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Flaxseeds: single most important food for mental health?


by R. Aiken MD PhD @rcaiken

Flaxseed helps lower cholesterol, lowers blood pressure, is anti-inflammatory, has good anti-oxidants, and fiber.  It is the single most neuroprotective food; oh yes, then there is the omega-3 content.

There is no doubt that this food is an excellent source of essential omega-3 fats in the form of alpha-linolenic acid, the basic building block to other omega-3s – eicosapentaenoic acid and docosahexaenoic acid. Omega-3, and a proper omega-3 to omega-6 ratio, is important in mental wellness and recovery from psychiatric disorders.

But flaxseed offers more than just the ideal omega-3 source; it contains many polyphenolic compounds such as phenolic acids[1], flavonoids and lignans along with vitamins C and E[2].  One study found that flaxseed significantly decreased chronic stress (cortisol) levels, indicating a possible synergistic effect between omega-3 fatty acid and polyphenols[3].  Other components such as a flaxseed lignan (a phytoestrogen compound called secoisolariciresinol) has been shown to have possible applications in post-menopausal depression[4].

Studies of flaxseed oil supplementation have indicated a good tolerance even in the pediatric population where one study indicated its effectiveness in child bipolar disorder[5].

I recommend a daily intake of one to three tablespoons of ground flax, each tablespoon of which contains about 30 calories, 2.5 grams fat, 2 grams fiber, and 1.5 grams protein[6]. Be sure to grind the flaxseeds as the fine seeds with their hard shell will likely just pass on through the gut otherwise. Flaxseeds can be ground in a coffee bean grinder and the ground powder added to grains, salads, beans – practically any dish for a little texture.

Note that the shelf life of the oily seeds is limited unless kept in an airtight container in the fridge or freezer.  Ground flaxseeds or flax meal should be kept in the freezer; at room temperature and exposed to air, use the ground seeds within one week. Smell the flax – if it has a strong odor such as fishy smell, it may be rancid.  A taste test should reveal a mild nutty flavor – if bitter or sour that also may be a signal that it is rancid.

For these reasons, chia seeds, rich in antioxidants and omega-3 PUFAs may be preferable to some.


[1] Oomah, B. D., Kenaschuk, E. O., & Mazza, G. (1995). Phenolic Acids in Flaxseed. J. Agric. Food Chem. Journal of Agricultural and Food Chemistry, 43(8), 2016-2019. doi:10.1021/jf00056a011.

[2] Bidlack, W. W. (1999). Functional Foods: Biochemical and Processing Aspects, G. Mazza, ed. Lancaster, PA: Technomic Publishing Co., Inc., 437 pp, 1998. Journal of the American College of Nutrition, 18(6), 640-641. doi:10.1080/07315724.1999.10718899.

[3] Naveen, S., Siddalingaswamy, M., Singsit, D., & Khanum, F. (2013). Anti-depressive effect of polyphenols and omega-3 fatty acid from pomegranate peel and flax seed in mice exposed to chronic mild stress. Psychiatry Clin Neurosci Psychiatry and Clinical Neurosciences, 67(7), 501-508. doi:10.1111/pcn.12100.

[4] Wang, Y., Xu, Z., Yang, D., Yao, H., Ku, B., Ma, X., . . . Cai, S. (2012). The antidepressant effect of secoisolariciresinol, a lignan-type phytoestrogen constituent of flaxseed, on ovariectomized mice. Journal of Natural Medicines,67(1), 222-227. doi:10.1007/s11418-012-0655-x.

[5] Gracious, B. L., Chirieac, M. C., Costescu, S., Finucane, T. L., Youngstrom, E. A., & Hibbeln, J. R. (2010). Randomized, placebo-controlled trial of flax oil in pediatric bipolar disorder. Bipolar Disorders, 12(2), 142-154. doi:10.1111/j.1399-5618.2010.00799.x.

[6] A very convenient way to have ground flax ready to serve is provided by Carrington Farms Organic Ground Milled Flax Seeds, two tablespoon packets sealed and lasting without refrigeration about one year.

Whole grains for the whole brain (and other organs)



Certain wild cereals, or grasses, contain edible components in their grain, botanically a type of fruit.  Grains are small, hard, dry seeds, with or without attached hulls.

Some argue that from an evolutionary standpoint, grains are a relatively new addition to our diets and therefore should be excluded.

Undoubtedly grains have existed for many millennia, but the problem with harvesting had been that first of all these grains must be separated from the inedible grasses, requiring some winnowing process.  Secondly, the wild grains usually shatter when ripe, dispersing the seeds, making collection difficult.  Then the tiny hard grains would have to be further processed to avail digestion. Thus, patches of such grains in the wild may not have been favored by hominids until at least primitive hand tools were used and present near sites of grain-containing grasses.

Nevertheless, grains were apparently consumed well before animal domestication 10,000 years ago.

For example, a large amount of starch granules has been found on the surfaces of Middle Stone Age stone tools from Mozambique, showing that early Homo sapiens relied on grass seeds starting at least 105,000 years ago, including those of sorghum grasses[1]. That’s more than 5000 generations ago.

Of course if one has celiac disease, gluten intolerance, a food allergy or sensitivity to grains, grains should be avoided.

Grains for brains (as well as other organs)

Whole grain includes dark bread, whole-grain breakfast cereal, popcorn, oats, bran, brown rice, bran, and many other examples.

Whole-grain foods contain fiber, vitamins, magnesium and other minerals, phenolic compounds and other phytonutrients[2], which may have favorable effects on health by lowering serum lipids and blood pressure, improving glucose levels, insulin metabolism and endothelial function, as well as alleviating oxidative stress and inflammation.

A meta-analysis of 15 cohort studies with nearly a half million participants revealed that whole grain intake was associated with a reduced risk of vascular disease[3].

There is an association between dietary whole grain intake and mortality; two large prospective studies of more than one hundred thousand participants indicated a significant life extension independent of other dietary and lifestyle factors[4].

The effect was pronounced up to one-half serving per day after which there was a leveling off. This is shown in the figure below, taken from the Wu et al. aforementioned article, where the mortality risk is plotted against servings of whole grain.

Relative Mortality Risk v. Whole Grain Intake



[1] Mercader, J. (2009), Mozambican Grass Seed Consumption During the Middle Stone Age, Science, 326.

[2] Anderson, J. W. (2003). Whole grains protect against atherosclerotic cardiovascular disease. Proceedings of the Nutrition Society, 62(01), 135-142. doi:10.1079/pns2002222.

[3] Tang, G., Wang, D., Long, J., Yang, F., & Si, L. (2015). Meta-Analysis of the Association Between Whole Grain Intake and Coronary Heart Disease Risk. The American Journal of Cardiology, 115(5), 625-629.

[4] Wu, H., Flint, A. J., Qi, Q., Dam, R. M., Sampson, L. A., Rimm, E. B., . . . Sun, Q. (2015). Association Between Dietary Whole Grain Intake and Risk of Mortality.JAMA Internal Medicine JAMA Intern Med, 175(3), 373.

Cocoa for vascular health: stunning anti-oxidant, anti-inflammatory – brain and heart wellness



by R. Aiken MD PhD @rcaiken

Foods and beverages made with beans from the Theobroma cacao tree  have been consumed by humans for over 5000 years, in pre-Colombian cultures along the Yucatan, including the Mayans[1].

Cocoa is the dried and fully fermented fatty seed of the fruit of the cocoa tree, native to the Americas. Cocoa liquor is the paste made from ground, roasted, shelled, and fermented cocoa beans, called nibs. It contains both nonfat cocoa solids and cocoa butter. Cocoa liquor is what is referred to as ‘‘percent cacao’’ on food packaging. Cocoa powder is made by removing some of the cocoa butter from the liquor.

Chocolate is a solid food made by combining cocoa liquor with cocoa butter and sugar. The proportion of cocoa liquor in the final product determines how dark the chocolate is. Milk chocolate, typically containing 10%–12% cocoa liquor, is made with the addition of condensed or powdered milk to the chocolate mixture and is the chocolate consumed most in the United States. Semisweet or bittersweet chocolate is often referred to as dark chocolate and must contain no less than 35% by weight of cocoa liquor.

Raw unprocessed cocoa is one of the richest antioxidant foods in the world. Studies indicate that cocoa has an effect on carbon dioxide levels that affect blood vessels and improve blood flow.  This has positive implications, for example, on reducing the risk of stroke.

Cocoa is a rich source of polyphenols, mainly flavanols, which have been recognized for having positive effects on vascular disease, cancer, diabetes, inflammation, oxidative stress, and blood pressure[2].  Because flavanols have the capacity to cross the blood-brain barrier, enhancing brain blood flow through the increased production of NO, which has been proposed as a mechanism involved in brain health[3]

Any form other than raw typically contains added fat and sugar and is to be avoided.

Overall, research to date suggests that the benefits of moderate cocoa or dark chocolate consumption likely outweigh the risks of obesity and glycemic load.


[1] Wood, G.A.R.; Lass, R.A. (2001). Cocoa (4th ed.). Oxford: Blackwell Science.

[2] Shrime, M. G., Bauer, S. R., Mcdonald, A. C., Chowdhury, N. H., Coltart, C. E., & Ding, E. L. (2011). Flavonoid-Rich Cocoa Consumption Affects Multiple Cardiovascular Risk Factors in a Meta-Analysis of Short-Term Studies. Journal of Nutrition, 141(11), 1982-1988. doi:10.3945/jn.111.145482.

[3] Nehlig, A. (2012). The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. British Journal of Clinical Pharmacology Br J Clin Pharmacol. doi:10.1111/j.1365-2125.2012.04378.x.

Hibiscus for mood, lowering blood pressure, and exercise performance


Flowers of Hibiscus (rosa-sinensis Linn) popularly known as “China-rose flowers” contain significant flavonoids (such as anthocyanin and quercetin) known to have antidepressant activity[1].

The antidepressant effect may be from its antioxidant activity[2]; there are few controlled studies on human populations. Hibiscus has been used in Hawaiian cultures to treat postpartum depression[3].

Another herbal tea, made from the sepals of Hibiscus flowers are beautiful, showy red flowers that are harvested and dried like most teas.  This plant contains bioflavonoids, which are believed to help prevent an increase in LDL cholesterol, and to lower blood pressure[4].  The research is quite clear on these effects. It may work by boosting nitric oxide production, generally an advantage for cardiovascular activities (aerobic exercise).

Again, why bother to make tea with this food and limit the nutrient availability when you can eat it! I use a heaping tablespoon in my morning smoothie. I also like to blend it with green tea and ice, then strain it into water bottles as a drink during exercise.


[1] Butterweck, V., Jürgenliemk, G., Nahrstedt, A., & Winterhoff, H. (2000). Flavonoids from Hypericum perforatum Show Antidepressant Activity in the Forced Swimming Test. Planta Medica, 66(1), 3-6. doi:10.1055/s-2000-11119.

[2] Vanzella, C., Bianchetti, P., Sbaraini, S., Vanzin, S. I., Melecchi, M. I., Caramão, E. B., & Siqueira, I. R. (2012). Antidepressant-like effects of methanol extract of Hibiscus tiliaceus flowers in mice. BMC Complementary and Alternative Medicine, 12(1). doi:10.1186/1472-6882-12-41.

[3] Kobayashi, J. (1976). Early Hawaiian Uses of Medicinal Plants in Pregnancy and Childbirth. Journal of Tropical Pediatrics, 22(6), 260-262. doi:10.1093/tropej/22.6.260.

[4] Siddiqui, A., Wani, S., Rajesh, R., & Alagarsamy, V. (2006). Phytochemical and pharmacological investigation of flowers of hibiscus rosasinensis linn. Indian Journal of Pharmaceutical Sciences Indian J Pharm Sci, 68(1), 127. doi:10.4103/0250-474x.22986.