Dhru Purohit Show - Harvard Psychiatrist Explains How to Use a Low Carb Diet to Reverse Brain Fog and Mental Health Disorders with Dr. Georgia Ede

Episode Date: January 22, 2024

This episode is brought to you by Vivobarefoot, Momentous, and Sweetgreen.  It’s undeniable that food can nourish our body or put it in a state of dis-ease. With mental health conditions and disorders on the rise, we often overlook how the foods that we consume each day have the power to transform and reshape our brain chemistry for better or worse. According to Dr. Georgia Ede, each bite can literally change our minds.  Today on The Dhru Purohit Podcast, Dhru sits down with psychiatrist Dr. Georgia Ede to discuss mental health disorders and their connection to our standard American diet. Dr. Ede shares the benefits of a ketogenic diet, the research behind how food changes our brain chemistry, and the top myths about foods marketed as brain superfoods. Dr. Ede also shares tips from practice and walks us through how we can nourish, protect, and energize our brains for optimal health.  Dr. Georgia Ede. Dr. Ede is a board-certified psychiatrist specializing in college mental health and nutritional psychiatry. She has 18 years of clinical experience in hospitals, community health centers, specialty clinics, and private practices, utilizing medications and psychotherapy to help adults of all ages. Her newest book is Change Your Diet, Change Your Mind.  In this episode, Dhru and Dr. Ede dive into (audio version / Apple Subscriber version): Changing brain chemistry through food  (2:50 / 2:50) What ultra-processed foods do to our brains and the symptoms that are not normal (5:36 / 5:36) The standard American diet examples for all three meals (12:54 / 8:35) The impact of insulin resistance on the brain (18:00 / 13:58)  The top myths about the brain (26:33 / 22:17) Dr. Ede’s patient testimonials and research (41:07 / 34:20)  Four categories that can lead to the harm in the brain (50:11 / 43:38) Optimal fasting insulin levels (1:00:14 / 54:04) Healthy Metabolism: diet is king and exercise is queen (1:03:17 / 57:21)  Who should consider a ketogenic diet (1:08:12 / 1:01:50) Dr. Ede’s hot take on meat protein as the true superfood (1:13:35 /1:06:10) Mediterranean diet and its impact on brain health (1:18:22 / 1:11:50) The importance of having quality research (1:37:00  / 1:30:33)  Dr. Ede’s experience with changing her diet (1:48:40  / 1:42:36) Nourish, protect, and energize the brain (1:57:03 / 1:50:42) Also mentioned in this episode: Dr. Ede’s new book Change Your Diet, Change Your Mind  Let your feet do their natural thing and upgrade your shoes. Just go to vivobarefoot.com/dhru and use the code DHRU15 to get 15% off any order.  Optimize your Omega-3 levels by choosing a quality fish oil made by and used by the best. Go to livemomentous.com and enter promo code DHRU to get 20% off any order.  Find out more about Sweetgreen and their newest protein plates at www.sweetgreen.com. New Users of the sweet green app can use the code "Dhru5" for $5 off.  Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Energy is really everything to the brain. There are many different things that can disrupt energy supply and energy production, but the thing that you have the most control over in terms of that process is how you feed your brain. Your brain cares very much about what you eat. Over a billion people worldwide have some form of mental health disorder or diagnosed condition, and it's growing every single year. This is an epidemic, and on today's podcast, we're talking about getting to the root of it, and potentially reversing it using a diet-first approach.

Hi, everyone, Drew Prode here. This week's guest on the podcast is Dr. Georgia Ead. Dr. Ead is a Harvard trained, board-certified psychiatrists, specializing in mental health and nutritional psychiatry. Dr. Eid has 18 years of clinical experience in hospitals, community health centers, specialty clinics, and private practices, utilizing medications and psychotherapy to help adults of all ages. She's served as a staff psychiatrist and nutrition consultant for seven years at Harvard University's health services and for five years at Smith College in Western Massachusetts.

In 2019, she established a new online video consultation service for individuals and families and fellow clinicians to support people using special diets like the ketogenic diet to treat psychiatric and other mental health conditions. Dr. Ed is a regular contributor to Psychology Today and Dietdoctor.com and speaks internet. nationally about nutrition and mental health. Her newest book, which is the topic of today's conversation, Change Your Diet, Change Your Mind, comes out on January 30th, but is available for pre-order today. And believe me, if you know anybody who's suffering

with some form of mental health, disorder, or condition, this book is for them. Stay tuned for a fantastic conversation with Dr. Georgia Ead. Dr. Georgia Ead, welcome to the podcast. I'd love to jump right in. something mind-blowing that you've shared in your book is that the most powerful way to change the brain and change brain chemistry, both for the better and unfortunately for the worst, too, is food. And right now we have an epidemic of mental health disorders. In fact, you've shared multiple times that we have a billion people on the planet that have some diagnosed version of a mental health disorder, including addiction, depression, depression, anxiety.

attention problems, mood swings, the list goes on. So if food can change our brains for the better or for the worse, what are some of the key categories or key foods that you believe are driving this epidemic of mental health disorders in the world? Fantastic question to start off with because it's a really empowering question, because if we can identify the ingredients in the modern, unhealthy, so-called, standard American diet, this ultra-processed, this diet that's so rich in ultra-processed foods, if we can identify what ingredients in this diet are the ones that are most damaging to the brain,

then all people need to do is avoid those ingredients, and they could feel so much better in a lot of cases. So what I would say to this question is that it's really, for the most part, the refined carbohydrates and the refined fats. So the refined carbohydrates are sugar, flour, cereal products, fruit juices, basically processed carbohydrates, as opposed to the carbohydrates from whole fruits and vegetables. And the refined fats. The majority of those are the vegetable oils, the so-called vegetable oils. So these are things like soybean oil and saffle oil and corn oil.

These are not the fats that you find in whole, foods such as avocados or red meat. These are, these come from oil refineries and take at least 13 chemical steps and explosive solvents to produce. These are not food. 60% of what Americans now eat is no longer food. It is ultra-processed fats and carbohydrates. And I think these are very, very damaging. And there's a lot of signs behind us. Very damaging for the brain as well as for every other part of the body. We're going to drill into these a little bit further, but tell us from your background as a psychiatrist, a medical doctor, what are these foods in these categories that you mentioned, ultra-refined carbohydrates in the form of processed sugars, right, refined flowers,

and the high consumption of these foods, right? We're not talking about maybe a little bit here and there. We're talking about these are the base of people's diets for breakfast, lunch, dinner, snacking, and then these refined unhealthy fats that you mentioned, what are they actually doing to our brains that would lead to so much mental health challenges, but also even if somebody doesn't have a diagnosed mental health condition or disorder, you're seeing also a lot of people who deal with massive levels of brain fog, the inability to focus, you know, move, swings, attention problems. So it doesn't have to be just people that have disease. It could be people that even have in a way kind of like pre-disease, but they don't feel good and they don't

feel like their brain is working. What are these two food categories doing to the brain? So we know a lot more even than we did 10, 15 years ago about some of the driving forces behind mental health problems. We used to, you know, for 75 years, it's really been about chemical imbalances, these sort of mysterious imbalances. and serotonin, norpenephyran, neurotransmitters. But really recently, we've come to understand that it has a lot to do with inflammation of the brain and something called oxidative stress in the brain and insulin resistance. So these three, you know, often we'll refer to these as sort of the unholy trinity

that are, you know, driving mental health problems, inflammation, oxidative stress, and insulin resistance. And so, and we can talk more about any one of those if you like, but before we do or don't, depending on what you prefer, I just want to make it clear that refined carbohydrates like sugar, flour, cereals, fruit juices, and refined vegetable oils, these directly promote inflammation and oxidative stress, and the refined carbohydrates are powerful promoters of insulin resistance. So, and these are ingredients that, as you alluded to, these were a relatively small part of our diet, in the case of refined carbohydrates, they've been a growing percentage

of our diet over many hundreds of years. But really, over the past 100 years or so is when we started to base our diet on these foods and have lots and lots of products that contain these foods. So these are the signature ingredients of the standard American diet. It's not red meat, it's not saturated fat, it's not those ingredients we've been eating since time and memorial. These are, when it comes to refined carbohydrate, it's not that they're brand new, it's that they're now in everything. And with the refined vegetable oils, it's actually that they are brand new. They really have only been part of our food supply for about 100 years or so, and really a significant portion of our food supply since the 19, since 1960, when the American Heart

association deemed vegetable oil as heart healthy. So now, vegetable oil is in every or nearly every food, processed food, product on the market, prepared foods, et cetera. It's almost impossible at this point to avoid this very, very new ingredient. This episode is brought to you by Vivo Barefoot. You know, my journey with VFO barefoot started a few years ago. I've always had this weird little kink in my knee and this chronic knee pain that would show up especially, I'd be walking for long periods of time or even sometimes doing a heavy workout. And I never understood why. You know, the truth is I thought that the sneakers that I was wearing, all the big brands that are out there that rhyme with schmike and blue balance.

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Walk us through breakfast, lunch, and dinner and give us an idea of how these two categories of foods show up because you'd be surprised how many people actually don't know what a refined carbohydrate in their regular day-to-day and the quantity and the amount of refined carbohydrates actually exists. So I've found that this example of you walking people through the day helps people really visualize how much of these might be in their diet, both the carbohydrates as well as the fats. Could you take us through a typical day and what you'd be seeing that would show the just the astronomical usages of these two categories of foods?

Sure. Yes, I think that's really useful because I think most people aren't aware, and most people think of, most people understand that they should probably be eating less sugar, but what they don't necessarily realize is that refined carbohydrates like flour and polished cereals and refined cereal products are essentially sugar. And so it doesn't have to taste sweet to turn instantly into sugar in the bloodstream. And so, start, Refined starches are just as sugary as sugars. So, and this is, I think, is a really common point of confusion. So, for example, if you have whole wheat toast in the morning, or if you have a sweetened yogurt, let's say you have a blueberry yogurt in the morning, let's say you have a smoothie that has a lot of fruit juice in it. Let's say that you have a bowl of cereal,

even if it's a quote unquote whole grain cereal, there are, eating a truly whole grain cereal, cereal is a very, very rare experience. There are almost no cereals on the market that are truly whole grain. And that's another whole conversation you could have because of the strange definitions, USDA's strange definition of what constitutes a whole grain. So if you're eating anything with flour in it, anything made with flour, any baked goods, cereals, if you're eating anything that's sweetened, whether it's a smoothie or a yogurt or a brand muffin, things that bagel, things that we've been taught to think of as normal,

breakfast foods, you're really flooding your system with a lot of glucose all at once. Whether it's sugar or starch, it all breaks down to glucose. And so that's, breakfast is actually one of the most sugary meals of the day for most Americans because of how we think, what we think about as, you know, a typical breakfast. And when people are trying, Starbucks coffee, double frapitino, that people get. Thank you for, that's another really excellent example, yes. And so, you know, most of Starbucks is fascinating to me because it's, it's, most of, most of the products that they, that they offer people are loaded with, with sugar. And so it's, it's become very, very common to drink, not just eat, but to drink

a lot of sugar starting from the very first part of your day. And so when people are trying to reduce the carbohydrates in their diet of any type, you know, improving the quality or quantity of carbohydrate in the diet. Breakfast is the toughest, that breakfast is where the most changes usually need to be made. Because as you move on through lunch and dinner, it becomes a little bit more balanced. You start to see more proteins showing up in the meal often. So for lunch, let's see a lot of people would have a sandwich for lunch, right? So you've got the bread which has refined carbohydrates in it. You might have, you know, your yogurt on the side or granola bar. A lot of carbohydrate, refined carbohydrate in those. But you might also have some cheese or you might have, you know,

a slice of ham or a slice of turkey or something with some protein in it, but breakfast doesn't always have protein in it because we've been taught to think of things like eggs and bacon and meat and cheese as dangerous. And then dinner is the easiest. Because dinner often will have a decent portion of protein, sometimes some vegetables. But then what comes along with dinner is often a starch on the plate. And if that's, say, for example, white rice, white rice is just pure glucose or baked potato, pure glucose. So, and then you might have dessert. And then you might, I think as many Americans do, rather than just eating three times a day, you might eat six times a day. You might have a snack around 10.30 in the morning, then around 2.30 or 3 o'clock, and you might have an extra

coffee like you said, sweetened coffee for Apogino. And then before you go to bed, you might have another snack while you're maybe watching TV or winding down. So most Americans are eating refined carbohydrates five to six times a day. It's mind-blowing. And you know, you mentioned insulin resistance. And we've done so many episodes, we've talked about metabolic health and insulin resistance, but particularly here, both for your waistline and for your brain health, can you make the connection of what happens to our body when we get stuck in this place of insulin resistance, what damage is it doing to the brain and what damage is it also doing to the waistline? Yeah, so insulin resistance is, you know, now depending on which study you look at and how

you define it, 88% of us in the United States now have at least some degree of insulin resistance. And, you know, this is a serious metabolic disorder that, you know, most people, many people still have never heard of, most doctors don't test for, and most of us already have. And this is, you know, we often, it's often called pre-diabetes because it so often can lead to type 2 diabetes over a long period of time and susceptible individuals. But if you have pre-diabetes, you don't just have a blood sugar problem. You have a brain sugar problem. Because what's happening, when your blood sugar is going too high and your insulin levels are going too high. Insulin resistance is caused by high insulin levels. So insulin is a hormone that you produce

in response to every meal and snack. Unless you're eating pure fat, you're getting an insulin response. It's normal and healthy to get an insulin response. We need insulin. But if you're eating too many of the wrong carbohydrates too often, you will get an exaggerated insulin response. and over time it may take longer and longer for that insulin response to normalize, because insulin is having to work harder and harder and rise higher and higher to deal with that incoming sugar load, three, four, five, six times a day. So what's happening, when people develop insulin resistance, it's a perfectly normal and natural protective response to being overwhelmed

by too much insulin in the system. cells do not want to be bombarded with insulin. So they naturally pull back and sort of start to tune down their response to insulin. So insulin resistance is the body's natural response to too much insulin. Too much insulin is the body's natural response to too much of the wrong carbohydrates too often, right? So high blood sugar, high insulin levels. So that's insulin resistance. So what is the problem with that?

So when you eat something very sweet, let's say you have a fruit smoothie and it's got a lot of sugar or juice in it, you get a glucose spike as your body absorbed all those glucose molecules, then you'll get an insulin spike right on its tail to squirrel away all that excess glucose into your cells. And so, and it brings the blood sugar back down again to normal. So you might think, well, what's wrong with that? As long as it comes back down to normal, what's the problem? There are two problems. One is the blood sugar spike, which is exaggerated and unnaturally, unnaturally high because high glucose levels are toxic. They're toxic to every cell in the body, and this is why people with type 2 diabetes risk damage to every organ in their bodies.

Glucose itself, when it's too high, is toxic, but high insulin levels are the things, insulin, it may take years and years and years and years for your blood glucose to go up and stay up, type 2 diabetes. But what's happening, when you go to go to, get a fasting blood sugar test at your doctor, which is what most people use to check metabolism. You're seeing your glucose level at the very first thing in the morning after you've been fasting all night long. It tends to be normal. What you want to know is how much insulin is your body needing to produce to keep your blood sugar normal? Because it will. It will keep your fasting blood sugar normal for years, 10, 15, 20 years until it can't anymore. And that's technically.

two diabetes. So what you want to know is not do you already have type two diabetes? You want to know if you have high insulin levels because high insulin levels slowly over time rob your brain of energy. That is very important for people to know. And so and it's not something most people measure. It's not something most people pay attention to. And it's not something most people make a connection you between their insulin levels and their brain's ability to produce energy. You know, one of my favorite sections inside of the book, and we'll come back to inflammation, oxidative stress, and then also you talk about nutritional deficiencies. We're going to come back to all three of those categories.

Those are four different categories that you outline that are all different ways that these mental health disorders and other chronic diseases can develop inside of the body. So we'll come back to that in a second. But one of my favorite sections inside of the book was you sort of walking us through some of the basics of the brain and how sophisticated of a system the brain is and how much of our total energy the brain uses and how sense of it is. Can you chat about that for a quick second? Because I think that'll be important to set up everything else that we get a chance to get into.

Sure. So the brain is just 2% of the body's weight, but it, but it, uh, but it commands 20% of the body's energy supply. So that's 10 times more than you would expect for an organ of its size. Why does it need all of that energy? It needs all that energy because it's an electrical organ. And it takes a lot of energy to produce electricity. And you have to do it 24-7. So, uh, it's really important for people to understand that if the brain doesn't have a really reliable, smooth, steady access to high quality energy every minute of every day, then something's going to go wrong. And what goes wrong for you is going to depend on your genetics, your family history, the way you've lived your life to that point, what other types of damage may already be present. And how you're eating

and how you're living your life, your metabolic health, right? So for some people, it will eventually look like depression. For some people, it will eventually look like dementia. For some people, it may, you know, on a certain vulnerabilities may look like bipolar disorder or schizophrenia. And so it may look like ADHD. So how the brain malfunctions will vary from one person to another, but there's no question that if you have poor metabolic health, you will not have optimal mental health. because the brain requires access to high quality energy 24-7 and if you want a stable, smooth, reliable supply of energy. If you're trying to run your brain entirely on or mostly on carbohydrate from your diet,

that supply of energy is not going to be smooth and stable. It's going to be unstable. And therefore, your brain chemistry will also be. unstable. So I think it's very important that people understand that, you know, energy is really everything to the brain. And there are many different things that can disrupt energy, supply, and energy production, but the most, the thing that you have the most control over in terms of that process is how you feed your brain. Your brain cares very much about what you, what you eat. And the information that most people have about how to feed the brain, probably what a

brain-healthy diet is, is unfortunately incorrect. So most of us have been feeding our brains improperly our entire lives. So that sounds dire, but really it's an empowering thought, because if you have the right information and you start feeding your brain properly, you have no idea how much better you could feel when you eat properly. It's that simple. Let's talk about some of those top myths, right? You've already talked about refined carbohydrates, the challenge with them. You talked about these refined fats that are a new addition to the human diet and their role in oxidative stress, inflammation, and other things. What are some of the top, some of the other top myths that people have about what works well for the brain and what doesn't?

You know, I think one of the most unfortunate misconceptions out there is about superfoods, brain superfoods. A lot of people think about foods like, you know, blueberries and red wine and dark chocolate and certain plant superfoods being, being exceptionally good for the brain, not just that they nourish the brain or not just that they don't damage the brain or support good health, but that they actually have these, that they have these superpowers that can supercharge your brain and that can, you know, give you extra protection against diseases of all kinds, that they have these special magical properties. And so these, not only did these, adding these foods to your diet, not only does that not work, doesn't work for improving your brain health, but these myths are dangerously distracting.

They distract us from making the changes in the diet that actually matter. And so it's lovely, it's wishful thinking. Wouldn't it be nice if all we had to do to feel better to fight up depression and ward off dementia was, you know, eat more dark chocolate and drink more red wine. Wouldn't that be a wonderful world? You know, on some level, we know that's not true. On some level, we know it's not that simple, right? And so these myths are really damaging because they're appealing. We love these ideas.

And, you know, most people aren't going to dig into the studies, you know, to figure out, you know, whether or not there's a lot of science behind them. But that's one of my favorite things to do. And so when you actually look at these studies, it's just remarkable. So for example, when they do these superfood studies on, say, chocolate and all the antioxidants and chocolate, they're not studying the chocolate you buy in the grocery store. No, they are studying these specially fortified cocoa products, which are very bitter, by the way, it's cocoa potters, in a lot of cases of cocoa powder, which has been fortified with extra

antioxidants called flabinols. You cannot buy this in a grocery store. And so, And the amount of chocolate that you would have to eat to reach the amount of flabinols or antioxidants, cocoa antioxidants that are used in these studies can be up to 50 bars a day. So even the most avid chocolate lover is going to have trouble eating 50 chocolate bars a day. And then, of course, what comes along with that chocolate? Sugar. So sugar is a powerful promoter of oxidative stress. So you might have this tiny little bit of a so-called antioxidant molecule inside your chocolate bar,

if you're lucky and you bought the right brand, and no brand tells you how much is in it. But you're eating an enormous amount of sugar. So you've got this tiny little bit of antioxidant diluted by this bar that's full of pro-oxidants, if you will, promoters of oxidative stress. And the same is true with the red wine studies. So red wine, do you know, how many bottles? of red wine, you would have to drink to take in the amount, even the lowest dose of the reservoir, the antioxidant molecule that is in red wine.

I think I read it like 12 or 11 bottles of red wine to get the equivalent amount of resveratrol, but you probably know the answer. 500 bottles. Oh, wow. 500 bottles of red wine. So, you know, and so that little tiny bit of resveratrol, there's one. one milligram of resveratrol in a glass of wine. It's surrounded. It's swimming in a sea of alcohol, which is a powerful promoter of oxidative stress. So we love the idea that we can fight

oxidative stress by taking in more antioxidants from these delicious and appealing foods and beverages. Why aren't we talking about, well, what is causing all of this oxidative stress in the first place? And the problem with this message is that what's causing it is that a lot of the food, that we are attached to and addicted to and surrounded by and find so delicious and appealing, it's all the refined carbohydrates and the vegetable oils and the alcohol in the first place that's creating this imbalance inside of us. We have our own very powerful antioxidants inside of our very own cells and if we don't overwhelm them with too many of the wrong foods, they do a beautiful job of keeping oxidative

stress and antioxidation forces in balance. So we don't need any help for from plant superfoods, they're really not useful. So I think that when you were talking about refined carbohydrates, you're talking about seed oils, you have been chatting about some things that people on this podcast have also shared that can be problematic, right? Even though I know there's different takes on seed oils,

we'll come back to that in a little bit. When you go into a couple of these other categories, I think that's going to be news for a lot of our audience. You know, you mentioned wine, alcohol, I think a lot of people are starting to understand the truth about that. Chocolate, okay, people are like, oh, wow, I didn't know that because, Drew, people have come on your show. You know, other psychiatrists, other individuals at accredited universities and come in and have shared about the power of things like chocolate, which you've addressed. But they've also talked about things like blueberries and how important blueberries are and the antioxidants in them.

So tell us, doctor, from your perspective, right, are our blueberries? bad for us? You know, should we not be consuming them? What is your take on them? No, blueberry is a very delicious fruit. It's a whole food. If you like them, they're pretty, they're called for the delicious. If you like them and you tolerate them well and you don't eat too many of them, especially if you have insulin resistance, you don't want to have too much fruit. We can talk about that if you like. But, you know, I have nothing against blueberries. What I have trouble with is the belief that simply adding blueberries to your diet is going to improve your brain health. And so I think that what the studies actually show

is not very convincing. So the antioxidants, these so-called these molecules, I call them plant antioxidants. So these magical compounds inside of blueberries, most of them don't get absorbed and the ones that do get absorbed are rapidly eliminated by the body. These are, these are not necessary nutrients for the body. They have no nutritional value. And so the, excuse me, so blueberries are not the powerhouses we think of them. They're just, they're just a whole fruit and they're perfectly lovely as a whole fruit, but they're not going to ward off dementia because the studies of blueberries don't use blueberries. They don't use whole blueberries that you buy in the store. The studies of blueberries use extracts and concentrates that,

that are mixed into special, and then they compare them to these sweetened beverages. The comparisons are really not designed to help us understand whether blueberries on their own, whole blueberries, a little basket of blueberries is going to help you with your brain health. So those are not the studies that they, why don't, if people think that blueberries are good for you

and you're good for your brain, why not give one group of people blueberries, whole blueberries, little basket and the other people know blueberries, give them something else, a different type of fruit, for example, and then see if there's, or give them nothing at all, and then see if there's any difference. But that's not the way the studies are conducted, and it's largely because these studies are funded by the food industry, which is trying to sell you more blueberries. So, if you enjoy them, eat them, but they don't have any magical superpowers. So I think that's the,

that's the thing I really want to emphasize. I don't want you to put all your, all your eggs in that basket because it won't serve you well. This episode is brought to you by Sweet Green. You know, after a busy holiday season, which I'm sure you had too, I love going into January and resetting all my daily habits, focusing on my diet and eating healthy foods that taste amazing, basically doubling down on the basics. So to help me do that, I usually head over to Sweet Green to get an amazing salad. When I walked in recently, I was surprised. I always thought of Street Green as a salad-only place, but they recently launched these new incredibly tasty protein plates. Their hot honey chicken plate is one of my favorites. It's perfectly seasoned and tasted incredibly fresh. The best part is,

if you're a fan of this podcast, you know how important protein is, and this plate had over 49 grams of protein. So it's the perfect meal for me after one of my tough workouts. Not only does it taste great, as I mentioned, but the protein keeps me feeling full because protein is satiating and it keeps my blood sugar stable well into the afternoon. Another awesome thing about sweet green. Their protein, veggies, and grains are all now cooked in either extra virgin olive oil or avocado oil. No more seed oils. That is huge for anyone who's looking to avoid seed oils like myself. Even though it's a controversial topic, I'd like to err on the side of minimizing or greatly avoiding them in my diet. And I love that Sweet Green's mission is to support local communities by working with local farmers and suppliers.

They've always had that ethos since the beginning and the founding of their company. I honestly go to Sweet Green a few times a week or order using a delivery app for a great meal. And I love it. And I'm not going to stop. Visit your nearest Sweet Green or find out more information about Sweetgreen at Sweetgreen. And by the way, new users of the Sweet Green app, they have their own app that you can order, go for pickup. have it delivered to you. New users of the app can use the code Drew 5, D-H-R-U. That's me, five, for $5 off. So either go to sweetgreen.com to learn more to download their app or go to your

app store to download the Sweet Green app and use the code Drew 5, D-H-R-U-5 for $5 off. So part of what I'm taking away from what you're sharing is that there's nothing wrong. If you can tolerate it and you have some enjoyment from it, there's nothing wrong with having a little about a dark chocolate. There's nothing wrong with having some blueberries as part of a foundational diet. And a foundational diet is a diet that does three important things to the body and especially the brain, which you're going to talk about in a second. But if you don't have a foundational diet, simply sprinkling these superfoods on top of a lot of excess calories, I think that's first and foremost. There's a lot of overconsumption of calories. Not that it's all calories in

calories out, but we're eating a lot more addictive food than ever before, partly because it's hyper-addictive and hyper-palatable for people. So these superfoods are not going to make a difference if there's a ton of calories from primarily ultra-process foods, which largely are to come back to super refined fats as well as highly refined carbohydrates. And then on top of that, you're adding what is largely a sedentary lifestyle on top of that. And for people who are often undermuscled, and so they don't have the ability to use that glucose or those sugars inside of the body and they're not burning those fuel sources. So you're saying question these superfoods because first we have to look at the found

foundational diet. Is that, am I understanding that correctly? Exactly. If you want real change, you have to make real change. You can't just take a junky diet and sprinkle some foods on top of it that you've been told are good for you. You have to fundamentally restructure your diet from the ground up. If you want real change, you have to make real change to your diet. And this is, you know, there's just no way around it. And I know that that's not as an appealing as appealing a message as just have a little bit more of this or a little bit more of that. But that's actually, you know, I think of this as sort of the appeal of these superfood myths is the, we love to add things to our diet. It's easy. You know, I'll just eat more blueberries. I'll

have more turmeric. I'll have, you know, more oatmeal chia seeds, nuts, whatever it is. It's very easy to add things to the diet. What's harder is to take things away. But there is a real power, a power most people have never experienced, a real power in removing the wrong things from the diet. Because that's usually the problem. It's not that you're not, it's not a blueberry deficiency. It's not a dark chocolate deficiency. It's certainly not a red wine deficiency. I mean, as a psychiatrist, I am not going to recommend to any of my patients with memory problems or depression to go home and drink more red wine and call me in a week. That's that's malpractice. So what we really need to do is take the things out of the diet that are causing these problems

in the first place. That's a root cause approach. It's not as easy, but it is much more powerful. You will actually see results in almost every case when you make the right changes. And it can take just a matter of a few weeks for people to feel dramatically better. In some cases, just even a few days. So it's worth a try, even though it's difficult. It's difficult to change eating habits. I absolutely understand that. But that is, you know, that's the reality. And I, you know, I just, I think people need to know that. Well, you mentioned people seeing results. You know, as a psychiatrist, you are not just pontificating about these ideas. And even though you're well equipped to go through the research and you present it in your book

in terms of what evidence base is there, what evidence space is not there, you also have another form of research, which is your clinical experience. And you have a multitude of case studies of individuals that you've helped enable this change. Can you share with us a story right now of a patient that came in? who was struggling with something, what you did with them, and what the end result was, because I think these clinical experiences are an important part of the evidence-based that we should be paying attention to. Yes, and we should also talk about the actual study that I helped publish last year.

But in my clinical practice, what's interesting about being a clinician in this space is that I work with people, all different kinds of people. I'm a general psychiatrist. I don't see children, adults. I work with adults with all different kinds of mental health problems. So people aren't coming to me specifically for one particular thing. I see people with ADHD. I see people with psychosis. I see people with PTSD, OCD, ADHD. I see people, really, I take all-comers in terms of my general practice and all, and really always have. So what's fascinating to me as a psychiatrist, you know, after practicing for 10 years conventionally using medications and psychotherapy, I've never seen. I've never seen

these kinds of results before. And, you know, these are the most powerful tools I have at my disposal to help people. In most cases, much more powerful than medications and much more powerful than psychotherapy. And the other wonderful thing about these approaches is that you can combine them with medications and or psychotherapy. You don't have to throw those. the baby out with the bathwater, if those things are helping you, you can add the diet, dietary strategies of different kinds to these conventional approaches and find the mix that works best for you, right? So what I, so I share a lot of stories in the book, but there's a story I didn't share in the book that I think is useful. I think it's really hopeful because I know there are people

out there who are thinking, well, you know, dietary strategy, dietary change, you know, that might be nice for you, maybe you've got mild depression or maybe you're a little, you're a little, you're little unfocused, maybe a little brain fog, you know, kind of cleaning up the diet a little bit. You know, of course, that's going to help a little bit, but not major mental illnesses. And or if someone's been really struggling with their mental health for a very long time, decades, they might think, oh, well, you know, it's too late for me. Or, you know, there's no way that a diet's going to help me at this point. But I'll share a story as a woman I'm still working with now. I think we've been working together for four years, maybe longer at this point. So in her

70s, and she has allowed me to share her story, but not her name. So I'll call her Bella. So a lovely woman in her 70s, a very highly intelligent, very educated woman who has essentially been intellectually disabled for 40 years by chronic bipolar disorder. And in her case, bipolar disorder, which used to be called manic depression, you know, is characterized by periods of mania. And often followed by depressions, but not in every case. All you need for diagnosis of bipolar disorder is to have had a manic episode where your energy levels are extremely high. And that was the case for her. So for 40 years, she would experience these periods of mania, very severe.

Winter and summer were the times when she had these manic episodes, and she would pretty much in the past 10 or 20 years, every year hospitalized for two to three months for a manic episode twice a year, summer and winter. Tried every medication was when her daughter contacted me, she was on very high doses of an antipsychotic, very powerful antipsychotic called chlozapine and a somewhat kind of a moderate dose of an antipsychotic called Syracquel.

or quatyapine, and a tiny little dose of limitlamyctal or limotrogen. So she had been on these medications for a long time, but still, nevertheless, twice a year hospitalized almost like clockwork for two to three months with mania. And then beyond that, as she was entering her 70s, she also started to develop some psychotic symptoms, some paranoia. This was new for her, and it was very, very, it was very, very disabling. So, for example, She lives alone in an apartment complex and is in frequent touch with her daughter. And if she misplaced something in her apartment, she would call her daughter and automatically assume that someone had broken into her apartment in the night and stolen the item.

And her daughter would try to convince her that wasn't the case. She was inconsolable, could not, could not fathom that that, that, that, that, that, that, that it wouldn't be the case that someone had stolen inside. In any case, the daughter went to the extent of installing cameras in the apartment to reassure her mother that nobody was breaking in at night. And even that did not convince the mother that this was not happening. So this was really, really stressful for both the patient, Bella, and for her daughter. And so she was hospitalized.

and there was very little they could do with her medications at that point. She had tried just about everything. And so the treating psychiatrists on her inpatient unit opted to treat her with ECT, electroconvulsive therapy, what used to be called shock therapy, multiple cycles. It really did almost nothing to help her. And then as the manic episodes started to subside, which tends to do after two or three months, she was then discharged home. And it was at that point that her daughter contacted me to see whether a dietary strategy might be useful,

had heard that I do a lot of work with ketogenic diets. Ketogenic diets are really the cornerstone of my practice for a lot of important reasons. They're really powerful intervention. And she adopted quite willingly, and with great enthusiasm, She was a wonderful positive personality. She adopted a ketogenic diet, a very strict ketogenic diet.

And within two weeks, the paranoia had subsided. Wow. She was, if she misplaced something in the apartment, she would call her daughter, and her daughter say, oh, Mom, you probably misplaced it. And she said, oh, yeah, let me go take a look. Completely different response to the same type of. of incident. She was getting up three hours earlier in the morning. She was able to read and remember and concentrate on books. Something is really a joy for her that she had not been able to

enjoy for several decades. And her mood improved, her ability to participate in conversations, to really enjoy her intellectual abilities, completely improved. And so over time, took maybe four or five months, she was able to completely come off the clozapine, 550 milligrams of clozapine, down to zero milligrams, and completely come off the Syracquil, the other antipsychotic she was taking. And those have since been, so this is an ongoing case, but those have since been replaced by smaller doses of a different medication that she tolerates better. And so I think that this is one of those, stories that, I mean, I honestly, when I first met this woman, I wasn't sure if a diet would be

useful. And I really never know what's possible for any particular individual until I try. And that's what I say to people, we don't know what's possible for you until you try. Only you can discover what's possible for you. And that's the empowering nature of these interventions is that I can't change your diet. Only you can change your diet. But if you change your diet and you feel better, you are going to feel so proud of yourself and so much more in control of your own mental health. And I think that's a really, really positive experience for people rather than saying, oh, this doctor gave me this medicine and I have to take it every day. I think that doing something positive for yourself it really builds confidence and builds self-esteem.

No, that's a powerful testimonial, and I appreciate you sharing that, truly showcasing how food is actually medicine for the body. You know, you've shared inside the book that there's four categories of things that when they go haywire, they can cause harm to the brain. We've touched on them kind of high level,

but in the context of this, woman that you just shared. Can you help us understand how changing her diet made a difference in each one of these categories you highlighted earlier? So that was nutritional deficiencies, inflammation, oxidative stress, and insulin resistance. How did going on a ketogenic diet address all of those? If you could just talk top line? Sure. So we'll start with nutrient deficiencies because one of the things that a lot of people don't realize about nutrient deficiencies is that even if you're eating a very nutritious diet, you can still have nutrient deficiencies because you may be eating some foods which interfere with your ability to absorb and utilize

those nutrients or those nutrients may not be in the proper form, kind of a human user-friendly form, right? And so depending on the foods you're eating, you may be able to, you may be absorbing and utilizing more or less of those nutrients. So that's one issue we can come back to is the quality of the foods you're eating, even if they contain nutrients, doesn't necessarily mean that you can access them. So that's one issue. And with this particular woman, we actually needed to make some changes to the composition of her ketogenic diet because she wasn't eating enough animal protein.

So her, for example, her iron levels were running well. So we needed to make some adjustments there and also take some of the foods out of her diet that were interfering with her ability to absorb iron. So we made some changes there. But even just switching from a primarily carbohydrate-based diet to a primarily fat-based diet, which a ketogenic diet, and a ketogenic diet, most of your calories are coming from fat, and followed by protein. protein followed by carbohydrate, which is a very, very small amount of carbohydrate and a ketogenic diet. High fat, moderate protein, low carbohydrate. When you're eating a carbohydrate-based diet, such as is recommended by the USDA or the Mediterranean diet, where, you know, 40 to 65

percent of your calories are coming from carbohydrates, you need a different quantity of nutrients in order for yourselves to process all that carbohydrate. So burning glucose for energy, for example, more magnesium. That's just one example of how the way that you eat affects your nutrient status. So if you're eating a high carbohydrate diet, you'll need more magnesium. When you eat a low carbohydrate diet, you need less magnesium. So that's just an interesting fact. So in any case, a ketogenic diet in and of itself is a diet that kind of spares your body, can protect your body against certain nutrient deficiencies by reducing the amount, by making your cells more efficient at producing energy using fewer nutrients.

So it reduces the demand for certain nutrients. I guess I'll put it that way. Now, that's nutrient deficiencies. When it comes to inflammation, ketogenic diets are really wonderful at reducing inflammation. You know, a lot of that inflammation comes from high glucose levels. And, for example, if you're eating a very starchy or sweet meal or snack or beverage, then you're going to get this glucose spike right after your meal that's exaggerated. And every time that happens, when you get a glucose spike in your bloodstream,

you're also getting a glucose spike in your brain. And so the brain glucose mirrors the blood glucose level. The higher the blood glucose, the higher the brain glucose. They're not equivalent, but they mirror each other, right? So they're proportional. So well, the sugar spike, brain sugar spike. Now, what happens when you get excess sugar in your brain is that that excess sugar literally sticks.

It sticks to proteins and lipids, you know, the fats in the brain that your membranes are made of DNA. It sticks to all the important molecules and structures in your brain and turns these molecules into these kind of sticky. dysfunctional, crippled, kind of caramelized clusters called advanced glycation end products or AGEEs. And they're called AGEEs. It's an appropriate acronym because they're also one of the main factors in premature brain aging and in premature aging of the rest of the body as well, these AGEs. So AGEs are advanced glycation end products. Glication means sugary, right?

So you've got too much sugar in the brain, you've got these dysfunctional molecules. But the brain doesn't take this lying down. I mean, if these were allowed to accumulate left to their own devices, they would eventually come up the work, so to speak. The brain is not going to function properly. Cells aren't going to be able to communicate with each other well. So the brain has an immune system. And the immune system responds by saying, okay, we've got this emergency.

Let's sound the alarm. we're going to now deliberately create inflammation and oxidative stress, which means we're going to release inflammatory cytokines, these little SOS molecules that create inflammation, and we're going to deliberately create oxidative stress, free radicals, reactive oxygen species, free radicals, to sound the alarm so that we can clear away these caramelized clusters. And that's all well and good.

And then, but then a period of healing is supposed to take place. The brain is supposed to return, the immune system is supposed to return the piece to the village, shall we say, right? Everything's supposed to go back to normal. But that's not what's happening. If you're eating refined carbohydrates three, four, five, six times a day, the brain never gets a chance. I mean, the healing never gets a chance to take place. So you're, instead of this temporary, controlled, targeted, healthy, functional inflammation and oxidative stress, which is a normal part of your immune reaction,

you've got chronic, uncontrolled inflammation and oxidative stress, which is very damaging to the brain, and destabilizes neurotransmitter activity as well. And so now you've got all kinds of problems, not just physical damage, but also chemical imbalances. And so when you go on a ketogenic diet, very reliably lowers and stabilizes blood sugar. So that also means it very reliably lowers and stabilizes brain sugar. And that's really, really important. So you've reduced inflammation. You've reduced oxidative stress.

And you've improved your ability to use nutrients more efficiently. And the other thing, and this is really the secret weapon of the ketogenic diet, is that it reliably lowers insulin levels as well, not just blood sugar, which you can do with kind of a relaxed low-carb diet that will lower your blood sugar. But to lower your insulin levels, you have to actually not just keep an eye on your carbohydrates, but you have to just keep an eye in general on everything you're eating and how often, how much, and how often. And so when you do a properly formulated ketogenic diet, you're also lowering. your insulin levels. And when you lower your insulin levels, you take all that pressure off of that

delicate insulin signaling system, which is creating all that insulin resistance, which is making it hard for insulin to cross into the brain, where it is needed for the brain to turn glucose into energy. So if you have insulin resistance, what's happening is you've got glucose waltzing into the brain, no questions asked, but you've got insulin having a harder and harder time getting in. and therefore your brain can be swimming in a sea of glucose and still be starving to death. That's exactly how we lay the groundwork for Alzheimer's disease, for example. So when you go on a ketogenic diet, you reduce your risk for all of the diseases that insulin resistance can lead to, including sort of sputtering brain energy and sort of slowly dying

brain tissue. But you also, when you go on a ketogenic diet, you stabilize your brain cancer. chemistry and you produce ketones. You're burning fat. The fat breaks down into ketones. These are a bite-sized fragments of fat that can cross easily into the brain. And the brain can burn those for energy and that bridges that energy gap. So if you have sluggish brain glucose processing from years of insulin resistance, which now, again, most of us have, then now you've got the supplemental fuel source, ketogenic diet, ketones coming to the rescue. bridging that energy gap so that some of those areas in your brain that are still kind of

sputtering along, they can come back online. So it really does, it's a multi-purpose tool that addresses many different underlying causes of mental health problems in one single intervention. So a couple of questions that I have about the ketogenic diet, who can do it, who, you know, who could be a good candidate for it, and whether or not it's therapeutic or people are on long-term. but really quickly, just because you mentioned insulin, you know, most of our audience knows and is familiar that there are continuous glucose monitors that are available that look at glucose. And there's a lot of great companies out there. I'm an investor in a company called Levels that I'm a big fan of that I've shared with my audience.

There's no continuous insulin monitors that we have right now, unfortunately, maybe one day that will come. So most people who listen to our podcast know and have heard multitude of experts say, It's important as part of your regular blood work that you start making sure that your doctor is looking at your fasting insulin, right? Do you agree with that? And generally, where do you want the numbers to be? Where do you want the fasting insulin to be as a marker of knowing that we are headed in the right direction or that we're maintaining a good sort of balance inside of our body? I want your fasting insulin to be in the single digits.

I mean, ideally six or below is really nice, but single digits. And that's not true for most people. So when I worked in college campuses for many years, tested lots of fasting insulin levels, 20s, 30s, 40s. These are, you know, young people, 18 to 22. Some of them look on the outside to be healthy, so to speak. You know, they're not overweight. You know, they don't have high blood sugar. You know, they don't have diabetes.

They don't have fatty liver. They have insulin resistance. They have high insulin levels. And so I want your fasting insulin to be in the single digits. And so just a quick question about that. You know, my fasting insulin typically is around, you know, before I got serious about strength training, where I turned 40 and I said, okay, I'm completely undermuscled because I grew up vegetarian, not eating enough protein, and in that sort of phenotype of the skinny

fat Indian, right? Like not eating a lot of carbohydrate. eating a lot of vegetarian food, which was Taco Bell and anything that just didn't include meat. So ginger ale and 7-Up and other stuff because it just didn't have meat in it. And then I've shared this story before with my audience, but it's always worth sharing. And then as I started to go down the world and become more familiar with integrated and functional medicine and other doctors that were there, a friend of mine said, you know, you've been vegetarian for a while and you've mentioned like, you know, you were doing good.

Like when you went vegan and you removed a lot of the processed foods out of your diet, which I ultimately did, you sort of felt like, oh, you had a lot more energy and your skin cleared up. And then that worked for about like six, seven years. And all of a sudden, I felt like my brain wasn't working as much. He said, you know, you should do an omega-quant test. There's this new test that's out. It's a mega-quant.

It's a little prick test. I have no affiliation with the company. And I did it. And I saw that my omega-3s were just super, super, super, super. super low. And my ratio of my omega index was way off. And I started including fish into my diet. And I felt like my brain turned on for the first time. Right. I had that sort of firsthand experience of like, wow, okay, like my brain is back to where its potential could be. And that was like in my mid-20s. But nonetheless, what I was sharing with you is that my, when I got serious

about strain training prior to that process, my insulin was like maybe around like five, six. Then I got serious about strain training. I even started including a few more carbohydrates in my diet, like white rice and other things, which I saw improved my performance in the gym. And because I added about almost 9, 10 pounds of lean muscle mass, I actually saw that even though I was eating a little bit more carbohydrates, my insulin on average dropped down now to like the high twos or threes. Right. So can you, do you have any commentary or thoughts on this? and the intersection of, you know, I think food is so important, but I think also muscle health and working out and being active and not having a sedentary lifestyle is important. Have you seen

this in your clinical experience? Absolutely. So, you know, I'm going to steal this line from a clinician who took my training course and said this. I don't remember who it was, but when it comes to healthy metabolism, diet is king and exercise is queen. And you can't, you can't, You can't run your kingdom, your metabolic kingdom without both of them. So just as you can't outrun a diet, you can't sort of, you know, you can't solve your metabolic problems with diet alone. And so both of these are useful. So what's wonderful about muscles is that they soak up glucose like a sponge.

Working muscles soak up glucose like a sponge. And so no insulin required. So your muscles will open the doors to glucose and let it in because they need the energy, right? And so that can help keep your glucose levels in better control and can improve insulin sensitivity and reduce the amounts of insulin that you need to get rid of all that glucose. What your muscles do is they help you squirrel away that glucose, which normally, if you're sitting around all day, insulin has to do all the heavy lifting. If you're building muscle, the muscles can do a lot of heavy lifting for you. you. So that's, I think, what's going on there. Now, and I want to come back to something else you'd asked about was the, we don't have a continuous insulin monitor. I mean, I would absolutely love

to have a continuous insulin monitor. But the next best thing, I mean, if you really want to know what, you know, fasting insulin is one thing because by morning insulin levels, you know, are probably lower than they were the day before because you've been fasting overnight, right? So, but, but, you know, what's happening to the insulin throughout the rest of the day? What's happening to it after you eat? And that sort of thing. So how high is it running on average? We don't know. But the beautiful thing about a ketogenic diet is it, as I said, it reliably lowers insulin levels. And when you lower insulin levels to a certain point, that will turn fat burning enzymes on. So when your insulin levels are too high, that turns fat burning enzymes off, you can't burn fat if your insulin levels too high.

when it comes down low enough, you will start burning fat and you will start making ketones. So ketones are the mirror image of your insulin level. So if you've got high ketones, you've got low insulin and vice versa. So for people who are following a ketogenic diet, which I know is not everybody in your audience, if you're following a ketogenic diet, that's a really, it's almost as though you're testing your insulin levels kind of indirectly. Because you know what I mean? And so it's a, it's a, I think a useful measure if people are wondering, you know, if they have high insulin, if you're never in ketosis at any point in the day or night, your insulin levels are probably a little too high.

That makes sense. So going back to the ketogenic diet, you know, as a psychiatrist and also having run, you know, clinical study, we'll talk about that in a second and, you know, working with patients, helping them get better, you're largely, I would imagine patients who are coming to you who have a mental health disorder, maybe not diagnosed yet, you'll diagnose it for them. And they're struggling with symptoms. Largely, I would imagine that many of them are dealing with, you know, poor metabolic health. And the ketogenic diet is a fantastic therapeutic tool that's there that you've demonstrated

that can get people incredible results. I mean, we've had individuals on this podcast like Hannah Warren, who's now at the Zooki group and the metabolic mind group, share her testimonial of how good going on a ketogenic diet, and she did it as a vegetarian because that was kind of part of her sort of spiritual and moral beliefs about not eating animals, which, you know, I have compassion for it, you know, anybody that feels that that's important to them. And she reversed her type one bipolar disorder going on a ketogenic diet. So, you know, our audience is very familiar, you know, with that. And it's, it's one of the most exciting things and tools in the toolbox, as

as you've shared. For individuals that are here that don't have something that they feel is a mental health condition or they don't feel that they have those symptoms, how do you want to share with them about who should consider or not consider a ketogenic diet? Or, you know, are there other themes that they can be taking about your nutritional recommendations and incorporating into their diet just to fine tune the direction that they're heading in? Great. You know, so one of, one of, I made it, I made a point. point in my book, I worked very hard in the book to have it not just B about ketogenic diets, because even though, again, they're the cornerstone of my practice, I find them fascinating.

I think they're really, really powerful tools. A, not everybody wants to go on a ketogenic diet. For some people, ketogenic diet is a non-starter, right? And I understand that. And B, not everybody needs to go on a ketogenic diet. It depends on your metabolic health and your personal goals, right? So I really wanted in this book to have people, to have there be different levels of different levels, different strategies that people could use to kind of connect to and grab onto and try

depending on what they, on their metabolic health, their response to different dietary strategies. And so there is a dietary strategy in the book, which is just kind of a lower carbohydrate strategy where you can have a serving of carbohydrate with every meal. you can have about 90 grams of carbohydrate per day. And that's going to really be, I think, help a lot of people, whether they ever progress to a ketogenic diet or not, that's going to lower your glucose levels. It's going to take a lot of pressure off your insulin system.

And if you're lucky, it may be all you need to do, right, to protect yourself, to get your fasting insulin level in a good range, to get your triglycerides down, to see whatever other health changes you were hoping to make. So that alone may be all people need to do is clean up their diet and kind of take down the amount of carbohydrate in the diet if they're not feeling well. That's a strategy you can try. But then if that's not good enough, if your glucose levels are still rising too much after meals,

if your fasting insulin is too high, if your triglycerides are still running too high, triglycerides are a wonderful reflection of whether or not you're eating too much carbohydrate for your metabolism, right? because excess carbohydrate gets turned into fat that floats around in the bloodstream. So if that doesn't get you where you're trying to go, then you can go to the next level, which is a ketogenic diet. But you may not need to do that. Or if you don't want to do that, you can at least benefit from making some other changes to the diet.

And I spell it a lot of different things that people can do to improve the brain healthy. I want everybody to be able to improve their brain health through dietary changes, and going to a ketogenic diet is not the only way to do it. So there are so many other changes you can make that can make a very big difference in the quality of your life and in your mental health and your physical health.

So many of the changes you can make, you just have to know what the right ones are, what the ones that are actually worth making are. So I've listed those in the books. You can pick from a menu of different. different changes, refined carbohydrates, seed oils, junk foods, grains, try grain-free, try legume-free, lots of different, dairy-free, try dairy-free. Many different strategies you can try. But if you want fundamental restructuring of the diet and optimal metabolic and mental health, if you follow this

kind of three-three plan roadmap that I'm the book, which starts with this lower glycemic, lower carbohydrate, treat uniquely modified paleo diet, then you're going to get so much more out of that intervention than the sort of nibbling at your diet around the edges. If you nibble at your diet around the edges, that's exactly the kind of results you're going to see. You're going to see, oh, maybe I feel a little bit here. I don't know. It's nothing really to write home about. But if you fundamentally restructure your doctor in the ways that make biological sense, you are going to see much better results. Let's talk about some of your hot takes on some topics that can seem to the outside as controversial, but really there's a whole reason, rhyme, method, and science about why you feel

that way. So I'm going to go through a list of a few different things that I'd love for you to chat about. So the first one is that, you know, you talked about how a lot of superfoods that are out there are not really superfoods in the way that we see that. that in themselves, the science that touts their benefits are often concentrated forms. And if you extrapolate how much would be needed, it'd be astronomical levels of these things. You dark chocolate, you mentioned red wine, which a lot of people on my podcast know about. And there's this flip side where you've shared that if there is a food that actually would be deserving or a category of food that would be deserving of that title, Superfood, even though you're not a fan of it,

you would say that meat actually is in its truest form, one of the most fundamental foods for human beings. So I'd love for you to chat about meat because when a lot of people hear that meat is a superfood, they start to think, whoa, what's going on here? Great. So I open the whole chapter about meat called meat, you know, the original superfood. And I open that chapter with a quote and I'm going to buy Tommy Smothers, the late great Tommy Smothers, who just passed away recently, who said red meat is not bad for you. Now blue-green meat, that's bad for you. And so this chapter really takes down every myth I've come across, but,

there will be more. As soon as the book comes out, there'll be more myths out there to be crushed. But red meat has really gotten a bad wrap. And when I say that meat is good for you, I mean, I'm not talking just about red meat. I'm talking about really the meat of any animals. So it can be, you know, seafood, poultry, meat, you know, the whole gamut of animal meat. And so the reason why meat is surprisingly good for you and why, you, and why the brain actually needs, hopes that you will include at least some animal food in the diet, is because meat is the only food that contains every nutrient we need in its proper form and without any toxins or anti-nutrients. And you cannot say that about any plant food.

So it really is superior in every way, nutritionally and even from a toxicity point of view to every plant food. And so this is extremely important. And I think it's very difficult to explain to people who have heard for 40, 50 years, maybe longer, that red meat is responsible for your world by death and destruction that's destroying every aspect of our health. It's so counterintuitive to hear this message. And that's why I spend an entire chapter explaining why it's so good for and what's wrong with the science behind the messages that meat are bad for you? And I think when people, if people are curious enough to take a look at, you know, what's wrong with the World Health Organization's, you know, proclamation that red meat causes

colon cancer, I've broken all that down in the chapter. I hope in a way that people that will make sense to people so they can follow it. If you're curious to know, like, why is it that plant-based diets are always, we're always told that there's so much healthier, I have a whole chapter called the plant-based brain going out on a limb, which explains the flaw, the sort of secret that people don't know about plant-based diet research was that there has never been a study where, there are definitely studies where it shows that a so-called plant-based or vegetarian or vegan diet, depending on the study. that vegetarian and vegan diets, in many studies, including randomized controlled trials, will look as though they're healthier. And so that's absolutely true. So those studies do exist. What people don't know about those studies is that those studies did not simply remove animal foods from the diet. They made lots and lots of other changes to the diet, such as removing almost all the fat, including all the vegetable oils, removing all the refined foods.

carbohydrates, you know, adding exercise or smoking cessation or, or refraining from alcohol or stress reduction techniques. And they compare that complete package that happened to include a vegetarian vegan diet to a junky standard American diet that happened to include meat. That is not a fair comparison. So we have, we don't have a study that's been conducted properly yet where all you're doing is swapping out the animal foods for plant foods and leaving every other element of the diet alone. That's what we need to see, but we don't see that being happening. So yes, whole foods, plant-based diets are healthier than junky standard American diets that contain meat. That's absolutely true. But that's really all we know.

Similarly, you pick apart inside of the book this recommendation that probably, probably multiple people have heard from our podcast from different guests who feel this way, that we should all strive to be eating what would be called a Mediterranean diet. Can you chat a little bit more about that? Yes. So the Mediterranean diet is, and is very similar to the vegan and vegetarian studies that are out there, the Mediterranean diet has been shown in multiple quality, randomized controlled trials to be superior in terms of in a variety of ways to, again, the standard American diet. So, especially when it comes to, you know, various aspects of metabolic health, cardiovascular health, obesity, et cetera, lots of, lots of good studies that show the Mediterranean diet is

superior to the standard American diet. And we now have three randomized control trials of Mediterranean diet showing that it has benefits for depression as well, clinical depression. So the Mediterranean diet is better for your health, your physical health and your emotional health, than the standard American diet is. But just because it's better than the standard American diet does not necessarily mean that it's the best diet for the brain or the rest of the body. And there are several good reasons to believe that it isn't. I think we can actually do much, much better.

but if you if you're sitting at home and thinking okay my diet needs a lot of help i'm going to try the mediterranean diet please do that is definitely a step in the right direction and a big one right because the midterian diet is a higher quality diet it can it contains nutritious animal foods it contains healthy fats it's lower in processed foods lower in added sugars there are many good things about Mediterranean diet. But here are the problems. The first problem is the Mediterranean diet, the foundation of the Mediterranean diet is grains and legumes, right? So it's a very high carbohydrate, very high in start. This foundation of the diet is very nutrient poor. Brains and legumes are very low in nutrients to the point that when you're eating, when you have cereal products and so

forth, they're always fortified and enriched. They have to be because on their own, they offer almost no nutritional value. And on top of that, grains and logoons are very high in anti-nutrients. So if you see on a package of beans or flour or whatever it is, oats, you might see minerals listed on the label? Good luck accessing all of those minerals because the grains and logoons, as well as nuts and seeds, contain antinutrients that interfere with your ability to absorb, especially minerals, magnesium, calcium, calcium, iron. zinc. So why would you want to make the foundation of your diet? Largely carbohydrate, which provides glucose, the only, carbohydrate is the only macronutrient that is optional

in the human diet. We can actually make all the glucose we need ourselves from protein and fat inside of our own bodies. It's the only macronutrient we have no need for. It's optional. Why would you create a diet that is based on an optional macronutrient and one that most people with insulin resistance, which is now most of us, can no longer safely process and tolerate. And one that's nutrient-pour and nutrient-rich. Why would you do that? So that's one issue. The second issue is the Mediterranean diet is, you know, kind of sends mixed messages about refined carbohydrates. Let's put it that way. It explicitly discourages things like added sugars, while explicitly encouraging foods made out of flour like bread and pasta.

So some refined carbohydrates are good, others are bad, that's a little difficult to square that circle, right? It also explicitly encourages red wine. And this, as a psychiatrist, I find to be very, very disturbing. I mean, alcohol is a toxic, it's a toxic compound. when the liver sees alcohol coming in, it drops everything else it's doing until it is oxidized, sort of burned through, metabolized, and detoxified, and removed, eliminated every molecule of alcohol. And then it goes back to doing everything else is supposed to be doing, such as putting some glucose into the bloodstream and burning fat.

So it is a toxin. It's been associated with about 200 different health problems. it's highly addictive. It destroys sleep quality for the second half of the night. And it can, depending on how much you drink, cause a lot of problems with depression and anxiety as well. No psychiatrist is recommending that people consume more alcohol. So the Mediterranean diet doesn't make a lot of sense on these levels, but really the most frustrating thing about the Mediterranean diet is that it really pays almost no attention. to metabolic health. So if you have insulin resistance, the Mediterranean diet, and don't take my word for it. If you're eating a Mediterranean diet, please check your blood sugars and you, where are

glucose markers, see what's happening for you. See if that Mediterranean diet is good for your personal metabolism, because nine times out of 10, it will not be good enough. And if you already have insulin resistance, eating a diet that's 40 to 65 percent carbohydrates is going to be very dangerous for your brain and the rest of your body long term. So personalize it. When people come to me and say, well, actually, when people kind of get dragged to me by a family member, this often happens, you know, say, oh, you know, my husband and I really love the keto lifestyle. We just feel so good in the ketogenic diet. Can you, I want our parents to have a consult with you. Can you convince them that, you know, they shouldn't be having oatmeal for breakfast? And well, you know, and, you know,

the son and daughter-in-law, they'll pay for the concept, the parents will get dragged onto the screen because I do a lot of my work virtually, and I meet them, they say, you know, I really don't think I need to eat a ketogenic diet. I think I really like that. My diet's really healthy already. You know, I eat a Mediterranean diet, eat a lot of whole brains, et cetera. And I'll say, and I'll say, you know, I have no idea if you need to eat a ketogenic diet. Why don't we find out together whether the diet you're eating right now is good for your metabolism or not? Because and we don't have the tools to do this. Thanks to, you know, programs like levels, which I'm a big fan of.

I don't have a financial relationship with them, but I love what they're doing. You're really empowering people with glucose monitors. You can do your own experiments and figure out for yourself. You don't even need me. You don't need me to do this. You can do this yourself at home. Is that bowl of oatmeal you're having in the morning? Is it spiking your blood sugar at over 140?

Let's find out. And do you need to make changes or not? you can now figure that out for yourself. So I think the Mediterranean diet, again, is a big step in the right direction, but I think it does not go nearly far enough. And we know Mediterranean diet, the mind diet, which is sort of a version of the Mediterranean diet, has not, there was a recent study on this, did not help with, you know, cognitive issues. It doesn't have any power. At least that one study hasn't shown that. And the Mediterranean diet has never, I know of no study showing the Mediterranean diet can quiet seizures. the way ketogenic diet can. The Mediterranean diet doesn't have the metabolic power you need to address metabolic disorders, which are now the number one cause of all kinds of problems

all around the world, from fatty liver to obesity to cardiovascular disease, to almost every brain illness, right? So good metabolism, good metabolic health is fundamental to good mental and physical health. And the Mediterranean diet usually is not going to go far enough. And that's my concern about it, is that it really has a blind, it's got this blind spot when it comes to glucose and insulin levels. Thank you for that. You know, when you hear individuals talking about these large observational studies as well as community questionnaires, and then of course there's documentaries like the Blue Zones documentaries that are on Netflix. And they point to these, especially let's say in the Mediterranean region, which could include Italy, you know, as part of that,

Sardinia, you know, Greece, these areas that are part of the Mediterranean. They are in the way that they talk about it, they're pointing to people who seem to be healthier than your, you know, typical American. And the thing that I love about the Blue Zones is that, you know, obviously they talk about a whole host of things that could be influencing community, a sense of purpose, you know, friendship, deep family

relationships, often multiple people, multitude of generations, you know, living together in, you know, the same household. Generally, more activity-filled lifestyle. They're not sedentary communities. But they point to, you know, naturally as part of these narratives that are there that are being presented. And even the work of research of, let's say,

like a Dr. Walter Longo, who's out there that's that's doing these community surveys of centenarians, they come back and they say, well, you know, these are producing these highly long-lived people. So there are some threads that are there. So what are your thoughts on that? You know, do you have any feedback on that? Sure, of course.

And so I think one of the problems with looking at long-lived population or, you know, people who are healthier than most of us now are, is that we make the mistake of looking at what they are eating rather than what they're not eating. So the thing, and no matter what's, do you take any diet, any study, and you will find this if you look for it, is that what every healthy diet has in common, whether it's mostly plants, mostly animals,

regardless of what it is, whether it's low fat, whether it's high fat, keto, not getting, what every healthy diet has in common is what people are not eating. It's that they're not eating a lot of refined carbohydrates, a lot of vegetables, a lot of ultra-processed foods. That's what every healthy diet has in common. Because you can find healthy long-lived populations who have eaten lots of starch. You can find healthy, along with populations in people who are eating more meat, that's not where the difference is. The difference is in what they're not eating and other aspects of their lifestyle, you know, other aspects of their metabolic health, as you said, you know, so things like exercise and,

you know, low stress and purpose and spiritual connection, all these other things that are good for us. But you will not find, I'm not aware of any study that shows that the less meat you eat and the more plants you eat, the healthier you will be. Blue zones is just another example, just as with, oh my gosh, what is the name of that book, the China study. There are lots of studies out there, large population studies, looking for these patterns and people's lifestyles and deciding, based on everything they've seen, that the reason why those people are living longer or that they're healthier is because of the diversity of

plant foods or the amount of plant foods that they're eating or that's a guess that's a guess so unless you test that in a randomized control trial you cannot tell me with any certainty that that particular element of their diet is the reason why they're healthier so this is the problem with a field of nutrition research which is the type of research that's behind most nutrition studies that you see in the headlines and most of the guidelines that you see in the United States and around the world is it's called nutrition epidemiology. And as you're saying, nutrition epidemiology, so these are not scientists

thoughtfully designing clinical trials with human volunteers changing people's diet to see what happens. That's not what they're doing. All they're doing is administering these very limited, somewhat biased, but even if you don't think that, they're very limited food frequency questionnaires

that ask people to, say, for example, answer the following question, like, how many half-cup servings of blueberries have you eaten in the past year? Now, I don't know how many people can answer that question truly accurately. But in addition to the fact that this is kind of a ridiculous question, I mean, I had a very limited diet, and I can barely tell you what I ate last week, let alone a year ago. But so the questions in themselves are absurd. But the problem with these studies is that not just that they rely on memories,

but that they force you to quantify your answer in a way that is impossible. They don't allow you on the questionnaire to say, I don't know. I don't really remember. Or you've got to be kidding me. You have to fill in a quantity. That guess, that wild guess about your blueberry intake, your dairy intake, your red meat intake, your fruit intake. That guess, that's data. They're viewing that as data. That's not data. Data is something measured and concrete and specific and quantifiable. You can't do science without data.

And the other thing you can't do science without is experimentation. Science requires two steps. A hypothesis? Oh, gee, I wonder if eating more berries will, you know, prevent cognitive decline. I wonder if eating more berries would be good for the brain. Okay, that's an interesting guess and you can survey people and see, well, gee, maybe those people who reported eating more blueberries have a slightly lower risk of eventual dimension than these people who reported eating slightly less blueberries. Okay, but now you've got to test your theory out an experiment. And if you don't do that, you will never know whether you're right or one.

And so that first step, the guess, the wild guess and the hypothesis, that's what gets published. That's what gets published in headlines. Oh, if you eat more blueberries, they'll stay off dementia. That's what gets published and that's what goes into our, that's what we take in as information. And without it ever having been tested, if you never test that theory, you won't know if you've write a long. And so nutrition epidemiology is not about, it's not science. It's simply not science.

A lot of people say, well, these associations between berries and dementia are very, very, we're too weak and that's why we should dismiss them. Oh, the associations between red meat and cancer were very weak and that's why we should dismiss them? No, I'm saying they should be dismissed because they are wholly unscientific and there is absolutely no data, not a single piece of data in any of these studies. This is not science. And this is what people are using to feed their families and make decisions about their own health. You cannot place your faith in this kind of junk science.

and it doesn't make any sense. And unfortunately, the institutions that are so revered, Harvard School of Public Health, you know, Tufts University, lots of places where they're just churning out these nutrition epidemiology studies, which are very cheap and easy to do, and they look so impressive because they can administer questionnaires to tens of thousands of people with the click of a button, and with computers analyze all that data very quickly,

and you see a study, oh, it came from Harvard. It included 200,000 women, and it found this association or link between, you know, take your pick, you know, red meat and, you know, death and destruction. The associations are extremely small to the point that any self-respecting epidemiologists in a field other than nutrition, because you can use epidemiology, epidemiology would be very useful, not with respect to human nutrition, but it's very useful fields, incredible field.

Any self-respecting epidemiologist from another field like toxicology would laugh at the tiny, tiny magnitude of these associations that are being magnified in our headlines. And this is very dangerous information because it's useless. It doesn't work. We're all getting sicker. We're all fighting for our metabolic health. And we cannot pin our hopes on, you know, blueberries and, you know, whole brains and superfoods. It just doesn't work.

You know, there's a whole section in your book where you break this down even further. It's called Why Most Nutritional Guidelines are wrong. It's Chapter 3. And I think that even whether people agree with you, disagree with you, or don't even know how to feel about it, why I found it very useful is just how you can have less nutritional. and cognitive whiplash because one week you'll read a study in the news that says one thing, and then the next week the headline might say something else. And then on top of that, the podcast Freakonomics has done a good job of this,

is even highlighting the fact that in upwards of 20 to 40 percent of those instances, the headline didn't even actually accurately describe what happened in the study in the first place. So not only do you have whiplash, that one study says, saying one thing, another study saying another, but then there's also, you know, did that study even say that thing in the first place? So it brings a little bit of healthy dose of skepticism, so at least you can understand how things are being powered, not that any of us that, you know, don't have that science background that you do would be able to immediately be able to dissect a study, but there can be a little bit more informed consent on the news intake that you, that you end up

pulling in. I want to get a chance to just briefly talk about, you know, what type of, you know, where can studies actually show us? And how do we start having better studies? And can you talk at all about the studies that you've been involved in? And how to design, you know, better studies that can actually get better information on what genuinely works and what doesn't work. I mean, the first thing to say is that we already have a wealth of information, really reliable scientific information about nutrition and human health.

It's just that those fields, those more rigorous scientific fields are not where we tend to look for the information we need. So we already know that all the nutrients, that meat is far more nutritious than every plant food. We already know that plants defend themselves with chemical weapons and use antinutrients to protect their nutrients from being lost, right? We already know so much about how the differences between plant and animal foods, for example, is just one example. We already know, you know, more than 100 years now, brain benefits of a ketogenic diet, how healthy it is for brain metabolism to spend at least some time in ketosis, if not all the time, if you need to do that.

We already understand so much about, you know, how we process carbohydrates, how we process fat, which fats we need. You know, how the body processes excess sugar. It turns it right into fat if we don't use it right away or store. We can only store a small amount. Anyway, so much I could say. My point is, we already have a wealth of information about nutrition without any more studies. But if you were to design a study, you need to design a study properly, meaning both groups have to be eating the same thing except for this thing that you are interested in changing. And it's hard to do nutrition studies properly. It's expensive. It's complicated. And I give lots of reasons why in the book, you know, because to really change people's diets and be able to isolate this one thing that you want to look at.

First of all, you can't ever change just one thing in a diet. You always have to change two things. So when you take something out, you have to put something in and vice versa. So there's usually two differences, at least between the two diets. But in order to really have people follow this diet to the letter, you have to put them in a metabolic ward, and you have to feed them every meal, and you have to weigh and measure everything and record everything. Otherwise, free living humans living in the wild

are not going to follow your protocol exactly as you wish they would. It's just human nature. And so to do a really good study, it needs to be in a metabolic ward, and it also needs to be a long-sum, study because if you put, let's say you put somebody on a ketogenic diet for two weeks and the person feels worse or some, maybe their cortisol levels go up or something happens to them and you think, oh, this is much worse than the other diet that we're comparing it to. Two weeks is not enough time

for your metabolism to shift gears and get to the other side where you really want to be, which is this usually very peaceful and metabolically superior place that people experience as life-changing. And I know that sounds dramatic, but that is what I often see. And so conducting these randomized controlled trials of diets, I'm not sure how interested I am in that. I mean, in terms of like proving a nutrition principle. But I am interested in that in terms of treating mental health disorders. because right now we don't have, and they're in the works, and thank goodness for the Bazuki Foundation, the Bazuki Brain Research Fund and the Basuki Group for funding clinical trials in

metabolic psychiatry because there are so every single person listening to your podcast right now, if they don't have a mental health issue themselves, there's someone very close to them who does. I mean, none of us is untouched by this. So we need better interventions. Medications have their place. I still use medications. They can be very helpful in some cases. And I still use psychotherapy every day in my work. So it's not the medication psychology don't have a place they do, but they fail far too many people. They're not, most people can't access psychotherapy. A lot of people don't respond to medications, can't tolerate medications, can't afford medications. or just don't want to take medications. We need another way forward, and every indication from clinical experience to the types of non-randomized trials that we have so far,

from beautifully published case reports, and lots of collective experience, we know that these diets have tremendous potential. So that's the kind of, research I'm interested in, and that would be fairly easy to do, because when you want a ketogenic diet, unlike any other diet, if you want a Mediterranean diet, low fat diet, low calorie diet, whatever, plant-based, whatever it is, there's no way to know if the person's actually following that diet. If you're a ketogenic diet, we have a biomarker. We know if people are in

if you're in ketosis, you're either in ketosis or you're not. If you're not in ketosis, you're not in ketosis, you're not following the diet. So it's, the research is much cleaner. And we've got something we can actually follow and measure that's reflective of what's going on inside your body. And it's really, really, that's the kind of research we need to do. And so I've never conducted a clinical trial. Let me be very clear about that. What I have done and which I'm very, very glad to have done is I helped a friend and colleague of mine, Dr. Albert Dena, who's a psychiatrist in Toulouse, France, who's been practicing psychiatry for 35 years or more now. He's nearing retirement. So it's not his, it's not his cup of tea to be talking about this on podcasts or going around to conferences. And so

I'm very happy to do that in his behalf, is that, you know, he was curious about whether a ketogenic diet could help his patients because he had witnessed. the family member improve rather dramatically, both with respect to epilepsy symptoms as well as autism symptoms, within several weeks of starting a ketogenic diet. And he thought, this diet seems to be good for the brain. Could it help my patients? So many of my patients that have worked for so long who are not responding to all this medication and my best psychotherapy interventions and repeated hospitalizations. So he asked 31 of his most treatment-resistant patients,

these were little schizophrenia, bipolar disorder, a major depression, severe major depression, taking an average of five medications, each, five psychiatric medications each, which is not at all unusual, and all of whom had at least one marker of poor metabolic health, which is extremely common among people who are taking psychiatric medication. And he asked them, they've been in his care for an average of 10 years, in some cases as many as 30 years.

Coming to the hospital, try a ketogenic diet, simple whole foods ketogenic diet under my supervision to see what happens. And 31 volunteered, came into the hospital, 28 of them stuck to the diet. Three dropped out. They didn't like the diet or they were worried that they didn't. It's not because it made them sick. They just didn't like the diet. Compliance. Right?

compliance adherence, right? So 28 people stayed on the diet. Every single one of those patients improved 100%. And the improvements were noticeable by week three. And that's what I often see in my own practice, right? And so, and not only did they improve, you know, 100% of them improved, but but they improved 44% of them achieved clinical remission from their psychiatric. diagnosis. And 64% of them left the hospital on less psychiatric medication than when they came in. You do not see those kinds of results in conventional inpatient care. You do not. And the magnitude of the improvements, you know, if you publish a study about an antidepressant and you're trying to show that it's better than placebo, the magnitude of improvements on the ketogenic diet that he conducted that he used in his hospital compared to antidepressants and antipsychotic medications, seven to ten times greater magnitude of the response. I mean that they got seven to ten times better than they would have on an antidepressant or a psychotic. So these are not subtle improvements.

These are life-changing improvements. And and this is, you know, these were people who had been sick for a very long time. So it didn't matter what their diagnosis was. It didn't matter how long they'd been ill. It didn't matter what medications they were taking or which ones they were or how many they were taking. And their metabolic health improved as well. Their triglycerides plummeted, which always happens on a ketogenic, almost always happens on a ketogenic diet. Their blood sugars improved. Their blood pressure improved. They lost weight. They lost a clinically significant amount of weight. Why don't more people feel comfortable thinking about using this intervention, even as an add-on treatment to existing treatment? Because that's all we were doing.

That's all he did and that I, you know, I analyze the results and published with him. You know, that's all that was done in this study. You know, nobody was, you know, pulling people off of medication. Nobody was saying, well, you shouldn't be in therapy. Nobody was saying you shouldn't make other life changes. We're just going to improve your metabolic health and see what happens. I think everybody deserves to know what that, you know, to really explore that possibility. There are very few people for whom this is not a good idea. I teach a training course for clinicians and ketogenic diets for mental health. I explain who is not a good candidate for a ketogenic diet. What are some of the things you need to understand about how to safely and, you know,

incorporate this diet into your practice. This was a medically supervised intervention in the hospital. There are things you need to understand. I put them in the book. I put a lot of this in the book for clinicians as well as patients, like what to watch out for what you need to know, why you should work with somebody, especially if you're taking medications. The diet's not dangerous, but you need to know what you're doing because it's a big, real, real powerful biochemical intervention. It's actually going to help you in most cases. It's, again, it's not nibbling at your diet around the edges, it's a real powerful intervention. So that's the kind of research I'm interested in. That's powerful research. You know, as we're winding down here towards the

latter part of the interview, I want to just touch on your personal story. You know, you've shared that you didn't have a mental health disorder. You didn't have something that you were kind of working through the same way that a lot of the patients you see. But you did have a personal experience with food. And that was waking up, and I believe it was in your mid-40s. and you found that a lot of foods that you thought were healthy and that worked with you previously, you started to notice that those foods weren't working for you. So can you just share about that topic for a minute? And what do you think was going on, whether it was hormones, age, the body, environmental toxins, antibiotics,

what was going on that all of a sudden you started to notice these changes inside of your body that led to this opening an approach to being more interested in how diet plays a role in all these aspects of health. Yeah, and I love the way you set up that question because there are lots of different possibilities, right? And I'm not going to pretend that I know the answer for sure about, you know, what was going on for me, but I have some guesses. So, you know, I, you know, four years of medical school, four years of psychiatry residency, we didn't talk about food in the brain once. I mean, I never, it never crossed my mind that food could be important to the brain. Isn't that ridiculous, right?

Sounds so silly now. I mean, like most women, especially I grew up with a weight problem as, you know, as overweight as a child even, and most of the people, my family, too, overweight as when we're young. I've always had a weight problem, and I just thought of food as a way to control my weight. I really, that was the extent of it. And so what happened was in my early 40s, I'm now 59. In my early 40s, I developed a number of health issues that are really common in my patients as well, especially in my middle age and older patients, but these are becoming more common even in younger people now.

You know, things like migraines and irritable bowel syndrome and chronic fatigue and fibromyalgia. And we have these syndromes now that are becoming so common. And I just felt terrible. And this is despite, you know, I was exercising. I mean, I was running four times a week. I was doing strength training on alternate days. I was eating a low fat, high fiber, lower, I mean, I ate, you know, things like, you know, skinless white meat chicken and fish and things like that.

You know, I ate the way a lot of women do who are trying to control their weight, you know, salads and diet Coke and fat for yogurt and things like that, right? But I was not feeling well. So, you know, I went to all these, I was working at Harvard at the time. I had access to a lot of great doctors and specialists. Nobody asked me what I ate, and nobody could find anything wrong. I had a lot of testing done. Nobody could find anything wrong. So I just started experimenting with my diet, just instinctively, because at least the IBS. I thought that might be related to food somehow. So I just started experimenting with my diet,

and after about six months of journaling, food and symptoms, keeping track of everything, I arrived quite methodically, I would say, at this diet, this very unorthodox diet after about six months that resolved every single issue I was having physically, which surprised me. But what surprised me even more was that my mental health improved. And I wasn't even trying to improve my mental health. You know, I had some winter depression. You know, I usually around September, I would start to feel. kind of low. I thought, well, you know, that's kind of normal, right? And I'd, you know, get very anxious

on Sunday nights before work or I'd get anxious about being on call, you know, or if I had, you know, a lot of stress at work. I mean, I had kind of what I consider kind of garden variety issues. I get really tired at the end of the day, didn't have a lot of mental stamina, easily overwhelmed, but nothing really to write home about right. A lot of people feel this way. All of that went away. And I thought, this diet seems to be good for the brain. And it's something. mostly meat, low plant, lower fiber diet. Now, I'm not saying that everybody needs to eat the way I eat. I have a lot of food sensitivities. So, you know, this is not about me. But it got me curious. And I thought, I need to study nutrition because if this diet could potentially help my patients,

what if this diet could help my patients? I can't prescribe this diet until I know it's safe. I mean, this diet is completely opposite of what we're told is healthy for us. I, you know, I don't want to recommend this to my patients and what if it kills them? You know, I honestly thought this diet could kill me. And that's everything I'd been taught or led to believe would suggest that this diet would be very dangerous for me. So that's when I started studying nutrition for the very first time. And that was back in 2008. And so that's how I came to my interest, my passion about nutrition.

It started not about ketogenic diets. It started about food and nutrition science. That was really good. And then 2012, I was the first time I'd really heard about ketogenic diets and started studying them and writing about them so much was 12 years ago. So what do I think happened to me in my early 40s? I have a lot of theories. So one is just worsening metabolic health over the years, right?

So I had, you know, lower and lower fat, lower and lower calories, exercising more and more. The older I got, the harder it got for me to keep my weight in a healthy range. So I was turning more to sweeteners and eating less nutritious foods. And I don't know, maybe that was part of it. And another thing is hormone changes, right? So in your early 40s, even if you're still sort of having normal cycles, which I was, your hormone levels start to drop, your growth hormone levels and estrogen and testosterone and everything changes.

And I've learned so much about the influence of estrogen on good metabolism and good gut health. And so I'm not an expert in this by any stretch of the imagination, but I do think that that has played a very important role in my particular issues in my early 40s. So I think that could have been part of it. another part was about a year before that I'd gone to Cambodia with a friend and I had used a lot of Diet. I'd used a lot of a lot of I was afraid to get malarid, other mosquito-borne illnesses, and so I was using quite a bit of, and permethrine. I had this clothing that was treated with permethrin. I was just really trying to protect myself against those diseases. Could that have had something to do with it. I don't know. I just had a course of antibiotics not too long before that

for a suspected bacterial infection, which turned out not to be a bacterial infection at all, which is so often the case, right? People will take antibiotics for no good reason. Lots of possibilities there. But what I can tell you is that improving my diet in these very fundamental ways reversed almost every problem I had. So even if diet wasn't the cause, it certainly was the remedy. And even if we never understand everything that can go wrong, if you have an intervention at your disposal that just takes a few weeks to try, why not see if that could help you? Powerful. Thank you for sharing your story with us. I know the audience and even myself, we're always curious about, you know, that we're all living in this kind of large petri dish with a lot of different experiments that are taking place

and we're trying to figure out what makes sense for us. And on that pathway, you know, to kind of wrap us up, on that pathway of people trying to make sense. You know, you've been very clear about the ketogenic diet is this one of the most powerful tools that you have in your toolbox to help people that especially are suffering from, you know, mild, medium and even severe mental health disorders. and your book is for more than just individuals that might be interested in that. If you do have that, great, that's a powerful tool. You talk about the ketogenic approach inside of the book, but you also talk largely for individuals that however they approach their diet,

that they want to be keeping their metabolic health in mind to protect their mind. And there's some basic core rules that I'd love to just recap as we end off here, as part of the quiet dietary approach that you have in the book. I mentioned them earlier, but they're nourish, nourish the brain, and we'll talk about just a couple key points that are there, protect the brain, and energize the brain. So just give us a couple top line things for each one of those things, regardless of what dietary approach people want to do.

And as I mentioned before, you know, while you and I are not vegetarian and I'm no longer vegetarian, Even there's ways that people can incorporate this that if they so choose to follow any kind of dietary philosophy and they care about their brain, they care about their metabolic health, they want to keep these things in mind. They can localize it. They can make it unique to any kind of diet that's there. So take us through the nourish, protect, and energize. And what are the key principles for each one of those? Yes. So you can make any diet brain healthier if you follow these principles, right? So nourish means you have to deliver all essential nutrients to the brain. So whatever diet you're eating has to contain all the nutrients your brain needs.

Now, ideally, the easiest way to do that is by including some, at least some animal food in the diet. If you don't do that, please supplement very, very carefully with a knowledgeable professional to see, you know, how, you know, to do the best you can to replace those nutrients that are missing. So that's nourish. You also, another key point about nourishing is maybe avoid or at least reduce the amount of foods in your diet that are high in anti-nutrients. So those are primarily the grains and legumes that you need to watch out for.

Those are the highest in anti-nutrients. So nourish. Protect. Take the foods out of your diet, or at least reduce them as much as you can, that are damaging the brain, that are causing inflammation and oxygen. stress. And those are, for the most part, the refined carbohydrates, sugar flour, cereals, fruit juices, and refined seed oils, the vegetable oils. And so I think that alone is going to go a long way towards protecting your brain. I put in a couple of other foods and then you want to be careful with that are interesting, but that will get us off topic. The third is

energize the brain. And that's where the metabolic quality of the diet comes in. Nourish and protect are mostly about the nutritional quality of the diet. Energize is about the metabolic quality to energize your brain safely over the lifespan, reliably over the lifespan, you want to keep your glucose and insulin levels in a healthy range. Now, depending on where you're at right now in your metabolic journey, that may mean you need to go all the way to a ketogenic diet, but it may not. if you can bring your glucose and insulin levels into a healthy range with a with a sort of less more relaxed strategy absolutely do that right so and and if you do need to do a ketogenic diet if you need to go all that way to a ketogenic diet it doesn't it's ketogenic

diets are not about plants and animals ketogenic diets are not about how many animals you eat or how many plants you eat you can do a ketogenic diet for vegetarian you can even do it for your vegan, it's hard, but you can do it. Ketogenic diets are about your macronutrient ratios. If you're producing keto, eating away, it produces ketones, it's a ketogenic diet. So nourish, protect, and energize. And I give lots of tips in the book about how you can take whatever diet you're eating now and make it brain healthier using those principles. So I'm hoping that there's a place in the book for everybody to grab on, regardless of their dietary philosophy or where they are at in their journey right now or what their food preferences

are. It's fantastic. Dr. Georgia, this has been fantastic. This has been a great summary of some of the key principles that are inside of the book. There's a lot more hot takes inside of the book, and especially in this anti-nutrient category, which is, I'm sure you would even describe it this way, a very controversial topic. You have a lot of people to have difference of opinions, and you weigh in with your opinions. And I'm of the belief that I want all the conversations to take place.

And I want people to sort of navigate those and sort of do some trial and error. There's some foods that I've eliminated over my diet over the years that largely could be maybe healthy for somebody else. But for me, they cause gut irritation. They cause challenges. In particular, tomatoes and nightshades, I notice that my face gets really red. And so I don't eat a lot of those foods. Do I, you know, avoid them like the plague? No.

but it's not a regular part of my diet, eggplant and other things that are there. I just can't tolerate those foods as well. There's other things that people eat that are really challenging for them, and I can include some of those foods inside of my diet. Like when my mom makes, I don't eat them regularly, but when my mom makes traditional Indian-style lentils, but she uses a pressure cooker, not only is it extremely tasty, but I generally tolerate them very well. I'm not gassy and bloating and everything else like that.

And, you know, I find that I can include some of those foods. But that's why did you just come from my trial and error. I get my blood work done regularly. So I make sure to pay attention to my metabolic health. And most importantly, I've figured out how to have some flexibility in my diet that allows me to stay compliant. Because I'm sure you've seen that a lot of the data that's out there and some of the strongest data is that the more challenging a diet is for someone, the tough for it is to stick to it. And I think that part of that helps is that when you are suffering from a mental health condition, when you are suffering with some sort of chronic disease, you're willing

to try to do a lot of things to upend your lifestyle to make it more suitable to stick to a little bit of a stricter diet through education, through access, through community. And just because of the fact that, you know, nothing tastes good as, you know, being healthy feels. So when you feel healthy, you're more likely to be compliant. But I always try to have some flexibility that's there within what works for me so I can make sure that I never completely fall off the rails and go back to eating the standard American diet of processed food, even though I highly doubt that's ever going to happen. But I'm just keeping that in mind for people because I know that first and foremost,

even if people listening today just stop eating as much ultra-processed food, that's a major step in the right direction. but your book is about that's a great step and there's more to be done especially if we want to get to the root of what's breaking our brains that's out there. I love that that flexibility and that's what I really try to encourage in the book too. So the plans that I've laid out, they're discovery plans, right? They're short term six to 12 weeks, see how this helps and see if this helps you kind of plans. but then if you respond well to one of these plans,

then you can gradually expand your diet and see where your safe outer limit is and how you feel different degrees of strictness, right? And so I think personalizing it is really important. If it's not going to work for you, you're not going to stay on. If you don't like the diet, if it's too hard to see, you're not. But what I find, and in my clinical work is very interesting, what I find is true for myself as well.

I've been on lots of diets over the course of my life as a, you know, growing up overweight, right? So this is a ketogenic diet is the easiest diet to stick to for me and for so many of my patients because it regulates appetite. And so, you know, you just feel, you feel in control of your choices. I describe it, you know, as like I describe it to people as a suit of armor. I mean, yes, you can still be killed. You can still be vulnerable. There are holes in chinks in the armor. But it gives you a fighting chance and you don't need nearly as much willpower as you do on any other diet. Because your cells are getting their needs met 24-7. Instead of being on this rollercoast, you have this

steady, smooth, reliable source of energy. And when people shift into ketosis, it's a very noticeable change. So yes, I think, you know, and I, and I explain to people how to deal with, what if you take a day off from the die, the die gets interrupted, what do you, how do you get back on? All these, because I know how hard it is from personal experience as well as clinical experience. So, you know, interruptions happen. And, you know, I help people how to, how to deal with that when they do happen, because life happens where humans, we're not perfect, but don't let the perfect be the enemy of the good. No diet is perfectly sustainable, including this one. They're all hard, but this one is actually much, much easier because it's metabolically different. Powerful. The book is out

there. People can pre-order, depending on the time, or they can get the book, depending on when this interview comes out there. But please do pre-order it. Get a copy for you, get a copy for a friend. It's a powerful book, a ton of great messaging inside of there. Change your diet. Change your mind. we have the link into the show notes. Any final words that you want to leave our audience with today? Just if there's anybody listening with a mental health concern and you think you've tried everything and you're starting to lose hope, I really, there is, there's so much more you can do.

There are other things you can try that you probably have never tried and may not even be aware of. And so I, you know, I really just want to encourage you to consider trying one more thing. Hope is on the menu, as I like to say. And just please don't give up. No matter how many medicines you've tried, matter how many therapists you've seen, even when you may have tried some special diets before,

please don't give up. Please at least, you know, take a look and see what some of the options are and give it, give it some time. You're worth it. It's worth it for you to discover what's possible for yourself. Powerful. Dr. Georgia Eid, thank you so much for coming on the podcast, sharing your message and leaving our community with a sense of hope that we don't have to live

in this place where our brains are constantly broken and the problem gets worse and worse. And the only thing that ever anybody's talking about is that we just have to increase access to mental health, which is important, but it's not in itself going to get to the root issue of what's driving this epidemic. Exactly. Root cause solutions. And these approaches work for most people, not for everybody. they work for most people and what other intervention can you say that about.

It's really, and it's very empowering. You know, you have it within yourself to do this. And so I give you as much, I put as much information as I could fit into this book to help you. And I really hope that it will help you. And the other thing is I hope it will really, I hope we'll start getting some new, fresh conversations going about food that are more respectful and less polarizing. Yeah, that's definitely the hope.

Thank you so much for being on the podcast. Thank you very much for having me. Hi, everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend.

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