Your Brain On Food: Dr. Uma Naidoo On The Intersection Of Nutrition & Mental Health - podcast episode cover

Your Brain On Food: Dr. Uma Naidoo On The Intersection Of Nutrition & Mental Health

Jun 20, 20242 hr 56 minEp. 840
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Dr. Uma Naidoo is a nutritional psychiatrist, professional chef, and nutrition specialist. This conversation explores the intersection between food and mood, with Dr. Naidoo sharing her expertise on how what we eat impacts our mental well-being. We discuss the gut-brain connection, foods that fight anxiety and depression, practical nutrition tips, and much more. Throughout the conversation, Dr. Naidoo provides actionable advice and fascinating insights into the world of nutritional psychiatry. Dr. Naidoo is a true pioneer in this field. This conversation is a must-listen for anyone interested in using food as medicine for the mind. Enjoy! Show notes + MORE Watch on YouTube Newsletter Sign-Up Today’s Sponsors:  Bon Charge: Use code RICHROLL to save 15% OFF 👉boncharge.com On: Enter RichRoll10 at the checkout to get 10% OFF your first order 👉on.com/richroll Peak Design: Save 20% OFF 👉PeakDesign.com/RICHROLL Brain.fm: Get 30 days FREE 👉brain.fm/richroll Birch: Unlock 20% off ALL mattresses and 2 free eco-rest pillows 👉BirchLiving.com/richroll AG1: Get a FREE 1-year supply of Vitamin D3+K2 AND 5 free AG1 Travel Packs  👉drinkAG1.com/richroll Squarespace: Save 10% off your first purchase of a website or domain 👉Squarespace.com/RichRoll  Check out all of the amazing discounts from our Sponsors 👉 richroll.com/sponsors Find out more about Voicing Change Media at voicingchange.media and follow us @voicingchange

Transcript

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Every food has some super powerful effects. The antidote to the standard of making diet is done reach out for the store bought oranges, which has no five banana sugar, which is eat the orange. One of the most powerful factors is how we eat. How can we integrate food into how we are offering solutions for people? Hey, everybody. Welcome to the podcast. My guest today is Dr. Uma Nado. Uma is a board certified nutritional psychiatrist on faculty at Harvard Medical School.

She's also an award-winning professional chef and the founder and director of nutritional and lifestyle psychiatry at Massachusetts General Hospital, which is a very cool first of its kind program that integrates mental health care with nutritional science. Uma is also the author of the International Best Seller. This is your brain on food. Her latest, calm your mind with food, is a primer on the nexus between diet and anxiety.

This conversation focuses on the relationship between what we eat and how we feel and how dietary changes can actually aid in reclaiming control over our mental well-being. Specific topics include the gut brain access, the neuroscience of mood, and the influence of diet on neurotransmitter production. We also discuss the nature of anxiety, specific foods to calm the mind and promote brain health, and many other topics.

In light of the increasing escalating rates of anxiety, depression, and other debilitating mental health disorders, Dr. Nado's work is not only salient, but empowering. So let's do it. This is me and Dr. Uma Nado. Well, Dr. Nado, it's a pleasure to meet you. Thank you for doing this. Thanks so much for inviting me, Rich. I'm excited to talk with you.

You're a very interesting figure. You are a trained chef and nutrition specialist, and also a pioneer of something called nutritional psychiatry, which I admit I had never heard of before. Can you explain what this area of expertise is precisely and how you kind of came into this field? That's a great question. Thank you. I like to explain nutritional psychiatry is the use of healthy whole foods and nutrients to improve your mental well-being.

And it is not exclude the use of medications, which may be very necessary in some cases, and the always important psychotherapies that are available to people. I came into this area mostly because as I grew up, I spent a lot of time with my grandparents during the day, my maternal grandparents, my mom was in medical school.

And I would watch my grandmother help her pick fresh vegetables from the garden, prepare meals, help her eat meals with my grandparents, and for fun, they teach me yoga and meditation. I recognized when I went to medical school and then even more so in residency that no one was talking about food and nutrition. Yet I was being taught to prescribe some heavy-hitting medications while they were lifesaving to some people. We also knew that they were creating side effects.

But no one was talking about that in we were discussing side effects, but we were not addressing lifestyle factors. And a patient early on, sort of took me on, was upset with me, and I knew that he had only been on the medication a week. So I had not caused him to gain weight. But this really opened my eyes to the power of interpreting information that someone can use in real life.

A lifestyle factor, a lifestyle change, what you put in your coffee literally can make a difference if someone knows that. So he was putting a quarter cup of processed cream and 80 spoons of sugar before you even ate breakfast and he had struggled with his weight for a while. And that made me want to pursue this more. Work was down research was ongoing and really evolved and is this still a very nascent field, which is probably why you haven't heard about it.

Right. So you do your residency and then you go into this area of psychiatry. And the point to you decide I'm going to become a trained chef or I'm going to dig deeper and get credentialed in nutrition science. As I recognized the gaps, I began my graduated residency and I was exploring food learning to cook on my own, really enjoying it and decided, especially when I understood. The kick of a V was my food hero was Julia Talf.

And I would watch as I was studying early on. And when I realized reading some of her books that this was her second creation. You're a great life. That's why it was late and I thought, well, why not me? You know, I love this. Can I do this? And it took a lot of hard work rearranging my schedule. But when I could a rearranging in a way that my patient care was covered, I helped my colleagues.

They helped me and I was able to go to school. I decided to do it and probably was some of the best years of my life. Did you pioneer this department at Mass General? How did you get by and from these large institutions, Mass General and Harvard University? I mostly got by and because the director meant his who saw what I was doing. And I spoke to him, but really supervising me throughout your career, you're always either supervisor, you have mentors.

And I was very fortunate to have that. And I sort of explained, look, this is what I'm doing. This is what I'm reading in the literature. This is what is coming forward. I'm talking more to my patients about this. Why can't we do it? Can we find a way to appropriately build for it? Can't because hospitals care about that. But why can't we include this? We're cutting edge institution. Why not?

And I was fortunate that I had had them support me. Meaning there wasn't resistance to doing, they were like, we know what you're doing. You can start this. Why don't you go ahead and start evaluating patients in this way. And it took off from there. And while it's a slow and it's a small and very dedicated, almost tertiary care service because it's preferable based.

It's not pivoted with the release of my books because what I recognize, which is that people reach out to me literally from all over the world. And they'll need this kind of help as an additional tool. No one has said stop your medications or stop therapy. But it is an additional tool to support their mental well-being. And I know that that lies in creating more educational resources. And I've been dedicating a lot of time to that.

Yeah, to that point, you know, sort of well understood that nutrition education really isn't a significant component in the medical school education can. And my sense is that that is changing, albeit slowly, has your work in this department percolated down into what students are exposed to during medical school or what is the kind of current state of affairs there. So certainly has helped with our students at Harvard at the medical school. I am part of the division of nutrition.

We have special interest groups, colleagues of mine have started accounting medicine curriculum. We actually have dedicated meetings where students are brought in and are part of it. We've also about to publish a textbook for medical students. I've written two chapters on that on my areas of expertise. And we come together with all specialties. So doctors and clinicians and dieticians on this committee are from different specialties.

And this book would be coming up later this year and it will be available to all medical students. So it's really to do what we can in a small and steady way to bring it forward. I don't think though that it's trickled into mainstream psychiatry. There's a lot of interest in lifestyle medicine, lifestyle psychiatry and nutrition. And I think through those mechanisms and with sort of trusted colleagues who really trying to bring it forward in the academic system.

Yeah, I suspect some resistance from, you know, the conventional institutions of psychiatry. I mean, you're not without your critics. Of course, you know, we can get into that if you like. But I think it is encouraging that yeah, a textbook and, you know, the receptivity of students and these students. And these institutions is a signifier of change. And then at mass general, we designed and created the first online training, asynchronous training for clinicians.

That's the me credited. So, you know, doctors and other clinicians care about getting their credits for their licensing, which we understand is important. So that's been an existence now for a few years. Yeah. Well, the fundamental premise of kind of the umbrella, you know, 10,000 foot view on your work is quite literally that food is medicine in a general sense, this hypocritic, you know, kind of trope. But in your case, I think of it more as precision medicine directed at targeted outcomes.

Based on another thing, a hypocrite said, which is bad digestion is the root of all evil and death sits in the bowels, which you quote in your book. So it's all about this relationship between the microbiome, gut health and other physiological processes in the body, most specifically, how they impact the brain and mental health.

So maybe we can begin to unpack that by starting with the gut brain access and kind of explain what that is and, you know, this relationship between food and brain health. There are several mechanisms, but I feel one that is easily more easily understood where this is a nascent field in mental well being is around that gut brain access because the gut and brain.

And so it's more like a person foremost to regenerate from the exact same cells in the human embryo. They divide apart. They form these two organs and then remain connected by the vagus nerve, the 10 cranial nerve. But there's more to the story because in addition to being this bi-directional messaging system between these organ systems, the neuro transmitters and the actual receptors for these about 90 to 95% are in the gut.

Even though there isn't all just a complete conversion into the brain and they're also located elsewhere, it's important to understand that where the food is being digested and interacting with the trillions of microbes is also where and in the same location as these receptors and the neuro transmitters.

I like to remind people that when you take a headache pill, you know, I'll ask the silly question and when you take a headache pill, you often you you experiencing the pain in your neural tissue in your head, maybe strontal, maybe it's inside whatever you describe it as, but you're actually swallowing something you ingesting something and it's working in a different part of your body.

I don't think about food that way. It's more complex. There are many more breakdown reactions occurring and all sorts of things physiologically, all of which I know that you know, but it's that similar principle when food is broken down. It's not as much of an immediate reaction like solving that headache after you take a pill. But it's a breakdown products that then can either be harmful or helpful to the gut microbes and the gut environment.

The less healthy, more harmful toxic byproducts of digestion that start to damage the single cell lining and over time, you know, cause inflammation dysbiosis and environment that can lead to from skin conditions to an uptake of anxiety to many different things.

So we have this relationship between the gut and the brain. It's bi-directional, meaning that the brain impacts the gut, the gut impacts the brain, the gut communicates with the brain in two ways via the nervous system, the vagus nerve, as you mentioned, but also through our circulatory system.

So essentially, we eat food, gut bacteria metabolizes it. This creates metabolites that then travel through the bloodstream to the brain where they're assembled into these neurotransmitters, which are chemicals that carry messages between your nerve cells.

And in turn, perform a variety of functions, including the regulation of mood. And this is where the whole world of kind of mental health and the relationship between what you eat, what you're putting in your body and the nature of your microbial kind of ecosystem has an impact, not just on physiological processes that we're unaware of, but actually translate into how we feel and, you know, behave in the world. Which is kind of a fascinating thing.

It is fascinating. And I'm glad you feel that way, because it certainly fascinates me. But it is not always easily understood. And it is not something that modern medicine, as much as we've come along, way focuses on, because food is usually seen. As firstly, nutrition is seen as a side by activity that you get referred to someone, maybe it's a dietitian, maybe it's a nutritionist that you have sort of side counseling, you know, really needs to be integrated in certain certain specialties.

It's more integrated with the primary medical team. I'm certainly that's what I've seen. But most people really think about nutrition when it comes to medical conditions, or as we should be in the United States in relation to our weight, but not in terms of brain health.

Sure. And then in terms of mental health generally, redress of mental health issues is generally focused on talk therapy, pharma interventions, SSRIs, and the like modest lifestyle suggestions, although perhaps that's not a primary thing, or maybe not as much of a priority as it should be, socialization, sleep, exercise, things like that.

But really nothing about this role that nutrition may play as both a contributing factor to mental unwellness, or as this intervention that you speak of to actually treat mental health symptomology. This is true. Alongside the ACLM, the lifestyle medicine group, actually many clinicians can study through lifestyle medicine. There's also this developing area of lifestyle psychiatry. And what I love about that is that it integrates and you can integrate pillars of nutrition.

You can integrate pillars of metabolism into this. And one of the things we also starting off, we already have developed education for clinicians outside the hospital. And now we are, you've had since 2017, I've lectured to our residents, our trainees at the hospital in their third year of residency about nutritional psychiatry.

So they have some awareness, but now there's more interest from our trainees. And so we're developing the first elective at the hospital, where part of their fourth year of training as they graduate at the end of that year, will be seeing these consultations being supervised and a whole curriculum that we're putting together. So I feel like those slow and steady changes that will take time, but it's hopeful.

Yeah, it's, it's a fascinating area. This idea that what we eat in turn impacts like how we feel like our mental health, not just how we feel physically in our bodies, but our kind of outlook on life and our general disposition. But I suppose to kind of understand the impact of diet on our brains.

We have to understand how diet impacts the balance of neurotransmitters, right, because those are the kind of active catalysts that we're speaking about here. So maybe just walk us through like the nature of these neurotransmitters. There's a bunch of them, GABA, serotonin, dopamine, acetycoline, et cetera.

How do they function to modulate our mental outlook on life? So it's interesting because mental health diagnoses based on the DSM 5TR is suddenly flawed because it doesn't really offer more than diagnostic classifications, which have been helpful to help mental health clinicians put this in order. I say that because we've also then through farmer dependent heavily on the serotonin hypothesis, which was upended by a research group in London, really saying that it's not the whole picture.

And while that doesn't and should never mean of stock your medications and come off the SSRI, it did provide a different way to think about this. And so serotonin being the leading neurotransmitter really, in my opinion, through where most of the medications have focused. I think it's not that it's not a mechanism, but it's not the only thing. One of the things that I like to think about is how a precursor to serotonin, something like food, either turkey or chickpeas actually have the precursor.

The trip to the fan and the farmer trip to fan that then has to undergo an interaction to cross the blood brain biome and then be converted. So it's cool to know these things and to understand how food can interact with these neurotransmitters. The other thing that has been very cool to understand through research is that there are different bacterial groups.

And now we know that the trillions of microbes are bacteria, archaea, protozoa, fungi, many different things, but mostly we study the bacteria. But now there are different bacterial groups associated with different neurotransmitters. That also has kind of led to us understanding a little better how these mechanisms can happen.

And the reason that a very targeted, prebiotic or probiotic oriented around that specific strain of microorganism that is a precursor to the neurotransmitter that you're trying to improve or optimize could be an interesting intervention. But short of that, foods being the precursors to the precursors.

Exactly. I think of it that way. And I also think that in addition to prebiotics, probiotics in that whole emerging area, there's also psychobiotics and where I think some of the research will go over time in being able to create interventions through food and maybe supplements that actually have an impact on mental well-being that are not in the form of the traditional medications we're used to prescribing. Explain what that means psychobiotic.

It's also part of a field of research where it's using food and nutrients to impact the microbes, impact the neurotransmitter levels instead of using a medication. I think it's kind of cool because I think it will over time offer us more solutions that are really based on an integrated and holistic approach to care rather than the first line being the, you know, SSRI or certain medication. Not that those are not needed, but they're not necessarily needed in every case.

Walk me through a hypothetical patient intake. Somebody comes into your clinic. Perhaps they're subsisting on primarily the standard American diet. They're depressed, they're anxious. They have a high stress job. Maybe not entirely sedentary, but not exercising enough. Suboptimal sleep, etc. How do you begin to unpack what's actually causal versus correlative in terms of their mental health and tailor a bespoke intervention around diet and lifestyle that could be beneficial for that person?

So the way that my clinic is set up is and was set up before moving more to educational objectives has always been as a tertiary care center. So I'm getting referrals from within my hospital system, which is pretty large. Different specialists knowing that we provide the service and saying, and sometimes interestingly, Richard, it might be a patient who's read the book or something like that and thinks, something is wrong here and I want to speak to this doctor and it's kind of cool.

So what I'm trying to say by using that term is they often come in with an identified problem. This is not necessarily a physician saying to their patient, you must talk to this psychiatrist very often. It's a very specific problem that they're trying and I'll give you an example that they're trying to heal or get help with an older patient who was referred by an infectious disease specialist had been in and out of the hospital due to multiple chest infections.

And every time that she got sick, she needed bolts of antibiotics. So she had read something in, I think, the local newspaper and she decided that her gut was disrupted and took this conversation to her doctor and then got a referral to see me. And I always remember this because one of the things she said is I know that I need these lifesaving anti-fungals anti microbial treatments and she was so sick with these infections, she needed to be admitted to the hospital each time.

She came to see me between one of these episodes, but she knew something was wrong and what I had to do was walk through a full length history, but when I uncovered in that, and I obviously spend a good amount of time on the eating pattern and nutrition. And I usually ask people to track just three days on their own, they can do it on their phone, we can provide them a form if they need to, but to track what they've eaten because often if you ask them longer than that, they don't remember.

I usually often want them to use their phone because it's with them and they'll type something in, you know, food frequency questioners are not a great idea and a lot of the research is based on them. And I really like to track in that way, sometimes it's a nutrition app if they're working with on and that gives me a snapshot into what they're eating. Interestingly, in her case, and I'll use this example, you uncover one thing that is it could be part of the standard make and diet.

That's usually an easy one, right, because you can start to work on cutting back on the foods that we know are not as healthy. She was actually my was kind of wondering, you know, she's eating healthy foods with rich and omega three she's eating lots of salads she's paying attention to vegetables she's really doing good job. Then she said, I have a sweet tooth, but I've really done better with that and I said, well, tell me more about that.

It wasn't just that she liked sugar, that's a common problem. Her grandkids lived in New York and she would see them on the weekends, they'd all get together. And when she saw them, she would bake up a storm on a Friday and from cookies to cake, whatever it was that they liked the particular treats of the week. And she'd always keep a few for herself and that ended up being a good amount of cookie or cakes or candy that she was baking baking from scratch.

Just through a very different way we found that that was the issue because she was consuming, although she was eating healthy neither rest of the week. She was walking, she did yoga, she was active despite her illnesses. She was consuming all of this stuff as part of, you know, loving them and wanting to prepare treats they liked. And it's a great example, I use it because it became the thing from which we work and reverse engineer plan.

So it's how do we start, once you identify at least one thing that's upsetting that person's metabolism, they're causing some dysbiosis, causing some inflammation in their body. You have a place to work, work backwards, work with their, in her case, infectious disease doctor to see what tests, you know, were needed. And then kind of work out a plan that she was willing to eat. It included some things around sleep, she was not sleeping well, some other lifestyle factors, sense of community.

She was had become a little bit lonely and isolated since her husband had passed away. So a few factors like that, all of which were important. Right, but fundamentally eliminating the sugar benches, which is where it started. It took a while to find what that was. In the context of a holistic kind of prescription. Yeah, interesting. You mentioned that serotonin is not the full picture, but it is key to maintain a healthy serotonin balance.

And if you are down or depressed or have anxiety, perhaps elevating serotonin through dietary choice has shown in your book, you talk about this. Some efficacy in terms of boosting mood and alleviating anxiety and depression and regulating sleep and appetite and the like. So what would that look like if someone's like, well, I'd like to elevate my serotonin.

First of all, how do you know if your serotonin levels are low and in the event that they are low, what are the specific dietary interventions to amplify or boost that? So the way that you know your serotonin is low is no different from evaluating you for taking an SSRI, right? Because it's not as though we're going in and getting a blood test. And I think when I commented earlier that the DSM 5 TR is not the whole picture either.

It's because mental health psychiatry, we don't have invasive tests. We can't do a brain biopsy. We have an unlimited number of things that we can do to diagnose people. And the reason that I feel the DSM 5 TR doesn't capture everything is very often. A person doesn't just have a little bit of depression, often depression and anxiety live together. They may have PTSD and anxiety or they might have focus issues and trauma.

It could be many different things. So it categories of things have helped the system move it forward, but they don't capture everything in a similar way. I don't necessarily know if I'm evaluating you from medication and I'm checking that symptom checklist in the hospital and going through the multiple sort of mood scales and anxiety scales that we are trying to do in an evaluation. Am I dealing with this, but we tend to go to an SSRI as a way to help you on anxiolytic or something else.

Food is not that different. I don't always know that that is low, but I can take from the history, from understanding their lifestyle, from understanding, poor sleep. Maybe it was eating differently during the pandemic, picking up an unhealthy habit that sustained itself beyond the pandemic. A lot of that has gotten people into great difficulties is 25% more anxiety since the pandemic worldwide. That was published in the Lancet, so we know these things.

Very similarly, a comprehensive diet to then help the individual kind of improve. And then what I do is track a lot of the symptoms through scales, through report, through things like sleep, even appetite, things like brain fog, a lot of those are just built into the system of how we track them. Yeah, I saw some alarming statistics. 26% of Americans struggle with diagnosable mental illness. 29% will experience depression, diagnosis in their lifetime.

I mean, it's basically one out of three 31% of people have a chance of experiencing anxiety. Like these are epidemics and they don't happen in a vacuum. They're, you know, co-factorial, obviously. Before we dig any deeper into this, maybe it would be worthy to kind of define what anxiety is, what depression is, how these things differ, because they don't stem from one thing. They're biological, psychological, and social.

They are environmental genetics, so they're multiple factors. Depression is primarily a mood disorder where, you know, you are just not feeling yourself. You are not sleeping well, perhaps. Your family is essentially telling you, your friends are telling you, you know, you don't go out with us anymore.

You're staying at home sleeping, you're not making it even onto your Zoom meetings, you're not making it into work. You might lose weight or you might gain weight because at a big depression can be slightly different. And people have an increased appetite often and more often we see sort of a loss of weight or loss of appetite, just a loss of flabidinal energy just across the board, someone who's struggling that way.

Usually, my clinical experience leads with that mood and affective disorder, distinctly with anxiety, because they do often kind of travel together with anxiety. Sometimes I think the biggest thing is people don't realize that they have anxiety, and it may be presenting as poor sleep, you know, in the afternoon, not being able to focus. And they think, well, I have a problem with attention, but when you deeper ask the questions, evaluate more and start to treat even if it is with a medication.

In fact, they realize that they karma with the medication. That's if the medication works and they pay frequently, don't work. So we do need more solutions. So it isn't that different. And then of course, they have the set criteria that we go through from DSM 5 to you. If you have a patient that is diagnosed with anxiety or depression and they are a good candidate for a nutritional intervention, what does a typical diet plan look like?

What are the foods that you're looking to increase in this person's rotation that might ameliorate some of the symptomology? So with anxiety, the way I think about it is I have an acronym COMFoods, and I also think about it in terms of finding out what they like to eat, what is a level of cooking expertise, or can they get help with that? Can they buy partly prepared foods and put together a meal based on really simple, and I speak about it in terms of anti-anxiety eating plate.

And what I do is I've created kind of a protocol that they can go through with different foods, and the foods listed there have the nutrients which really targeting anxiety, things like cruciferous vegetables that are higher in sulfurophane.

And then the little trips and hacks, a trick I should say and hacks around how you prepare these foods to really make sure they're nutrient dense, with things like broccoli for example, research is shown, there was published in a journal of agriculture that if you especially chop the broccoli fine, let it rest for about 90 minutes, it actually has a higher level of sulfurophane.

So I give my patients tips like you know prepare the night before that it's a doubt put in the fridge and then cook it up the next day or when you do your meal prep day, we try to make it as easy as possible for people. So that's that's just one thing. So the protocol walks through recipes that are linked that you can pretty much go make that recipe that are meant to be simple and follow this eating plan for week one.

The way that those are targeted on a plate is I want people to lean into plants like the blue zones calls it I'm in power nine the plants, I want them to focus in on plants because these are low calorie high fiber, highly nutrient dense foods with multiple fighter nutrients.

And so I like to say instead of brain, but you know kaleidoscope of color because they're bringing so many things to your brain and body. And then when you think about the rest of the plate, unlike the food perimeter that we learned in school, you know, it's really reversed that a small portion of some healthy healthy brain like him.

And then your healthy fat is could be avocado olive oil and then a clean protein, whatever that for me, it would be you know like nicely flavored seed or oven baked piece of tofu or the gooms and lentils for someone else could be chicken or or beef or whatever is their choice. So when they think about it visually, it's really largely vegetables and these other three components in them, of course, they always should be hydrating with things like water kind of a calming tea.

You mentioned the kaleidoscope, which is basically a way of saying increasing the diversity of plant foods on your plate, which is one of these six pillars that you have to calm the mind. So maybe walk us through what those six pillars are. So one of the pillars is eat whole be whole, the antidote to the standard of making diet, which is done reach out for the store bought orange juice, which has no five banana sugar, but just eat the orange just eat the orange.

So whether that's an apple on orange, eat the whole food more times that you can the idea there is to encourage people to really move away from the processed ultra processed version of things. Whenever there's a so called better food or new food that is comes into voc take cauliflower, for example, it turns into cauliflower pizza crust. Now, nothing wrong with that. If you're making it at home or you have a sense of what's in that, there are healthier versions, but it's so processed in some way.

So just eat when you can eat the whole food. Another one is magnify micronutrients, which comes back to that kaleidoscope of colors. One of the things that the world health organization has told us is that 30% of people worldwide, especially women in sure on our deficient in iron. And often goes undiagnosed. So magnifying micronutrients things like magnesium, many Americans are short on magnesium becomes important.

So that just is really a reminder to include these when you can through foods. Another one is, you know, exclude the anxiety triggering foods. And this is not a surprise, but again, people don't always associate ultra processed foods with causing anxiety or certain junk foods of fast foods or highly sugared foods or sodas.

And that connection is often not made and very often it is someone will say, well, but I feel good when I eat that donut, you know, why shouldn't I eat it? It's the long term effect. It's that in that short term, you may actually feel really nice, but very often, if you've, you know, if you've eaten one donut, ten minutes later, you need a second or third. So these are not sustainable options, especially if you're metabolic health.

So now the one is consistency and balance. And what I mean by this is 80% of the time, I want this to feel comfortable for people to do and not be about food rules and make people feel uncomfortable because, you know, they took their childhood birthday party and cupcakes were served.

These things happen. This is life, but 80% of the time, if you are mostly trying to follow this, it's an opportunity to cross correct on those unhealthy foods you may have started eating or you may be concerned about. Another one is prioritizing healthy fats and it's where we get the fats from, right? It's, you know, avocados, it's extra virgin olive oil, nuts and seeds. These are highly nutrient dense foods, which are bringing in the healthy fats to our body, but also to our brain.

And when we talk about omega three, the short chain of megas ALA from things like nuts and seeds, the little things like the fact that turmeric actually activates and can help the conversion. So this is why my cheer putting often have turmeric in them, you know, it's to help that absorption if you're obtaining your omega three's from nuts and seeds. So little things like that are meant to really help people and focus in on these.

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These pillars, which you describe as a protocol for calming the mind, are basically just good advice for how you're going to guide your nutritional priorities going forward for all aspects of health, of course. Like some of them are very straightforward, probably not new information for many of the people who are listening to this. But I'm interested, you mentioned anxiety producing foods.

We all know, you talked about the donut, but we all know what it's like to gorge on processed foods, and then it tastes really good. Well, you're doing it, and then you feel lousy and you're lethargic and you have brain fog and you feel terrible afterwards. But what is going on physiologically when you eat foods that are ultra processed that has a direct correlation or relationship with enhancing anxiety or some of these negative mental health in dish.

So I think I think you raise a good point. I think that there's a lot of the lot of these foods that we want to eat for overall health. But here's the thing most most people are not right because because of very large percentage of Americans have struggles with mental health, the statistics you just quoted and are not really familiar that food can be a way that they cannot only maybe clean up insulin resistance and other things,

but also improve mental well-being. So it becomes powerful in that way because it's an additional tool that someone can use often as a side effect. Some of my patients lose weight. And it's again because they moving towards healthier principles. Mechanisms that causes include information, the dysbiosis, which is that again, that disruption of the negative and the healthy and unhealthy microbes in the gut.

Also setting off metabolism because of how we eating. So when you are leaning into ultra processed foods, you may in fact develop leptin resistance. So the leptin receptors no longer work effectively. They essentially start not telling you what they should, which is you know, you eat in a plate of food and you fall. It's time to get up from the table.

They malfunction and you lose a sense of satiety and satisfaction when you eat that can lead to metabolic health factors. In fact, most of your metabolism gets set off and yet studies have shown you can actually walk yourself back from leptin resistance by adjusting your diet through lifestyle and healthier foods. So the only thing that sets off is very high levels of anxiety because you're metabolically dysregulated, you're de facto neurotransmitter dysregulated as well, right?

So the signaling to the brain gets screwed up in some way that is. One of the interesting things that happens is that the actual receptors malfunction in leptin.

You're not at a high level of leptin, but they're not reaching the receptors. Your anxiety gets set off and it's really all I think you might have probably also heard that some people use the term, you know, type three diabetes for conditions like Alzheimer's because there's really this through line of not only metabolic health problems, but also inflammation that is underlying so many different conditions.

These become mechanistic ways of how we are understanding things right now. And they also then provide intervention points to walk ourselves back from some of these symptoms. Well, let's talk a little bit about inflammation. There is this connection as well between the immune system and mental health, the immune system, the majority of which resides in your microbiome.

And this growing awareness that chronic inflammation is incident to all of these chronic lifestyle elements that most people are dying from or suffering from. So define inflammation and the differences between acute and chronic and why it's important to understand this and the impact that it's having.

So interestingly, you know, the type of information that that comes into play and is so important for healing is, you know, you're running a marathon, you follow up and trip and you scrape your knee. Well, inflammation needs to help you heal that wound, help the pain and you know, create new skin on that scrape wound and that is incredibly important just for normal functioning.

And when we talking about this in nutritional lifestyle and metabolic psychiatry, we are talking about the chronic and serious inflammation that gets set up through how your lifestyle factors are working. So post sleep can be one of them, but also through how you're eating and what you're eating.

And very simply, you know, if you are consuming, if you kind of tapping into the six pillars we spoke about and you trying to adjust your diet towards healthier norms, the breakdown products are actually good and positive and really the gut microbes are making short chain fatty acids, which we need.

And the short chain fatty acids in the gut microbiome help create balance because gut microbiome is almost like its own isn't an organ yet, but you know, it's performing so many functions is helping with sleep and circadian rhythm, which is our internal body,

and the environment production, hormone production, immunity, mental health, so many things and more. So when you are healthy in that area and you are eating in a way that is keeping that balance okay, short chain fatty acids are helping us.

And as are the breakdown products of the foods that we eating, the interaction of the plant polyphenols with the microbes all lead to healthy substances, but if you tapping into the outer process foods, there are microbes that are unhealthy that that live there as well and their breakdown products are toxic toxic polysaccharides, which start to circulate, create inflammation in that environment and ultimately lead to piercing and penetrating the single cell.

So you are out there, you are going to reach the brain and you know this process of information gets set up and again, you can walk yourself back from that and one of the most powerful ways our lifestyle and nutrition factors. So when you are eating these ultra processed foods and you're seeding your gut with a certain type of micro organism that is you know metabolically producing quote unquote toxins, the immune system is triggered to respond it rushes in and produces inflammation.

How does it do that is it like increasing blood flow to the area like how does that translate into a less than optimal kind of cellular lining to your gut is it like a T cell response like what is happening specifically like I'm still trying to understand you break a bone you cut you know you get swelling your immune system is responding to repair the damaged area. We talk about inflammation all the time still not quite clear on like what that looks like in its chronic form.

Yeah, so you get you know inflammatory cytokines being produced you get these toxic breakdown products from food that are going to pierce that cell lining of the gut and they all sort of interact in this environment to flip the balance of healthy microbes and healthy breakdown products in concept with everything else in that environment to really set up for things like inflammatory markers that have been found.

There are certain things you can look for they're not traditionally done and they're not something that routine blood tests for sure because it's in hospital based systems a lot of that is dictated by insurance. But that that can actually show up as inflammatory factors and inflammatory markers so it's linked in that way in turn what's happening in the brain as a result of chronic inflammation and how is that translating into anxiety depression or other

indisha mental health issues so once these let's just call them toxins or these these inflammatory substances reach the circuitry system they're going to circulate throughout the body and the brain is vulnerable you know they get through the blood brain and they start to impact neurons and ultimately lead to neuro information which is essentially brain

inflammation and you know one of the things that one of my mentors always talks about is if people understood and I think it'll tie into what we're saying here that many of us just like people walk around with nascent cancer cells that nothing happens to them you know one person develops cancer someone else does not in a similar way we also have some imperfect neurons in our brain and they could lead to cognitive impact and cognitive changes.

And we know this but one of the most powerful factors is neuro information and how one of the things that impacts your information is how we eat if we dealt and worked towards improving our neuro information in the brain simply by dietary and lifestyle factors we could actually fend off cognitive changes.

This is a mentor who pretty much I think discovered the first Alzheimer's gene or something like that but something important so I always remember that because it was a really seminal moment in my understanding of what we can change in in brain health in that way and we can have a more compact neural information which if we start to work on and food is a factor lifestyle is sleep is a factor and lifestyle is a factor that we can really improve our ability to fend off cognitive changes over time.

So then what do we know or not know in terms of the relationship between chronic inflammation or dietary choices and more longer term brain deterioration diseases dementia Alzheimer's and the like.

What we know is that that food and lifestyle like I just said our our factors I think that we're not at the point of finding that cure Alzheimer's we know that we can emulator a lot of things through things like the process of inflammation we can improve things through certain certain types of eating patterns certain people will use fasting time restricted eating.

We can choose certain nutrients we know that things like trimmac with black pepper blueberries certain foods are targets for cognition beyond that I think that there's a small you know we have a way to go with with the research and I'm glad it's ongoing. We had Dr Sarkis Mazzmanian in here the other week are you familiar with his work at Celtic not all of it but I know I know I know the name yeah it's quite fascinating I mean he's looking at the relationship between the microbiome.

And neurological disorders specifically Parkinson's and autism and finding this connection between the nature of the gut ecology and incidents are onset of these disorders and there's still a long way to go to figure out what an intervention might be or you know how to how to actually you know deal with it and these are all studies that are done in mice thought in humans so it's a leap but I think it underscores this idea of just how powerful.

And significant the microbiome and in particular like the health of the microbiome is in terms of all of these things that we think of as being different or unrelated like the human brain likes to categorize things separate them and put them into buckets the brain and the body as two different entities and we treat them separately when in truth you know we are holistic creatures and these things are not separated they're interrelated in ways that are much more important.

And I love what you saying because not only do I agree with it but you know mental health is no longer above the net concept we are understanding that it is so related to other parts of our body. Understanding that we are holistic beings and that one thing impacts another have become so so critical with grouping one of the pillars on this idea of the bi directional relationship.

Between gut and brain. How does it work in reverse we've been talking about how you know the microbiome can influence the brain but how is our mental state influencing the gut and maybe more specifically how does anxiety affect metabolism because this is going not just from the bottom to top but top to bottom as well.

So a few different ways that we know so far the research is always evolving so I always want to main how more than that space realizing that it changes that this is what we know and this is how I understand it so far. The the few things when we are anxious we know that say you have a bad day and you have not given it someone whatever it might be we know that actually those emotions are transmitted to the microbes and that they respond.

And they show changes and they evolve just like you know when you eat whether it's healthy unhealthy less healthy they they are responding you don't see the effect immediately so we know this from the research that our motion of Vegas nerve started interrupt like how is that messaging yes getting translated one of the strongest pathways is through the Vegas so whether it's new transmitted changes that are being transmitted down to the microbes we know that our emotional health.

Get transmitted when it comes to things like stress and anxiety the other things that's get set off is our you know levels of cortisol and this is not something that we unfamiliar but we know that something gets set off and our metabolism changes all of these things really start to drive anxiety like we know in the brain that the

hippocampus are related to sort of the hot beds or the hot spots for anxiety we understand that it would so many people having some struggle with metabolic health that this is impacted as well so our

mind state so to speak actually impacts the gut directly one of the most direct mechanism is through the Vegas now it becomes powerful because that's where alternate holistic and integrated practices like meditation and breath work can be very powerful like I always make sure that my patients learn a breath work exercise

and research published in early 2020 that was looking at pranayama yoga breath work yoga and cardiac disease secondarily show that it improved depression and anxiety so we know that there ways that we can modulate this through these external factors and you know improve mood and suddenly

and in turn is there a sense or an understanding of how something like pranayama or or another form of breath work or yoga or you know anxiety ameliorating behavior in turn aids with metabolism or the nature of the gut microbiome does it work

and in that way as well you know I think that with metabolism is more complicated because you have the interplay with leptin you have other factors going on you have the potential of you know insulin resistance being impacted so I don't necessarily think it's that exact same way when we know that when our metabolism is set off and is sort of not in check and we know many Americans

are struggling with this that our anxiety levels kind of pop up and we know that that's related in part to to leptin resistance walk me through a day in the life of food for somebody who I want to be very practical here somebody is listening to this and it's like just tell me what I should not eat and eat you know like what does my breakfast look like tomorrow what is my lunch and dinner look like what should I be snacking on if I'm just looking to

you know kind of care for myself a little bit better in terms of reducing anxiety or perhaps even taking the edge off some form of depressive condition sure so some of the foods and I'm going to go through different meals with you but some of the foods I'm going to be leaning into once we've spoken about

and then I'll try to pick up on on certain metabolites and factors that are involved so let's think about breakfast you know I think breakfast is a choice these days because some people choose to use intermittent fasting and time restricted eating for mental health we don't have long term studies on whether fasting or time restricted eating is improving mood anecdotally my patients who do fast will notice that they have more energy

and have a little bit more focus that they speak about but they're also being monitored by team of physicians and not just out there deciding how they should eat a little bit more careful is there an optimal windowing of time that you've noticed that works better than another no not not really I think it honestly comes back to personalization it varies with people and we know that the windows are different in men and women

but there are a lot of patients my patients who wake up in the hangry and they may need to be taking other medications so it's important for them to eat so good choices are I like things like cheer pudding great source of ALA simple recipe with literally a plant based milk or milk of your choice a drop of honey and I do mean you know very little just for some sense of sweetness or I prefer cinnamon which is not only a spice that helps

control of the sugar levels in your body but it allows the sweetness and I like nuts and seeds and berries on my cheer pudding and it's very it's sort of nutrient dense it's fiber filled and protein rich so you don't need a lot of it and you can make it ahead I also like choices of a tofu scramble so I add in spices I add in lots of vegetables if I'm making a large portion I can save some for the next day as well

so I you know use my tofu I kind of chop it up but let's it in a food processor and I love to really pack that up with those vegetables that add in biodiversity I'm always adding spinach or some green because the folate one thing they have iron we know that many people are not efficient but the folate is rich in vitamin B9 and low vitamin B9 is associated with the low mood so adding those in becomes important I also like to use a different way of making an omelette so I was raised vegetarian

so always like to have options for what different people eat and so another thing is to use chickpea flour and to make sort of a chickpea scramble for which I have a recipe in the book another great way to add in spices, herbs, flavorings all of which have powerful nutrients for your brain but also vegetables and adding in your plant slump there

snacks that I like are basically like a granola but made from raw nuts some extra dark natural chocolate chips there be conversions of this that I actually am really liking and often you know coconut chips just for the crunch and it can actually be a really nice snack on the go even if you're traveling or some berries or just a handful of nuts on the go and then lunch I like to some people want a heavier lunch and light dinner and some people flip that

I like to think of a really large salad with lots of greens same nutrients we're talking about here but remember we're also getting the fiber that really feeds the gut microbes we're getting the biodiversity from that kaleidoscope of color bringing different nutrients to the gut

we talked about the plate variation proteins there could be a clean protein so for some it could be tofu, tempeh, some legumes, lentils for someone else it might be chicken and then I like avocado or olive oil sometimes the olive oil is just the dressing for that bowl and one of my favorite grains because I can make you know small amount ahead in the week is something like quinoa but I really use a lot of spices

because it doesn't taste good on it all it's got to be flavoured up and same you can interchange the afternoon snacks also like to add calming teas into your day so passion flour lavender, chamomile tea, mint tea just made with French mint leaves a great in the afternoon and mint contains an antioxidant called luteel

and which helps with brain fog. Not for my patients will say you know I feel sluggish in the afternoon I don't have enough energy it's a great way to and green tea does green tea is rich in you know altheonine and agcg and it also gives people a little bit more focus without the buzz from caffeine

and for dinner you know I go in the direction of always bringing in spices when I can so I like cauliflower steaks and I'll make a take a masala spice on that use my air fryer add in tons of veggies around that someone else in the family may eat a different protein

but lots of vegetables I like a side salad at all I like lots of side vegetables along with that some of my favorite choices are broccoli you know different colours of broccoli like purple spawning broccoli the beautiful orange you know cauliflower that we get whatever it is that you like green beans you know choose the vegetables that you love and add them in because not only are those satiating they flavorful and they're good for you so you know that's sort of how I'd walk people through a day

and I have options for you know people who love dessert because you can make almost a chocolate pudding from using avocado and extra dark cow sure you know people do innovative things and so you know you don't have to exclude these things from your life and there things like extra dark natural chocolate which I learnt in culinary school and I thought that you know clementines are oranges paired with extra dark chocolate was a flavor profile I'm clearly understood that extra dark chocolate is the

highest source of plant based iron and since we know many people are anxious and many people are I'm deficient you need the vitamin C from say the clementine on the orange for the bio availability for the bio availability so it's a lovely pairing for you know people who want a nice snack and it's great for kids to yeah to your point about iron deficiency obviously you want to be sourcing all of your nutrients from food the matrix of the foods that

you're intaking is the optimal way to source all of that but if somebody is iron deficient or they do a blood panel and they realize oh my goodness my vitamin D is low or this is off and that's all important where is your your head in terms of supplementation yeah does that have its place what does that look like what are some of the more common supplements that you would recommend obviously it's going to be specific to that individual but is

there a tether or a relationship between certain supplements or deficiencies and you know mood disorders like anxiety or depression I think that's an excellent point you made about iron deficiency because sometimes people are so iron deficient but they need iron supplements and that's the long time to deplete those stores and then in turn a long time to build them back up correct so they might actually need to do both they

can always eat healthy and add in those I enrich nutrients but taking some from maybe what they doctor recommends and they really should do it to to get to that point with it at the healthy level they might be able to talk to their doctor about coming off that supplement but when they've normalized

and that does take time but generally I'd really feel there's a place for supplements and the reason I feel that is many of us including myself don't eat a perfect diet and supplements actually fill those nutritional gaps so we have some of the ones that are very related to mood and anxiety are things like vitamin D I live in the northeast of the country many people are vitamin D deficient and should have a

check yes you can get you know 80% of your vitamin D by spending time in daylight not only making sure you're attending to your circadian rhythm but also absorbing before you put on some block of sunscreen absorbing some daylight doesn't work through a window but low vitamin D is associated with high levels of anxiety and a low mood another one that I sort of favor is magnesium because so many Americans magnesium deficient and magnesium is involved in so many other biochemical reactions in the

body there's also like seven different types of magnesium right so walk us through which type of magnesium you would recommend and the various applications or or uses for those different forms of magnesium so let me explain my position here so I feel like magnesium can do so much from

helping constipation to helping anxiety that there's a very wide range of uses so I want people to be aware that there are few that I talk about that will help with anxiety but for the most part they really should be speaking to their doctors about it because magnesium does so much and with any of

these supplements they should always be a way in which you're following the recommendations right of the dose because people think well let me improve this by having a ton of the supplements can be unsafe so the other ones are in a lot of also sorry I keep interrupting you feel like I think it's important to point out that again you know these things are operating in the context of a holistic system and I

think our brains are like well if I take this this happens but if you're taking a bunch of different supplements like how are those all interacting with each other how are they interacting with the foods that you're eating and it becomes very complicated very quickly right so the solution isn't just a sort of binary you know X X does why you have to really take into consideration you know multi-variant factors I agree with you and I think I was more answering your specific question around

which supplements impact mental health and specifically move on anxiety but completely one of the things that you know kind of led for my early days I was spending time with my grandparents is this holistic and an integrated approach so how someone's sleeping you know what are they doing for

hydration being dehydrated can actually precipitate anxiety sometimes and people sometimes wake up just because we slept overnight with dehydration and just having a glass of water their bed stand is important so it is always an integrated and holistic approach with these different factors and

individual to that person I've had a patient who came in with the biological relative who had an opposite reaction to the same healthy food and you know I think to myself how incredibly personalized approaches need to be so all of these things are hugely important and what works for

your supplementation may not work for me some general guidelines you know test on guess so let's make sure we know what supplements you need and how you can replenish it involve a provider because they might guide you or maybe you have a different system where you get your blood test

there's so many different ways to access care these days maybe you do it that way but usually there's a nurse there's a practitioner there's a telehealth visit involved and then assess what needs to be replenished if you a vitamin B12 I grew up vegetarians so I would get with

pediatric adult visits get a vitamin B12 test and see if I needed to get that but you know the options now like nutritional yeast which I use in many fine recipes so there are ways to get other supplements and just check a lot of a lot of foods like the plant milks etc are

fortified with B12 do you have a sense or preference around the type of B12 and this is for the plant-based people methylated methecabalaman cabalaman like there are different forms and there seems to be some confusion about which one people should be opting for so it's

interesting because my understanding is that the oral supplementation may not be as effective you might need to take take it as a shot as an I am injection so speaking to your provider about that is important in terms of supplementing it and the one that I tend to lean towards is methylcabalaman. This podcast is brought to you by Squarespace whether you're a budding entrepreneur, a passionate creator or someone with a bold idea Squarespace is your go-to platform for crafting a standout online

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by the folks at On's Swiss labs. They're cutting edge approach from sustainability to precision testing for performance enhancement is next level. It is truly Swiss innovation at its best. Visit on.com slash Rich Roll and use code Rich Roll 10 at checkout to get 10% off your first purchase. You mentioned calming teas which made me think of the role of adaptogens.

You talk about ashwagandha. What is an adaptogen and how are these working in concert with everything else and impacting our mental health? So you know interestingly ashwagandha is sort of a route that was used and doesn't, does not taste good taste very better which is why I stopped them and it's a good idea. It was used in ancient diabetic medicine for eons and for different conditions but it has actually and I'm having a good number of human trials helping anxiety.

So I really come to embrace it as more than just my cultural roots but something that can help individuals who are looking for a few solutions that are not a prescription medication. You know what an adaptogen does is use the mechanisms of your bodily systems to actually improve a certain condition and in this case with ashwagandha we know that people actually have some relief over time for anxiety. So it's a good compliment to consider.

Saffron is an herb that I love to you know spice I love to cook with. It's expensive and you don't use a lot of it yet. Saffron has a number of trials showing that it helps with mood and helps with anxiety. Saffron is another one that I like to suggest as a supplement and anecdotally individuals have told me on podcasts and other places that you know it's something they've given their children because it's something they found to be safe.

They've spoken to pediatrician they don't want their child to take a prescription medication. So it's just an interesting thing to consider. What are your thoughts on so-called like what I'm quote super foods not in the sense that they are panacea is I think they get perhaps too much attention there's sort of the cherry on top of the Sunday that in the Sunday being like the pillars that you already reference.

They're great as long as you're doing all these other things but there are benefits to incorporating things like turmeric or meringue things like this that perhaps are a little bit more exotic for most people. But have you know a wide ranging array of like positive benefits on the body turmeric of course being a powerful anti inflammatory.

Yeah. Often I might be asked by media around you know what is a certain super food night I have to tell you I try to food is food right exactly like I tried to do a lot of attention but yeah. It's like the food of the day. Well the sexier than a whole grain. That's face it. It's like you know each a keen one no not really I want a super food.

Yeah whatever it is so I try to you know push back if I'm asked that because I feel as though it's so important you know we talked about biodiversity of the different foods the colors the kaleidoscope the nutrients in these foods it's really. Every food has some super powerful effects it's what you choose it's the sourcing it's the portion you know rather than people counting calories for example.

I rather they have a bowl of bowl of broccoli as their side dish because we know that that is rich and so few of fans we know that this is going to have positive effects so I try to step back from that a little bit. And if someone says well is blueberry super food well blueberries are fantastic one of my favorite but the other berries are great too maybe you have access to black raspberries maybe you have access to other delicious berries but these are all going to be good for you.

I just don't want you to go you know get a as going to say a lot of profession of them you know because that's not that's not the idea I think that's where marketing food companies and the whole something you're very familiar with is just it's leading people stray from the healthy obvious choices that the police may talk about and

me I actually helping people go back to what probably the way I grand pens are great campaign sweetie beyond anxiety and depression there's a whole litany of other mental health considerations what is your sense of the impact of dietary choices and and ancillary lifestyle choices on things like OCD or ADHD or something I personally suffer from which is seasonal affect disorder I get very down you know when the days are are short and it's cold and dark out.

It's a very real thing the full so OCD has some interesting factors remember this is your brain on food I go through the different conditions and nuances so in OCD glutamates actually in in some healthy foods like different types of soy sauce certain mushrooms things like that can actually offset symptoms of of OCD

and what is helpful for people to know if they're struggling with these symptoms is to work with the clinician to figure out excluding even those automators you know some of those foods are relatively healthy with omiso actually for example that they might want to cut back on to help.

A study done in sure and with ADHD showed that a meeting breakfast actually was not helpful because it was in their symptoms and was harder for them to maintain focus throughout the day and this is interesting because if they prescribe medications is there's a lot of you know medications that are being prescribed to sure and with ADHD and focus and attention they suppress appetite.

Yeah it's yeah you don't want to eat breakfast so you don't want to eat breakfast so little nuances like that that I think help guide in the different conditions and that you know food food can just be a tool not the only tool but a tool that people can use to bolster how they feeling emotionally you know things like light boxes things like having that access to sunlight becomes hugely important

and especially you know in different parts of the country seasonal affective disorders disorders huge again related to sometimes the level of sunlight as well. If I want to enhance my focus and my cognition I want to sit across from you for a couple hours and be completely dialed in present paying attention alert what are some of the foods I want to avoid what are some of the foods that are going to possibly enhance that.

So let's get rid of the ones we want to cut back on and just eat a pizza you know my eyes will swell up I don't have celiac but I can tell you like I feel like my head grows two sizes after I eat something you know like refined grains. Refine grains yeah or sugar and crash and all that of course there's the obvious or thing.

Exactly. I'll tell you the one that so you know we know sugar is obvious we know so does things like that but people can't underscore this enough that people don't realize that. An ultra processed packaged and a processed food just has a ton of it's the colors of eyes a food stabilizes a study done in mice published in a reputable

journal in 2022. I think it was much looked at the gut microbiome given what our conversation earlier and a food they can call CMC carboxy metals cellulose and showed that in these animals when they were fed this it actually led to actually no production of short chain fatty acids and they got microbiome and this is frequently used in our foods to thicken things.

If you read the labels you might see it so it's it's yes it was an animal study but a lot of our research in medicine starts with animals you know aspirin did many medications did so. What I'm saying is that I think you know which starting to find this connection so let's underscore ultra processed foods because they actually are very damaging and it's not that we can avoid them but let's be mindful about the choices we make around that.

The seed oils the issue with seed oil says more that our standard American diet that most many people eating is kind of flips the ratio for mega six and omega three in the favor of mega six which can be prone flammetry we need some omega six and we should be eating them but that ratio becomes important and that's where we go wrong and they're not official sweetness so the old artificial sweetness a problematic to the gut microbiome they trick our systems our bodies into thinking

that sugar is you know going to reach us and that is one of the reasons that people using a lot of artificial sweet to say that died so does or foods that they're eating can actually develop cravings and eat more and may gain weight so just something to watch for that is a controversial take though is it not there are other people who say otherwise when it comes to artificial sweet

I think people have a very number of opinions I'm not saying that I'm 100% perfect or right but I am saying that's my understanding of the science and I think they're new sweetness which actually have been shown to right now the research is not showing anything bad but a lot of stuff that's in died so does and things like that can be problematic certainly to the gut microbiome and to these signal signals in in the body

so but you know the things that we can be dialing into one of the things that's sort of a hidden pharmacy in our kitchens is our spices you know they can be bought in small quantities if you can get organic those are obviously a better choice

but the power of the plant polyphenols and things like turmeric that you mentioned capsicum from chili peppers the luteleon from mint all of these things actually help not only flavor foods they can flavor your tea they can flavor your food but they also enhance your meal with you know note little calories because if they just a pure spice you're adding flavor without sometimes meaning to add less of something sweet because of the cinnamon

and then you know leaning into the berries the nuts the seeds you know my Christopher's vegetables some of my favorites your leafy greens I just some components of how I think well how am I going to stock my fridge is we can then your choices of protein is there something specific I should be thinking about though if my focus really is to improve focus like what are the key foods that are going to do the best job at elevating my ability to like I said be present

focus concentrate so you did outside vitamin C is one of the important nutrients with focus and omega-3s is another one so those two definitely showed up in terms of helping probably one of the mechanisms is the anti inflammatory effect again but it's becomes important because and then

so green tea with e GCG and out the any super helpful for people with kind of focus and that's good enough I don't drink enough green tea what are your thoughts on caffeine there's two sort of things two threads to pull on here I think yeah so I'll tell you what I think caffeine is part of coffee but coffee on its own has a lot of plant polyphenols that can even help you know organ systems like the liver and this has been outlined by one of my colleagues who's a hepatologist

at Harvard and really feels like coffee and I read the books he probably drinks more coffee than I want into but drinks a lot of coffee is okay it's the caffeine that often sets off some issues especially in conditions like anxiety

so my guidance is around coffee is when you can get clean sources of coffee what you put into it becomes important because going back to the start of our conversation my patient is putting a quarter cup of processed cream and it sugars that's you know that's setting it off in a different way

so I'm a fan of coffee for anxiety have it early in the day if you tolerate it if you drink a sip of coffee and you get jittery it's not for you that's you know paying attention to body intelligence I have noticed in myself that more than two cups you know early in the day what I can tolerate I forgot this recently before television interview and it was around the holidays and I had family over and we would drinking coffee with you know the early afternoon and I literally went to the interview

and I thought I should know better so you know I also as a sleep dysregulator I mean it has a like a seven hour life right so you're sleep disrupted in any way and you're not getting your you know solid eight hours and getting you know the restorative sleep that you need

to do some level of caffeine consumption and you're going to be de facto dysregulated in every other way and that's going to affect your mood and everything that's going to be impact of that is sleep and mood and anxiety and all that is huge impact of metabolic regulation and correct sleep impacts that as well so my kind of for what I say to people is 12 I'm guiding someone in a plan I'll usually say 12 noon but usually that gets pushed about one or 2 p.m.

but I like to create that kind of something for myself and I think it works for most people that because if they having an early dinner that hopefully gets gets the caffeine metabolized and it's not impacting their sleep so I like them to have it if they can tolerate it for the other benefits of coffee and pay attention what they

want to say to alcohol alcohol the other hot topic so my position in alcohol is we know the negative impacts of it we know that it can be toxic we know that it can be hugely problematic but I also in mental health feel strongly that I need to address more of the people that I'm treating and it's harder for me to say to people I want you to just stop

stop drinking this entirely can I say to them let's work on this plan that is improving different elements of your health overall to improve your mental well being and can we start cutting back on this because one of the things that happened in the pandemic is many not many but some people

are going to do a little bit of difficulty with that because people were home and I evaluated someone in a telehealth visit once who I was sort of surprised and I had to ask a you know as part of this initial evaluation are you drinking wine because it looked like wine less

like wine I thought maybe it's general but I'm not sure I asked and it was and she had gotten to the state of such extreme anxiety on her own during the pandemic that in order to and my meeting with her was like a 12 noon meeting it was her first meeting of the day that she couldn't get on to her first meeting without a glass of wine and she was kind of all siloed on her own struggling with you know what had become this devastating anxiety

and so people got into different types of issues around that so only in moderation you know if people are advising you that something is a misheight tension you might need help and if it's not for you please don't start drinking alcohol because they I'm not saying there are some great benefits for you I'm mostly trying to address that many people than not I think more people do not

consume alcohol in my practice and if they do how can I work with them to feel better I would just tell them to cut it out I know it's just not easy I mean look just like with the other process if you say to people if you cut it out yeah I mean just give them the hard facts oh come on I understand if somebody's in a high stress situation or they're experiencing anxiety it's like I want to have a drink it takes the edge off it emeliorates that anxiety

but what it also does is set in motion a chain of events that are going to make your sleep less restful like it's ultimately going to exacerbate the anxiety that you're looking to treat and similarly you know with excessive or chronic use in the same way that marijuana operates like a lot of people use that to calm themselves but ultimately it ends up being a situation where their anxiety is way worse and then they're dependent upon it because without it

the anxiety spikes but in truth it's the causative impact of a lot of that experience I respect what you're saying I also want you to know that the studies in alcohol are quite mixed and I'm not saying that I agree with them but I am saying that I have to offer just like I was raised

in the UK and really never ate me growing up I have to be flexible with someone in mental health because they may come in with a different diet but I will tell you that you know there is a so be curious movement that I'm really behind in terms of helping my patients and there is education that is provided to people

but just like you mentioned marijuana you know I'm very mixed about the psychedelic movement so what are we doing in the big picture of things and I'm not saying one is right or wrong but where we headed with this you know what what is that big picture of you how do we help our integrated

I'm sure you have people come in and they say well I heard I heard this about ketamine therapy or psilocybin etc certainly as you know like there is some really interesting research coming out about this and there's no question that it's helping certain people in certain situations veterans with PTSD etc but I do think that there is still some misunderstanding around how powerful these these these

compounds are and our relationship with them feels a little bit too casual and I think it's human for us to think well I just need to if I do that thing it'll solve my problem right I think the search for that solution is always a case and I agree with you I think that it's honestly and brain sense I think I think it's too soon for us to know

definitively and I am very cautious you know and I'm not training ketamine therapy and I'm as a reason I didn't go in that direction in my career I'm not saying you're wrong it might be for person and guided treatment with the right clinician but I don't think it's it's the be all solution and neither psychedelics you mentioned the importance of like working with people and meeting them where they're at

in your experience with all the people that you've seen and that you work with what is the differentiator between the person who can take the council that you're providing and put it into action and make those changes and experience the results and sustain them over time versus another person who sits across from you and you tell them what to do and they just can't quite do it I think of that first hook that first and I mean positive hook to get them started as a positive gateway effect

so meaning that if I can identify that and it's a critical part of that evaluation one thing that's bothering them that we can change because if someone is sleeping better within the first week has more focus or energy these are powerful and someone who is struggling with anxiety or a

mode condition that for me is one very huge factor and this times that I've really run into honestly who want to try to say this in a nice way with people who don't make it they don't get behind the plan they can't get behind the

plan it's often a condition that I see a lot of my practice called author X here and it's not identified by NATO which is the National Eating Disorder Association as an eating disorder but it is a fixation on a certain healthy food or healthy food group and they really do

struggle to work with me around can we adapt this can we add this in can we take that out can we change because they tend to come back to well but this is what I've done and I can't really explain to them that they're overwrought anxiety might be related to the rigidity of holding onto those principles so that's why I've had the most difficulty which of course is rooted in a control issue that is driven by some kind of

latent fear that they have right I mean the psychiatrist in thinking about the mechanics of trying to guide somebody through a lifestyle change all these things come into play or the rexia of course but also what is this person's sense of self are they insecure are they self-loathing do they have a muted capacity of what they're capable of and trying to figure out how to how to like get in there so you can inspire and motivate and educate and guide them in a way that's going to work for

them and it becomes very complicated but I'm really fascinated with this difference between people who are like oh you told me to do that and I did it and people who are like yeah I tried or didn't work for me or I couldn't do it or you know how do people change like as a psychiatrist what have you discovered or experienced in the treatment of you know as a clinician that that gets people over that hump and feeling empowered enough to you know make changes and sustain them.

I think it's a great question so we're just going to make the author rexia that's where team is helpful because having someone you know be the primary therapy but if I'm in this role having them work with someone to work out the fears the underlying issues may take time and that becomes a key part of that almost treatment team approach but it's people get you know advice all the time I'm a firm believer that people generally know what healthy foods

versus unhealthy foods are but affecting change becomes extremely hard behavioral changes hard and for me it's trying to work using almost my skills training as a therapist and and in psychiatry to find my way in to their psychological space in a safe way that I can help them to grab on to the one thing that they want to change and sometimes it doesn't work initially sometimes someone struggles for a little bit you know I can't

get that I and sometimes it involves other factors we need to put into place exact meal planning assistance from a nutrition coach having them in addition to checking in with me having them get help from a dietician who works out the plan with them helps them implement things a family member who helps them shop wherever might be it sometimes takes a while to get to that point but when I mention that gateway

effect when they click with something that shows them like the coffee the gentleman at the beginning of a chat it becomes the focus of change because then they want to do more I've learned they have to have like a tactile experience where they they do something and they experience that results and that sets in motion like a chain of events that engenders encouragement and motivation you've highlighted a very important thing which is

behavioral change is really hard so providing someone with just a plan is not enough they has to be a relationship involved and a way to understand what's going on with them psychologically that they want to make a change and so sometimes finding a way to understand what's bothering them they've come to me for a reason they've been referred but what is bothering them about the eating yeah there is the individual who's like I read the book and I just

went and did it all and changed my life they don't need any accountability to anybody or any community aspect of it and there's the other person who has to have their handheld and you know walked through the tiniest of change and constant kind of accountability to a team of people and those are very different individuals I don't know what distinguishes them psychologically but yeah every person has their different levers I suppose and you know it's only a trained

person who can divine what's going to get that person to make changes I suspect though overall kind of on the James clear atomic habits thing it's like give them a tiny little thing that they can succeed at and let them experience what a win feels like and then that will embolden you know and you know part of my method my protocols we're not the same when I first started because I I had a different view I thought it should always be food first and

there wasn't a place for supplements and I'll really admit that and I also thought well I need to give them five steps to follow and I learned the hard way clinically working with individuals five is too many you know people need a supplement because they just may need to fold that nutritional gap to help them with what they're eating and a lot of that was education for me in in how to adapt meeting someone where they're at and honing the method

you know it's not perfect it's always evolving yeah also like the paradox of choice if you're like well you can eat any one of these ten things like that's that's like paralyzing like just give me the thing to do it right and then on top of that getting them to take ownership of it for themselves because I don't want to take responsibility I want you who I'm going to do you do it for me this is why I'm here I'm paying you you're going to fix this for me

and I actually don't really have to shoulder that responsibility or do any kind of hard work because you're going to fix it and honestly that's where that has been the power of a prescription right in the US medical system it's been you know the urgency the immediacy of coming I need this fix right now you know I need that SSRI I need that medication to help my anxiety and it's a system that's failed us so it's helped people there's always a place for those medications which can be

life-saving but it's not the whole picture and so many people either suffer the side effects or don't recover in terms of anxiety from medication that we have to think more broadly about not only where the responsibility lies but how do we help people be guided with with changes it's not easy you said something along the lines of if we're not looking at lifestyle factors diet sleep exercise etc it's not in terms of like mental health outcomes like it's not

even worth having the calm I'm miss quoting you completely but something along the lines of like all the focus is on medication farm interventions we're overlooking all these lifestyle things what we really need to do is look at the lifestyle stuff first because if we're not addressing that no the other stuff stuff matters I feel like that's a quote that got you in a little bit of trouble it's a bold statement is that something you stand by is it more nuance than that like what is the role of

pharma interventions psychiatric pharma interventions in the context of these lifestyle choices my assumption is that these things need to be kind of handled in an integrative way together but what is your I mean you touched on it earlier but I just want to make sure I understand your perspective right so let me reframe this I feel that mental health is a very big topic that's a very hot topic right now and I feel that unless you've you know been on the

front lines kind of working with Swiss I like the Asian and helping someone and working through those factors that opinions about mental health are very different from clinical can research and I think one has to be cautious about that so I would never you know say lifestyle factors first you know eat these foods I think they're all they're all integrated and what I do is sometimes individuals are referred to me who already on a medication and they may

have been on that medication as we work on lifestyle choices I still prescribe medications when needed but I am more thoughtful and my career trajectory has taught me to be more thoughtful about when that's a better choice than not so they are meant to be a holistic and integrated approach and would never think it's one or the other or that we should push medications aside in favor because someone could be unable to get out of bed and so severely depressed or so

walked with anxiety that they they can't make it out of bed to get to the first meeting or their shower that's when you know acute conditions where medications are absolutely needed and so that food can't help but it wouldn't be the first line so it's always that integrated approach if somebody's listening to this obviously we're just touching the surface of what you address in your books which in addition to being you know

canvassing everything that we spoke about and going more in depth on on all of the subject matter also provide like recipes and meal you know all kinds of guides but if somebody's looking for a little more hand holding and they don't live in Massachusetts like is there like a directory of people who do what you do or something similar that people can find out more about this field and find a clinician who's kind of on your

page that they can reach out to I don't get have that but it's a plan for me to build that out and I mentioned earlier which that you know I've pivoted from immediate direct clinical care to building out the resources because what the books brought forward is a need for this and not just within the country a need for it from other parts of the world as well they're definitely doctors practicing and using these methods I

don't yet have that directory but I'm planning to build one and I'm sorry that those resources are not yet ready okay so fair enough beyond your books though is there some place you can point people to where there's more available information and resources that they can you know edify themselves with so one of the things I write extensively for media if you go to nutritional psychiatry you will come up with a few doctors do

this sort of work you might want to check within your state if there's anyone practicing this way we are trying to build out resources through things like IFM the Institute of Functional Medicine there's some private entities so there are ways that we are trying to improve the resources in this field they also say people can take if they clinicians actually coaches can take the course as well so where are those

courses available so there's a course at Massachusetts General Hospital online the psychiatry academy we have a course cooking for mental health clinicians and we have a course on as a nutritional psychiatry primer there's a course on my website for just basically learning to get deeper into this knowledge and you know they it's a slow and steady yeah yeah those are for clinicians only though not the one of my website is for anyone

it's actually intended for people who it's almost likely want to get deeper than just book if you were to wake up in a parallel universe and found yourself to be the surgeon general of the United States I always

asked this question to the doctors what is your what is your initiative like where where are you placing your focus the exact integration we just spoke about bringing food is medicine forward but in a way that's integrated so no one is saying you shouldn't take a medication or you shouldn't

be using alopathic medicine primarily as what you're doing but why not we integrate lifestyle and nutrition is the one remedial factor across all chronic diseases we know this this is not unknown to doctors and to clinicians to all of us so integrate that make sure that as we are having a

discussion with someone about their blood pressure is it at a point where we can help them intervene with lifestyle measures can they come back three months later and go through an exercise program and eat differently and lower their blood pressure before we prescribe that what about

stethns the same thing what can we do as an integrated system I'm not denying the use of medications but bring that food is medicine movement more front and center that also includes systems around hospital food school foods which California is definitely

on the forefront of changing that and I'm always impressed by that but there are different things that would be to it not just you know eat this versus that it's building out the system the ecosystem of integrating food is medicine at medical school levels in schools things like

community gardens learning or teaching kids to have a little garden at school that they could work on just understanding food from the ground up so it's it would be a whole ecosystem but it would be that primary motivation and given that you would be wielding great power and on this subject of

you know systemic overhaul would there be certain policy initiatives like I'm thinking about the you know hospital insurance industrial complex some of the aspects of the great bureaucracy that are at odds with or are counterproductive in terms of the type of care that you would like

to see people get for one thing you know even at I feel like with primary care visits with suddenly for mental health visits there should be an integration of a food prescription and by that I don't mean this food is going to cure your depression I do not mean that at all but the

integration of how can we integrate food into how we are offering solutions for people at a very basic level so it doesn't wouldn't work in the emergency room but it would work in primary care and outpatient visits lifestyle medicine doctors lifestyle psychiatry all of that and I think having ways to make this part of the conversation maybe it's educational materials maybe it's video materials maybe it's something you can access on your phone it's helping people

get to that point of why it makes a difference. I actually let you go we're almost out of time here but I want to end this with some real practical takeaways like if there's one core precept concept that you want people to take away from the work that you do the message that you're putting out in your books and you're writing you're talking etc you know how would you distill that down

into something that is going to lodge in people's brains and activate change. Start with one thing start with one thing that's bothering you about something you're eating or drinking it could be the coffee it could be the dizzier it could be ice cream it could be whatever it is something

probably bothers most of us and it is the way if you truly feel you're ready to start so pick one thing start there and work your way into a bigger plan once you start to experience the positive change of better sleep feeling more focused having more energy at work whatever that might be in your life I think is a good way to really dip your toe into this nutritional psychiatry lifestyle

measure to see if you if you want to do more. Hmm beautifully put. Thank you. I'm thinking if there is a question that can be coupled with that like what is a question that you want all of us to ask ourselves that would help us kind of clarify what change we might want to make like what is the question you could ask that would trigger something to help us reflect more deeply on the relationship between our lifestyle choices and our dietary choices and our mental health outcomes.

It would be am I living a joyful life right now am I and maybe that's a too strong award am I enjoying my life right now is everything perfect you know um for most of us it wouldn't be but I guess I'm trying to reach what am I in control of because that's where food is very powerful

we can make the change we can make the difference we don't want to make a change but it's within our control so our prescription it's not something I have to remember to take I can literally when I leave go to the supermarket and make a difference in in what I choose so am I am I happy with how I'm

living my life right now is a good way to um I like it thank you thank you this is great we did it how do you feel um I feel great the books are calm your mind with food that's the newest one and this is your brain on food you can find them wherever you buy books you can find them on your website

um I do md.com yeah and is there anywhere else you direct people to learn more about your world um social media I'm at dr uma naidou on social media channels and I have a new um mood food newsletter that we have updated and if evolved and you can sign up for that on my website

yeah I saw your Instagram post about that very cool this was great thank you very much I loved it peace and plants and uh hopefully we'll talk again soon I hope so thank you so much we sheathe it we're brought to you today by bone charge go to bonecharge.com and take the next step in your wellness

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