tempering enthusiasm. There is still a lot of research and proof to be discovered on the connection between gut health and serious mental illness. At this point, treatments focusing on gut health should be viewed as potential add-on treatments instead of alternate strategies. For many, traditional treatments and therapies such as medication can be lifesaving.
“I definitely recommend you follow your clinician’s advice and trust the people treating you, and on top of that, take care of your general and physical health because we know from experience that physical health can have an important aspect on mental health. This is often overlooked by both patients and clinicians. Taking care of your physical health will have a huge impact on your disease trajectory in the long run.”
Dr. Amedeo Minichino
To listen to the full podcast episode, visit our podcast page to view all streaming platforms or use one of the players below.
ABOUT THE GUEST
Dr. Minichino leads the Oxford Prevention and Early Intervention Service and is researching how gut health might impact mental illnesses and how it could inform personalized treatments in the future.
SPONSOR
In addition to our primary funder BC Partners, this episode is brought to you by Castanet, the Okanagan’s trusted source for news, events, and community updates. Thank you to Castanet for supporting our show and helping us share these stories with you.
