The Dr. Hyman Show - The Science of Mood And Your Microbiome with Dr. Uma Naidoo

Episode Date: August 5, 2020

The Science of Mood And Your Microbiome | This episode is brought to you by Thrive Market and Joovv We often hear about food in the context of physical health—eating for a strong heart, healthy weig...ht, and glowing skin. But what about the other impacts of food, like how it makes us feel emotionally and mentally? The growing field of nutritional psychiatry is shedding light on this profound connection, and it’s something I’m personally really excited about. On this episode of The Doctor’s Farmacy, I was so happy to talk to Dr. Uma Naidoo about the connection between food and mood, looking at how what we eat impacts everything from anxiety and depression to ADHD, and more.  Michelin-starred chef David Bouley described Dr. Uma Naidoo as the world’s first “triple threat” in the food as medicine space. She is a Harvard trained psychiatrist, professional chef, and Nutrition Specialist. Her niche work is in nutritional psychiatry and she is regarded both nationally and internationally as a medical pioneer in this more newly recognized field. In her role as a Clinical Scientist, Dr. Naidoo founded and directs the first hospital-based clinical service in Nutritional Psychiatry in the US. She is the Director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital (MGH) and Director of Nutritional Psychiatry at the Massachusetts General Hospital Academy while serving on the faculty at Harvard Medical School. Dr. Naidoo is the author of the recently released book, This is Your Brain on Food. In her book, she shows the cutting-edge science explaining the ways in which food contributes to our mental health and how a sound diet can help treat and prevent a wide range of psychological and cognitive health issues. This episode is brought to you by Thrive Market and Joovv. Our mitochondria get weaker and less abundant as we get older, plus lots of things in our lives like stress, bad food, and toxins damage them over time. But a modality called red light therapy helps me support healthier mitochondria and fight inflammation. I use Joovv red light therapy devices. If you want to check out Joovv’s various red light therapy devices for yourself just head over to joovv.com/farmacy Right now, Thrive is offering all Doctor's Farmacy listeners an amazing deal - When you sign up for a new membership, you can get up to $20 in shopping credit that goes towards all your favorite natural food, body, and household items. And any time you spend more than $49 you’ll get free carbon-neutral shipping. Just head over to thrivemarket.com/Hyman to check out all their awesome products.  Here are more of the details from our interview:  Dr. Naidoo’s cancer diagnosis and how she used food to help her anxiety while undergoing treatment (7:49) How Dr. Naidoo came to think about nutritional psychiatry (10:31) America’s mental health crisis and reliance on medications to treat anxiety, depression, etc. (14:23) Creating a personalized nutritional plan to treat mental illness (17:47) The relationship between gut health, diet, anxiety, depression, ADHD, OCD, etc. (20:15) The correlation between anxiety, depression, gluten, omega-3 fats, and folate (21:41) How the food we eat can drive neuroinflammation (25:20) Is food driving divisiveness in our society? (39:00) Mental health issues in children (44:01) The benefits of eating a diversity of vegetables and fruits (52:42) Get Dr. Naidoo’s book, This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More, at https://book.umanaidoomd.com/ Learn more about Dr. Naidoo at https://umanaidoomd.com/ and follow her on Facebook @DrUmaNaidoo, on Instagram @DrUmaNaidoo,  and on Twitter @DrUmaNaidoo Learn more about the research cited in this episode: Persistent microbiome alterations modulate the rate of post-dieting weight regain https://genie.weizmann.ac.il/pubs/2016-christoph-nature-november.pdf Lach, G., et al., Anxiety, Depression, and the Microbiome: A Role for Gut Peptides. Neurotherapeutics, 2018. 15(1): p. 36-59. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794698/ Hoban, A.E., et al., The microbiome regulates amygdala-dependent fear recall. Mol Psychiatry, 2018. 23(5): p. 1134-1144. https://www.nature.com/articles/mp2017100 Hosted on Acast. See acast.com/privacy for more information.

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Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. Things that seem to worsen anxiety include 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. Hey everyone, Dr. Hyman here. Starting the morning off right has a huge effect on the rest of the day and personally I love having a super nutrient-dense gut healing smoothie for breakfast so I can feel energized and focused and balanced all day long. I like to use a ton of green leafy veggies, healthy fats like avocado, nuts and seeds,
Starting point is 00:00:46 a handful of antioxidant rich berries, and then some good gut foods like pre and probiotic fibers and collagen peptides. Now you might have noticed that collagen has gotten a lot of hype lately. Now I know a lot of nutrition trends come and go without the science to back them up, but collagen is one we can all actually get excited about. It's great for supporting healthy bones, nails, skin, joints, and as we get older, collagen production slows down. So I love using collagen peptides to support my connective tissue and my gut health. But quality is key. My favorite collagen is from Primal Kitchen because it's grass-fed and doesn't have any fillers, artificial ingredients, dairy, wheat, or soy. I get my Primal Kitchen Collagen Peptides at an amazing discount
Starting point is 00:01:31 through Thrive Market. Thrive Market offers 25 to 50% off all their items compared to other retailers, and they have a huge selection of natural and organic foods. They make it pretty easy to shop by diet type and get frozen, bulk grass-fed meats, wild-caught fish, or even get skincare products and cleaning products shipped right to your door, all at a huge discount. Right now, Thrive is offering all Doctors Pharmacy listeners an amazing deal. Select a free gift from Thrive Market when you sign up for a one-year membership. And anytime you spend more than $49, you'll get free carbon neutral shipping. Just head over to thrivemarket.com forward slash hyman to check out all their great products.
Starting point is 00:02:12 That's thrivemarket.com forward slash hyman. Now you've heard me talk about the importance of eating whole foods and exercising and meditating. And I'm always trying to live well and age gracefully. And one way I do that is by supporting my mitochondria. Now, these are the little tiny energy factories in our cells and they get gunked up by inflammation and it really impacts how we look and how we feel. I like to call this process inflammaging. See, our mitochondria get weaker
Starting point is 00:02:39 and less abundant as we get older, plus lots of things in our lives like stress and bad food and toxins can damage them over time. But there is a modality called red light therapy that helps me support healthier mitochondria and fight inflammation. I use the Juve red light therapy devices. That's J-O-O-V-V. Now, Juve delivers concentrated light directly to my skin and cells,
Starting point is 00:03:02 and this can boost cellular energy production in the mitochondria and support the body's natural healing and repair process. Juve could not be easier. I just stand in the relaxing red light for a few minutes a day, and my body really responds to getting a full dose of that healthy light. Plus, Juve has the best customer service in the business, answering questions and helping you decide which Juve device may be best for you. So to check out the Juve product for yourself, head over to juve.com forward slash pharmacy. That's J-O-O-V-B.com forward slash pharmacy with an F-A-R-M-A-C-Y. And once you're there, you'll see a special bonus the Juve team is giving away to my listeners. Just use the code pharmacy at checkout. Now let's get back to this week's episode. Welcome to the doctor's pharmacy. I'm Dr. Mark Hyman and that's pharmacy with an F,
Starting point is 00:03:54 F-A-R-M-A-C-Y, a place for conversations that matter. And if you want to know if your depression, anxiety, ADD, and all kinds of other mood and mental issues may be related to what you're eating, you want to listen carefully to this podcast because it's with an extraordinary physician, a triple threat, as my friend David Boulay, the chef, says, Dr. Uma Nadeau, who's the world's first triple threat, as he said, in the food is medicine space. She's a Harvard-trained psychiatrist. She's a professional chef. I don't even, can't tell you how jealous I am that you're a professional chef, really. And a nutrition specialist. It's incredible that you're doing the work you are doing. And you're doing it at Harvard. And you created a work, working
Starting point is 00:04:36 program called Nutritional Psychiatry, which I've been waiting for, for a long time. So thank you. And she's regarded nationally, internationally as a medical pioneer in this newly recognized field of nutritional psychiatry. She's been featured in the Wall Street Journal, ABC News, Harvard Health Press, Goop, and lots of other places. She's really interested in the special impact of food on mood and under mental health conditions, particularly in the gut and how the gut and food and mood are all connected. As a clinical scientist at Harvard, she's found and directs the first hospital-based clinical service in nutritional psychiatry in the United States. This is a huge advance in our thinking about the brain, mood, and food and
Starting point is 00:05:17 how it all connects. She's the director of nutritional and lifestyle psychiatry at the Massachusetts General Hospital at Harvard, director of nutritional psychiatry at the Massachusetts General Hospital Academy, and she's on the faculty of Harvard Medical School. Welcome, Uma. Can I call you Uma? Of course you can. Thank you so much, Mark. Thanks for the invitation. Of course. And she's the author of a great new book that's coming up called This Is Your Brain on Food. In her book, she shows the cutting edge science that explains the ways in which food contributes to our mental health and how a sound diet can help treat, prevent, and reverse a wide range of psychological and cognitive health issues from ADD to anxiety to depression to OCD and lots
Starting point is 00:05:59 more. And I can't wait to talk to you about this because I've been waiting to find a legitimate psychiatrist who's been willing to talk about these issues in an intelligent way for the last 20 years. So I'm so excited to have this conversation with you. Thank you. Okay, well, here's the deal. I wrote this book about 12 years ago called The Ultra Mind Solution. We were chit-chatting about it before the podcast. And I came upon this book by accident.
Starting point is 00:06:22 So I was treating people's bodies. I was treating their gut and their microbi accident. I was treating people's bodies. I was treating their gut and their microbiome. I was treating inflammation. I was treating their toxic burden. I was treating their nutritional deficiencies. I was doing all these things that I would do in the course of treating their physical ailments, whether it was autoimmune disease or diabetes or whatever it was. I began to notice that they would say things like, Dr. Hyman, my depression is gone. My anxiety is gone. My OCD went away when you gave me these antibiotics to treat my overgrowth of bacteria in my gut. My memory is better. My brain fog is gone. And I
Starting point is 00:06:58 was like, really? So I said, yeah, what's going on? So I jokingly called myself the accident psychiatrist. And, you know, you've really been steeped in this world for a long time. And a lot of this has come from your own experience with your own health. And that's sort of, we all got into this that way. I mean, I got into it when I was sick and ended up really needing to focus on food as medicine. Same thing happened to you. So you talk about what happened with your breast cancer diagnosis. And you talk about this in your book, This is Your Brand on Food, and how you were sort of making a cup of tea,
Starting point is 00:07:29 and you were thinking about how your life sort of completely was upside down, and you were kind of nervous and scared, and this light bulb went off. So talk about that experience and how you ate and what happened and how you flipped the switch in your head to support your physical and mental health during that time. Thanks for asking about that. You know, it's, it's an interesting thing because the, the one didn't inspire the other. I happen to be working and doing the things that I've been doing for a long time. It's only in the last, say,
Starting point is 00:08:01 I would say five to seven years that we've started calling it nutritional psychiatry, but really have been doing this work since residency, and had been offering advice to all of my patients and was feeling pretty healthy and well. And that was when I was diagnosed. And I remember being in a, you know, I was in a fortunate position of being connected in a really great medical system. Mark, I'm sure you've had this type of experience when you've been ill. And literally within seven days, including a weekend, I was diagnosed. And treatment began probably just about a day later than that.
Starting point is 00:08:41 So it was very sudden. And it was somewhat of a shock to me. And I remember none of my work that I was doing by patients really kicking in for myself until this morning that I was going to my first chemotherapy. And there was natural anxiety. I was now facing the stuff that I'd learned about, had talked to other patients about, and now I was the patient. And there was a similar moment that happened. I was making myself a cup of green tea and, you know, the kettle shut off. And I suddenly, in this sort of little bit of a state of shock, realized, you know, why am I not thinking about what I tell everyone else. Why am I not taking with me to my treatment day
Starting point is 00:09:26 all the appropriate foods? And it really changed from there. From moving from state of shock, I really moved into the things that I knew had made a difference to my patients. And week after week, my oncologist, as well as my fellow helping to take care of me would say, you know, we want to know what you're eating today. And what did you bring in? And it was really the simple things. It was what I put in a smoothie, it was, you know, having the green tea, it was thinking about things that could combat nausea. And, you know, I was fortunate to, to really combat the anxiety that I was feeling little things like adding turmeric to my smoothie with a pinch of black pepper and little things like that.
Starting point is 00:10:09 And I truly learned to see the effectiveness from my own experience, but it was very unintentional. And so I felt relatively healthy. Well, that's so great. So you've been down this road for a long time, then you had to practice it on yourself. But what led you as a psychiatrist to start thinking about nutritional psychiatry? Because it seems like a big gap, right?
Starting point is 00:10:38 Absolutely. Most psychiatrists learn about this book called DSM-5, which is categorizing diseases and diagnoses based on symptoms. It has nothing to do with the cause. And you began to think about, gee, what is the cause? And explore the role of nutrition and later got into the role of the microbiome, which we're going to talk about. But how did you first go, the light bulb goes on and go, wait a minute, this is not what I learned in medical school. It's not what I learned in my residency, but there's something here.
Starting point is 00:11:06 It starts off a little younger in life because I came from a family where food was, you know, source of nutrients, source of a lot of love, lots of cooks in the kitchen. And I brought that with me as I went into residency. And for me, cooking at the end of the day and making a meal was something where I was able to de-stress. It was a very mindful time. And I didn't realize it until I put together the fact that I was enjoying getting home at the end of the day and actually cooking something. So that, you know, speared, even from young on in my life,
Starting point is 00:11:38 I was sort of interested in what people are eating and what types of food and what spices you use, et cetera. And where this sort of came, grew into an interest is I realized there was a real gap in my nutrition education. And I, as a resident, became very interested. You know, if I was going to prescribe, say, Zoloft, Prozac, whatever it was, I wanted to know more about the side effects and how to counsel my patients. And I remember something that I also wrote about in the book,
Starting point is 00:12:03 which is the patient came in and, and, and, you know, Dunkin' Donuts is up most, one of our most popular coffee shops in Boston. And he was complaining, you know, at the clinic and saying, I don't understand, you know, you put me on this medication and I gained all this weight, but you also came in with a 20 ounce Dunkin' Donuts coffee. And really it was a sweetened one, a sweetened one, you know, and I broke broke I sort of
Starting point is 00:12:25 unpacked it for me I said well how much how much of sugar and cream did you do you think it went in that we calculated it was more than a quarter cup of of cream you know as well as probably six to eight teaspoons of sugar and from that moment I think it was it became something for me changed because I realized that what I went to intuitively was helping someone understand what I knew as a doctor I should be learning more about and it led me to really study more about it and understand that if I was prescribing something I really cared about the lifestyle changes that went with it and I later came to understand that what I was really looking at was sort of the root cause in psychiatry rather than putting someone into a list of criteria, because many of us know who practice that people just don't fall
Starting point is 00:13:09 into those easily. And a lot of patients who come for nutritional psychiatry consultations and work, you know, they may not meet the criteria, but they want to find other ways to feel better. And, you know, that was that was, uh, that, that was the path that, that led me there. Incredible. And you've gotten so deep into that path. And I remember seeing the obvious cases in my own practice. This one guy came in once and he was this very overweight guy, big belly. He was like, Dr. Hyman, I get panic attacks every day at two o'clock. It was like, yeah, what happens? Well, I get short of breath.
Starting point is 00:13:44 And I start sweating and I feel anxious. I feel like I'm going to die and everything's terrible and the world's closing into me. And then what do you do? He says, well, I drink a can of Coke and it all goes away. And you know, he was having hypoglycemia, which is low blood sugar, which was causing this fluctuating, spiking sugar and adrenaline. He's fixing it with Coke. Right. And I was like, well, and you start to pay attention to these stories. And it's not the stories we link up in medical school. It's the stories that we pay attention to when we listen to our patients, which is really important. And clearly that's what you've done. And so how did you sort of go down the rabbit hole, you know, rather than saying,
Starting point is 00:14:20 looking at antidepressant medication, which when you look at it, you know, mental health is a big issue. We are seeing a mental health crisis in America. You know, I recently wrote a book called Food Fix, and then I was shocked to discover that the biggest driver of costs in our healthcare system and in our society, when you look at both the direct and indirect costs, it's not being overweight or diabetes, it's actually depression. It's mental health issues are the biggest driver of years of quality of life loss. Yes. And disability. Absolutely. Disability. And you're like, well, wait a minute. This is a pandemic also, but really not talking about how to address it. And we think, oh, well, we'll take antidepressants. But talk to us about
Starting point is 00:15:00 how that approach has really not lived up to its promise. In severe depression, it can be helpful for select patients, but for the most people who have it, it doesn't seem to be that effective. So can you talk about what the challenges are and how we need to think differently and connect diet and food? Absolutely. So, you know, there's actually, we're facing a Zoloft shortage at the moment. So certainly there's some shortage in certain dosages. And it's happened during this time because people have become so much more anxious and actually depressed. People were not feeling that way before. And I feel that what happens when we see people clinically is that, you know, we may prescribe and I do prescribe medications,
Starting point is 00:15:40 but some people come to me who want to try an alternate mean. If they're not actively suicidal or not manic and not experiencing a psychotic episode, it's perfectly reasonable to start with nutritional strategies. But what I find is in the medication population that I treat of patients, not everyone gets better. And I really push against having to add on a second medication if I don't need to, unless it's for a separate symptom completely, which almost never happens. So they don't get better. I always suggest that they be in other forms of therapy. So someone with anxiety should be using one of the apps that I would suggest that they use for anxiety and mindfulness. They should be doing and learning breathing exercises. They should be paying attention to exercise and sleep as well.
Starting point is 00:16:29 So it's not just one component, but with the medication, they don't necessarily get better. And sometimes they develop side effects that put them off wanting to be fully adherent for the medication. And they get disheartened. And it's unclear, you medication. And they get disheartened. And it's unclear, you know, whether they get disheartened as maybe some of the weight gain happens or they're just not feeling good. And I think that there's something, you know, we need to look at as psychiatrists.
Starting point is 00:16:56 So you're depressed, the medication doesn't work, and then you gain weight, and then you're even more depressed. Exactly. So, you know, it's sort of this cycle that they get into. And they don't necessarily fit into, you know, it's sort of this cycle that they get into, and they don't necessarily fit into, you know, criteria. So I do think that we need to re-examine that in a more global way. But that's where these alternate strategies can be very useful for someone who's invested in really trying to unpack for themselves what might be the problem and work in a consistent way who wants to embrace a healthier diet and healthier foods to feel better. And I think that's where this could be a very useful tool for people. So how do you drive into the nutritional strategies? Because you see a patient comes in with a mental health issue, whether it's ADD or anxiety or
Starting point is 00:17:40 depression or OCD, where do you start? What do you eat? What do you tell people to eat to fix that, to work on those issues? More and more, as I've studied the microbiome and the gut-brain connection, I've moved from more general, when I first started in my clinic, for more generalized suggestions based on someone's individually telling me what their diet is and essentially what they're doing to a very highly personalized plan. And some of that is based on some fascinating research that has come up around things like yo-yo dieting that has shown that in some animal studies that, and the science was very nicely done, that there's almost a, for want of a better word, like a fat memory in my set were overweight that was recorded in the microbiome. So it has taught me that each person is so different and
Starting point is 00:18:34 that I have to think about them more in terms of what they're eating, what their symptoms are, what their makeup might be. And so I, you know, first obtain a proper history, ask them what they think they should be eating and what they are eating. And often in that history taking, I'll uncover something that is a startling, most often something startling that they didn't realize. And I've talked about some of those examples in the book where they may be eating something that they perceive to be somewhat healthy, part of a diet, part of a cultural diet, whatever it is, and they actually either packing in sugar that they didn't know about, something that is obviously driving the gut in the wrong direction or driving dysbiosis.
Starting point is 00:19:17 So what's an example of that? Sure. So for example, I had, and I speak about her in the book, I had a patient who was pregnant and had a healthy pregnancy and was eating a lot of her favorite spice, which is a Korean spice called gochujang. But when you get the straw pot version, there's a very high, some of those preservatives, but there's a very high sugar level in that. And she was just adding this to her healthy foods, her vegetables and her lean proteins and stuff, but she was consuming a larger amount of it because she sort of was craving it during the pregnancy.
Starting point is 00:19:54 And so some of what we had to do is really peel, peel back on that and figure out other ways we could do that. Either we created a sauce that, you know, worked on a little recipe that would give her the a sauce that, you know, worked on a little recipe that would give her the flavors for that, but take away the unhealthy ingredients. So, you know, sometimes it's little things like that. That's amazing. All right. So talk about how specifically the studies recently have shown that diet can have a profound impact on our mental health. Things like ADD, depression, anxiety, sleep issues, dementia, OCD.
Starting point is 00:20:28 I mean, we don't think, for example, OCD is being diet-related or ADD is being diet-related. But how are these linkages being discovered in the science now? Because I've been witnessing them for decades as a clinician and I've been waiting for the science to catch up, and it's kind of catching up. So what have you found? You're at the, you know,
Starting point is 00:20:49 Harvard medical school. This is, this is not some fringe idea. This is now mainstream. So talk about, talk about what these studies show and how we can learn about how these things are all connected. Sure. So, you know, the basis of how I described a lot of it is around the gut microbiome and how, and I'm sure your, your audience is very familiar with just how information gets formed and things like that. The way that it works with examples of things like, let's take anxiety, and I will speak
Starting point is 00:21:14 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 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 consume gluten. So things that are positive are the use of things like turmeric with black pepper. But what makes the gluten become a problem?
Starting point is 00:22:15 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,
Starting point is 00:22:37 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,
Starting point is 00:23:32 actually is 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 salmon, you know, and it could be oven roasted, it could be baked, and, you know, using all the healthy oils and to make a left over, you know, as well as some other things. So that's, you know, those would be a good way to go. With, you know, with the 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.
Starting point is 00:24:17 But, you know, 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 are 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
Starting point is 00:25:02 serotonin in a healthy way back and forth, it all depends on what's being transported via the vagus nerve to the brain. And by eating the poor foods and creating dysbiosis in your gut, you're driving the mechanism in the wrong direction for you. So 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 neuroinflammation. Now, when your joint hurts, you get arthritis, it's inflammation in the joint, it hurts. If you have a sore throat, is 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?
Starting point is 00:25:47 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, 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
Starting point is 00:26:38 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 three, 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
Starting point is 00:27:38 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 acertraline for his symptoms of panic. 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
Starting point is 00:28:05 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 supratentorial phenomena which in english means it's all in your head but maybe it's actually something else maybe it's an infra diaphragmatic phenomena meaning it's below your diaphragm or in your stomach. And yet, as psychiatrists, how much did you learn about the gut? Zero, right? Exactly. As well as nutrition.
Starting point is 00:28:33 You know, these are not things 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 would. And this was also someone who had developed these symptoms also in the context of that poor diet. He had not early on in his life,
Starting point is 00:29:18 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 healthier and it did take time, it seemed like he can cause a better bacteria to grow. And some of that really kicked in. 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,
Starting point is 00:30:02 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- 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.
Starting point is 00:30:32 I love it. 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 it's it's very 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 or you think oh i'll just
Starting point is 00:30:50 you know i'll get some dinner on the on the way home as that particular patient was doing but there's so many added just bad ingredients in 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, fruited yogurts and stuff. That's just one element of it. Then there's the added gluten in people who are gluten sensitive. Then it's the unhealthy fats
Starting point is 00:31:17 that you don't realize are there. 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 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 sugar is one teaspoon. Look at the food label, see what's in it.
Starting point is 00:31:36 Because any of those poor foods that, you know, 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, you know, 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 causing your inflammation. Well, you know, this is music to my ears because 20 years ago, I remember having conversations with physicians talking about
Starting point is 00:32:09 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, you know, 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. And your work is so important because we've had on the podcast a psychiatrist who's talked
Starting point is 00:32:32 about metabolic psychiatry, which is a role of sugar and insulin. But you're taking all this down into the gut. And there's an incredible bunch of studies that were looked at by psychiatrist Stephanie Chung and her colleagues that looked at gut health and depression. And they found that people with major depressive disorder had about 50 different types of species in their gut microbiome that were different from the control groups that didn't have depression. And a lot of recent research shows that these bacterial species are associated with high quality of life, are often depleted in people who are depressed and bacteria that cause
Starting point is 00:33:05 inflammation are found in a lot higher numbers in people who have depression. So can you talk about what these studies showed and the connection between this inflammation and depression? Because I mean, I saw a study recently that just made me crazy, which was using TNF alpha blockers for depression, which are these powerful drugs that cost 50,000 a year. They use for autoimmune disease to shut off inflammation. I'm like, why not deal with the source, which is the gut? So talk about what these studies show and how this connection exists between inflammation and depression.
Starting point is 00:33:33 So the more that we learn about the gut, the more that we realize there might actually be certain specific bacteria that are involved with the positive drive of depression versus the negative drive. I want to actually mention a study, and the reason I'm talking about it is that it's linked to this in the sense of how people don't realize the impact of certain gut bacteria and a food mechanism that can help you. A study that looked at yo-yo dieting, and this becomes significant because my patients
Starting point is 00:34:03 who come in who've gained the weight from, say, a medication don't know how to get off it, and they might start to lose weight, and then they gain it back. And the sort of yo-yo piece of dieting has also happened with, say, reality TV shows, and people don't realize that there could actually be a mechanism in the gut. The study that was done and published in Cell sometime this year showed that in particular lean mice and mice that had gained weight, they identified that certain gut bacteria were driving this and it was almost for want of a more elegant word, like a fat memory coded in the bacteria in the gut. Then they found that if they fed back proper and certain antioxidants, that the inflammation caused by this gut memory improved. And I think that what is so cool about this is it's one of those studies that
Starting point is 00:35:06 directly showed a mechanism where antioxidants worked in a positive way. And I think that for me, it goes back to the Stephanie Chung study and those that have shown the multiple bacterial species, a quality of life factor, a lowering of depression. And, you know, I think I appreciate what you've been saying all throughout this conversation, Mark, because going into this, you know, I think that I didn't, when I said at the beginning, you know, the illness that I had didn't lead to the book. It was because I wasn't sure that there was a book. I had been doing the work. But it was some of the work that got more publicity that led to my writing the book,
Starting point is 00:35:50 because I knew the science was there. And what this did for me is it pushed me to look at, like you were saying, you know, 700 references condensed to over 550, because there was science behind it. And sometimes, you know, we get pushed to, we get pushed to the side as complimentary alternative or soft science, but there's real data behind it. And I think that the more we can, we can explain that to people and have them try things that, you know,
Starting point is 00:36:17 it's not going to, it's not going to harm someone unless you have an allergy to try a different diet and to use these mechanisms to feel better. And we can be highly specific in some of these situations. Yeah, exactly. And what you're saying is so, what you said was so important because, you know, if you're looking at trying a drug that's very expensive or that has potential risky side effects, the bar is a lot higher than saying, why don't you stop eating sugar and gluten and eat some vegetables and fiber and fix your gut? And the evidence is there. We may not have large randomized trials, but we have a lot of evidence, like you said. And the kinds of studies that are done now are just so compelling and so beautifully done. And I remember one of the studies I looked at was
Starting point is 00:37:00 the SMILES trial, which looked at just swapping out people's normal processed food diet with more whole foods. And it was as good as any antidepressant, right? Exactly. It was as good as an antidepressant and they added in counseling and coaching. So you had, you know, you followed this diet and then they also had someone check in with you and ask you some questions and see how you're doing. So, you know, a lot of, a lot of, say, weight loss programs have built-in coaching now because there's this almost contact part and accountability part that is very helpful to people. There was a great trial done by my colleagues in Australia. And I think that, you know, one of the things that we're trying to do more of is really larger human
Starting point is 00:37:45 trials. The difficulty is that how to capture some of the actual food that people eat becomes a little bit of a challenge. And so, you know, I think that we're... Because we're not lab rats, you can't just lock us away and feed us the same diet. Feed us the same diet, exactly. Free-living humans are hard to study. It's hard to study. It's different if you're prescribing, you know, if you're doing a pharmaceutical trial. And, you know, there's also a lot more funding that goes to pharmaceutical trials and very little incentive that goes to nutritional science and nutrition epidemiology studies. There's definitely a difference. And so, you know, I do think that with the studies we've looked at, even if the numbers are smaller, we've looked at the science and tried to pull out for people facts that will be digestible to them that they can actually on the same day, a study that's against the same thing.
Starting point is 00:38:45 It's how we interpret it for people and show them the balance of what has worked. And that's where clinical, you know, like, like you said, so many, the many patients that you've treated, that's where the clinical piece also becomes so important. Yeah. It's so interesting. One of the things that you sort of write about and talk about is the role of the amygdala, which is our fight or flight, you know, reactive out of fear, anxiety. And our society seems to be falling apart based on this incredible increase in this kind of behavior, which I've
Starting point is 00:39:37 never seen before in my life. I mean, there's always difference of opinion and so forth, but this is just very different. And I'm wondering if it correlates with the increases in processed food in our diet, the changes in our gut microbiome over the last 50 years, the changes in, for example, glyphosate, which is over the last few years has a powerful gut microbiome destroying properties, which is basically weed killer that they use on 70% of our crops. So I can go on antibiotics. I mean, there's so many things that are gut busting things. You think there's a correlation between the microbiome and the amygdala and you think it's related to this change in our diet.
Starting point is 00:40:12 And do you think that's connected to all the changes that we're seeing in our society and this incredible conflict? I just, I just can't help but wonder if that's true. I, you know, I, I, I like, and I, I think this is a worthy hypothesis to think more about. Certainly the rates of depression and anxiety, substance use and possible abuse of partners or people in the home increased during COVID. A very short survey was done during March by the American Psychiatric Association. And we haven't yet collected enough data to comment on the rates of increase of mental illness.
Starting point is 00:40:52 However, separate to that, the overarching increase of disability, as you were speaking about early on in our conversation, has increased. And, you know, what has changed in the world? Well, what has changed in our lives and in the world is how we eat. That has been significantly different. Our dinner plate size from the 1920s and 30s has changed from nine inches to about 12 inches. And if you have, you know, family who visit you from overseas,
Starting point is 00:41:24 they'll want to share the appetizer or share the share the main course because the portion sizes here are very different so if you think about how our food is evolved then you know you talk about the the high fat and the low fat issue you talk about um you know the use of glyphosate in our crops. All of that combined with high fructose corn syrup and everything that has happened, yes, our diets have changed. I sincerely think that how we eat, not to be too cliched, but it really does impact how we feel. And I think the level of irritability, anxiety, agitation, depression has, whether it's diagnosed or not, whether it's treated or not, has increased in society. It's almost as though people are just more on edge.
Starting point is 00:42:12 And how can it not be linked to our brain and how we eat as well? For sure. I remember talking to Bruce Ames, who's one of the leading sort of scientists in the world, this incredible guy, probably in his late 80s now. And he was doing studies of high fructose corn syrup on the gut. And he had this finding, which was striking, which is typically when you get fructose in fruit, it's sugar in fruit, it's combined with glucose, right? So when you just have pure fructose, which is rarely found in nature, which is found in high fructose corn syrup, it's free fructose, which is very different than what you find in fruit. It actually requires energy to be absorbed by the gut and uses up ATP, which is the energy molecules.
Starting point is 00:42:59 And he said, because of the increased volume of high fructose corn syrup, it literally is punching holes in the gut because the tight junctions, which are keeping the gut from being leaky, can't stay together because it's an energy dependent process. It gets interrupted because all the ATP, the energy that's used to keep the gut lining together gets used to help absorb the fructose. I don't know if that's true, but it was a fascinating theory. And I was like, it makes sense because it's about 15% of our sugars and our calories is corn syrup, which is terrible. And it's in everything.
Starting point is 00:43:31 It's in everything that you don't even realize, and that's where I think I really feel diet has to be part of it. I don't think it's the only thing, and I don't mean to seem like I have blinkers on, but I do think that even diagnoses in childhood disorders has increased. So all of that has to make a difference, as well as the facts around childhood obesity and things like that. Well, let's talk about the childhood mental health issues. Because I grew up 60 years ago and there was that one kid in the class who was kind of a troublemaker and everybody else was pretty okay. And now you go to schools and the school nurse is like a pharmacist. She's dispensing all these psychiatric medications, antidepressants,
Starting point is 00:44:26 ADD medications to kids. One in 10 kids is on ADD medication. I mean, you look at the kids' illnesses, it's not allergies or eczema anymore. It's depression and obesity are the kids' main chronic illnesses. It's frightening. And so how would you say this ADD crisis, which is exploding, is connected to diet? And how do you tend to treat these patients? So I have, I see, I'm an adult psychiatrist, but what I know about these disorders is that- A lot of adults have ADD too. Exactly. So I do deal with that. However, you know, one of the interesting studies showed us that, you know, we've always thought, well, sugar drives the agitation and the almost hyperactivity.
Starting point is 00:45:14 There are significant studies that show that that wasn't the cause. And I found that really fascinating because I had always thought, you know, that to me that was a clear link. I mean, just go to a birthday party when kids are eating cake and ice cream. Exactly. So it seems sort of counterintuitive. But, you know, I think it starts at exactly where we've been going in this conversation. It starts with what they're eating, what's happening in schools. You know, when the funding to school lunches are changed, there are industries that are moving vending machines to schools. And so kids who want a snack and, you know, where the lunches have changed are naturally
Starting point is 00:45:53 driven to, well, I'm going to get a candy bar and get a bag of chips or whatever it is. So there are things that have happened in society separate to the processes, you know, of high fructose corn syrup and all of that and the added sugar, then the food labeling laws and the pushback from industry around the food labeling laws, where they're wanting to show large labels, the quantity of added sugar, so people became more aware. If we take it to the children in our society, they've basically grown up with all of this. So unless they've, if they've grown up eating the regular diet that most people eat in this
Starting point is 00:46:28 country, they have therefore eaten, you know, glyphosate, they've eaten, you know, all of these processed ingredients, all of this added sugar, and how could they not be obese? So how, you know, it's almost, it's a setup. Sadly, it's a setup for failure. There isn't anyone, you know, it's almost, it's a setup. Sadly, it's a setup for failure. There isn't anyone, you know, to blame about it. It's that, how do we change that? How do we truly have them eat in a different way? I have a member, the newest member of my extended family,
Starting point is 00:46:57 his parents basically decided that he shouldn't, you know, shouldn't initially eat sugar until maybe he went to his first birthday party or something like that. And, you know, he eats fruit, he loves berries. And, you know, he, if you gave him an ice cream, he would probably eat it because he's little, but he doesn't really know that taste. And it begs the question, if you if you know, we all have these different taste receptors and things. But if you not, if you haven't grown up with that super sweet taste that we have in all of our foods, if you're not avoiding them, then what do you do? You know, and I'm really curious to see how he grows because he eats his, he loves fresh fruit. He loves all foods. And it's just, again, it's because his parents have done this. So, you know, it's a big question. It's a bigger question than I have the answers to.
Starting point is 00:47:48 I mean, I just remember a kid I had with ADD that was just so striking. And I've talked about it before, but it really got me thinking about this more specifically and actually inspired me to write this book, The Ultra Mind Solution. He was 12 years old. His mother brought him in because he had severe ADD and ADHD. He was so disruptive. He got kicked out of kindergarten. He was on Ritalin for years and struggled, really struggled to focus, pay attention, and had all these other problems. He had irritable bowel. He had stomach cramps. He had eczema. He had allergies. He had headaches. He had insomnia. He had muscle cramps. He had this whole list of symptoms that were unrelated to his brain dysfunction, according to his psychiatrist. And I'm like,
Starting point is 00:48:43 well, I don't know if I can help his ADD, but let's see if we can, you know, his guts and mass, I mean, his diet, I don't think he ever ate a vegetable in his life. He lived on junk food. He ate processed food. He ate foods with trans fats and high fructose corn syrup. And I, you know, based on his symptoms,
Starting point is 00:49:00 I projected he was going to be deficient in omega-3 fats, deficient in vitamin D, deficient in zinc, deficient in magnesium, deficient in E6, deficient in folate. I mean, he was just deficient in everything. And his gut was a mess. And I'm like, well, let's just see if we can heal his gut, get him off the bad stuff, put him on good stuff. I gave him a whole foods diet, got rid of processed food, got him off gluten and dairy because he had all these inflammatory issues that often can be related to those foods. Right. And he did have some antibodies to glide and they weren't like off the chart celiac, but he definitely had some reactions. Some sensitivity. Yeah. And
Starting point is 00:49:40 I gave him a basic malty and fish oil and vitamin D and a little magnesium because he had a lot of magnesium deficiency symptoms, which can cause anxiety, which he had. I mean, you know, we waited, you know, two months. He came back and his mother had brought his handwriting before and after, like he was treated. And before his handwriting was illegible. We call it dysgraphia. It's just this illegible handwriting. It's common in these kids. These kids have bad penmanship, dyslexia, dysgraphia.
Starting point is 00:50:11 Two months later, his handwriting was perfect. Wow. I was like, what happened here? And not only was his handwriting perfect, but all the other symptoms went away. His behavioral issues went away. His ADD went away. His allergies, his eczema, his irritable bowel,
Starting point is 00:50:23 everything went away. And I was like, wait a a minute the brain suddenly went from this dyssynchronous chaotic incoherent right thing disruption to this coherent focused synchronous functioning and I was like wow if that's true then this then I'm on to something And then I began to really pay attention. And so story after story like this in adults and kids. And I think, you know, we don't really tend to focus on these approaches. It's not that we can't use medication. Yes, sometimes we need medication. Some people really need it.
Starting point is 00:50:58 And absolutely, it's life-saving for people. But do one out of every 10 kids need to be on medication? Exactly. Is that our birthright? Is that, do we all genetically defective that we have to have, no. We have nature deficit disorder. We have too much technology. We don't have enough good food.
Starting point is 00:51:18 Exactly. And I love what you said about, you know, he probably never ate a vegetable in his life. And that's what happens in, you know, with the school lunches and all of that stuff. And then you start to introduce better foods, whole foods, healthy whole grains, everything, depending on what they eat and depending on the specific diet. And, you know, you see the improvements.
Starting point is 00:51:38 And I've certainly seen that in adult patients who over time, you know, are able to focus better, able to manage their work better. You know, they feeling that, you know, they'll actually physically feel better. And there's almost a calming of the gut. It, you know, really is almost like the gut is soothed. And through that, as do the transmission of the neuro chemicals and things all start working in the right way, and they start to feel better. Well, it's so true. In your book, you talk about these five things that are, I think, central concepts that are so important. And I'd love you to just share a little bit about each. We touched on neuroinflammation, talking about neurooxidative
Starting point is 00:52:19 stress, neuroplasticity, emotional immunity, and the gut the gut brain access and how to support that I mean these are really radical ideas that we never learned in medical school but that now seemingly are what our understanding of the brain is and how we need to approach not just and not just psychiatric disorders but all neurological issues absolutely so you know we've talked a lot about the gut brain access and what I say to people is, you know, I may sound like your mom, but you know, I'm telling you to eat more vegetables, eat more food. Why? Because you get the fiber from those from the nuts, seeds, legumes and beans.
Starting point is 00:52:56 And that will help your healthy gut. That is also linked to the antioxidant foods that are rich in your diet. So you know, when we say, we say eat the rainbow, we are asking you to do that because of polyphenols, carotenoids, flavonols, all of the great colors and nutrients in those foods. Again, that antioxidant load works as antioxidants against the radical oxygen species that get formed during inflammation and so you get the calming down again by eating these antioxidant foods and so you know those they all to me all these different pieces work together but we we tend to discuss them separately as we as we go. With neuroplasticity, we've understood that the brain can change. And so we understand that, you know, there are these really cool things like BDNF,
Starting point is 00:53:55 which is a neurotropic factor in the brain that can actually help the growth of new cells. It's like miracle growth for the brain. It makes new connections. Exactly, I love it. Yeah. Exactly. It's like miracle growth for the brain. It makes new connections. Yeah, exactly. It's like miracle growth for the brain. So it makes new connections. And we didn't, you know, for a long time, we didn't know that this could happen. So again, I bring it back to what you eat and what's happening to your gut, because you can positively affect those growth factors or negatively. You know, you can have the miracle grow work for you, or you can have work against you. And then the way that I think about the emotional immunity part is that there's a ton
Starting point is 00:54:32 of evidence in a field called psychoneuroimmunology, where they look at the different hormones, they look at the brain chemicals, they look at immunology. The way I bring this back to depression and anxiety and the main, I would say the more common mental health conditions is that there's a huge amount of immune system housed in the gut. So again, the food gets to your gut and if it's the right food, you thrive. If it's the wrong food, you don't thrive and you lead to the dysbiosis, the leaky gut and all of those symptoms. But that also then drives your depression. It drives your anxiety all in the wrong direction. And so, you know, we try to, we sort of try to just unpack these ideas.
Starting point is 00:55:18 But I feel and I hope that what people will take away from it is there are these mechanisms we know about and we understand, but that you can use food in a way to implement this. It will not cure everything. It is not necessarily the first line of treatment in severe illness where you might need a medication initially, but I have used it adjunctively with even very sick patients to help heal them as they either come off medication or get into more stable phase. Amazing. So you find you need less medication using this approach as a psychiatrist? Over time, not in every single case, but over time, if people come to me on medications and if they're doing much better and they're in a safe situation and they're being
Starting point is 00:56:06 monitored and can report their symptoms, we can certainly taper down the medications, absolutely. But it doesn't become a replacement. Some people do have a recurrence and we need to step in and figure that out. Well, what's amazing to me is you're talking about this concept of the gut immune system and dysbiosis and the microbiome and nutrition and leaky gut. And you're at Harvard. How are your colleagues responding to this? Do they think, oh, there's my crazy friend Uma over there. She's doing her thing. She's nice.
Starting point is 00:56:41 We'll just ignore her. But let's do the real medicine over here. What are they saying about you so it's interesting you know because i think that i had the opportunity to start this clinical service because i had mentors who encouraged me to do it and saw the different pieces that i was trying to put together and uh you know um the chair my chair my department is someone who did a lot of these studies in folate most initially. So I think that I'll know when the book comes out as to who fully agrees and who disagrees. But they know you're working on these issues, right?
Starting point is 00:57:16 They know you're studying. I mean, people have been very supportive, sending me referrals and that type of thing. And I don't want to imply like it's the most and largest growing service, but I think what you highlighted is some of these ideas start small in the sense that they're in larger institutions. But if someone's paying attention, we have the ability to grow them and have people come to us and have the ability to help more people. So, you know, I use the word earlier that, you know, sometimes it's thought of as a
Starting point is 00:57:46 soft science and this and that, but now there's evidence. And this book really pushed me to dive deeper into what's out there and what are the studies saying. And, you know, make a choice for yourself when you read it. We do not necessarily say give up a certain food or eliminate a certain food or go on a specific diet. And the reason for that is as a psychiatrist, I have to meet someone when they come into my office, meaning figuratively, you know, they tell me that they only eat red meat. I've got to find a way to work with them. If someone comes in and says that they're vegan, the other end of the spectrum, I've got to find a way to work with them with their independent and individual diet, irrespective of what I eat. It's really about trying to personalize that plan.
Starting point is 00:58:31 And I think that more and more I'm getting a lot of referrals from my primary care colleagues and lifestyle medicine colleagues. You know, my own department sends me patients. So it's growing steadily. And I'm happy about that. Well, that's great news. I'm so excited. I'm so excited about your book, which everybody should get a copy of. It's called This Is Your Brain on Food, An Indispensable Guide to the Surprising Foods That Fight Depression, Anxiety, PTSD, OCD, ADHD, and More. And you can find it everywhere you get your books. And you're also working on enhanced nutrition information for
Starting point is 00:59:05 your recipes. Can you talk about that? Yes. So I have an amazing researcher on my team who has studied nutrition, nutritional science, and metabolics. And what he's done is created an app that is, you know, he is still developing, but what it will do is take our recipes and break them down into the, literally the combination of what the breakdown of polyunsaturated fatty acids are compared to the monounsaturated fatty acids. So taking it to a much deeper level than you would normally do when you use a recipe. And I think that if individuals want to sort of follow recipes from this book or in the future follow programs that are looking at nutritional elements, that could be helpful to them.
Starting point is 00:59:56 You know what I'd recommend also is it's going to be a lot of work. But I don't know if you know about this, but the Rockefeller Foundation is working on the periodic table of phytochemicals. Oh, that is fantastic. There's 25,000 phytochemicals in plant foods. I did not know that. And they're characterizing all of these phytochemicals. And when you're talking about the role of antioxidants in the gut and modulating inflammation, the polyphenols, these colorful compounds in plant, colorful plant foods actually feed different bacteria. So it's not just their antioxidant effect. It's actually how you literally feed the bugs in your gut. So it's not just pre and probiotic foods, it's not just lots of fruits and vegetables. It's all these other compounds that we're just learning about. So maybe one day
Starting point is 01:00:40 we'll be able to have an app that actually tracks all these compounds. Yeah. And you can go, well, these ones are super great for the brain. These are going to calm down my gut inflammation. These are going to feed these 50 good bacteria over here that improve the quality of my life. That would be really pretty amazing, wouldn't it? That would be awesome. I did not know that about the Rockefeller Center.
Starting point is 01:00:55 I'm going to look into that because it's so exciting to know that stuff like that is going on. Yeah, it's very exciting. I think the more information people can have when they're trying out a recipe or trying out a food beyond the calories and the stuff that we've known for a while would be super helpful for them, especially if they're trying to, you know, eat the healthy fats. Well, thank you for your work. Keep it up. We need to know more and more about the gut and the brain and food and mood and all the connections there.
Starting point is 01:01:20 And everybody should definitely pick up a copy of This Is Your Brain on Food, an indispensable guide toable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADD, and more. That's a long title, but you should get the book and it's going to be fantastic. I really wish you a lot of luck. And if you've enjoyed this podcast, please share with your friends and family on social media, leave a comment. We'd love to hear from you. Subscribe wherever you get your podcasts and we'll see you next time on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my
Starting point is 01:02:12 weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S
Starting point is 01:02:42 and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now back to this week's episode. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical
Starting point is 01:03:04 professional. This podcast is provided on the understanding professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

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