According to Dr David Servan-Schreiber, author of Healing Without Freud or Prozac, “On the day historians begin to analyse the history of medicine in the 20th century, I believe they will point out two major events. The first one, without any doubt, was the discovery of antibiotics, which practically eradicated bacterial pneumonia — the leading cause of death in the West until the Second World War. The second is a revolution that is still in the making: the scientific demonstration that nutrition has a profound impact on practically all the leading causes of disease in Western societies.”

Great leaps in understanding have recently occurred in nutritional medicine. For many years, what we ate was studiously ignored by the scientific community, and with the funding for many of its studies coming from pharmaceutical companies that focus on patenting artificial derivatives, we can see why. There is no serious money to be made from food as medicine, and this is a shining example of where the free market economy does not serve the whole person within the whole community.

In matters of nutritional health, we need some guidance beyond the moneymaking principle. In my opinion, we need our governments to get up to speed on these matters and to offer some leadership — which we are now seeing to some extent in Australia with the Senate enquiry into childhood obesity.

The huge costs that we, as a community, now face in maintaining a national health budget that continues to “blow out” (especially in hospitals, which are basically dealing with health issues when they have often reached the “too late” stage) may finally spur our political leaders to seek a preventative health strategy. It will not be cheap to begin with: we will have to spend more to educate doctors, health professionals and the media so they can pass that knowledge on to the general public. However, in 10 to 20 years time, it will save us billions of dollars and improve the quality of life and the life expectancy of our community.

An example of the institutionalised neglect of food as medicine can be seen in many of our hospitals, where meals are often served with scant regard for their potential healing properties. Unappetising fare produced without up-to-date knowledge of nutritional medicine and with little understanding of the importance of colour, freshness and presentation is not serving us well in many of our healing institutions.

The highly publicised TV chef Jamie Oliver and his recent attempt to revolutionise a British school canteen highlights a similar need to appraise our attitude to our children’s diet. So-called health food has been on quite a journey since the 1960s and ’70s — from a time when those who consumed mung beans and lentils were derided as “hippies” to the present situation where we see the large supermarkets rapidly expanding their range of organic foods to cater for an ever-growing demand.

In the general community, we tend to receive nutritional health information in a piecemeal fashion through word of mouth, stray news reports and the like; suddenly, there may be concern for the high level of salt in processed foods, and then it’s bad fats like monounsaturated fats versus polyunsaturated fats, followed by low-carbohydrate diets or high-fibre diets, and so on. We hear the alarm bells that warn, “Don’t eat this or that!” but we don’t see or understand the whole picture because it is considered too complex for the media. Or perhaps we just want the desired health result with little regard for how we get it.

The omega-3/omega-6 balance

Recently, the focus on polyunsaturated fats has been refined to include omega-3 and omega-6 fatty acids, which are essential to the body’s cellular make-up and needs. Common omega-3 fatty acids used by the body are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Gamma-linolenic acid (GLA) is an omega-6 fatty acid, as is arachidonic acid; the latter is an important precursor of anti-inflammatory prostaglandins.

It is the anti-inflammatory activity of omega-3 fatty acids that has caught the attention of scientists with regard to many common diseases in the Western world. Coronary artery disease, myocardial infarction, stroke, cancer and arthritis are all caused or worsened by inflammatory reactions within the body. It is now also posited that depression may be an inflammatory condition of the brain, and several randomised, placebo-controlled studies into the effectiveness of EPA in the treatment of severe depression have shown profound results. These studies have been published in leading journals such as The American Journal of Psychiatry and the UK’s Archives of General Psychiatry.

The two essential fatty acids, omega-3 and omega-6, are present in many of our foods. Omega-6 is derived primarily from grains, but we consume most of our omega-6 in the form of all vegetable oils (except canola) and the meat and fats of grain-fed animals. Omega-3 is found in algae, plankton and some leaves, including grass. Although both essential fatty acids are vital for the health of our cells, too much omega-6 can provoke inflammatory responses in the body.

The key to understanding the effects of omega-3 and omega-6 fatty acids in the body is to look at our evolutionary origins and our first diet. When the modern human brain was developing, early humankind lived around the lakes of the Great Rift Valley in Africa. There is scientific evidence that the diet of these early humans was balanced on a 1:1 ratio of foods containing omega-3 and omega-6 fatty acids. This proportion of omega-3 to omega-6 is thought to have provided their bodies with the perfect nutritional resources to develop the neurons that enabled skills like language, self-awareness and the utilisation of tools to evolve.

Today, however, we have lost that ideal 1:1 balance of omega-3 and omega-6 in our diet. It is now so out of kilter that in countries like Australia, the US and the UK, the ratio of omega-3 to omega-6 intake is thought to be between 1:10 and 1:20. Why has this occurred? We can partly attribute this to economics, particularly in the livestock industry, where the practice of feeding animals grains rather than pasture grass has taken root. There is also the overwhelming presence of omega-6-rich vegetable oils in all our processed foods, as well as the high incidence of soybeans in so many foods. Basically, we are feeding ourselves the wrong ingredients because it is seen to be cheaper, but in the long run, the consequences to our health will be (and already are) much more expensive.

Foods rich in omega-3

If we look to coastal Asia where the diet is rich in seafood, there isn’t the prevalence of depression and heart disease we see in Western societies. Perhaps the underlying message here is that we are of the sea — we originated from the ocean — and our bodies work best when fed foods from the sea.

With the exception of grain-fed farmed fish, fish are rich in omega-3 fatty acids because they eat plankton and algae or smaller fish that have eaten plankton and algae. Fish store the omega-3 fatty acids in their fat tissue. The healthiest source of omega-3 are the smaller fish, which are the least contaminated by mercury, dioxin and organic carcinogens.

Flaxseed is an excellent vegetarian source of omega-3, but like all non-animal sources, it requires a further metabolic step to become part of our neural membranes. Green leafy vegetables contain precursors of omega-3 fatty acids in small amounts. Meat from organically raised, grass-fed animals is a good source of omega-3, and the eggs of free-range chickens contain up to 20 times more omega-3 than their grain-fed counterparts.

Olive oil has more omega-6 than omega-3 but has very little of either, so it can be used without adding further to the omega-6/omega-3 imbalance in our diet. We need to redress this imbalance if we are to return our bodies to a state of health, and if we don’t want to head towards the potentially fatal diseases from which our community so often suffers. Doing this involves limiting the amount of processed foods in your diet (if you can’t comfortably eradicate them altogether) and becoming far more aware of what is actually in the foods you eat (people with coeliac disease, for example, soon discover the prevalence of wheat additives in processed foods). It’s not only important to add more omega-3-rich foods to your diet; you also need to reduce your intake of omega-6.

In terms of the possible antidepressant effects of omega-3 fatty acids, you’d need to consume between one and 10 grams daily of a combination of DHA and EPA, which are the two omega-3 fatty acids in fish oil. These can be taken as supplements, but, as with all nutrition, they are better consumed as wonderful foods.

Recipes to boost omega-3 intake

Here are a few of my recipes that will boost your intake of omega-3 fatty acids and hopefully transport your tastebuds to delicious new territories. If the salty fish in my omega pie seem too daunting, you can substitute them with fish that are less salty but still oily, such as trout or tuna. Vegetarians can leave the fish out and use spinach and other green leafy vegetables instead.

Sudha’s omega pie

Serve: 4

Pastry

• 1½ cups plain wholemeal flour
• 1 cup linseed/sunflower/almond meal (LSA)
• 100g unsalted butter
• 1 tbsp linseed oil
• 2 free-range eggs, whisked
• 1 tsp purified water

Filling

• 4 fillets of fresh sardines, or 2 tins
• 4 fillets of anchovies
• 1 Spanish onion, diced and sautéed
• 3 cloves garlic, minced and sautéed
• 1 punnet cherry tomatoes, sliced and sautéed
• 1 tbsp canola oil
• 1 can diced tomatoes
• 1 tbsp fresh rosemary, chopped
• 1 tsp fresh oregano, chopped
• sea salt and black pepper to taste
• 1 cup chopped continental parsley
• 1 large Desiree potato, cooked and sliced
• 1 cup fresh ricotta cheese
• 1 cup walnut meal
• ½ cup parmesan cheese

Preheat oven to 180°C. To make the pastry, sift the flour into a mixing bowl or food processor, then add the remaining ingredients and combine to form a soft dough. Knead until smooth and refrigerate for 30-60 minutes. (When the pastry is in the fridge, you can make the filling.) Remove the pastry and roll it out to about 5mm thick, then mould it into a 15-20cm pie dish. Prick the pastry and bake blind for 10-15 minutes or until golden brown. Remove the blind beans and bake for a further 5 minutes. Set aside to cool.

To make the filling: in a large frypan or saucepan, sauté the onion, garlic and cherry tomatoes in oil for 5 minutes. Add the canned tomatoes, rosemary, oregano, salt and pepper and simmer for 10 minutes. Stir in the parsley and set aside. Lay the sliced potato and fish fillets inside the pastry case and top with the tomato sauce, then crumble ricotta over this before sprinkling with walnut meal and parmesan to finish. Add salt and pepper to taste before baking for 20-30 minutes or until golden brown.

Marinated salmon with spinach and watercress

Serve: 4

• 2 fillets of salmon, sliced into 8 wafers 1cm thick
• 1 lemon, juiced
• 1 lime, juiced
• 2 cups baby spinach leaves, washed and dried
• 2 cups watercress, washed and dried
• 1 tbsp capers
• 1 tbsp sliced pickled ginger
• 2 tbsp flaxseed oil
• 1 tbsp tamari soy sauce
• 2 tbsp lime juice
• sea salt to taste
• black pepper to taste

Place the salmon wafers in a shallow, flat container and cover with lemon and lime juice. Cover and refrigerate for 30 minutes. Remove, drain and dry with a paper towel. In a mixing bowl, toss the spinach and watercress together with the capers, pickled ginger, flaxseed oil, tamari, lime juice, salt and pepper. Arrange the salmon and salad on plates and serve at room temperature.

Steamed mackerel with pan-fried shiitake mushrooms and seaweed

Serve: 4

• 4 mackerel fillets
• 2 tsp minced garlic
• sea salt to taste
• 2 tsp minced ginger
• 1 tbsp canola oil
• 1 punnet fresh shiitake mushrooms, sliced
• 1 cup wakame seaweed, rehydrated in water and chopped
• 1 bunch bok choy, washed and chopped
• 1 tbsp rice wine
• 1 tbsp tamari soy sauce
• 1 tsp lemon juice
• black pepper to taste

Have your steamer ready to cook. You’ll need to steam the fish and pan-fry the mushrooms at the same time to coordinate the serving of this dish. In a large saucepan or frypan, sauté the garlic, salt, ginger and oil for 3-5 minutes before adding the mushrooms, seaweed and, finally, bok choy. Finish with the rice wine, tamari and lemon juice. Add pepper to taste. Place the fish fillets inside your steamer and cook for 3-5 minutes, depending on the thickness of the fillets. Place the fish on plates and spoon the mushrooms, seaweed and bok choy over the top.

 

I wish to acknowledge the inspiration and source material I garnered from Dr David Servan-Schreiber’s book, Healing Without Freud or Prozac (Rodale, Pan Macmillan, 2004). “The Revolution in Nutrition” is but one chapter in an extraordinary book.