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- A Chinese trial comparing clinical outcomes of COVID-19 patients treated with the antimalarial drug hydroxychloroquine and those receiving standard of care alone reports “disappointing” result
- The hydroxychloroquine group only had a 28-day negative conversion rate of 85.4% compared to the control group’s rate of 81.3%. No difference in the alleviation of symptoms was observed between the two groups
- The study did not, however, use supplemental zinc, which helps prevent viral replication. Evidence suggests hydroxychloroquine works for COVID-19 because it acts as a zinc ionophore, meaning it shuttles zinc inside your cells
- A Brazilian chloroquine trial stopped the high-dose arm of the study early due to patients developing ventricular tachychardia, a dangerous heart rhythm problem. Chloroquine is known to be more toxic than hydroxychloroquine
- Quercetin is a naturally occurring zinc ionophore. Taken with zinc, it may be helpful to prevent and potentially treat COVID-19. Research is currently underway to assess quercetin’s effectiveness against COVID-19
The debate about whether the antimalarial drug hydroxychloroquine is an effective treatment for COVID-19 continues, as a Chinese trial1,2,3,4 comparing clinical outcomes of those treated with the drug and those receiving standard of care alone reports “disappointing” results.
Hydroxychloroquine Trial Reports Disappointing Results
Seventy-five COVID-19 patients at 16 Chinese treatment centers received 1,200 milligrams of hydroxychloroquine in addition to standard of care for the first three days of treatment, followed by a maintenance dose of 800 mg per day for two weeks in mild to moderate cases and three weeks for severe cases. Another 75 patients received standard of care only.
The primary endpoint was a 28-day negative conversion rate of SARS-CoV-2 (viral load reduction). Secondary endpoints included improvement rate of clinical symptoms and the normalization of C-reactive protein and blood lymphocyte count within 28 days.
According to the authors, the hydroxychloroquine group only had a 28-day negative conversion rate of 85.4% compared to the control group’s rate of 81.3%. No difference in the alleviation of symptoms was observed between the two groups.
Adverse events were also higher in the hydroxychloroquine group (30%) compared to controls (8.8%). You can find a listing of the adverse events in Table 2 of the study.5 The most common adverse event, at 10%, was diarrhea. That said, the authors point out that:6
“A significant efficacy of HCQ [hydroxychloroquine] on alleviating symptoms was observed when the confounding effects of anti-viral agents were removed in the post-hoc analysis (Hazard ratio, 8.83, 95%CI, 1.09 to 71.3).
This was further supported by a significantly greater reduction of CRP (6.986 in SOC [standard of care] plus HCQ versus 2.723 in SOC, milligram/liter, P=0.045) conferred by the addition of HCQ, which also led to more rapid recovery of lymphopenia, albeit no statistical significance.
Conclusions: The administration of HCQ did not result in a higher negative conversion rate but more alleviation of clinical symptoms than SOC alone in patients hospitalized with COVID-19 without receiving antiviral treatment, possibly through anti-inflammatory effects. Adverse events were significantly increased in HCQ recipients but no apparently increase of serious adverse events.”
Limitations of This Study
A few things are worthy to note about this study. Aside from its small size, the patients received a far higher dose of hydroxychloroquine than typically used in the U.S. — 1,200 milligrams for the first three days, followed 800 mg per day for two to three weeks, compared to the U.S. Food and Drug Administration’s suggested dosage of 800 mg on Day 1, followed by 400 mg per day for four to seven days, depending on severity.7
Secondly, most patients had mild disease with little hypoxemia, and thirdly, treatment was administered quite late, on average 16 to 17 days after the onset of disease. Commenting on the findings, Josh Fargas, associate professor of pulmonary and critical care medicine at the University of Vermont writes:8
“Much of the pathogenesis of critical illness seems to result from dysregulated inflammation, rather than direct viral cytopathic effect. This raises a question of whether any antiviral treatment will be beneficial for late-presenting patients with severe illness.
Of course, it is possible that earlier use of hydroxychloroquine could be beneficial (e.g., perhaps at the first signs of illness on an out-patient basis). This is under investigation and additional data is likely to be forthcoming soon. Even if this does work in the outpatient clinic, it would probably have little impact on the management of these patients within the intensive care unit.”
This Study Failed to Use Zinc
Perhaps most importantly, however, is the absence of zinc, which Fargas does not mention. We now know that chloroquine and hydroxychloroquine act as zinc ionophores,9,10 meaning they shuttle zinc into your cells, and zinc appears to be a “magic ingredient” required to prevent viral infection.11
If given early, zinc along with a zinc ionophore should, at least theoretically, help lower the viral load and prevent the immune system from becoming overloaded. Without zinc, hydroxychloroquine may be more or less useless.
So, in my view, I doubt this study is worth placing too much stock in, seeing how it did not administer supplemental zinc. As noted in the preprint paper, “Does Zinc Supplementation Enhance the Clinical Efficacy of Chloroquine / Hydroxychloroquine to Win Todays Battle Against COVID-19?” published April 8, 2020:12
“Besides direct antiviral effects, CQ/HCQ [chloroquine and hydroxychloroquine] specifically target extracellular zinc to intracellular lysosomes where it interferes with RNA-dependent RNA polymerase activity and coronavirus replication.
As zinc deficiency frequently occurs in elderly patients and in those with cardiovascular disease, chronic pulmonary disease, or diabetes, we hypothesize that CQ/HCQ plus zinc supplementation may be more effective in reducing COVID-19 morbidity and mortality than CQ or HCQ in monotherapy. Therefore, CQ/HCQ in combination with zinc should be considered as additional study arm for COVID-19 clinical trials.”
Chloroquine Trial Stopped Due to Side Effects
In related news, a Brazilian chloroquine trial13,14 stopped the high-dose arm of the study early due to patients developing ventricular tachychardia, a dangerous heart rhythm problem. As reported by Live Science:15
“The Brazilian researchers planned to enroll 440 people in their study to test whether chloroquine is a safe and effective treatment for COVID-19. Participants took either a ‘high dose’ of the drug (600 milligrams twice daily for 10 days) or a ‘low dose’ (450 mg for five days, with a double dose only on the first day) …
However, after enrolling just 81 patients, the researchers saw some concerning signs. Within a few days of starting the treatment, more patients in the high dose group experienced heart rhythm problems than did those in the low dose group. And two patients in the high dose group developed a fast, abnormal heart rate known as ventricular tachychardia before they died.”
As explained in my previous article, “Antimalarial Medications: A COVID-19 Treatment Option?” chloroquine and hydroxychloroquine have been shown to be effective in the lab against the SARS coronavirus that appeared in 2003.16,17,18 Laboratory testing also suggests chloroquine is effective in cell cultures against COVID-19 when combined with an antiviral drug, remdesivir.19
However, chloroquine (Aralen) appears to be a more hazardous choice than hydroxychloroquine (Plaquenil), which is a derivative of chloroquine.20 Both use the same pathway, but hydroxychloroquine is thought to be about 40% less toxic21 and, overall, has a safer side effect profile.22,23
Quercetin — A Safer Alternative to Hydroxychloroquine?
Considering the risks of chloroquine and hydroxychloroquine, and the evidence suggesting the reason these drugs work for COVID-19 is because they act as zinc ionophores, it’s worth questioning whether other more natural zinc ionophores can be used.
One prime example would be quercetin, which is a naturally occurring zinc ionophore.24 As reported by the Green Stars Project,25 “Researchers from Oak Ridge National Lab used the world’s most powerful supercomputer, SUMMIT, to look for small molecules that might inhibit the COVID-19 spike protein from interacting with human cells and, interestingly, quercetin is fifth on that list.”26
Quercetin is one of only three natural products found to inhibit the SARS-CoV-2 spike protein. The only natural product found to be slightly more effective is luteolin, a polyphenol found in radicchio, green peppers, serrano and green hot chili peppers, chicory, celery and many other foods.27
Quercetin is another flavonols compound found in a variety of foods, including apples, Brassica vegetables, capers, onions, tea and tomatoes, just to name a few. It’s also contained in medicinal products such as Ginko biloba, St. John’s Wort (Hypericum perforatum) and elderberry (Sambucus canadensis).
Research has already demonstrated that quercetin is a powerful immune booster and broad-spectrum antiviral. As noted in a 2016 study28 in the journal Nutrients, quercetin’s mechanisms of action include the inhibition of lipopolysaccharide (LPS)-induced tumor necrosis factor α (TNF-α) production in macrophages.
TNF-α is a cytokine involved in systemic inflammation, secreted by activated macrophages, a type of immune cell that digests foreign substances, microbes and other harmful or damaged components. Quercetin also inhibits the release of pro-inflammatory cytokines and histamine by modulating calcium influx into the cell.29
According to this paper, quercetin also stabilizes mast cells and has “a direct regulatory effect on basic functional properties of immune cells,” which allows it to inhibit “a huge panoply of molecular targets in the micromolar concentration range, either by down-regulating or suppressing many inflammatory pathways and functions.”30
Another 2016 study31 concluded it helps modulate the NLRP3 inflammasome, an immune system component involved in the uncontrolled release of pro-inflammatory cytokines that occurs during a cytokine storm.
In vitro studies32,33,34 have shown quercetin exerts antiviral activity against SARS-CoV, and preliminary findings35 suggest quercetin can inhibit the SARS-CoV-2 main protease as well. You can get even more details about the anti-inflammatory and antiviral powers of quercetin in “Quercetin Lowers Your Risk for Viral Illnesses.”
Quercetin Being Studied for Its Use Against COVID-19
The good news is researchers are in fact planning to study the use of quercetin against COVID-19.36 As reported by Maclean’s,37 Canadian researchers Michel Chrétien and Majambu Mbikay began investigating quercetin in the aftermath of the SARS epidemic that broke out across 26 countries in 2003.
They discovered a derivative of quercetin provided broad-spectrum protection against a wide range of viruses, including SARS.38,39 The Ebola outbreak in 2014 offered another chance to investigate quercetin’s antiviral powers and, here too, they found it effectively prevented infection in mice, “even when administered only minutes before infection.”
So, when the COVID-19 outbreak was announced in Wuhan City, China, in late December 2019, Chrétien contacted colleagues in China with an offer to help. In February 2020, Chrétien and his team received an official invitation to begin clinical trials. According to Maclean’s:40
“The Canadian and Chinese scientists would collaborate on the trials, which would include about 1,000 test patients. Chrétien and Mbikay plan to join colleagues from the non-profit International Consortium of Antivirals — which Chrétien co-founded with Jeremy Carver in 2004 as a response to the SARS epidemic — in manning a 24/7 communications centre as soon as clinical trials go ahead.
The U.S.-based Food and Drug Administration has already approved quercetin as safe for human consumption, which means the researchers can skip testing on animals. If the treatment works, it’ll be readily available … Chrétien’s team says their treatment would cost only $2 a day.”
Dosage Recommendations for Quercetin and Zinc
While the COVID-19 pandemic is in full swing — and for any future influenza season — supplementing with quercetin and zinc may be a good idea for many, in order to boost your immune system’s innate ability to ward off infectious illness. As for dosage, here are some basic recommendations:
•Quercetin — According to research from Appalachian State University in North Carolina, taking 500 mg to 1,000 mg of quercetin per day for 12 weeks results in “large but highly variable increases in plasma quercetin … unrelated to demographic or lifestyle factors.”41
•Zinc (and copper) — When it comes to zinc, remember that more is not necessarily better. In fact, it can backfire. When taking zinc, you also need to be mindful of maintaining a healthy zinc-to-copper ratio. As noted by Chris Masterjohn, who has a Ph.D. in nutritional sciences,42 in an article43 and series of Twitter posts:44
“In one study, 300mg/day of zinc as two divided doses of 150 mg zinc sulfate decreased important markers of immune function, such as the ability of immune cells known as polymorphonuclear leukocytes to migrate toward and consume bacteria.
The most concerning effect in the context of COVID-19 is that it lowered the lymphocyte stimulation index 3 fold. This is a measure of the ability of T cells to increase their numbers in response to a perceived threat. The reason this is so concerning in the context of COVID-19 is that poor outcomes are associated with low lymphocytes …
The negative effect on lymphocyte proliferation found with 300 mg/day and the apparent safety in this regard of 150 mg/d suggests that the potential for hurting the immune system may begin somewhere between 150-300 mg/d …
It is quite possible that the harmful effect of 300 mg/d zinc on the lymphocyte stimulation index is mediated mostly or completely by induction of copper deficiency …
The negative effect of zinc on copper status has been shown with as little as 60 mg/d zinc. This intake lowers the activity of superoxide dismutase, an enzyme important to antioxidant defense and immune function that depends both on zinc and copper …
A study done with relatively low intakes of zinc suggested that acceptable ratios of zinc to copper range from 2:1 to 15:1 in favor of zinc. Copper appears safe to consume up to a maximum of 10 mg/d.
Notably, the maximum amount of zinc one could consume while staying in the acceptable range of zinc-to-copper ratios and also staying within the upper limit for copper is 150 mg/d.”
How Much Zinc Do You Need?
Masterjohn goes into even greater detail in his zinc article, discussing maximum absorption rates and much more.45 In summary, he recommends taking 7 mg to 15 mg of zinc four times a day, ideally on an empty stomach, or with a phytate-free food.
The recommended dietary allowance in the U.S is 11 mg for adult men and 8 mg for adult women, with slightly higher doses recommended for pregnant and breastfeeding women,46 so we’re not talking about taking significantly higher dosages.
Additionally, you can take one zinc acetate lozenge per day, which will provide you with an additional 18 mg of zinc. If you’re exposed to the virus, take one additional lozenge after the exposure.
Masterjohn stresses that you’ll want to keep your total zinc intake below 150 mg per day to avoid negative effects on your immune system. He also recommends getting at least 1 mg of copper from food and supplements for every 15 mg of zinc you take.
Keep in mind that there are many food sources of zinc, so a supplement may not be necessary. I eat about three-fourths of a pound of ground bison or lamb a day, which has 20 mg of zinc. I personally don’t take any zinc supplement other than what I get from my food, which is likely in an optimal form to maximize absorption.
- 1, 6 Medrxiv.org April 14, 2020 DOI: 10.1101/2020.04.10.20060558 [Preprint]
- 2 Medrxiv.org April 14, 2020 DOI: 10.1101/2020.04.10.20060558 [Preprint] (PDF full study)
- 3, 8 Emcrit.org April 16, 2020
- 4 Reason April 16, 2020
- 5 Medrxiv.org April 14, 2020 DOI: 10.1101/2020.04.10.20060558 [Preprint] (PDF) Table 2, Page 37
- 7 FDA.gov Fact Sheet, EUA of Hydroxychloroquine (PDF)
- 9 PLOS ONE 2014; 9(10): e109180
- 10, 11, 12 Preprints April 6, 2020 DOI: 10.20944/preprints202004.0124.v1
- 13 Medrxiv.org April 11, 2020 DOI: 10.1101/2020.04.07.20056424
- 14 Medrxiv.org April 11, 2020 DOI: 10.1101/2020.04.07.20056424 (PDF full study)
- 15 Live Science April 13, 2020
- 16 Antiviral Research, 2020;177:104762 Highlight bullest
- 17 Clinical Infectious Disease, 2020; 10.1093/cid/ciaa237 Abstract
- 18 Virology Journal, 2005;2(69) Abstract/Conclusion
- 19 Cell Research, 2020;30:269 Abstract
- 20, 21 Nature March 18, 2020; 6 Article number 16, Correspondence
- 22 Clinical Infectious Diseases, 2020; doi.org/10.1093/cid/ciaa237 Abstract
- 23 Medicinenet.com Chloroquine vs Hydroxychloroquine
- 24 Journal of Agricultural and Food Chemistry 2014, 62, 32, 8085-8093
- 25 Greenstarsproject.org March 27, 2020
- 26 ChemRxiv.org March 11, 2020 (PDF full study), Table 3
- 27 Myintakepro.com Luteolin Rich Foods
- 28, 30 Nutrients 2016 Mar; 8(3): 167, 5.1.2 Mechanism of Action
- 29 Nutrients 2016 Mar; 8(3): 167, Table 1: Mast cell
- 31 Mediators of Inflammation 2016; 2016, Article ID 5460302
- 32 Journal of Virology October 2004: 11334-11339 (PDF)
- 33 Biotechnology Letters February 15, 2012; 34: 831-838
- 34 Bioorg Med Chem 2010 Nov 15;18(22):7940-7
- 35 Preprints.org March 12, 2020
- 36 CBC February 28, 2020
- 37, 40 Maclean’s February 24, 2020
- 38 Bioorg Med Chem. 2006 Dec 15;14(24):8295-306
- 39 Journal of Virology Sep 2004, 78 (20) 11334-11339, Antiviral activity of an analog of luteolin
- 41 Appalachian State University, The Variable Plasma Quercetin response to 12-Week Quercetin Supplementation (PDF)
- 42 Chrismasterjohnphd.com
- 43, 45 Chrismasterjohnphd.com Best Dose of Zinc for COVID-19 Prevention
- 44 Twitter, Chris Masterjohn April 10, 2020
- 46 NIH Zinc Fact Sheet
Reproduced from original article:
- While the food industry has become notorious for funding anti-obesity programs that focus on physical activity, research clearly shows that processed foods, sugary beverages and high-carbohydrate diets are a primary concern
- Processed vegetable oils, which are a staple ingredient in processed foods, also promote obesity and ill health. Soybean oil, the most widely consumed fat in the U.S., upregulates genes involved in obesity and is more obesogenic than fructose
- Sugar-rich diets generate excessive reward signals in your brain that can override normal self-control mechanisms and lead to addiction and overeating
- Recent research found a single week of bingeing on fast foods impaired appetite control, making the volunteers more likely to desire more junk food, even if they’d just eaten
- The more added sugar your diet contains, the lower your intake of important micronutrients such as calcium, folate, iron, magnesium, potassium, selenium, vitamin C, vitamin D and zinc
The struggle with weight gain and obesity is a common and costly health issue, leading to an increase in risk for heart disease, Type 2 diabetes and cancer, just to name a few.1
Obese individuals also have substantially higher medical expenses and indirect costs associated with lost productivity, transportation and premature mortality, and obesity is the reason why 1 in 3 fail to qualify for military service in the U.S.2
According to the 2019 State of Obesity report,3 18.5% of American children (ages 2 to 19) and 39.6% of adults are now obese, not just overweight. Between the 1988-1994 and 2015-2016 National Health and Nutrition Examination Surveys, the adult obesity rate rose over 70% and the childhood obesity rate rose by 85%, and there are no signs of this trend slowing or reversing.4
While the food industry has become notorious for funding anti-obesity programs that focus on physical activity, research clearly shows that processed foods, sugary beverages and high-carbohydrate diets are a primary concern. Sure, inactivity certainly contributes to the problem, but you cannot exercise your way out of a poor diet.
Processed vegetable oils, which are high in damaged omega-6 fats, are yet another reason why processed food diets are associated with higher rates of heart disease and other diseases.
Soybean oil, which is the most widely consumed fat in the U.S.,5 has been shown to play a significant role in obesity and diabetes, actually upregulating genes involved in obesity.6 Remarkably, soybean oil was found to be more obesogenic than fructose. It’s also been shown to cause neurological changes in the brain.7,8
Junk Foods Addiction Is Real
Processed junk food destroys your metabolism and promotes obesity through a variety of mechanisms. Among them is the way these kinds of foods affect your appetite control. Several studies have also demonstrated that processed foods are addictive.
As detailed in “The Extraordinary Science of Addictive Junk Food,” your body is designed to naturally regulate how much you eat and the energy you burn. Food manufacturers have figured out how to override these intrinsic regulators, engineering processed foods that are “hyper-rewarding.”
According to the food reward hypothesis of obesity, processed foods stimulate such a strong reward response in our brains that it becomes very easy to overeat. One of the guiding principles for the processed food industry is known as “sensory-specific satiety.”
In a 2013 New York Times article, investigative reporter Michael Moss described this as “the tendency for big, distinct flavors to overwhelm your brain.”9 The greatest successes, whether beverages or foods, owe their “craveability” to complex formulas that pique your taste buds without overwhelming them, thereby overriding your brain’s satiety signals.
Potato chips are among the most addictive junk foods on the market, containing all three “bliss-inducing” ingredients: sugar (from the potato), salt and fat. And while food companies abhor the word “addiction” in reference to their products, scientists have discovered that sugar, in particular, is just that. In fact, sugar has been shown to be more addictive than cocaine.
Research10 published in 2007 showed 94% of rats allowed to choose between sugar water and cocaine chose sugar. Even cocaine addicted rats quickly switched their preference to sugar once it was offered as an alternative. The rats were also more willing to work for sugar than for cocaine.
The researchers speculate that the sweet receptors (two protein receptors located on your tongue), which evolved in ancestral times when the diet was very low in sugar, have not adapted to modern times’ high-sugar consumption.
As a result, the abnormally high stimulation created by sugar-rich diets generates excessive reward signals in your brain, which have the potential to override normal self-control mechanisms and thus lead to addiction and overeating.
Junk Foods Interfere With Appetite Control
Most recently, Australian researchers found a single week of bingeing on fast foods impaired appetite control, making the volunteers more likely to desire more junk food, even if they’d just eaten.11 They also scored lower on memory tests, thus confirming previous findings12 showing a Western-style diet impairs learning and memory. As reported by Science Alert:13
“The findings suggest something is amiss in the hippocampus — a region of the brain that supports memory and helps to regulate appetite. When we are full, the hippocampus is thought to quieten down our memories of delicious food, thereby reducing our appetite. When it’s disrupted, this control can be seriously undermined.”
For this eight-day experiment, healthy volunteers between the ages of 17 and 35 with a body mass index14 between 17 and 26 (slightly underweight to mildly overweight) were instructed to eat:
- Two Belgian waffles on four days
- A main meal and a drink or dessert from a popular fast food chain on two days
On days 1 and 8, the volunteers were given a toasted sandwich and milkshake for breakfast at the lab. The control group were given the same breakfast at the start and end of the study, but were instructed to eat normally during the remainder of the week.
On days 1 and 8, participants also completed pre- and post-breakfast “wanting and liking tests,” in which they were first presented with six sugary breakfast foods and asked to rate how strong their desire to eat the food right now was. Next, they were instructed to consume the samples and rate how much they liked it, and how much more of it they thought they would be able to eat right then. As reported by the authors:15
“One week’s exposure to a WS-diet [Western-style diet] caused a measurable weakening of appetitive control, as measured by the two key ratings on the wanting and liking test.
Prior to the intervention, participants viewed palatable breakfast foods and judged how much they wanted to eat them, and then how much they liked their actual taste. This test was repeated after participants had eaten to satiety.
Across these pre- and post-meal tests, wanting ratings declined far more than ratings of taste liking. This manifestation of appetitive control — that is the expectation that food is less desirable than it actually tastes — changed in participants following the Western-style dietary intervention.”
High-Sugar Diets Lower Nutrient Absorption
If you eat a fast-food burger, you can easily take in close to half your daily caloric requirements. Add in fries and a soda and you may be nearing an entire day’s worth of required calories. However, you have not received the vitamins and minerals, the live enzymes and micronutrients, the healthy fats or high-quality protein that your body needs to function, let alone thrive.
This was recently demonstrated in a Swedish study,16,17 which found that the more added sugar your diet contains, the lower your micronutrient intake (i.e., vitamins and minerals).
To examine this relationship, the researchers examined dietary data collected in two Swedish population based studies (the National Swedish Food Survey and the Malmö Diet and Cancer Study).
Each individual’s added sugar intake was estimated by subtracting naturally-occurring fructose from the total sugar content of the diet as a whole. Energy intake for added sugar was then stratified into six groups:
|Less than 5% of energy intake from added sugar||5% to 7.5%|
|7.5% to 10%||10% to 15%|
|15% to 20%||Greater than 20%|
They also calculated the intake of calcium, folate, iron, magnesium, potassium, selenium, vitamin C, vitamin D and zinc, finding an inverse relationship between added sugar intake and intakes of all nine micronutrients. According to the authors:18
“These findings suggest that in two Swedish populations the higher the intake of added sugar in the diet, the more likely it is that the intake of micronutrients will be compromised …
However, although the trends are significant and consistent with those obtained in other studies on the subject, future studies are needed in order to build the necessary scientific knowledge to establish a threshold of added sugar intake based on micronutrient dilution.”
When fast food meals are consumed day in and day out, for months and years on end, weight gain is virtually guaranteed, yet your body may still be starving and malfunctioning for lack of essential nutrients.
Depression Is a Junk Food State of Mind
Aside from promoting obesity, processed food and fast food diets have also been strongly linked to depression, especially in teens. In a 2019 study,19 researchers at the University of Alabama at Birmingham looked into the role diet plays in symptoms of depression.
To do that, they analyzed the excretion of sodium and potassium in the urine of 84 urban, low‐income adolescents. Higher levels of sodium in the urine can be an indication of a diet high in sodium, such as processed foods and salty snacks. A low level of potassium, meanwhile, is indicative of a diet lacking in fruits, vegetables and other healthy potassium-rich foods.
As expected, higher sodium and lower potassium excretion rates were associated with more frequent symptoms of depression at follow up 1.5 years later. “This study was the first to demonstrate relationships between objective indicators of unhealthy diet and subsequent changes in depressive symptoms in youth,” the authors wrote.20
It’s possible that eating foods high in sodium and low in potassium may lead to depression by negatively influencing neurotransmitters and neural function during a time that is particularly vulnerable.
“Given the substantial brain development that occurs during adolescence, individuals in this developmental period may be particularly vulnerable to the effects of diet on the neural mechanisms underlying emotion regulation and depression,” the researchers said.
In addition, poor diet could influence depression by disturbing the gut microbiome, which could further influence brain function. Past studies have also confirmed the diet-depression link among children and teens.
For example, a systematic review21 of 12 studies involving children and adolescents also found an association between unhealthy diet and poorer mental health. Conversely, those with healthier diets had better mental health. The consumption of junk food has also been linked to a higher risk for psychiatric distress and violent behaviors in children and adolescents.22
Adults may also suffer mentally from a diet based on unhealthy foods. A 2016 study23 found women who ate a pro-inflammatory diet (which can include one high in processed foods), were more likely to have recurring depressive symptoms, and a 2018 systematic review and meta-analysis,24 which looked at data from 101,950 participants, also found an association between a pro-inflammatory diet and risk of depression.
The Scourge of Ultraprocessed Food
Unfortunately, Americans not only eat a preponderance of processed food, but 60% of it is ultraprocessed25 — products at the far end of the “significantly altered” spectrum, or what you could typically purchase at a gas station.
Any food that isn’t directly from the vine, ground, bush or tree, is considered processed. Depending on the amount of change the food undergoes, processing may be minimal or significant. For instance, frozen fruit is usually minimally processed, while pizza, soda, chips and microwave meals are ultra-processed foods.
The difference in the amount of sugar between foods that are ultraprocessed and minimally processed is dramatic. Research26 has shown 21.1% of calories in ultraprocessed foods come from added sugar, compared to just 2.4% of the calories in processed food and none in unprocessed foods.
In addition to obesity, depression and other chronic health problems, ultra-processed foods will also shorten your life span. French researchers found that for each 10% increase in the amount of ultraprocessed food an individual consumed, the risk of death rose by 14%.27
This link remained even after taking confounding factors such as smoking, obesity and low educational background into account. The primary factors driving the increased death rate was chronic diseases such as heart disease and cancer.
In my view, eating a diet consisting of 90% real food and only 10% or less processed foods is an achievable goal for most that could make a significant difference in your weight and overall health.
Ultraprocessed foods should be kept to an absolute minimum and consumed only rarely. As noted in a 2016 study,28 “Decreasing the consumption of ultraprocessed foods could be an effective way of reducing the excessive intake of added sugars in the USA.” To get started, consider the following basics. For more detailed guidance, see my nutrition plan:
•Focus on fresh foods, ideally organic, and avoid as many processed foods as possible (if it comes in a can, bottle or package and has a list of ingredients, it’s processed).
Severely restrict carbohydrates from refined sugars, fructose and processed grains, and increase healthy fat consumption. Examples of healthy fats include grass fed butter, ghee, lard, coconut oil and coconuts, avocados, nuts and seeds, raw cacao butter, extra virgin olive oil, organic pastured eggs.
You can eat an unlimited amount of nonstarchy vegetables. Because they are so low in calories, the majority of the food on your plate should be vegetables.
•Replace sodas and other sweetened beverages, including fruit juices, with pure, filtered water.
•Gradually reduce your eating window to six to eight hours with your last food intake at least three hours before bedtime.
•Shop around the perimeter of the grocery store where most of the whole foods reside, such as meat, fruits, vegetables, eggs and cheese. Not everything around the perimeter is healthy, but you’ll avoid many of the ultra-processed foods this way.
•Stress creates a physical craving for fats and sugar that may drive your addictive, stress-eating behavior. If you can recognize when you’re getting stressed and find another means of relieving the emotion, your eating habits will likely improve.
The Emotional Freedom Techniques (EFT) can help reduce your perceived stress, change your eating habits around stress and help you create new, healthier eating habits that support your long-term health. To discover more about EFT, how to do it and how it may help reduce your stress and develop new habits, see my previous article, “EFT is an Effective Tool for Anxiety.”
- 1, 2 State of Obesity 2019 (PDF), Page 7
- 3, 4 State of Obesity 2019 (PDF), Page 1
- 5, 8 Eurekalert January 17, 2020
- 6 PLOS ONE July 22, 2015, DOI: 10.1371/journal.pone.0132672
- 7 Endocrinology January 8, 2020, bqz044
- 9 New York Times February 20, 2013
- 10 PLOS ONE August 1, 2007; 2(8): e698
- 11 Royal Society of Open Science February 19, 2020, DOI: 10.1098/rsos.191338
- 12 PLOS ONE 2017; 12(2): e0172645
- 13 Science Alert February 20, 2020
- 14 Body Mass Index
- 15 Royal Society of Open Science February 19, 2020, DOI: 10.1098/rsos.191338, Discussion
- 16, 18 Nutrition and Metabolism February 11, 2020; 17, Article number: 15
- 17 MedicalXpress.com February 14, 2020
- 19, 20 Physiological Reports August 23, 2019; 7(16)
- 21 Am J Public Health October 2014; 104(10): e31–e42
- 22 Nutrition 2014 Nov-Dec;30(11-12):1391-7
- 23 Clin Psychol Sci. 2016 Nov;4(6):1125-1134
- 24 Clin Nutr. 2019 Oct;38(5):2045-2052
- 25 BMJ Open 2016; 6:e009892
- 26, 28 BMJ Open, 2016;6(3):e009892
- 27 JAMA Internal Medicine 2019;179(4):490-498