From Traditional Markets Together, Let’s Improve the Nation’s Mental Health to Achieve Global Excellence
A Psychobiotic Approach Through Local Food Treasures
Tauhid Nur Azhar
The culinary wealth of the Indonesian archipelago is an extraordinarily special blessing that we must be grateful for. Why? Because the abundance of food sources from plants, livestock, fisheries, spices, and rhizomes is inseparable from our country’s comparative advantage of being located right on the equator.
The tropical climate, combined with soil fertility due to the ring of fire — a chain of volcanic mountains — and the meeting of two oceans with varying current characteristics, has made us a country with incredibly rich biodiversity.
I am always amazed when I have the opportunity to visit markets in the morning in various corners of the archipelago. From the market in Tambolaka at the western tip of Sumba, the Paotere fish market in Makassar, to the Kranggan market near Tugu Jogja, all are rich in resources. Fresh fish and seafood, rich in protein and omega-3 fatty acids, meet a variety of vegetables and fruits grown on the fertile slopes of mountains, rich in nutrients from volcanic ash and magma.
Not to mention the spices like nutmeg, cloves, and pepper, as well as rhizomes like the curcuma family, and various plants with multifunctional active compounds such as antioxidants, anti-inflammatories, antimicrobials (antibiotics), immunomodulators, and metabolic optimizers. These beneficial substances are found in lemongrass, betel leaf, garlic, bay leaf, galangal, and candlenut.
On the other hand, we also need to be concerned. There is a trend in the health sector indicating an increase in various lifestyle-related health disorders, including their connection to environmental degradation, increased social pressure, disproportionate nutritional intake, and decreased physical activity, partly driven by technological advancements.
From a physical perspective, there has been an increase in several metabolic degenerative diseases such as metabolic syndrome, cardiovascular diseases, and various types of cancers. Meanwhile, the same dynamics and conditions also cause an increase in pathological mental conditions. According to data from the Ministry of Health, about 1 in 10 people in Indonesia suffer from mental disorders. According to Sehat Negeriku data, 6.1% of Indonesia’s population aged 15 and above experience mental health disorders.
The results of the Indonesia-National Adolescent Mental Health Survey (I-NAMHS) in 2022 also show that 1 in 3 adolescents (34.9%) or equivalent to 15.5 million Indonesian adolescents have mental health problems in the past 12 months. Even data from the Indonesian National Police for the period January-June 2023 revealed that there were 663 suicide cases in Indonesia.
This is indeed a quite concerning condition, right? Of course, the various mental disorders mentioned above have a relatively broad spectrum of types and causes. There are many factors and variables involved. It is not as simple as we might think because mental issues involve a complex system that includes biological, psychological, sociological, and ecological aspects.
However, despite all that, one effort to improve and prevent the occurrence of mental disorders, both organic and reactive, comes from nutrition and the role of the microbiota that accompanies it. At the very least, the microbiota can help regulate the axis known as the gut-brain axis or GBA.
In the last decade, the emergence of the psychobiotic concept has provided a new direction in mental disorder research and therapy. Psychobiotics themselves are certain probiotic strains that can modify gut microbiota, potentially influencing mood, behavior, and cognitive function through their impact on the gut-brain axis or GBA.
Several studies have shown that certain probiotic strains have the ability to regulate neurotransmitters and proteins such as gamma-aminobutyric acid (GABA), serotonin, and brain-derived neurotrophic factor (BDNF), which play important roles in controlling the balance of neural excitation-inhibition, cognitive function, learning processes, and memory formation.
Psychobiotic research often uses animal models to evaluate their effects on behavior, especially in mice. Sudo et al. have identified the role of microbiota in regulating the hypothalamic-pituitary-adrenal (HPA) axis, where mild stress conditions in GF (germ-free) mice cause a greater increase in the release of corticosterone and adrenocorticotropic hormone compared to SPF (specific-pathogen-free) mice. This finding highlights that gut microbiota imbalance can increase susceptibility to stress, trigger the excessive release of pro-inflammatory cytokines, and worsen blood-brain barrier (BBB) permeability, which in turn is associated with mental disorder symptoms such as depression.
Psychobiotics demonstrate psychotropic activity by regulating neurotransmitters such as GABA, serotonin, and norepinephrine (NE). Certain strains of Lactobacillus spp. and Bifidobacterium spp., such as Lactobacillus brevis, Bifidobacterium dentium, and Lactobacillus plantarum, are known to produce GABA and serotonin. Lactobacillus plantarum PS128 has been proven to reduce anxiety and depression in mice by increasing dopamine and serotonin levels in the prefrontal cortex and striatum, two brain areas closely related to mood regulation and motivation.
Furthermore, the strain Lactobacillus helveticus NS8 can increase BDNF levels in the hippocampus, enhance neurotransmitter activity, and reduce symptoms of anxiety and cognitive dysfunction. The increased BDNF activity by psychobiotics potentially promotes brain neuroplasticity, facilitating the brain’s ability to adapt to psychological stress or trauma.
Several studies have shown that interventions with the single strain Bifidobacterium longum 1714 can reduce stress and anxiety behaviors. Similarly, Lactobacillus rhamnosus JB-1 has also shown the ability to reduce anxiety and depression by altering the expression of GABA receptors in the brain. The strain Bifidobacterium longum NCC3001 has been proven to increase BDNF expression in the hippocampus, which plays a crucial role in memory formation and learning processes.
Serotonin synthesis, a primary neurotransmitter in mood regulation, is not solely dependent on brain tissue but can also be produced by gut microbiota. Some gut microbiota, including spore-forming bacteria, have been found to induce serotonin biosynthesis from enterochromaffin cells in the gut. This explains how psychobiotics can provide potential therapeutic effects on mental disorders through the production of essential neurotransmitters. Additionally, strains of Lactobacillus plantarum and Lactobacillus odontolyticus can produce acetylcholine, which plays a role in cognitive function and memory.
Indirectly, the research results above have legitimized the important role of microbiota in regulating mental conditions and brain performance in humans. While gut microbiota, which are probiotics and normal flora in the human body, originate from the food or nutrition we consume. There are nutrients that act as prebiotics, which serve as a support system or logistics for gut microbiota, and various types of probiotics that enter along with various types of food we consume.
Therefore, the diversity of food and the ways of processing food into various types of food or drinks with various local wisdoms in utilizing the extraordinary biodiversity wealth of the archipelago can be a key process in efforts to improve mental health quality in Indonesia.
Various studies show that traditional foods rich in fermented ingredients, spices, and natural fibers not only impact physical health but also influence mental health and the immune system. Through the concept of psychobiotics, we can see the connection between food, immunity, metabolic performance, and brain function, which are influenced by neurotransmitters. More specifically, we can also see the role of traditional food in supporting the balance of body and mind.
According to research by Cryan and Dinan, gut microbiota play a “key role” in the gut-brain axis/GBA, which can influence mood, anxiety levels, and cognitive function (Cryan & Dinan, 2015). Local cuisine with fermented ingredients, such as tempeh in Indonesia or kimchi in Korea, contains natural probiotics that can maintain gut microbiota balance and potentially act as natural psychobiotics.
The fermentation tradition found in many cultures worldwide, such as tape, oncom, or tempoyak in Indonesia, creates food products rich in probiotics. Strains of Lactobacillus and Bifidobacterium in fermented foods are known to produce neurotransmitters such as GABA and serotonin, which play a significant role in mood regulation and reducing depression symptoms (Bravo et al., 2011; Messaoudi et al., 2011). In Japan, miso and natto offer similar effects, while kefir in the Caucasus has long been used as a health drink believed to strengthen the body’s resilience.
Research by Sudo et al. shows that microbiota can influence the release of corticosterone, a hormone triggered by stress, so consuming probiotic-rich foods can help reduce stress and strengthen the immune system simultaneously (Sudo et al., 2004). This fermentation culinary tradition demonstrates how local wisdom, unknowingly, has involved preventive health care with a holistic approach through dietary patterns.
Gut microbiota balance is not only beneficial for mental health but also plays a crucial role in the body’s immune system. About 70% of the human immune system is located in the digestive tract (Belkaid & Hand, 2014), so gut microbiota diversity is essential in maintaining a balanced immune response. Immunologist Dr. Mayer states that gut microbiota can prevent chronic infections and inflammation by supporting the gut barrier and activating various immune cells (Mayer et al., 2015).
Local cuisine with spices like turmeric, ginger, and galangal is also rich in bioactive compounds with anti-inflammatory properties. Curcumin, found in turmeric, can reduce inflammation and improve the body’s immune response (Aggarwal et al., 2013). In India, the use of turmeric in curry has become a common practice and is now recognized by modern science as a spice with the ability to enhance digestive health and reduce the risk of inflammatory diseases.
Fiber from vegetables, legumes, and grains, which are a significant part of local foods in various cultures, plays a crucial role in maintaining gut microbiota health. Fiber is a prebiotic, or “food” for beneficial microbiota, and the fermentation of fiber in the gut produces short-chain fatty acids (SCFAs) such as butyrate, acetate, and propionate, which help suppress inflammation and increase gut resilience (Zhao et al., 2018). In Indonesia, the consumption of corn, cassava, and vegetables like sweet potatoes, sago, and moringa supports digestive health, directly impacting the stability of the immune system and mental well-being.
Recent research has found that certain strains of gut bacteria can help prevent and reduce symptoms of anxiety disorders and depression (Allen et al., 2017). On the other hand, research by Desbonnet et al. shows that Lactobacillus rhamnosus can reduce corticosterone levels and alter the expression of GABA receptors in the brain, indicating a direct effect of microbiota on anxiety regulation (Desbonnet et al., 2010).
The use of probiotics such as Lactobacillus plantarum PS128 added to daily meals shows potential for increasing serotonin and dopamine levels in the brain and reducing inflammation (Liu et al., 2016). This indicates the potential of local cuisine as an easily accessible and safe medium for maintaining mental health and body immunity.
Therefore, it is possible that if we regularly consume local foods from Indonesia’s rich biodiversity, processed or cooked with the right knowledge and skills, we can optimize their health benefits. In the long term, this can play a role in building a strong nation.
Eating Manado porridge, which is rich in fiber, high in protein, capsaicin from chili peppers, antioxidants from pumpkin, and various active compounds, prebiotics, and probiotics that act as psychobiotics, can serve as a mental supplement to enhance the mental capacity of the Indonesian people. Similarly, tongseng and tengkleng, rich in the benefits of rhizomes and spices like turmeric, ginger, and garlic, in proportional servings and ideal measurements, can be part of the effort to improve the quality of the nation’s children at a global level, right?
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