The Dr. Hyman Show - Brain Food: The Top Foods for Mental Wellness

Episode Date: May 27, 2024

View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal We often hear about food in the context of physical health, but food is very tied to emotional and mental health, too. The growing field of nutritional psychiatry is shedding light on this profound connection between food and mood, and how what we eat impacts everything from anxiety and depression to ADHD and more. In this episode, Dr. Hyman speaks with Max Lugavere and Dr. Uma Naidoo about the best foods to eat to support your brain and the beautiful symphony between what you eat, your gut microbiome, and cognitive function. This episode is brought to you by Rupa University, ButcherBox, and Cymbiotika. Rupa University is hosting FREE classes and bootcamps for healthcare providers who want to learn more about Functional Medicine testing. Sign up at RupaUniversity.com. ButcherBox is giving new members two pounds of wild-caught salmon for FREE plus $20 off. Visit ButcherBox.com/Farmacy and use code FARMACY. Upgrade your supplement routine with Cymbiotika. Get 20% off with free shipping on all orders. Head to Cymbiotika.com and use code HYMAN.

Coming up on this episode of The Doctor's Pharmacy. You find three times the vitamin E in grass-finished beef as you find in grain-finished beef. It's also a great source of a compound called creatine, which supports brain energy metabolism. So people who don't regularly consume creatine, which is found naturally in beef, fish, and you give them supplemental creatine,

you see an improvement in their cognitive function. Before we get into today's episode, I'd like to take a minute to remind you of some exciting news. My new cookbook, The Young Forever Cookbook, will be released on Tuesday, June 4th nationwide. In my new cookbook, The Cooking Companion to my book, Young Forever, you'll find over a hundred mouthwatering anti-inflammatory recipes that are going to help you live a longer, healthier life. You can pre-order The Young Forever Cookbook at youngforevercookbook.com. Just click on the pre-order button at the top right. I'm so excited to share these recipes

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That's rupahealth.com. I'm always talking about the health benefits of wild-caught salmon, and it's one of the easiest ways to up your intake of protein and healthy omega-3 fats. And eating it twice a week can cut your risk of a heart attack, stroke, high blood pressure, and high triglycerides. But it has to be top quality salmon. And sadly, most salmon you

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because right now, as a special offer to my listeners, ButcherBox is giving you two pounds of wild-caught salmon from Alaska free in your first order, plus $20 off your first box. Just go to butcherbox.com forward slash pharmacy. That's F-A-R-M-A-C-Y. Now let's get back to this week's episode of The Doctor's Pharmacy. Hey everyone, Dr. Mark here. Brain disorders for so long have been made to feel out of our control, but there's so much we can do to prevent and reverse the range of signs and symptoms that steal our brains, our bodies, and our health as we age.

Now, one very potent way of supporting our brain is through food. A diet rich in healthy fats like omega-3s, quality protein, and anti-inflammatory spices will do the trick. In today's episode, we feature three clips from the doctor's pharmacy about how food that we ingest at least three times a day can have a massive effect on our brain health. Max Lugavere takes us through all of the healthiest brain foods. And I forewarn you about the foods you shouldn't eat, encourage you to eat the ones you should, and remind you that you can't forget hydration. And finally, I talk with Dr. Uma Naidoo about how food can impact the microbiome, which has a direct effect on brain conditions like anxiety and depression. So let's jump right in. I looked through the medical literature

and I determined the foods that were gonna be the most accessible, the most available to people that are listening to this and watching this, that are going to serve a neuroprotective effect. Foods that are literally superfoods for the brain. And I coined the term genius foods, which is not a scientific term,

but it's the term that I've applied to the foods that are going to give your brain the most bang for its buck with regard to neuroprotection with regard to promoting neuroplasticity by providing important builder block molecules like mucosa hexaenoic acid or dha fat which we know is one of the most important and yet under consumed structural building blocks of the brain and so we can look to certain foods like um avocados for example avocados at this point are pretty widely available and avocados are a fruit that provide the highest concentration of fat protecting antioxidants of any other fruit or

vegetable wow yeah like this this is of relevance to the brain because the brain is made of fat right Dr Hyman the brain is made of fat but not just Dr. Hyman? The brain is made of fat, but not just any fat. It's made of a type of fat that is most prone to oxidation, most vulnerable to what's called oxidative stress. And so you eat an avocado, which is rich in vitamin E, a fat-soluble antioxidant. It literally is one of the most powerful brain anti-aging foods that you can consume it's also loaded with fiber which makes it satiating and it helps support gut bacteria which is promotive of a healthy gut microbiome it contains potassium which we know is really important for helping um maintain a healthy uh level of blood pressure and it also contains compounds called uh carotenoids which we know protect neural tissue

both in our eyes and in our brain this is one of the reasons why avocados and dark leafy greens are protective against age-related macular degeneration they contain these carotenoids which we now know also protect brain health so that's one of my favorite foods avocados yeah the thing i'm probably my problem with that is it often comes in the form of guacamole unless you order the vegetable sticks instead of the chips it's a danger zone for me because i can i just kind of like those chips or i don't like crack i don't know why but if anybody else has this corn chip thing it's like i can't eat them because i just can't stop yeah i'm the same way i think it's it's better to for me well it's

it's that slogan once you pop you can't stop we know now thanks to scientific research that that that's a slogan with scientific backing at this point that is that is a truism at this point right because foods like tortilla trip chips are hyper palatable they combine salt fat flour yeah and they're they're so calorie dense that it would have actually been a life-saving food potentially for a hunter-gatherer right well that's why that's why i actually i'm afraid of mexican restaurants now i'm like i'm gonna and then someone orders that i don't order that i usually don't order the chips and guacamole then someone's like bring the chips i'm like oh no i'm the same way i'm the same way it's like giving a crack addict some crack yeah I mean the thing

is we feel as though we I feel like there's this innate sense that we should be able to moderate our consumption of those foods right that's part of having a healthy relationship with food however I think what most people fail to realize and what's certainly not um acknowledged by even our most esteemed health care professionals and and and those in the nutritional orthodoxy it's that these foods are not designed to be consumed in moderation they're hyper palatable and by the time you've filled yourself up on them you've already over consumed them unfortunately people tend to experience a sense of moral failure when they're not able to stop eating the chips right yeah at a at a

reasonable level of consult consumption but that's because your brain has been honed by millennia where the where food um scarcity was a real problem right we didn't have food security the way that we have now for the vast majority of our evolution so yeah as i mentioned those chips as calorie dense as they are would have been an amazing food for a hunter-gatherer who didn't have uh access to grubhub on their phones or or a supermarket on every corner and that's why it's easy to eat an entire bag of corn chips but no one's going to be binging on 12 avocados right there you go because avados are, they're satiating in a way that, in a way that ultra processed foods simply aren't.

Another example of a, of a brain food. Um, Before you, before you jump on the next example, I just want to highlight what you just said, because there's been an elegant study done by Dave, by Kevin Hall, looking at feeding people an unlimited amount of ultra processed food or nourishing whole foods. And they let them eat whatever they want, and they tracked over a few weeks, they tracked their consumption and their actual weight gain. And they found that the ultra-processed food group essentially ate about 500 calories more a day than the people eating whole foods and they

gain obviously more weight so you know it really speaks to this whole idea that there's some nutritional intelligence that we have that causes to seek nutrients in our diet the problem is we don't find them we keep eating more like looking for love in all the wrong places and we end up just over consuming because we're not getting the nutrients we need. And we see this like with kids, for example, we've talked about this in the podcast, who are iron deficient, they'll eat dirt. They'll eat dirt because dirt has iron. In animal studies, and we've had Fred Provenza on the podcast, there's an innate nutritional

wisdom where they're sampling maybe up to 50 to 100 different plants to get the medicinal properties of each of these plants to heal their body, to make it work properly, and they know when to stop. We don't have that nutritional intelligence anymore. And there was a study done decades ago, I think in the 20s maybe, of orphans. And I've talked about this in the podcast too, but the orphans were led to eat whatever they want brain kidney liver weird vegetables kind of give them an array of foods that were nutritionally dense that you think kids wouldn't eat right what kids gonna eat liver on their own or kidney uh and then they then they then they kind of track what they did and these kids were far at the end of the study were

far more healthy and far more robust because they chose all this variety of weird foods that actually their body's own nutritional intelligence told them to eat. But we lose that as we get older because our brain chemistry, metabolism, immune system, microbiome, all of its hormones have been hijacked by the food industry deliberately. So when you have that deliberate usurping of your own internal guidance system and wisdom about what to eat, we end up in this chaotic state of constantly searching for ingredients and nutrients and compounds that we're needing to survive,

but we can't get from the foods, so we just keep eating more and more and more. That's really the problem. Yeah, the movement towards what's been called intuitive eating that's why i think that that's such a short-sighted um and and not very evidence-based um uh initiative because when i sample the pint of ice cream that's sitting in my freezer right now intuitively what my body wants is to eat the whole pint oh yeah so um so i i agree with you that we need to get back to um we need to get back to foods that are that are uh less industrially processed and you bring up an

interesting point i mean the the over the tendency to over consume ultra processed foods i think it's really important for people to know the three things that make a food satiating because then they can use this as a tool in their own lives. The first thing that makes a food satiating is its protein content. So there's actually the protein leverage hypothesis, which stipulates that our hunger mechanisms are driven in large part by our necessity for protein, which is an essential nutrient, right? And not just any type of protein, high quality protein and the protein leverage hypothesis I mean people should remember that protein can be used powerfully to leverage um as a way to kill hunger and unfortunately ultra processed foods are depleted of protein in part because protein is the most expensive macronutrient so typically with all

processed foods what you get is just carbs and fat some combination of energy rich carbs and fat right and so protein protein is crucially important one of the major factors that makes a food satiating the second aspect would be its fiber content because fiber mechanically stretches out the stomach it's not an essential nutrient but it does uh draw water it does absorb water and so it stretches out the stomach which turns off the release of the hormone ghrelin which is the hunger hormone um usually ultra processed foods are depleted of fiber right it's one of the reasons why your average american today consumes between six to ten grams of fiber every day whereas one of our hunter-gatherer ancestors probably consumed about 150 grams a day yeah that that reminds me of that study by

dennis berger where he looked at hunter-gatherers who'd moved to the city it became urbanized in africa compared to their hunter-gatherer neighbors and the hunter-gatherers had stool weights of four of two pounds and the city dwellers had stool weights of four ounces so their poop was just a little hard poop and the reason is all the fiber and the tubers and the nutrient-dense food so you said fiber is not an essential nutrient it isn't for us but it's essential for the microbiome yeah microbiome is essential for us to stay healthy so in a sense it is really an essential nutrient it is yeah through through the through the lens of of the microbiome absolutely it is and it it certainly makes life better studies show that people who consume more fiber um have reduced uh inflammation they live longer um so it's it's

definitely a i would call it a conditionally essential nutrient absolutely um that we that we definitely want to look to consume um more of and then the third factor that makes a food satiating is its water content because when water ceased to be available for hunter-gatherer, the second best place that they would look to meet their requirements for hydration would be food. Food is actually a viable source of water. Shelf-stable, ultra-processed foods are depleted of water because water impedes a food's shelf stability because it allows mold to grow um and so these are the three factors that are that are all but missing in ultra processed foods and and all always very present in um minimally processed whole foods so definitely worth uh worth seeking out you know any of those nutrients didn't you miss the most satiating nutrient of all which is fat fat is satiating nutrient of all and our favorite fat fat is satiating yeah it slows it slows the

absorption of food it slows gastric emptying um so that's why well most most high protein foods are going to come with a are going to have a fat source right grass-fed beef for example is a good source of healthful fat um wild fatty fish great source of fat and so fat is fat basically here's the here's what fat does fat prolongs the satiety effect the protein fiber very very satiating but fat prolongs that effect so that you're not hungry 30 minutes later so it's definitely good to um to look and find healthful sources of fat and by the way the thing that makes you hungry is sugar is basically when you when you eat a lot of carbs and sugar you just get hungrier and hungrier because you produce more insulin which triggers all these secondary downstream biochemical challenges changes that

actually lead to increased hunger so the more you carbs you eat the more you want to eat and the less you eat the less you want to eat and the less you eat the less you want to eat i mean you know that from your own experience so do i it's like wow god that bagel doesn't look like food to me anymore or that muffin doesn't look like food or cookie why would i ever eat a cookie it's not that you're depriving yourself it just stops looking appealing yeah you're absolutely right dr hyman there was this really fascinating study that i'm sure you're familiar with uh you might have even talked about it on your podcast, but they basically took, scientists took two porridges.

They were controlled for carbohydrate content and calorie content. It was just two wheat porridges that were identical in terms of their overall nutrition facts. But the difference was the degree of processing. So one was a more coarsely ground porridge, and the other was a more finely ground porridge. And it's the finely ground porridge that sent subjects blood sugar through the roof and led to a higher release of insulin. But what was most interesting about that study was that in the post-absorptive state, so after they consumed the more finely ground porridge, the finely ground porridge sent their blood sugar below baseline which the more coarsely ground porridge didn't do and when your blood sugar goes below baseline what that what that is is reactive hypoglycemia and that can trigger in people that are susceptible to anxiety trigger anxiety it can increase hunger that sensation of hanger and that was uh that um

the capacity for the food to do that was driven purely by the degree of processing that the food had undergone. The more finely ground porridge was more akin to a sugar, right? Because it was just so easy for the subject's bodies to assimilate. Whereas the more coarsely ground, the less processed version of the porridge actually sent, brought subject's blood sugar back down to baseline really smoothly and evenly so that's why you definitely want to avoid added sugar to the best of your ability um and also reach for foods that are that are less processed because this is not about calories this is not about carbohydrate content this was purely about the degree of processing that that food is undergone

yeah so it's a great point. Yeah. I mean, you know, yeah, I mean, it goes without saying people listening to the podcast understand by now that, you know, the ultra processed food is the number one killer on the planet. Like if you want to do one thing to improve the quality of your health is never eat ultra processed food. And what is ultra processed food is basically anything that comes from a factory

unless you recognize the ingredients. And always the rule is if you can basically cover the front of the package and just read the ingredient list and know what it is, it's probably okay to eat. If it says tomatoes, water, and salt, or sardines, olive oil, and salt, you know what's in the can. But if it's got 45 ingredients, most of which you can't pronounce or in Latin, and you have no idea what it is, you can't tell if it's a corn dog or a pop tart from the label. Then you shouldn't eat it.

Absolutely. Real foods don't have extensive ingredients lists. They are the ingredients. They are the ingredients. Exactly. Like an avocado doesn't have a nutrition facts label or an ingredient list. It's an avocado. It should have an ingredient list of

phytochemicals so people can see what they're actually getting. It should. You're right. But I mean, and the biggest irony is that they don't make health claims either. Like avocados, grass-fed beef, wild salmon, eggs. You know, they don't make health claims. It's the ultra-processed foods, the kinds of foods that have ads on TV, right? Those are the ones that are making all the health claims.

And yet those are the worst foods for you. It's generally true. Modern foods aren't nearly as nutrient dense as they used to be. So we all need a little help from supplements if we want to function and feel our best. But supplements can also be tricky. Some use low quality ingredients that are difficult for the body to absorb, and others add cheap fillers and additives. And that's why I love Symbiotica. Cutting-edge formulas they have, like liposomal glutathione and liposomal vitamin C, use liposomal technology, making them the most bioavailable and optimal for absorption.

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Just go to Symbiotica.com slash hymen and use the code hymen. That's symbiotica, C-Y-M-B-I-O-T-I-K-A.com forward slash hymen and use the code hymen for 20% off plus free shipping. Yeah. So we've got, we've got a really beautiful insight here, which is one, that we should be eating phytonutrient-dense food. We're going to talk about some more genius foods. But two, the quality of our food and the ability to understand what makes us feel satisfied really are key principles.

So protein, fiber, water, fat are kind of the secrets to keeping your metabolism healthy. And you said that, you know, there's no biological requirement for grains. It's even a step further. I would say there's no actual biological requirement for carbohydrates. There's no essential carbohydrates. So there's essential fatty acids, essential amino acids, but there's no essential carbohydrates. So you literally don't have to eat any carbohydrates. with that said i often also say that carbohydrates are the single most important food for long-term health and longevity and what i mean by that is that vegetables are carbohydrates and they do contain some protein and sometimes fat depending on the vegetable but essentially they're phytochemically rich foods so the phytochemical richness is such a key principle

that most of us don't pay attention to. And when you talk about a genius foods, you're often talking about the phytochemical richness of the food. So tell us some more about other genius foods that we should be focused on, particularly in terms of the brain. Yeah, so I mean, phytochemicals are abundant in avocados,

dark leafy greens, but because we already talked about avocados, I feel like we should ping pong and talk about a good protein source like a grass finished beef, I think is a powerful brain food for people. It's actually one of the more controversial recommendations. But when you look at grass fed and finished beef, it's

a great source of vitamin E, which I talked about as being a powerful fat protecting antioxidant you find three times the vitamin e in grass finished beef as you find in grain finished beef it's also a great source of a compound called creatine which supports brain energy metabolism so people who don't regularly consume creatine which is found naturally in beef fish and you give them supplemental creatine you see an improvement in their cognitive function but we know that dietary creatine plays an important role in good brain health and good brain function we our brains level of creatine tends to decline with age and is also uh apparently depleted in carriers

of the apo e4 allele which is the oh wow most well-defined alzheimer's risk gene um so i'm a i'm a big advocate of uh in general foods that contain that contain creatine naturally and grass-fed beef is a viable source so so so let's pause there for a minute because you know i i agree with you i'm just just putting it out there i think there's so much confusion about meat and as we were joking before the podcast it it's not the cow, it's the how. Can you break down for us the conversation that is raging today, which is that one, meat, if we eat it, is going to cause heart attacks, cancer, and death, and shorten your life. And two, that it's the worst possible thing we can do for the planet. And it's obviously very inhumane.

So how do we tackle those three arguments against meat because you just said something that was really important which is that meat is an essential part of our diet for keeping us healthy particularly our brain health and our muscle health and so many other things in our immune system how do you navigate this land minefield of controversy between meat eating and veganism? Yeah, it's a great question. And it's a question that requires a nuanced answer. But the reality is that we have no good evidence to say that beef is unhealthy, right?

We have lots of evidence to the contrary. We have mechanistic plausibility suggesting that beef provides unhealthy, right? We have lots of evidence to the contrary. We have mechanistic plausibility suggesting that beef provides very important nutrients, nutrients that in particular tend to be under consumed today like vitamin B12, zinc. The problem is that much of our nutritional recommendations come from their origins or what's called nutritional epidemiology,

which is one of the primary tools used in nutrition science because getting people to adhere to various diets um as part of clinical trials it's just not feasible for the human animal right they so so that's just the that's not a tool that's very viable with regard to nutrition science so instead what we look at is nutritional epidemiology observational studies we look at is nutritional epidemiology, observational studies. We look at populations, we see what they eat, and then we associate those observations with their health outcomes. And the problem with meat is that it's mired by the observations associated with meat consumption is mired by what's called healthy user bias. So people who consume more meat tend to smoke more. They tend to be more sedentary and this is this is true with all meat

um but it's certainly uh true and especially true rather with with processed meat consumption so processed meat consumption if you would imagine what what what processed meat the form that processed meat takes in the standard American diet it's hot dogs it's chicken nuggets it's Subway sandwich that's processed meat right so you take a meal what is what is there 38 different ingredients in a chicken nugget or something yeah most of which are not chicken and and people are consuming these food products right these food like products with uh an abundance of white refined flour with a soft drink with a large fries they're doing unhealthy things in

their lives generally speaking because i mean somebody who's eating fast food on a regular basis i mean is probably not adhering to a to the most optimized lifestyle right so that's observationally that's what we tend to see but now observational research is getting better and better and better and we're able to control for those different variables And what you see is what is that when people consume meat and overall diet quality is high, meat consumption is not associated with any of those bad things, heart disease, cancer, diabetes, nothing like. Yeah, and and that makes perfect sense because meat is a is a pristine source of protein, an abundance of micronutrients, which we know support metabolic

health, which only one in 10% of the US population has metabolic health, right? Because nine in 10 have some degree of metabolic illness. And I'll just, you know, to cap it, there has been no randomized control trial to show us that red meat consumption is causally related to any negative health outcome. Again, the opposite is true. The only mechanistic thing that's been looked at is TMAO, which is looking at a metabolite that comes from eating certain compounds in meat that are produced by certain bacteria in the gut that's going to be linked to increased risk of heart attack on a mechanistic level. What do you think of that data tmao is also abundant in fish and fish consumption is associated with better cardiovascular health and certainly better neurological health

so we can't we can't just isolate these mechanisms and then make these leaps uh in terms of our assumptions about those foods well cleveland Clinic when they did this study, it was fascinating because they looked at what happened when they fed vegans meat. Like, nothing happened. Because their microbiome was already pre-built up with healthy microbiome because they're eating a lot of plant-rich foods and fiber,

which is good. And also, he found that if you drink wine and have vinegar and olive oil, you actually mitigate the effects of meat on TMAO production because of all the various kinds of phytochemicals in there. Also, if you marinate meat, it actually decreases some of the compounds that can happen when you grill it, although grilling isn't probably a good idea in general around meat. Slow cooking is better and also it's sort of the data really ignore some of the the sort of the conversations ignore some of the data that really is contrary to what we're hearing around the badness of meat for example there was a large study looking at 11 000 people half of uh who are vegetarians half meat eaters who all shopped at health food stores so if you're shopping a health food store you're more health conscious, you probably have better health habits. You also are eating more plant foods. And within a plant-rich diet,

meat actually isn't harmful. And they found that the risk of death for both groups was reduced in half. The PEER study also was done that looked at enlarged meat consumption of a protein. And it was the carbohydrates that really were driving so much of the problem. And so the problem with these observational studies is they're one, they're not causative in terms of their conclusions and they're often confounded by a lot of problems that make it look like there's a problem but there isn't. And in these studies, you know, we've had probably studied before like the Nurses Health Study that showed that all women who took hormones, Premarin, had reduced heart attacks and strokes and didn't have

an increased risk of cancer. And when they actually did a randomized controlled trial, the Women's Health Initiative, which was a billion-dollar study over 100,000 women, they found that, gosh, it was the opposite, that actually the hormones were killing women. They were causing cancer, heart attacks, strokes at dramatic rates. And all the earlier data from the observational study was completely overturned. So I think we have to be really cautious. They can often point to problems, but the effect size has to be big. For example, smoking, the effect size for smoking and lung cancer was a hazard ratio

of 20 to 1, which means a 2,000% increase. When we talk about changes in meat, you're talking about for colon cancer, for example, you're talking about with processed meat only, you're talking about a 1% absolute increase in risk, 1%. And if you go from 5% to 6%, you go, oh, that's a 20% increased risk. Sounds bad, but 20% is meaningless unless the hazard ratio is at least 2%, which is basically 200% increase. It's pretty much garbage and I wouldn't pay attention to it. meaningless unless the hazard ratio is at least 200 to you know two which is basically 200 increase it's pretty much garbage and I wouldn't pay attention to it yeah it's relative it's relative versus absolute risk and you see these studies or you see you see the headlines all the time that egg consumption is associated with a 14 increased risk of cancer for example and so that and that

that makes that puts people on high alert about egg consumption but as you mentioned i mean that that leads to a such a tiny increased risk of absolute in terms of their with regard to their absolute risk that we almost can't take it seriously right because nutrition because the tools of nutrition science aren't foolproof right we use food frequency questionnaires which are not the most reliable way to ascertain this kind of data to begin with so um it's it's it's very tenuous uh at best and that's why i think it makes more sense to integrate a food that we know that our ancestors have been consuming since since we've had ancestors right since the dawn of humanity humans have been omnivorous

and and also i would add that beef consumption the dreaded beef consumption has actually declined in the united states over the past 40 50 years and yet chicken consumption's gone up but which may be worse for you actually yeah i mean it's it's factory farm chicken was high in omega-6s it's it's full of antibiotics it's full of arsenic it's not of arsenic, it's not health food. Yeah, and most people consume it as fried chicken, right? Chicken dishes, which who knows what constitutes a chicken dish, but rates of obesity, rates of type 2 diabetes, rates of Alzheimer's keep climbing. One of the best ways to access brain health is through our diet, both what we eat and what we don't eat. Let's start with the

don'ts. The most dangerous thing for your brain is sugar and starch. Those cause inflammation in the brain. They cause dementia. They cause depression. They cause behavior issues. They're really nasty for the brain. So it doesn't mean you can't ever eat them, but think about those things as recreational drugs, as I've said. So starch and sugar. The third thing you really want to get rid of is bad fats. So trans fats are very dangerous. They're still in our food supply, even though they've been regulated as not safe to eat.

They're still out there. And a lot of refined processed oils. So those would be the things that I would avoid, number one. And of course, processed food. That just kind of goes without saying. 10% of our calories come from soybean oil. It's increased 1,000% in our diet. Didn't even exist as a real food in our diet until probably 1900, early 1900. So we really entered an era where we are eating a diet that is so different than we have for almost all of our human evolution. And those fats tend to drive inflammation.

They're easily oxidized. They go rancid. They're made with extraction processes that have hexane. And they're often causing significant inflammation and damage in the body. Unless you know what's in it. I mean, if you have to have a list of ingredients, yes, there's some packaged food that's fine. But if you have to know what's in it, like, I mean, if you have to have a list of ingredients, I mean, yes, there's some packaged food that's fine, but if you have to know what it's in it. So if it says some big chemical words, you can't recognize it, or you've got 14,000 things on the label, probably not what you should be eating anyway. Most people don't know this, but your

brain is mostly fat. You know, we really are all fatheads. And about 60% of our brain is made of fat. And most of that is what we call DHA or docosahexaenoic acid. Sounds like a big chemical name, but essentially it's fish oil. It comes from algae too. You can get it from algae. So if you're plant-based, you can get it from algae, but it is the main ingredient for a healthy brain. And so we need to be eating fatty fish that's low in mercury. We need to be eating algae. We need to be doing things that actually help boost our DHA levels. The second thing is good fats in general, because our brain actually responds really well to fat. MCT oil, for example, is the derivative of coconut oil. It's really great for

the brain's energy system and can help improve cognitive function. It also improves athletic performance. The third category of foods we should be focused on are phytochemicals. There's 25,000 compounds in plants, maybe more. The Rockefeller Foundation is now doing the periodic table of phytochemicals. They're spending hundreds of millions of dollars to map out the medicinal properties in these foods. But it's really easy when you think about it. Just eat the rainbow. If it's colorful and it's not Skittles, it's okay to eat. So all the dark colored vegetables, greens, blues, purples, reds, yellows, those foods that contain these pigments are full of these phytochemicals. And they're really extraordinarily helpful in regulating brain function in so many different ways.

You know, one of the things that often people forget about is the bottom of the matrix in functional medicine, which is the sort of the map we use to figure out what's out of balance for people. And hydration is really, really important because most of us walk around dehydrated. Most of us don't drink enough water. We have other fluids like sodas and juices and coffees and teas, but we don't really have enough water. And often when we do, we're not getting intracellular hydration, which is so critical. So not only in your bloodstream, but inside your cells, which is what makes you feel good. So it gives you energy and performance. So my favorite athletic performer is Tom Brady, and he never drinks water without electrolytes. Maybe that explains his seven Super Bowl rates. I don't know. But I agree. Using electrolytes in your water is so important

and not the kind with tons of sugar and all kinds of weird stuff. My favorite one, I have no affiliation with this brand, it's called Light Show, L-Y-T-E Show, but it's simply liquid drops you can put in a glass of water. And every time I drink, I try to add those in and there's a portable container

you can take your little drops with you. So intra-cellular hydration is really, really important and it's important for your cognitive function, it's important for energy, it's important for your cognitive function. It's important for energy. It's important for everything. Examples of things like, let's take anxiety. And I will speak about that because it's what my clients are coming in

most commonly with right now. The uncertainty, the fear, loss of jobs, quarantine, you know, restrictions changing and going back the next day is really creating an immense amount of anxiety. And what the studies have shown is that there's certain things that, so the way that I look at it is the things that you, in terms of food that you need to embrace and the things that you need to avoid. And the things that seem to worsen anxiety include things, foods with gluten in them. And it's not necessarily people who have celiac disease or

non-celiac glucose sensitivity, but there seems to be a correlation in the studies around the level of anxiety and eating and consuming gluten. So things that are positive are the use of things like turmeric with black pepper. But what makes the gluten become a problem? What is the mechanism? Has anybody figured that out? So we think that from what the studies have shown, that it's that there's some sort of disruption that occurs in the microbiome that leads to dysbiosis in individuals who have anxiety. So I've had patients who can tolerate gluten, but if I were to give a general recommendation to someone based on what we've learned, we try to have them avoid it. With the turmeric and black pepper, we know that curcumin

and turmeric is activated by the piperine in black pepper and it actually increases the absorption by a significant percent. And a study also showed that where omega-3s are involved, that can enhance the absorption. So this combination and the work that's been done on omega-3s in both anxiety and depression, for example, there was a study of medical students done that looked at treatment of anxiety using omega-3s. And we've heard about omega-3s and people know about using it for mood, but it targets anxiety as well. And the combination of turmeric, black pepper, as well as omega-3s, and I'm talking mostly about food sources of omega-3s. Some people do take supplements, and it's perfectly fine. Actually, it's quite powerful for lowering anxiety levels.

So those right there are things, you know, that people should move toward. So maybe like a sardine curry with a little black pepper. Exactly, exactly, you know. Or, you know, some sort of like really fancy glaze that you put on on salmon, you know, and it could be oven roasted, it could be baked, and you know using all the the healthy oils and to make a left over, you know, as well as some other things. So that's, you know, that those would be a good way to go. With studies of depression, there's been trials that were done using folate and mucal folate decades ago by some of my mentors at Mass General.

But adding them in as leafy greens are thought to be helpful. And so there's a real logical way in which adding simple recommendations that we make about fruits and vegetables, adding that fiber back into your diet actually drives down any type of inflammation in the gut. And therefore, with the gut-brain connection, lowers any type of potential neuroinflammation. The thing that many, many people, and I think they're more aware of these types of things now, is that serotonin the happy hormone 90% or more of the serotonin receptors in the gut so it really does make a difference what you eat because if you're eating poorly those serotonin receptors are going to be affected and the passage

of serotonin and a healthy way back and forth you know it all depends on what's being transported via the vagus nerve to the brain. By eating the poor foods and creating dysbiosis in your gut, you're driving the mechanism in the wrong direction for you. One of the things you said, which I want to back up on, which is so important, you kind of glossed over it, which is this whole idea of neuro inflammation. Now when your joint hurts, you get arthritis, it's inflammation in the joint, it hurts. If you have a sore throat, there's inflammation in your throat, it hurts. If your brain's inflamed, it doesn't hurt, but it shows up

as depression, anxiety, ADD, dementia, OCD, whatever, right? Autism. These are all inflammatory diseases of the brain. And what you're saying is that a lot of the source of the inflammation comes from imbalances in the microbiome, in the bacteria in the gut, what you call dysbiosis, which is the difference between symbiosis, which is a nice balance with your gut flora, which is dysbiosis, which is really bad bugs that are growing that drive inflammation. And when you're eating different foods, which is a nice balance with your gut flora, which is dysbiosis, which is really bad bugs that are growing that drive inflammation. And when you're eating different foods, you're feeding different bugs,

and that may be how the mechanism of this works with mental health. Is that what you're saying? Exactly. So a few different things, and thank you for backing up on the neuro information, because it is such an important point. I'll give you an example of a patient.

So a gastroenterologist referred me a patient who was having severe panic for the first time at a stage in life that you wouldn't expect someone to develop anxiety and panic disorders going by the DSM-5-TR criteria. And as I took a history and spent time with him, it turns out that his actual, even though he was presenting with the panic to me, what was

distressing him was his irritable bowel. He was very uncomfortable. He had developed these symptoms over time. And as we took, you know, found out more information, he had moved to a new job, highly stressed, eating very few meals at home, eating either in the afternoon from the vending machine, eating lunch out, getting takeout, and getting fast food on the way home. From being a relatively healthy weight and from being someone who was eating, I would say probably from what I remember, three to five meals at home in the evenings, his diet had changed over the period of 18 months. He developed discomfort in his bowel.

He had lots of diarrhea and constipation, but he presented to me with panic. And rather than do that, as we tried to figure out the details and placed him on the proper diet, these symptoms, it took time, but these symptoms abated over time so much so that he didn't need clonazepam

or Xanax or acetylene for his symptoms of panic. So, wait, wait, wait. So you're saying you fixed his gut and that fixed his anxiety and his panic attacks. Exactly. But you and I went to medical school. We're old enough that we went to medical school and we were taught that there's something called functional bowel disease or irritable bowel syndrome which we had a pejorative way of talking about as a super tentorial phenomena which in English means it's

all in your head but maybe it's actually something else maybe it's an infrared diaphragmatic phenomena meaning it's below your diaphragm or in your stomach and and yet as psychiatrist how much did you learn about the gut? Zero, right? Exactly, as well as nutrition you know these are not things that where we've made the connections yet there are treatments for depression like vagal nerve stimulation you know there are things that actively target the vagus nerve that will help to treat depression so we sort of know some of the science around it but we haven't put this in. And some of it goes back to something you said at the beginning, Mark. You know, going back to my story

of the Dunkin' Donuts coffee, from there, I just began to have more of an open mind around these questions. And I didn't know when I tried to help him evolve and change his diet that it would work. Part of it was trying to see if it if it would. Yeah. And this was also someone who had developed these symptoms also the context of that poor diet. He had not early on in his life, you know, for want of a better name for the syndrome, that was what his gastroenterologist called it. But as that evolved and he ate healthy and it did take time, it seemed like he can cause a better bacteria to grow

and you know some of that really kicked in so so I do feel that that root cause part of it may take time but we just have to figure out where it is. Well this whole gut connection is so fascinating because what you're saying is the type of food we eat changes the type of bacteria. How do you do that? And why is it important that we focus on that? Sure. So, you know, if you take a typical, you know, the standard American diet that, unfortunately, is the diet used as the point of comparison in a lot of nutrition studies. You know, it's generally, here are some

fun facts. A lot of fast food french fries have sugar in them. We know that sugar is fine. And gluten. And gluten. And gluten. I don't even know this story, but I had this patient who was like, went to get some french fries at a fast food place. And it's like, you know, I want to make sure the french fries don't have any wheat in them. And they're like, oh, no, no, they don't have any wheat. We just dip them in gluten and then we fry them. So there you go.

So since it's absolutely true, they have a lot of stuff that we don't realize is in them because you're just thinking it's a potato. But no, it's very far from that. And it's made through a whole process of extrusion to make it a truly processed food. But the point being that it's a simple thing where you think, oh, I'll just, you know, I'll get some dinner on the way home as that particular patient was doing. But there's so many added just bad ingredients in foods that you don't realize. So, you know, you're familiar with sort of the added sugars and savory foods, salad dressings, ketchup, you know, fruited yogurts and stuff. That's just one element of it. Then there's the added gluten in people who are gluten sensitive. Then, you know, it's the

unhealthy fats that you don't realize are there. You know, the last time I checked, there was 61 other names for sugar. I think there's 250. I'm sure there are. By now, I'm sure there are. And so I will, you know, teach people to just think about four grams of sugars, one teaspoon. Look at the food label. See what's in it. Because any of those poor foods that are the foods to avoid are the things that are going to disrupt those gut bacteria. So basically, the imbalance is going to be the bad bacteria having a party. And the good guys are not doing well because they're being overrun.

And that imbalance is what leads to the leaky gut or the intestinal permeability. And, you know, that's when it really starts to back up and also then cause the neuroinflammation. Well, you know, this is music to my ears because 20 years ago, I remember having conversations with physicians talking about intestinal permeability and dysbiosis and leaky gut and gluten. And they just looked at me like I was from Mars, like I was some kind of quack. They didn't know what he was talking about. I'm like, all I know is what I'm seeing. And I see when patients change their diet, when we fix their gut, they get better from all sorts of things. Thanks for listening today. If you love this podcast, please share it with your friends and family.

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