Some of the most exciting highlights of the research from this past year:

• Researchers found that a Western diet (lots of junk food) actually shrinks the hippocampus, a brain structure involved in mood regulation (1)
• Data from the Women’s Health Initiative study found that a high-glycemic index diet (that is, lots of sugars and white flour products) increases the risk of depression (2)
• Cocoa and chocolate are rich in flavonoids that improve cardiovascular health – and now have been found also to improve cognitive function (thinking) (3)
• A whole foods-based diet, especially one following the Mediterranean pattern, is associated with improvement in depression and anxiety (4)
• A placebo-controlled study found that a specific probiotic supplement (Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum) significantly improved symptoms of depression, along with metabolic health markers like C-reactive protein (hsCRP). (5) This builds on previous evidence showing decreased moodiness with probiotic intake.

In addition to a whole foods-based diet and probiotics, don’t forget that exercise is one of the most powerful natural antidepressants there is. If additional mood support is needed, there are many powerful herbs and nutrients that can help – just be sure to use them with appropriate guidance, since some (like St. John’s wort) can have significant interactions with drugs.

1. Jacka FN, Cherbuin N, Anstey KJ, Sachdev P, Butterworth P. Western diet is associated with a smaller hippocampus: a longitudinal investigation. BMC Med. 2015;13:215.
2. Gangwisch JE, Hale L, Garcia L, et al. High glycemic index as a risk factor for depression: analyses from the Women’s Health Initiative. Am J Clin Nutr. 2015;102:454-463.
3. Mastroiacovo D, Kwik-Uribe C, Grassi D, et al. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trial. Am J Clin Nutr. 2015;101:538-548.
4. Agarwal U, Mishra S, Xu J, Levin S, Gonzales J, Barnard ND. A multicenter randomized controlled trial of a nutrition intervention program in a multiethnic adult population in the corporate setting reduces depression and anxiety and improves quality of life: the GEICO study. Am J Health Promot. 2015;29:245-254.
5. Akkasheh G, Kashani-Poor Z, Tajabadi-Ebrahimi M, et al. Clinical and metabolic response to probiotic administration in patients with major depressive disorder: a randomized, double-blind, placebo-controlled trial. Nutrition. 2015 Sept 28. [Epub ahead of print]

The secret is not-so-secret:  eat your veggies.  I have written previously that one of the simplest things we can do to improve our health and longevity is to ensure that we’re eating plenty of fresh fruits and vegetables.  I also reported four years ago that 90% of Americans don’t get enough of these disease-fighting powerhouses.  A recent report in MMWR (Morbidity and Mortality Weekly Report) found that that number has  not improved any:  Only 13% of Americans are getting the CDC-recommended intake of 1.5-2 cups of fruit per day, and 8.9% are getting the recommended 2-3 cups of veggies per day.

Besides providing health-promoting phytonutrients, fruits and veggies provide that forgotten nutrient, dietary fiber, that is profoundly linked to good health.  How do you get started on jumping out of the 90%?  Just be sure to include a serving of fruit or vegetable every time you eat (and no, French fries don’t count).

Must we live on broccoli alone?  Of course not — nuts and seeds also promote longevity, and you can grab some dark chocolate for dessert.  Besides its by now well-known cardiovascular benefits, a recent study from the University of Arizona found that chocolate containing at least 60% cacao actually improves attention, as measured by EEG.  So after a nice salad for lunch, grab an ounce of dark chocolate to help you through that mid-day slump.

1.  Coles, L and Clifton, P.  Effect of beetroot juice on lowering blood pressure in free-living, disease-free adults: a randomized, placebo-controlled trial.  Nutr J. 2012; 11: 106.

On the other hand, the evidence for the health benefits of chocolate have been accumulating more and more in recent years.  The perks seem to be related to the flavanol content of the cocoa bean (Theobroma cacao).  The higher the cocoa (cacao) content, the better:  and dark chocolate (55% cacao or higher) is your best bet.  Eating an average of about one ounce per day can really boost cardiovascular and general health, including:

• Decreasing stroke risk by 14% for women (1) or 17% for men (2)
• Decreasing risk of heart failure in older women by 26-32% (3)
• Modestly reducing blood pressure (4-7)
• Decreasing “bad” cholesterol (LDL), and increasing “good” cholesterol (HDL) (8-9)
• Improving cognitive function (10)
• Most surprising of all:  decreasing body mass index (BMI) (11).  In other words, chocolate can lead to weight loss!

A review (1) in the journal Clinical Lipidology (yes, you read that right; “lipidology” means the study of cholesterol and other fats) looks at dietary factors most associated with lowering cholesterol.

“The foods with the most evidence for cholesterol reduction are nuts, legumes, whole cereals rich in soluble fiber, and cocoa and its main commercial product, chocolate.”

OK — this sounds a lot like the Mediterranean diet.  What the author goes on to point out, though, is that all of these foods are actually seeds.  Obvious once someone points it out, isn’t it?  Yet with as many years as I’ve taught patients and students about nutrition, this struck me as a beautifully concise revelation.  Even whole grains like oats are seeds.  And chocolate?  Yes, please!

Seeds contain fiber, healthy fats, and disease-busting phytonutrients.  Think of them as plant foods bursting with concentrated potential.

1.  Ros E.  How Important Is Dietary Management in Hypercholesterolemia?  Clin Lipidology. 2012;7(5):489-492.

Prior research showed cardiovascular benefits from dark chocolate, which have a higher cocoa content (55-90%) than milk chocolate (30%).  So for maximal benefit, reach for the dark chocolate.  This also avoids the high amounts of sugar and saturated fat in milk chocolate, which can contribute to obesity and metabolic syndrome.

It might take time to get used to the less sweet taste of dark chocolate, but with small amounts (1/2 – 1 ounce per day), your palate will adjust.  My advice?  Become a chocolate snob.  Buy good quality dark chocolate, and really focus in and enjoy that little tidbit, rather than cramming down a whole bar of cheap milk chocolate.

1.  Chocolate consumption and risk of stroke:  A prospective cohort of men and meta-analysis.  Neurology. 2012;79:1223-1229. Published online August 29, 2012.