The Liz Moody Podcast - Food & Lifestyle Hacks To Beat Depression, Anxiety, Insomnia, Brain Fog and More with Dr. Drew Ramsey

Episode Date: June 1, 2022

I’m so excited to welcome Drew Ramsey, M.D., one of psychiatry’s leading proponents of Nutritional Psychiatry and author of Eat To Beat Depression and Anxiety. Dr. Ramsey is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and the founder of the Brain Food Clinic. On this episode we talk about: the 6 nutrients that influence our brain health why balancing BDNF levels is as important and serotonin and dopamine how to support your BDNF levels the best ways to tackle insomnia how to eat to help with depression why you should stop taking melatonin changes you can make now to help protect your brain from Alzheimer’s and other neurodegenerative diseases what causes brain fog and easy ways to help beat it a surprising cause of depression and anxiety OR how viral infections can cause depression and anxiety how to activate your glymphatic system and clean up the waste in your brain tips for vegans and vegetarians to support their mental health whether intermittent fasting helps with mental health the one food you should be incorporating into every meal that you’re probably not the breakfast food that’s an under appreciated gut health superstar This episode is sponsored by Nuzest. You can use the code “LIZM” for 20% off your order on http://nuzest.us/liz This episode is sponsored by Thrive Market. Go to thrivemarket.com/healthiertogether to get 40% off your first order AND a FREE gift worth over $50! This episode is sponsored by Seed. You can get 15% off your first month’s supply of Seed’s DS-01™ Daily Synbiotic by going to https://seed.com/daily-synbiotic and using the code LIZMOODY. This episode is sponsored by Paleovalley. Head over to paleovalley.com and use the code LIZM for 15% off. Healthier Together cover art by Zack. Healthier Together music by Alex Ruimy. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello, friends, and welcome back to the Healthier Together podcast. I'm your host, Liz Moody, and I'm a best-selling author and longtime journalist. This podcast is all about helping you live your healthiest, happiest life, whether we're learning healthy cooking secrets, talking about the pros and cons of having kids, or diving into what's really causing our gut and bloating issues. And yes, those are all real episodes, so if any of those topics sound good to you, scroll on back in the archives. Today's episode is all about eating for our brain and mental health. I am so excited to welcome Dr. Drew Ramsey to the podcast. I have known Drew four years, and he's got such a brilliant mind and perspective. He's one of the leading proponents of nutritional psychiatry and the author of the amazing book,

Eat to Beat, Depression and Anxiety. He's also an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons, and the founder of the Brain Food Clinic. On this episode, we talk about the six nutrients that influence our brain health, something called BDNF that I never hear people talking about but is as important to your brain as serotonin and dopamine. The best ways to tackle insomnia, depression, brain fog, anxiety, and more, how to activate your glyphatic system and clean up the waste in your brain, why you should stop taking melatonin or at least reduce your dose. The one food that you should be incorporating

into every meal that you're probably not and so much more. Basically, if you are interested in taking care of your beautiful brain, and let me be clear, all of us should be because it is the only brain that we're going to get. This is the episode for you. We also have a super exciting giveaway for this episode. Hint, it involves a one-on-one virtual consult with Drew to talk about whatever you want. So definitely stay tuned till the end to find out how to enter that. I am so excited to hear your thoughts. So definitely screenshot and tag me. I am at Liz Moody and Drew, he is at Drew Ramsey, MD on Instagram. Okay, let's get into all things, brain health and mental health.

All right, thank you so much for joining me on the pod today. This is like a very personally interested conversation because anxiety has obviously played such a huge role in my life, so I'm really excited to get into all things brain health. I can't wait to talk with you as well, Liz, just because we've known each other for a long time. I've been emailing each other for a long time. and I'm a follower of yours, and so I'm going to try not fan girl too much. And everybody who's tuning in thinks, is a treat for me to be with Liz. She's just one of the people who are really early, just a little behind the scenes

to me really early as I was like a neurotic, academic, psychiatrists, and shit in food and worried that everybody thought I was nothing. Liz really helped with a lot of the early pieces for me with my body green, but also just really kind and giving and thoughtful and, like, always encouraging. and so really helped me very early on in nutritional psychiatry feel some confident. So thank you for that, Liz. I don't know that. That is so lovely to say, and I really appreciate it.

And I remember you always had the best, like we would often email a bunch of people to do like these roundup posts, and you always had such good advice and insights and stuff like that. The feeling was very mutual. I really loved working with you, and I'm excited to get to dive even deeper today. So let's get right into it. I would love to just get a little bit of an understanding about how the food that we eat impacts our brain health. What is the actual mechanism of action that's going on there?

Yeah. So there are nine. There are nine ways mechanisms that I've identified that have reasonable evidence finds that they work. Starting from like the most basic, right, your brain is constructed of food. Everything that is in your brain except for oxygen comes in through your mouth and you eat it. Whether it's the serotonin made by tryptophan or the tectophan. tyrosine that makes dopamine or the iron that you need to make other reactions to make those molecules a lot of people have heard of. There's kind of the construction way that food influences

mental health. There's the way that food is one of the factors that kind of regulates the dial on whether our brains are in repair mode and grow mode or not. This is a new concept called neuroplasticity. Food dictates the microbiome. The microbiome is all the organisms that live in our gut. Everybody listens to Liz, know what the microbiome is. But that really has a lot of to do with mental health and mental health risk and also inflammation. But for eating more plants and specifically lots and lots of fermented foods, I'll be chugging my kombucha this whole talk, getting my CFUs in for the day. Those are some of the ways.

And then there's the other ways food affects mental health food connects us to our food web. That feeling if you go to your farmer's market and you bump into friends and you buy some, I don't know, or then there's a sitting down and eating food with people that's good for mental health. There's the sharing of food, right? There aren't a lot of concrete ways. It's like, hey, I see you, I care about you. I really want to give you something that I've thought of and I've made. Talk to me about the repair mode thing.

You said that food signals our brain to be in repair mode or not. What do you mean by that? If we're eating in a way that really allows us to have a healthy, diverse microbiome, theoretically, over time, minute by minute, we have a kind of less reactive stance of our immune system. Not that our immune system doesn't respond appropriately, but that there aren't a lot of false alarms or there isn't that chronic din of I'm not sleeping enough. I'm drinking too much alcohol. I'm eating a lot of sugar and garbage.

I'm not engaged in a lot of good loving connection. You know, a lot of kind of signals that tend to make the brain grow and repaired itself from the environment. And food is one of those. There are six nutrients last time I counted that have direct biochemical pathways that influence. the major molecule involved in brain growth and repair, this process also called neuroplasticity, called BDNF. I think it should be everybody's favorite brain molecule. Because when I tell people on the psychiatrist,

they're like serotonin or prozac. I mean, those are interesting, that's an interesting molecule. But BDNF is a molecule of hope in the brain because it signals to the brain to make new connection. So anytime we're learning, anytime we're falling in love, anytime we're tapping into our motivation,

it's a brain connection thing. So that's why I like BDNF. And so there are a number of nutrients, a couple of phytonutrients, molecules and plants, magnesium, B12, DHA, the one chain of omega-3 fat. And they all seem to signal more BDNF, or there's a little, there's one, the only one study I think to date on BDNF levels in humans and nuts, eating daily nuts. Any nuts? I would say in the study, I think it was almonds and cash.

My bias is probably almonds, cashew. choose, walnuts, those are probably the main that I kind of think, too, is one, the sort of rules of brain food for me are, it's got nutrient density. Nuts are amazing in terms of news, like a little packet of olive oil, which is like one of the few things that all the food people agree. It's only a couple who are like, blah, olive oil is bad. Because it's hard to see. Like, only a few of those, mostly people like it. So it's a little packet of olive oil. It's full of minerals and also some fat soluble, fetid nutrients. So that's nutrient density.

How would you relate BDNF to something like dopamine? You mentioned it was like the molecule of motivation, which is something I think of for dopamine. Yeah, it's motivating. I mean, dopamine is more of kind of like at the molecular level would help us with like goal seeking behavior and motivation. I think about it as motivating more, I guess, on the personal psychological spot,

especially when we're struggling with their mental health, right? We're struggling with anxiety or depression. Or a lot of times you can feel stuck. or if you've been in treatment and you've been doing well and then things kind of get worse or relapsed or you get unexpectedly triggered. The happiness to patients all the time have had all kinds of different types of trauma. BDNF, I think, for me, allows us to be hopeful that wherever we are with our mental health, we can come to understand ourselves.

We have capacity and power in our everyday life to change our brain health, that we're really not stuck. I think about BDNF is kind of like meta when it comes to the, molecules in the brain, right? It's controlling the dynamics of brain growth and brain repair and even the birth of new brain cells. Whereas dopamine, I think about it a little bit more like the workhorse. It's like an operatic of the brain. It's like it's great. It's fun. You can make it go up, drink coffee. But then it goes down and people feel sad and dysphoric and have a hard time with energy and motivation. Do you mention the nuts and BDNF correlation? Can you just, and then we'll move on to something other than BDNF. But I think it's an interesting.

concept that I haven't heard explored that much before. Could you give us maybe one or two other very specific, actionable things that we could do if we wanted to support our BD and F levels and our brain? Yeah, it's a great question. I'm glad that we haven't talked about it much because I think, again, it's exciting that this isn't like something that's been out there for a while. It's not like it's a perfect biomarker like your doctors ever going to measure your BD and F level, but I think it's a perfect concept for us because again, it keeps us motivated. So things that really influence and help us with BDNF. In the diet, again, if we're talking about long-tune, omega-3 fats, for folks who are eating animal products in seafood, we're talking anchovies, sardines, wild salmon, and also the bavals, mussels, clams, and oysters.

But particularly mussels, I think, are kind of like the sweet spot there because they're the least expensive, the most verisodal, culinarily, and also have this really nice mix of B-12 and B-12, whereas, like, the clams. clams are really packed with B12 and oysters are really mineraly, but I think the muscles hit that sweet spot. So anyway, DHA and the long-chain omega-3 fats. For the vegans and veggies, folks who don't eat seafood, besides fish oil pill, I guess for some folks who would want to go that route, and then there's algal oil pills, which are pure DHA usually. So challenging, they're usually quite low dose.

And then the other problem is that in the studies, at least for depression, the studies that have been positive that fish oil can help have more EPA than DHA. So they're like two different types of omega-3 fats and it has a little bit more of the EPA. But other nutrients that help in kind of foods that can correlate and it's a big part of, I guess, my work in nutritional psychiatry. And I don't know, when Liz and I first met, called me like an integrative psychiatrist or a psychiatrist. But now they call me a nutritional psychiatrist because it's this new concept, an idea that we can, one of the tools we can use in mental health and in psychiatry is to look at how dietary patterns that a lot of people are eating contribute to mental health disorders. That's very

clear on the data now. It's very exciting. They're not five randomized controlled trials showing that you can do a diet intervention and treat clinical depression. It's never been shown before in the data. So BDNF is probably a part of that, but I just think the notion that, wow, for the first time, really in Everett in history, The first study was published in 2017. The most recent one was just published, I think, two weeks ago. I've got the preview manuscript here. It still is in final edits, but it's a treatment in young men. You give them a Mediterranean diet.

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I mean, they don't have, sorry, I've got some. medical. A lot of fish oils do not have much fish oil in them. They say a thousand milligrams, that's usually two pills. So there's 500 milligrams per pill. And then in the pill, there's a couple hundred milligrams of DHA and EPA. Instead of a thousand milligrams, you're getting more like four or five hundred milligrams. Well, a five ounce piece, four ounce piece of wild salmon, if it's good wild salmon, you're going to have between two to four thousand milligrams. Just eat the salmon. So I appreciate some people don't. Yeah, I don't eat. I have a mild seafood allergy, so I can't eat seafood basically at all. Can you take the fish oil pills?

I can take the pills because I believe it's the protein that is the issue. Yeah, yeah. That's why I've always told patients, but like everyone's always like nervous when it's like, I'm nervous every time I try a new fish oil. I'm like, am I going to die? But I'm like personally invested in the fish oil thing. So what should I, if I'm looking for like an ideal amount of EPA, DHA total dosage, like what am I looking? for my brain health. Yeah. When we would recommend fish oil regularly when the data was better, people would push between one and two grams. What that translated in my clinical practice and the brain food clinic is I told people to take a teaspoon of fish oil because a teaspoon back

then it was like a Nordic Naturals lemon flavored liquid. I think it's the ultimate omega. And I think with the one to two grams is kind of the dose. The issue is for depression. The most recent meta-analysis tell us their statistical significance. and the effect of fish oil and mood, but it's not clinically significant, meaning that it improves a mood scale by one point. So what do you do with that? What's your interpretation of that? Well, my interpretation of that is there's a big difference between fish and fish oil.

With fish, one, you're usually replacing another protein meal. For some people, that's great. You're going to get a lot more nutrient density in a piece of wild salmon or Miami, using noki with sardine sauce. That's delicious. And I'm not a big fish eater, folks. That's an honest statement. You're just going to get calcium.

You're going to get all these other nutrients. You're really going to get nutrient density. Whereas with you know, fish oil, you're just going to get, you know, the fat. And so you can still, and I find a lot of people who take supplements, right? They're not eating like Elizabeth. They're oftentimes struggling with a lot of aspects of the modern American diet. Look, I'm never going to make everything that I wear organic. But your sheets, your pillows, your comforter are literally touching your skin for eight hours

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That is Marley Spoon.com slash offer slash Liz Moody. So remember to get the offer in there. Marley Spoon.com slash offer slash Liz Moody for up to 25 free meals. If you were me and you weren't going to eat seafood, just to. to put a fine point on it. And you weren't going to eat seafood. Would you say the next best thing is to do a fish oil, but just make sure I have a nutrient-dense diet outside of that so that any sort of synergistic reactions that would be happening

with eating a whole fish, not a whole fish, like, you know, eating actual fish would be mimicked? Well, for sure, that would be the best way is for anybody doing supplements. And really, you want to have a nutrient-dense diet, in my opinion, and you're augmenting that. I think in your case, you know, as a nutritional psychiatrist, those of you were my patient, first, I'd want to hear the story of the fish, I'd want to hear about the seafood allergy, I'd want to hear about the worst time. Because usually there's, the food is very charged for us. So what food was like and how secure it was as you grew up, what kind of traditions did or didn't

get passed down. So I'd want to hear about that part of your fish allergy. And then I'd want to gently and appropriately explore within that food category some of the other elements just to see whether you've never tried them. And so the bivalves, for example, very different set of proteins and trink, you know, and a lot of people, they're allergic to all, they've tried it all, or they don't like it. But I just kind of try and poke around because I'm one of those people. I didn't eat any seafood until I was 30. Yeah. And they've taken me a long time to kind of develop the palate and really enjoy it. So I'm always sort of curious are things like scallops where it's a way, in some ways, a more excited. accessible, bivalve, or pasta van gole, where you're getting those glimbs. So any of those,

for someone in your case, I want to think there's a question of do you need a fish oil supplement, right? That I think there is an argument that can be made that a lot of people don't eat fish. We do make some long chain omega-3 fats ourselves. So for you maybe seeing what it's like to be on the plant base, the shorter chain to ALA, but kind of pushing that with probably flaxseed is the one that I see use a fair amount that's a really high omega-3 fat-containing grain, that might be a route for you, because again, if folks mostly, you mentioned anxiety, there's a little data. But I also think if you take fish oil for a month or six weeks, you don't notice a significant

change in your anxiety. I only put people on antidepressants for anxiety and they don't get better. You stop it. But with supplements, it's funny, people kind of continue on. There's also a little safety issue with fish oil that never really existed. There was some data coming out. We've always thought when I trained 20 years ago, fish oil was like, oh, it's great for heart. It prevents arrhythmias.

I had a little atrial fibrillation years ago. It was terrifying. I was like, where's my fish oil? And then Largetty came out really, I think, suggesting some concern about fish oil is really leading to more heart arrhymias. I kind of do ask that question of whether you even would need one. You've got to help you diet. you have an active lifestyle. There are lots of other ways to manage anxiety.

Omega-3 fats, it's not like they're highly correlated with anxiety or that there's a lot of data in treatment. Mostly the data right now in nutritional psychiatry for anxiety would suggest really trying to dial in a Mediterranean-style diet or a pure culture's traditional version of that is kind of how I like to put it. It's nothing magical about the Mediterranean diet, but it's a traditional diet that's the one that's most studied.

You mentioned that there were six nutrients that have been studied to have a large impact on the brain. Can you just go through all of those really quickly? There's one magnesium. And magnesium, since ketamine's in the news a lot, is this great paper looking at the mechanism of magnesium and how some aspects of mechanisms work, magnesium's working in the brain.

It's kind of like a same or similar pathway as ketamine. Ketamines is kind of old anesthetic that we're using in psychiatry as an antidepressant increasingly effectively. So magnesium is one. I think it's B12 or B9. So folate or vitamin B12, pretty sure it's B12. DHA is a long chain of omega-3 fat. There are a couple of phytonutrients.

I think they're in the flavonoid family. And there's actually a number of different plants on phyter nutrients that are involved. And some of that date is a little, I'd say, frontier-esque. That's five if we do the phytonutrients. I want to say iron, everybody. Yeah. And then I would also point out there's one of those ways that bench science, right, kind of what something does in the lab or how maybe iron or more iron promotes more BDNF expression

in a cell culture. I always kind of hesitate in the sense that we often see people in the wellness space like translating that directly. If you're anxious, you must not have enough serotonins. You should take a triptophan supplement or 5HT or 5HDP or 5HDP. Or if you're not sleeping, It's because you don't have enough melatonin, so you should take that rate or no. I love the way that it motivates us and it's like good psychoeducation, but I think also sometimes it gets a little almost like concrete, like a very nuanced dynamic system, the idea that, I don't know, we're going to eat or we're going to have this sort of alter it in a variety of ways, often good intention without a lot of data.

It is advisable. I don't know. I just always see that as a little bit of concern. So if somebody came to you in your practice and said, I'm not sleeping well, where would you start? If you come to see us or one of us and you're not sleeping, we're going to get a history of that and how it works for you, whether that's falling asleep, staying asleep, I'm going to want to hear about what kind of sleep hygiene game you have, right? Whether that's a concept you know, whether you're already doing the basics, whether there are identifiable things that you know,

disrupt your sleep and you've kind of struggled with the motivation or maybe tools to change that. I'm going to want to know about your early morning light exposures. So we do all that. And then I, dieterally, I'd want to hear, are there things in the diet disrupting people eating later? They're having a lot of late-day caffeine. Or they, you know, they listen to Dr. Drew Ramsey and they're, like, eating dark chocolate all day, but they're like bug-eyed and anxious. And they're getting way too many theobromines, but for some people, can be kind of stimulating. Is there something that is interrupting their sleep that I haven't thought of? And so I'm kind of looking for that as we assess somebody's poor sleep, sleeping environment then, is a lot?

huge. A lot of people are, you know, they don't sleep well because they're on the couch or, and I'm going to go through this too, you know, it's like, it's hard to turn off Netflix. It's hard to really have discipline around sleep. And then in terms of other dietary things, you know, I kind of in the back of my head of thinking about protein and tryptophan. A lot of people don't realize that melaton is actually made from serotonin, which is what the pineal gland does. And that melaton is really, you know, it's a lot more than sleep. Melatonin's involved and energy regulation and weight regulation, all these other very powerful antioxidants. Yeah, and actually the National Sleep Academy just issued a statement advising that no one take

melatonin as adults for insomnia until those first their research time just came out last month. Well, it's a hormone. It's one of those things that always makes me incredibly nervous for people to just be essentially prescribing themselves casually. Yeah, and I'm like, that's a hormone. What are you doing? Yeah, it makes me really nervous as well. So I'm glad you said that with tryptophan, I always picture turkey, because that's what I feel like you always hear about it with. But is there other foods that are high in tryptophan? There are. And triptophan is the most rare amino acid.

Just to pick up what list in the American Psychiatric Association annual conference, we have all these great workshops for you to learn from the expert. So I learned from the sleep expert on melatonin. This guy only treats depression with light and melatonin. That's it. It is incredible up in Washington in Seattle. And he said that, you know, you should never take more than point. milligrams of melatonin. We often have patients come to us taking five or ten. We were

consulted with a woman. She consulted. She was worried that her daughter was drinking so much coffee. Her daughter was like a late teen and we took a full of history. Her daughter was drinking a lot of coffee. But the reason is because her daughter was also taking 10 milligrams of melatonin every because she was so anxious about sleep and anxious about school. So sometimes there are homeruns like that where you can clearly shift things in terms of identifying the culprit of someone struggle with sleep. Where else are we getting our trip to fan? Sorry, asparagus. What was that question? So asparagus is a good sort. Cod is a great source. You know, turkey is a fine source. That idea that like you fall asleep because you trip to fan is ridiculous. It's not like you

have a filet of cod and you're like, oh my goodness. Cod's put me down. That's not how it works. It's more about like levels over time and keeping them in a certain place. Yeah. And it's also this model of the brain where it's like there are like nine layers of fat and cell membranes you have to get through to get to like the middle of a brain cell. So it's sort of this idea like you eat it so it goes up in the brain. Like if you really want to increase triptophan and serotonin in the brain, you should just drink sugar water and you should eat some protein. Then, you know, it's one of the reasons I think people crave dessert is you eat a big protein meal and it's all these amino acids then floating around and your brain's like looking through it being like, I just want the triptophan right now. You know,

I've got everything else. And so when you eat, you eat it. eat sugars, the other large neutral amino acids that triptophan competes with for transport into the brain, those other amino acids get preferentially pulled into muscle. But triptophan is going to be most meats and proteins, is where I think about it, and then asparagus and one other plant that I'm forgetting. But, you know, it's just one of those things again to sort of pay attention to eggs are always going to have it because eggs have a perfect protein. So it's one of those easy, peasy solutions to protein set questions. Are there any more nourishing or doable on a daily basis alternatives to just drinking sugar water, like a hack that would raise your serotonin or your

tryptophan levels? I would say that the number one way that you're going to want to maintain good levels of triptophan in your serotonin in your brain right now, according to the latest science, is to avoid any amounts of inflammation. And the best way, according to science, do that right now, to eat six servings of fermented foods a day. So I think if you're carb craving a lot, you're really wanting sugars a lot, the two things that really obliterate that are making your main, three things. Main source of sweet, dark chocolate would be one. I would say eating more fermented foods in terms of shifting the microbiome would be number two.

And then I would say third, making the main source of carbohydrates something. Oh, three would be stopping alcohol if you drink alcohol for a little while. If you really want to get control of carb craving and you're drinking alcohol, those two things don't go together ever. If you have carb craving, and I don't mean to sound like a teetotaler, but if you have carb craving, you can't drink alcohol. It's just you're drinking like copious amounts of sugar water every night and buckets of it on the weekend. Is there a better or worse type of alcohol for brain health? No, there's no amount of alcohol that's good for brain health. There's really not.

And also the most recent data, you know, everybody in medicine. I figured there was nothing good, but I figured I was like, is there anything less bad? I would say that the least harmful is going to be the lowest alcohol fermented product, which would be kombuches, not hard kombuches, but there's probably a tiny little bit of alcohol. I mean, I consider myself sober from alcohol, but there's a tiny little bit in here maybe. A lot of brands are really responsible and get rid of it. I would say the idea for ever medicine doctors like me would say like, well, you know, two glasses have read this like very sexist statement, right?

two glasses of red wine for the ladies, one. That's good for your heart and your brain. And I just think one, that's such garbage. Anytime you see a statistic like that repeated over and over and over and over again, it means there's no good science because we never have just one good statistic in science. How many eggs are safe to eat? There's only one study about that, the Harvard Egg study. Everybody says the same thing.

It's a nice piece of science, but my goodness. That's actually a great point when people are trying to make their way through, all of the misinformation in the world right now. I think it's a great point that science does tend to be nuanced and complex and disagree with itself. And so if there is one talking point everybody is sticking to, it's probably because there's only one study and further research is needed. That's like a great point.

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to support our brain if we're dealing with something like depression? Yep. There's a couple of things I really love. One is people, if you like fish, I think you're canned fish. up being your canned fish game. I just think that it's a great way to get fish where it's fresh. It's inexpensive. It's fresh because it's in the can, right?

It's inexpensive. And there are lots of easy ways to use it, like a real Caesar salad or pasta comsardi. So that's one. I think Pesto is a second one of just a way of getting a lot of nutrient density, a lot of nuts, especially, you know, basal limits in season. Just a wonderful thing also to make a big batch and put in the freezer, especially if you're busy or you're in grad school or you're working shifts. And you just you need something that you can like, bam,

throw it on the pasta and it makes it healthier than just pasta with red sauce. Well, and you mentioned the phytonutrients as one of the six things. And I feel like herbs are such an underlooked source of phytonutrients. Like people are always talking about lettuce and all of like salads and all of that. But herbs taste really good. You could add them to basically anything and they are so high in phytonutrients. Yep. At the farmhouse in Indiana, we have this little hoop house and has this like massive ancient

oregano and rosemary plants. And I just like go out there and just like grab a handful, chop it up, grab some basil, chop it up, and just dump it in anything, dump it in an egg, dump it in your stew. Put it in your smoothie. The herbs are totally inheritable in vital nutrients. The most important thing if you're having depression right now and you're not eating fermented foods is you should check out the kaffir smoothie or any smoothies that Liz is making with fermented foods. All mine have kaffir in them. If you're not a dairy person, you can use other stuff. But upping your fermented foods, first of all, the studies say you're going to have about maybe two to four weeks of a little more gas, a little more bloating. But as your gut microbiome adjust, you're then going to have a more diverse microbiome and you're going to modulate your immune system. This isn't like crazy wellness talk. This is like a very, very important study that came out by Washtick and Gardner out of Stanford. I don't know, maybe six months ago.

I've got some info up on our blog, but it's just a very cool study that said, eating plants, it's interesting. Eating more fermented foods. It was just really impressive the difference. They did all these complex like protonomic and metabolomic studies on what happened to individuals and looked at their immune cells. And the people who ate fermented foods really had a robust response. We did a deep dive. If anybody's interested in that, we did a deep dive into that study in the future of gut health episode of the podcast.

And it is, it's a fascinating study. And it definitely encouraged me to start being more serious about incorporating fermented foods into my diet. It's hard. It's one of the things that's hard to do on a regular basis so you're not used to it, right? I'd buy a little jar of sauerkraut or fermented carrots or something like that, something from the refrigerated section. Because if it's not the refrigerated section, just word to the why is anybody listening. If it's not the refrigerated section, you're not getting the benefits that you want. But I just literally will have spoonfuls of it. Sometimes I'll incorporate it into meals, but I found that I was stressing myself out too much, trying to figure out how to fit it into all these meals and now I just kind of like eat it by the

spoonful. And then I have it done. And if I put it in a recipe or a meal, great. But then I like have it. And it's something I've actually grown to really crave. I don't know if this is my head, but it seems to help with sugar cravings like in the moment too. It's like one of my best tips for that. Yes. That's nutritional psychiatry. And also, well, yes, I think your evolution of it being this thing and, you know, occasionally to like you craving it and wanting it. And also the I don't know how I'm also like the intuitive notion you have of its effect and even a rapid effect. I think that makes, yeah, I mean, I think that does make some sense.

But yeah, fermented foods, kaffir, sourcrowt, kimchi, that one. I don't have a lot. There's a kimchi fried rice is a way that I've used that more effectively. And then I think probably for a lot of people who are struggling with mood, it's keeping it simple. It's easy to get overwhelmed. I think a lot of us when we get depressed, part of the acting out and perpetuation of the depression is this vicious circle of not having a lot of energy and motivation, having a lot of self-loathing, not engaging in self-care, feeling worse.

It's like when you notice like, oh, yeah, I haven't had a shower for three days. And then I felt amazing. It's like, wow, no shit, Sherlock. You feel good when you take care of yourself. But I'll even see myself engaging in those kind of patterns where it's like, why do you feel so bad? sure part of it is certainly clinical depression but part of it is the way that that depression takes us out of all the stuff that feels good right we're isolated we're not nourishing ourselves often we're not sleeping well but yeah the hope is for there to be some optimism for people to hear the

data there's a lot of data now looking at has particularly around depression how food's involved in depression and then feeling some motivation right it's not like every single bite has to be perfect brain food but the more you can trend things that way over time, certainly much better for your brain health. There was a study in folks 60 to 65. They looked at nutritional patterns. And the amount of brain shrinkage difference was stark and measurable, which is really surprising that over four years, if you eat garbage food from 60 to 65 versus you eat healthy food, your brain just shrinks much faster in the processed food. So it's a nice study by Felice Jacob.

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That is branch basics.com and use code Liz Moody. And you're asking for other tips. I think cooked together. That's one. And then I like to have a little project. It's just me. Like, I don't know, I got a grill. I've had a grill before. I've never had had like that pizza stone you put on the grill. And I don't know. So it's like I don't think I'm going to do a ton of that. But I'm excited to kind of just make pizza with my kids. I do think that learning is such an underlooked part of adult life. And it's something that's so foundational and important in childhood. And then we just kind of let go of it in our adult life. I'm learning tennis right now. I'm taking tennis lessons. And I can literally,

feel like different parts of my brain turn on that have just been sitting dormant. No, no, no. I think learning is, it's funny. When you think about BD and F, unless triggers BDNF, learning, engagement, feeling progress, all those things are hugely important. During the pandemic, I started jumping horses. I'd always ridden a little bit, but I'd never been, like I said, never had a horse lesson, really, that many times.

And, man, the mental state I would get into was just, you know, the learning, but just also this kind of physical, mental, spiritual challenge that would happen. It was incredible. Could you share two to three of those little changes if somebody listening wants to just have like a long-term protective effect for their brain? They are maybe concerned about getting a neurodegenerative disease or Alzheimer's or things like that and they just want to bolster their defenses as much as possible right now. Yeah, a few things that pop into my head or guacamole.

I mean, in terms of just swaps, just more guacamole, just avocados, or just really, they've got a special seven-chain sugar in them. They've got lots of mono-unsaturated fat. They're very satiating. I think long-term protective, if you look at from depression, you know, a lot of the data is what people take away. And the way we approach that, I guess, a little backwards like in our clinic, I'd really think about how do you replace things, and that's how you get rid of them. How do you replace things? That's how we get rid of them. So if you love burgers, I love burgers, but is there a way to occasionally do a wild salmon burger with canned salmon. It's less expensive than a burger if you do it, right, and tons of omega-3 fats. You mentioned guacamole, right? If you have cheese dip, a ranch dip, you know, swapping that out for guacamole and hummus or one of these more delicious but healthy sauces that are out on the market these days. I think sauces are a place where a lot of people struggle. I think diversity, I see a lot of meat eaters who it's burgers and steaks, or a lot of fish eaters where it's tilapia, period, or shrimp, period. And working to diversify yourself as a nutritional psychiatrist, we work in food categories.

I was a big kale eater forever. I loved kale. I asked Dr. Kale for a little while. That was fun. I got teased a lot about that at some annual meetings of doctors, to be honest. But it's my trauma. I'll work that out. But you don't have to every kale.

You want to diversify in the leafy greens, whether it's sunflower sprouts or mesclin or microgreens. They all have a bunch of interesting benefits. Okay, let's do a few more. I'd love to talk about brain fog briefly. What's actually happening in our brain when we're experiencing something like brain fog? The cause of brain fog for some people is inflammation. About a third, maybe 40, 50% of people who are having struggles with depression and struggles with mood.

Your inflammatory factors actually go up when you have depression. It's really interesting. And when peripheral or body inflammatory factors activate the brain's immune system, Well, what happens is our brain does a couple things. One, it shunts triptophan from being made into serotonin into being made into these like reactive oxygen species, these things that are there, they're there to make more inflammation in the brain. When the brain's inflamed, three circuits get messed with mostly mood circuits, anxiety circuits, and cognitive circuits. So that kind of brain fuzziness, it could be inflammation. Everyone's felt that like when you get the flu or when you had COVID, that where your brain is just like, wow, my brain is not working as well.

It's fascinating that you say that with the three things, because when I had COVID, I also felt extremely anxious and extremely depressed. And I thought that that was fascinating because it was a really hard mental health period and it wasn't something I was expecting to experience. Yeah. Anytime people get a kind of viral on us, I'll see in my practice a lot. I actually saw it was COVID a lot. One of the benefits of telepsychiatry is I got to see people in all stages of COVID.

And there's really a mental health component as a lot of people experience, right? A lot more mood reactivity, a lot of pessimism. And that's because of like literally those three things happening in your brain. So it's actually nice to be able for me to divorce. I don't know. Like there's something wrong that I should be solving. And this is a viral infection that's impacting my brain at this way. It's like when you're really, really irritable, your mood's down and you haven't eaten.

Yeah. Right. Like we can all get into that spiral of like, oh, like, wow. Should I quit my job or should I eat some peanut butter? Yeah. Yeah. And it's just, you know, like I said, you want to be well nourished. You want to be well rested.

You want to be in a contemplative state when you're thinking about your mood and your mental health and the meaning of things. I think that's an important tip for sure. So that said, would anything that we talked about earlier in terms of quelling inflammation be something that if we're experiencing brain fog on a regular basis, that would be something we'd want to look to try? Yeah, the things that I would think about are the most common kind of really important nutrients people tend to be missing. So we mentioned fermented foods. That would be atop. More plants would be a top recommendation. Sources of zinc, so pumpkin seeds, oysters, turkey.

I mean, zinc and magnesium and root two nutrients that people know what they're missing, but just kind of don't eat a lot of making sure it's not something reversible. Like anybody who has a change in your mental status, you're depressed, you're anxious, your memory is going, get to your primary care doctor, get your B12 checked, get your iron checked, right? Make sure that you don't have a low-lying, level-level and infection. Like 10 to 15% of folks over 60 have a B12 deficiency, and a lot not because they're eating it because they can't absorb it. I think about 10% of women of childbearing age who still have mencies are iron deficient. I mean, iron deficiency is just going to lead you to have fatigue and brain fog. Make sure those things are cleaned up for sure. And then sleep would be the next one. We focus so much on food. And people don't have a good sense of their sleep list. I didn't. I know, I've been taking people's sleep histories for, I don't know, 20 years. And he asked folks, people say, yeah, yeah, try like six, eight hours.

And they can be like, I got some sleep hygiene. You know, I'm trying to do better. And you say, okay. And I'd say the same thing. Like, yeah, I'm getting about eight hours. So I started tracking my sleep. Unless you really work at it, there's no way in hell you're getting eight hours of sleep the night.

And most people, I was going to, you know, unless you're going to bed at nine, like if you're a parent, if you're not in bed by nine, you're not getting anywhere close to seven or eight hours of sleep. I will also say, so I have an aura now which tracks my sleep and I love it, not sponsored at. I wish that. Like, I really want to be there. Like, I really want to be their spokesperson, like, their long term, but they don't.

We all do. We all do. I was like, yeah. I was like, you guys. But I was noticing that I was often counting the time I was in bed as like my time asleep, but you go to bed and you futs around in your phone for a while. And then I read for a while. And I've lost like an hour at both ends.

And I was counting that at sleep time. Oh, you just get up in the middle of the night a couple times. You get disturbed a couple of times before our dog passed away. He was in our bed with us. And it's like not as sharp because I just, the reason also is that you clean out. So this new course healing the modern brain, I got to do some deeper dive into sleep science. And there's this whole system of the brain that got discovered not that long ago. We didn't even know it existed called the glimphatic system.

The glimphatic system is how your brain cleans out waste. And so there's all this like work I see a lot of people doing to eat clean foods, eat brain foods, exercise. eyes, but their sleep is not addressed. And the glumphatic system, correct me if I'm wrong, isn't that activated during deep sleep specifically? Yeah, they think like stage three, four. And so that's how when I had an ordering, that's what I would look at and just look at how much deep sleep.

It's not a perfect measure, the rings and all the trackers, but one, it gamifies it a little bit. Yeah. Two, it allows you to make some correlations. Like, you get a little bit more of that good sleep when you are active and move during the day. Yeah, but it's seven grand. of waste in night that gets cleaned out of your brain. And so who doesn't want a clean brain?

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That means it contains both pre and probiotics, which is super important. In fact, if you remember my Ask the Doctor gut health edition, we talked about how prebiotics are one of the most important and often overlooked components of great gut health. Let me break it down for you. Probiotics are the live bacteria that are so beneficial to our gut. gut health. But prebiotics are the food that those probiotics need to thrive. If you don't have ample prebiotics, the probiotics you're consuming will be undernourished and not be able to help your health in the way that you want. Speaking of your health, there's also a common misconception that probiotics or symbiotics are for people with gut issues, which is so not true. Like, yes,

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breaks down the science behind your microbiome in some of the easiest to understand ways that I have ever seen. And if you'd like to try seed for yourself and pretty much change your life forever, you can get 15% off your first month's supply of seeds DS01 daily symbiotic by going to seed.com slash daily dash symbiotic and using the code Liz Moody. Again, that's code Liz Moody on seed.com slash daily dash, S-Y-N-B-I-O-T-I-C. Now, let's get back to the episode. Do you have any hacks for getting that deep sleep in the glymphatic system activating sleep? Like, I've heard that if you go to sleep earlier, you're going to get more deep sleep because deep sleep tends to occur earlier in the night.

So if you go to sleep at one or two, you're never going to get as much deep sleep. Is there anything else we can do to activate our lymphatic brain cleaning system? I would say that probably seeing somewhat hydrated is helpful. That moment's kind of obvious, but you're trying to mobilize and clean stuff out so you want lots of fluids up there.

I think the early bedtime is great. Get up and look at light, right? Because that sort of starts the clock. It's 6 a.m. Like I sit here and I face east. the minute the sun comes up, I open the door, I go look out. I kind of schedule that actually. I skip a little time between patients to go and just get my early morning light. But I think that's probably one of the most critical is to kind of start those clocks.

I think avoiding late night eating. I just think everything slows down. And so heading into sleep also, I would say in a relaxed tape. A lot of people don't stretch. I find a lot of patience, my patients, when they're in their heads a lot, just getting them into their body, getting on the foam roller, getting on the roller ball. It's been in a good five or six minutes kind of preparing the body. There's no evidence I have, but I think that's very helpful. Air filter. Again, there's no data, but like if you have cleaner air,

it's going to be a cleaner thing for you to be breathing in and dealing with. Well, and I would widen that to anything you can do to make sure that you're breathing well throughout the night, whether you need like a breathe right strip, you need an air filter, but making sure you're not having. those like micro wake up moments from not literally getting enough oxygen in your brain. Oh, and the one we should mention to be medically responsible if you are told you you are snoring or you make this noise at night ever, you have sleep acne until proven otherwise. If you're anyone, it's super dangerous.

If you're a man, it's the most common cause of sudden death and men. Wow. And so if you've got a man in your life, you've got a little thick neck, you've been next to him, he's normies, get a sleep study. A lot of them are done at home now. You have to wear a little mask or you can get some nasal cancer. I always tell people, you can make decisions about treatment once you hear all the options and you know what you have. But a lot of people avoid just getting that definitive answer. So that's a major cause of sleep disturbances for people. In terms of hydration, are there any hydration hacks that you like or any little hydration tips that you like? I add a little

pinch of mineral salt to my water to get those sort of electrolytes in and get more hydration in? Is there anything other than just drink more water that you can offer in terms of hydration? Yeah, I'm a big fan of tea and also herbal teas. People are having trouble sleeping and they want to start with something really natural and gentle. I think some of the sleepy time teas, whether it's skull cap or chamomile or kava kava. They'll call them sapperific teas that help people sleep. I think all those are really quite interesting and quite effective for some people. That's a nice way to kind of stay hydrated. Also helps, you know, drinking water gets kind of boring to some people and some patients. So, yeah, and cutting out alcohol, I know he's said that. If somebody listening is

vegan or vegetarian, is there anything that they should definitely be including in their diet to make sure they're protecting or boosting their brain health? For vegans, 100% B12 supplement, please avoid all this, there's this debate about whether you can get B12 from food or not and like data about B12 analogs and seaweed. And it's like so frustrating to me. Like 80 plus percent of British vegans have low levels of B12 of that. I think it's 52 percent are frankly deficient. So that means those gentlemen who are trying to be healthy and live a vegan lifestyle, their brain is shrinking day by day as they head towards depression and dementia. That's just what happens with B-12 deficiency. It's not like an accusation against our vegan friends. That's important. I think

if you have mood disorders or anxiety disorders, really thinking about your fat intake and your protein intake, right? Where is that going to come from? To be other big challenge for vegans and vegetarians is staying off the processed foods. There's just so much marketed to them. I was veggie for like 10 years, but for people kind of in their late 30s or 40s, you've lived some of your life in like vegetarian hell, right? Like, I was a vegetarian in the 90s and it was. It was like there were veggie burgers and snack well cookies. That's kind of it. Yeah.

You get excited. You're like, oh, there's so many options available. Totally. And there's so many new products to try. So I think just really watching for the creep of processed food. But the B12, iron and sink, there's little data in both vegetarians and vegans. I feel kind of defensive about this. And I don't mean it in that way.

I'm a brain health guy. I want to carry your brain. And so there's some data that mental health disorders are more common or more prevalent in vegan and vegetarian. There are three large meta-analyses that came out about that maybe four or five years ago. It's correlational studies, so it's not 100% clear what that means. For vegan or vegetarian, and you're thinking about your mental health, you want to look at your fats, you want to look at proteins, you want to think about B vitamins and zinc and iron.

And I think you want to do that in a, I would say, non-defensive way, just it's your brain. I'm genuinely confused how Masterclass gets literally the absolute top people in every single field to teach every single one of their classes. I use it when I want to learn things directly, like the cooking class from Thomas Keller has all of the wisdom that you would normally have to go to culinary school for. But also, I'm being honest, this is like a use case I don't hear a lot of people talking about.

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It is actually rolling the clock back at a cellular level. I've been using the face moisturizer for almost six months now and I love it so much. It feels amazing. It goes on really smoothly. it's not tacky at all. And I actually see a difference, which I just feel like is never the case with skincare. You want to always like see a real difference and you're kind of like, do, do I? Do I? And this I genuinely do. Because it's clearing the senescent cells, it doesn't just target one thing. So my skin looks firmer. It looks glower. The texture feels dramatically smoother. And I feel like you can see that too. I also love the body moisturizer. It dries down really quickly, which is always a pet peeve of mine with moisturizers. I hate that like sticky

feeling when you go to put your clothes on. This does not do that. But it does moisturize really, really well. And then again, I'm reducing my skin's biological age. I am not making it just look younger. I am making it actually younger. One Skin has four peer-reviewed clinical studies in over 10,000 five-star reviews. The data backs everything up for a limited time. Get 15% off with code Liz at oneskin.co slash Liz. Again, that's 15% off at OneSkin.co with code Liz. Let's do a little bit of a quick fire of like favorite this for this. Do you have any favorite spices for brain health, things you love to incorporate your cooking? I like to incorporate ginger into a lot of my cooking. I think that's one of my favorites. I like to have some reasonably

fresh herbs or fresh jars of spices to kind of go through them quickly. I mean, I try to not have a lot of them at once because I find them they just sit. I would actually say that's like a hugely under-discussed thing with spices, is that they lose both their flavor, but also all of their therapeutic properties over time. And so if you have old spices, they're not going to be as good for you or as delicious as if you have fresh spices. Yeah, and I also look to experts like you, Liz,

or Linda Shoe, who's a physician who is also a chef and has a spice box kitchen. She's got a great book all about spices. For me, I'm a like salt, pepper, olive oil, fresh herbs kind of guy. Right now, honestly, I have salt, pepper. I've got that, like, fancy salt that I like the Maldon salt. I've got like some grammer salt. I mean, I don't have a lot.

I really am kind of very, I've gotten as a really simple middle-aged guy groove of like, I like roasted vegetables with olive oil, salt and pepper. What about teas? Do you have favorite teas for brain health? I'm a huge Earl Grey drinker. There's a little date about Bergamont. I think of BDNF. I really like mint teas, ginger tea, I like Sleepy Time teas.

I'm a huge tea drinker. I like green teas. I probably try and drink. I mean, I said I'm a shrink, right? So I sit in therapy. You don't have a lot. You're like listening and you can take little notes and drink like a kombucha or tea. And so I probably put down, I don't know, two or three cups of tea and several

kombucha today. Yeah, I love tea. And then all the TMI, my kombucha. What's the data about Bergamont and BDNF? That's interesting. It's like a little study. It's like one of those like cell line studies that it's interesting, but there's not ample data. What are your thoughts on intermittent fasting in brain health?

Intermittent fasting is a way of decreasing caloric intake, which generally is good for longevity and brain health. You know, not to any dangerous way, but you know, to look at people who eat 3,000 calories versus 2,000 calories a day. One way to think about it is the more fuel you put in, the more oxidation that happens, the more free radicals that get formed. So less fuel equals fewer free radicals. What I like about it is how people contend with and experience hunger in a healthy way, which I think has really gotten moved for a lot of people with all the snacks and waters and drinks and beverages, the idea that you're going to go and extend a period of time without consuming anything. I think is really an intriguing spot for people to be in. I think the mental state that happens with a little fasting after you get past it's really kind of an interesting space when I fast before my labs annually.

My doctor, I worked in one year. I was late as like one. She's like, you're still fasting? I said, yeah, she's like, are you feeling closer to God? I was like, yeah, I kind of am. So I like it. I also think that it's the intermittent fasting or the eating windows. Some people, it really helps them to have some hard fast rules.

I mean, I think we have to acknowledge as much as we can all have good ideas and talk about change, it's really hard to change things for a lot of people. And so having a window where there's a hard, fast rower, I've met a few friends who are vegan. He asks them why, and they're like, you know, I just don't want to eat garbage me. I don't want to eat fast food. I just found like when I adhere to a vegan lifestyle, I just don't find myself making those choices. I think when eating window does that for some folks as well. Is there data, though, that it would help with something acute like anxiety or depression or brain fog? No, I mean, pretty much going into ketosis initially makes people's mental health a little bit questionable or shaky,

and then over the long term, there's not a lot of data. A lot of people in ketosis, you know, really feel more energy and better mental health. But yeah, in terms of longer term, you know, for the most part, restricting calories, you know, isn't great for people's anxiety of your mood. You're listening to the Healthier Together podcast. When I worked as a magazine editor, I wrote more than a thousand articles about turmeric because pretty much all of the doctors that I used as sources kept recommending it or citing it is one of the supplements that they would personally take. Here's the background. Turmeric is one of the most powerful ways to fight inflammation. In a nutshell, there are two types of inflammation, acute and chronic. Acute inflammation can

actually be a good thing. It's one of the ways that your body heals and repairs itself. But when that system goes haywire, we get chronic inflammation, which essentially makes your body feel like it's constantly under attack. The vast majority of doctors I work with cite chronic inflammation is one of the root causes of so many of our modern ailments. And research links inflammation with heart disease, diabetes, autoimmune conditions, cancer, arthritis, and gut issues like Crohn's and ulcerative colitis. I am never going to sit around and tell you that a supplement will cure everything that ails you,

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That's PaleoValley.com and code Liz M for 15% off your order. And if you have any questions, feel free to hit me up on Instagram. I love chatting about this stuff. Now, let's get back to the episode. Are there any little weird tweaks that we haven't talked about yet that maybe aren't being widely discussed that people could do that would benefit their brains? This could be either something that you would consume or something that you would do. I think there's so many things that most people don't do every single day to take care of their brains. I mean, it can be as simple as like, I don't know, looking into your friend's eyes or partner's eyes or kids' eyes just more intentionally and not really sitting with that or gratitude exercises, right? So many of us have

such blessed lives of so much choice and so much privilege. So to really soak that in, especially as we live in a very kind of accomplishment and focused society. I think in terms of food, we've talked about most of my favorite swaps and changes. I don't think we've talked a lot about colorful vegetables and just, you know, one of the simpler things, just are there three or more colors, natural colors on your plate at every single meal. Also, the way, we didn't really talk a little bit about microgreens, but I find I'm not eating a lot of big salads. I find myself sprinkling a lot of microgreens on things, especially if like, I don't know, I'm rushing. I'm in a bowl of pasta. I like pasta. I'll just chop a bunch of kale or drop a bunch of microgreens on there,

mix it in. I find that really makes me slow down, chew it a little bit more. And microgreens tend to be like a little bit more nutrient dense than larger grains, yes. They're like the veal of the vegan world. Like when I eat those sunflower sprouts, think about it. You're eating that sunflower sprout. That thing's going to become a sunflower. Yeah, it's got all that packed into it. You're taking all that genetic potential just for your greedy self.

It's true. I mean, it's true. Sunflowers are beautiful. Another idea just popped into my oatmeal. We haven't talked about oatmeal. Okay, talk to me about oatmeal. It's one of those underrated foods that when you look, you know, Look at those prebiotic food, right?

If everybody Googles the foods that are supposed to be really good for the microbiome, you see things that most people don't have to do with like Jerusalem artichokes, chicory root, right? Which I think, again, drive people towards processed foods and powders that contain those things, as opposed to, I don't know, oatmeal, super inexpensive, really easy, you can make it savory, you can make it sweet, you can just put berries and nuts on it, an incredible source of fighter, particularly beta glupin fiber, it's really good for you. And then nuts in your smoothie.

We talked about nuts and them kind of being a good choice. But, you know, again, one of the reasons I like them is putting them, like, I'll put pumpkin seeds in my omelets or my salad. They put cashews in almost all my smoothies. Just find that it prevents the smoothie from just being like a sugar bomb. It gives that satiety effect. Yep. And then I'm trying to think of other tips I have. We've got a new download the ultimate mental fitness morning, and I feel like I'm missing

a couple of the essential tips, which I'm going to regret as soon as we hang up. Is there anything that you do every morning that we haven't talked about yet? Well, let's see. My morning routine is pretty straightforward. Every morning I get up. The very first thing I do, but it's a system I worked out with myself, is I check the front page of the New York Times to make sure that nothing is gone nuclear, because that's sort of a catastrophic way that I control my anxiety about the state of the world. Once I've checked that off the list, I give a big gratitude prayer and put my feet on the ground and take a deep breath. I then go make a very strong pot of black coffee. And then every morning, yeah, I smell my kids. I go and make sure they've got their covers on their toes.

And so their last like hour of sleep is kind of cuddly. And I give them a little kiss and smell them and tell them I love them. And then I hang out with my wife for a little bit and I don't know, process any dreams. And if I have time, I like to try and do like a little, I don't do a lot of movement before I start seeing patients. but a little bit, but also, you know, ideally if I get like a little music in my life early in the morning, I find that really important. Yeah, then hygiene, bathing, shaping. I like that.

But I really like spending that as, you know, very, like, good mental health time. I really am very intentional. That's, like, really delicious. And I'm really grateful for the warm water and for, like, a little time for myself. But by then, that's all I've got to then get in and start seeing a patient. If it's a day that I don't start early, which is for me is usually, I don't know, 6 a.m. local time, then if I can get early morning exercise in, especially usually I need a partner challenge buddy with that to come in. But if I've got somebody committed, I love being on

the mountain top early. You know, it's just such a wonderful spot to be in. We've talked about, obviously, a ton of stuff in this episode. I would love for you to just leave us with one thing, one homework assignment, maybe the smallest thing that would potentially have the largest benefit that we could all start doing today for better brain health? It's going to be maybe surprising. We've talked so much everyone about food and nourishment and all these things. But I really think the most motivating, stimulating thing for us is human beings really revolves around our attachment and engagement with other brains. And so I think if there's anything, I would hope that everybody stayed with us all this time.

And I really appreciate your time. I'm just so honored to share so many of your fans and followers, Liz. But to really this week think about what active activity, what active thing you can do to deepen an important relationship. And that can be a simple thing like a phone call. That can be a nice thing. I meet a lot of people who have forgotten about date nights in the relationship, forgotten about romance in some way. So whether it's a friendship of just making a plan with somebody, I don't know, I have a couple new friends. And I just, you know, the idea is sometimes I get to go, instead of going out solo, meet some guys for a ride.

I don't know, such as just affectively different treats. I think partially, Liz, that comes from a sense that there's all kinds of choices we make every day in terms of our food and our activity. But my sense is right now coming out of the pandemic, with the war in Ukraine, with the political polarization happening in our country, that people are really overwhelmed emotionally. And I think as a mental health professional and psychiatrist, to me it's also felt like there hasn't been a period of processing. We've been constantly adapting. We've been really resilient, right? But for people who have lost someone whose lives has significantly changed, it hasn't been a lot of time to sit with that and process it.

And so I guess that's where my recommendation comes from right now. Maybe you have me back on. I'll have a wittyer one. I'll be like the secret Amazonian cacao that I've found. I completely agree, though. I do think that we're going to see on a mass societal level, the implications of the fact that we were just told, like, okay, get back to normal with no processing, no anything of the fact that we've all experienced two years, unlike any other in our lives.

Yeah, I think you're entirely right. And I think also because of that, because it's not anything we've experienced, how we process it is a little challenge. I've been shrinking for 20 years. I've never been through something like this where my patients and I are in the same boat, right? Or like early in the pandemic talking about like, well, I don't know. How long do you let the package just sit outside with alcohol. And I'm like, well, there's what I read. What did you read? So where the fear, anxiety, insomnia that you're all having, you're experiencing together, I've never had to that. And so figuring out ways to process that, the very new are different, right? Maybe you've never journaled. Maybe you've never spent a lot of time in nature. I've spent a lot of time going down

mountains. I haven't spent a lot of time going up to them. I found this energy and peacefulness and energetic spiritual connections is just going up these mountains out here. I don't know how to explain it. I feel there's like some perpetual energy machine inside me that just turns on and wants to go. Well, I think there's something about giving ourselves permission. We have experienced trauma. You don't have to compare it to somebody else's trauma or another trauma. Like, you have experienced trauma and you can give yourself the space to process it. And I think that's wildly important. And a lot of people aren't doing it. Maybe that's a better tip. I'm going to go back. Let's ask me what my thought, but it's like, don't invalidate your trauma.

That's what I would say. That I think that oftentimes when we think about trauma, it's violent crimes, it's right, you know, it's horrible traumatic thing. And then when we think about other traumas, we call them like a trauma with a little tea, which I kind of get personally offended by. Like, yeah, my trauma's all sound like they have little teas, but that's not how it feels to me. And your brain isn't like, oh, it's like a little tea, you know.

Don't worry, that parental neglect that you had back when you're a kid, don't worry, that was a little tea. Yeah, it gets in there and things get triggered, right? Lots of people, I mean, even the stuff that people are embarrassed about it, but I hear about all the time we're like, no, we just lost a pet. And that pet has been, I've pet predated our kids, right? It's like, it comes up and it hits you in the weirdest ways of seeing cute puppies. I heard a jingle I thought.

I was like, Lucy, I heard it like a jingle of her dog's collar and like choked up, you know. So I'll say that trauma doesn't have to be something that is there, stuck with you forever, saying that we're traumatized or being quote unquote triggered by things emotionally. I think oftentimes people feel as signs that they haven't healed. It's like people who are maybe struggling with addiction if they have a craving. That means they didn't heal. And I don't think about it that way at all. I think about when our nervous systems and our emotional systems get really activated.

It's really potent times for us to learn, but also to be really gentle with ourselves and really not invalidate our personal experiences. It's more or less traumatic than other people's, but sit with what they're doing to us, how they're inside of us, how they need to be worked out in some way or understood. I completely agree. And I think that's a really beautiful and important note to end on. Do you want to talk a little bit about the stuff you have going on?

You've mentioned courses and your book and all of these things. Yeah, I appreciate that, Liz. I mean, everything folks can find on drew rams, MD.com, I'm excited to have a new course healing the modern brain, which is really my biggest effort to date in terms of resources. and new science on mental fitness and just the many activities I want people to be engaging in on a daily basis. The new book, Eat to Beat Depression and anxiety

and folks are interested in nutritional psychiatry. I really try and bring together all the science along with some great recipes and a six-week plan in the book. And then we have our Friday Fields newsletter, which is, you know, if you're interested in mental health and working with your health, check it out. And then I guess we mentioned the clinic.

We just have great clinicians. So if anybody is looking to do some deep work, we've got a great team. and we'd be happy to think about that. And Liz, thank you. I just want to say it's really fun to get to talk with you, and it sounds like we're going to get to hang out here in Wyoming. So I'm going to get to thinking about what super cool wellness activities,

the hot springs. Hot springs for sure. The hot springs are the way to my heart, always. Okay. The elk curd. It's going to be. We're going to find a moose for you. It's going to be epic.

It's going to be epic. Some buffalo. It's going to be good. Thank you so much for planning my itinerary. and also for coming on the podcast to share all of your wisdom with us today. I really appreciate it. Thank you so much for the opportunity, Liz. And everybody, thanks for listening. It's really a treat to be with you all for a while. I hope you loved this episode with Drew. If you're new here, make sure that you're subscribed so you don't miss out on any future episodes. We have amazing ones coming up, including a top psychologist talking about how to be happier at work and the world's leading imposter syndrome researchers sharing pragmatic tips for beating imposter syndrome in your own life.

We also have a super fun giveaway for this episode. Drew has so generously agreed to give one lucky listener a free 30-minute virtual consult to talk about anything that you want. This is a big deal. He's literally not accepting new patients at any price right now. So to be able to get in with him at all, much less a free visit is amazing. We will also be giving away a few copies of his brilliant book, Eat to Beat, Depression and Anxiety, which is available wherever books are sold, just so as many people can. can win as possible. To enter, just follow both of us on Instagram. I am at Liz Moody and he is at

Drew Ramsey, MD, and then comment one thing that you loved or learned in this episode on my most recent Instagram post. The post can be about anything. I can tell that you're entering from what the comment says. You can also get a bonus entry by sharing anything that you want about this episode on your stories and tagging both of us. It can be literally anything. It can be a recipe that you're trying, a tip that you learned, just that you love the episode, just make sure that you tag both of us so that I can see it so that I can know that it counts as your bonus entry. I will DM winners in a few weeks. Good luck.

Okay, I love you. I hope that you're taking gentle care of yourself. And I will see you on the next episode of the Healthier Together podcast.