The One You Feed - How to Eat for Better Mental Health with Dr. Drew Ramsey

Episode Date: January 18, 2023

In this Episode, We Discuss How to Eat for Better Mental Health and… The emerging field of nutritional psychiatry and why it's so important Simple strategies to enhance mental health and prevent mental health problems How exercising and eating well are the most powerful antidepressants Why healthier brains lead to less conflict, more love, and more laughter Why we tend to overcomplicate nutrition when it is actually quite simple To learn more about Drew Ramsey and his work, click here!See omnystudio.com/listener for privacy information.

What should all of us be eating to have super healthy brains? Because with healthier, happier brains, there's like less conflict, more love, there's better art, there's more laughter, all the stuff I like. Welcome to The One You Feed. Throughout time, great thinkers have recognized the importance of the thoughts we have.

Quotes like garbage in, garbage out, or you are what you think, ring true. And yet, for many of us, our thoughts don't strengthen or empower us. We tend toward negativity, self-pity, jealousy, or fear. We see what we don't have instead of what we do. We think things that hold us back and dampen our spirit. But it's not just about thinking. Our actions matter. Instead of what we do, we think things that hold us back and dampen our spirit. But it's not just about thinking. Our actions matter.

It takes conscious, consistent, and creative effort to make a life worth living. This podcast is about how other people keep themselves moving in the right direction. How they feed their good wolf. I'm Jason Alexander and I'm Peter Tilden and together our mission on the really no really podcast is to get the true answers to life's baffling questions like why the bathroom door doesn't go all the way to the floor, what's in the museum of failure, and does your dog truly love you? We have the answer. Go to reallynoreally.com and register to win $500, a guest spot on our podcast,

or a limited edition signed Jason bobblehead. The Really No Really podcast. Follow us on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Thanks for joining us. Our guest on this episode is Dr. Drew Ramsey, or wherever you get your podcasts. professor of psychiatry at Columbia University College of Physicians and Surgeons. Today, Ginny and Eric and Drew discuss his book, Eat to Beat Depression and Anxiety, Nourish Your Way to Better Mental Health in Six Weeks. Hello, Drew. Welcome to the show. Hi there, Ginny and Eric. How are you both doing? It's great to be with you. It's great to be with you. We are really

happy to have you on. We have both admired your work for a while, and we're going to get into all of that in a moment. But we're going to start like we always do with the parable, and I'm going to let Ginny take the parable. All right. Let me give it a go. So there was a grandparent talking with their grandchild, and they said, in life, there are two wolves inside of us that are always at battle.

One is a good wolf, which represents things like kindness and bravery and love. And one is a bad wolf, which represents things like greed and hatred and fear. And the grandchild stops and thinks about it for a second and looks up at their grandparent and said, well, which one wins? And the grandparent said, the one you feed. So I'd love to know what that parable means to you in your life and in the work that you do. Well, thank you for that, Janie. I think that parable in a lot of ways is at the root of my work and what I do, which is helping human beings ascend and transform from where they often meet me, which is often a state of mental crisis or struggling, whether that's something

psychiatric or depression or anxiety or something that's something psychiatric, a depression or anxiety, or something that looks psychiatric, but is often bigger than that. A notion of not feeling in touch with the self, not feeling in touch with that kind of higher echelon of our human power to be creative, to be loving, to be kind. And all of us are battling with those two wolves, right? All of us feel how wonderful it is when people are kind to us and we're kind and loving and, you know, and the good wolf, as they say in this parable. And then all of us also know the ferocious snarl of our aggression, our irritability and our fragility and how defensive we can all become. fragility and how defensive we can all become. So the witch you feed really is around, in some ways, to be the basics of mental health work, which is thinking and being mindful about where we put our time, energy, and emotions, right? If we are consumed with jealous thoughts, not that we just

want to throw them away or aggressive thoughts, that we honor them as having deep meaning, but that is not the end for us, right? That we are going to continue to work that. Everybody listening right now, can you think about someone that you have a lot of aggression towards? Like whoever comes to your mind, right? For whatever reason, you should dislike them. And how can you in any way imagine connecting with them around kindness, right? It's kind of hard sometimes. It's like, you know, it's easy to have gratitude for all of our blessings, which we should take a daily accounting of that. You know, many of us have so many blessings that we don't sit with. You know, having gratitude for the hard

stuff is much more challenging. So that's some of, I guess, what comes up for me in terms of this idea of what you feed. I think it also really applies to nutrition in a very concrete way. You make choices. And I think what the grandmother, what the elder, what the ancient tradition tells us is that if you are feeling powerless, you're probably right. You're acting and behaving in a stance that is powerless because you are not choosing the beast that you're going to feed. And it's a very hard thing for all of us, especially when we're feeling depressed or anxious or powerless, to really be very clear that actually there are choices in our lives, from our food to our partners to our sleep,

you know, to our bedtime, actually make a big difference for us, whether we can be kind or loving or not. Okay, so before diving into the heart of nutritional psychiatry and the epidemic we're in with mental health, I did just want to touch briefly on something you just said. And that was having an element of mindfulness where our attention and our energy and our focus and our efforts and our choice where we are with that. In fact, I was looking at, I think it was a recent blog post you did around seven factors that can really make a difference when it comes to mood and depression. And one of those you list is mindfulness. I'm a certified mindfulness teacher, and that's a realm of life that has been meaningful to me in my own practice and also in the work that I put out in the world.

I'd love if you'd just spend a minute maybe talking a bit about the role of mindfulness in that context. Well, thank you for that, Jenny. And hey, everybody who's listening. Sorry for that super long first answer I gave. Mindfulness is a process that all of us can work on. It's like a muscle. It's an aspect of your brain. And like any of your mental health or cognitive functions, you know, one of the things that

we always have to take a step back and realize, remind ourselves of is our capacity to work that. You know, just like if everybody in this room right here, this Zoom room, wanted to learn another language next year, we all could. We'd actually be fluent. Ginny and Eric, they could start running their entire business in another language if they really needed to

because of the power of their human brain. So mindfulness is us utilizing the power to harness and focus our mind and all of our attention onto singular things. We have to do that to get things done, right? I can't do a math equation and think about what I should get my kids for Christmas and focus on my patient and write the prescriptions and do my list and feed myself, right? You got to do one at a time. And so we think about exercises to help the mind focus. Oftentimes people talk about meditation, which is about clearing the mind, right? Wanting to like really know that the mind is in a continuous flow and to try and

stop that, kind of slow it down or calm it. I like active meditations or mindfulness work where we're drawing our focus on something. It's where I think people are often drawn, for example, if you play a musical instrument, right? where you get pulled in and you're playing and you get that feeling, right, where you're somewhere at your fingertips and we're on your vocal cords and out in space, it's a wonderful spot, right? But you're very mindful or oftentimes when people exercise or like when hunters go out and hunt, right? And you're sitting there in this really quiet Zen spot, right? There's a notion of mindfulness or i'm just looking over here at this cucumber and one way to do mindfulness is like i could just eat this right

now for lunch pop it in right or i can really sit with it right i can use all my senses i can feel how cool it is now i can see all the segmentations of the seeds i can really be with this cucumber i you know actually we want to get on my reading glasses here because, yeah, it's sort of incredible, right? Everything that's right here. And to spend really some moments thinking about all the different textures here. So to do that kind of exercise, right, is then to settle things down, especially if you've got a lot going on.

And to use an exercise like this cucumber is more than just some hydration and a little nutrition, but it's something that can draw and focus my attention. It's one of the reasons I love being a therapist these days. I've got so much going on, but actually it's one of the last places where like, no, nobody's going to check their phone. Everyone's messages are off. There's no interruption. There's nothing else, no emails.

It's funny when you see, at first you think, oh, this digital stuff's great. Like you'll see somebody and do a little note or write it. It's like, no, we all know the second, the second. The full attention isn't on the person, right? And so it's wonderful in that way because it's kind of an act of mindfulness, of just constant attention. Yeah. Yeah.

You're so right. I mean, and I think that that ability to really pay close attention is the beginning of when we can really cultivate appreciation and intention for the choices we make and what's there. So back to the realm of when we can really cultivate appreciation and intention for the choices we make and what's there. So back to the realm of nutritional psychiatry, you talk about us being in a mental health epidemic, right? A mental health crisis and rates of anxiety and depression really being steeply on the rise. Why do you think that is? What is going on that's put us in this place? Well, one is that we're more aware about mental health, so we're talking about it more.

And a lot of this comes from this new book, Eat to Beat Depression and Anxiety, where I was able to really look at some of the modern statistics of what's going on in the past 10 or 20 years. Part of it is people are getting more help right now. women. In the last, there was a survey from 2002 to, I think, 2019 of what percentage of people were engaging in mental health care services. And I think it's about 16% of women now and 11% of men every year. So there's this big increase in interest in treatment in people wanting to address mental health. The other things that are going on prior to the COVID epidemic being on the edge of some sort of calamity world war wise, lots of political discord and lots and lots of hatred in all of our feeds and all of our news broadcasts. Before all of that, we had a mental health crisis. The way that usually gets defined is we were losing, let's say, between like 50 to 75,000 people to suicide a year.

The statistic is somewhere in the middle of that, but I just think a lot of people die by suicide that doesn't get reported that way. We lost over 100,000 people to death by overdose. The majority of those are fentanyl. idea that what used to be like going out, having a little party, blowing a line right now is actually a group of, you know, folks who aren't significant substance users, but just have a little party and then are all dead from fentanyl to the point now, when I talk to people who have some substance use in their lives, you know, you got to be really clear, like you got to have a fentanyl test kit that you cannot go out and think about anything because you will die. It's really scary.

So that's driving the epidemic. There has been a real ongoing crisis in our mental health care system. Clinicians like me, we are getting worked hard. And there aren't enough of us. And even if you've got a great, I have a wonderful private practice. I've got amazing clinicians to work with who support me. I mean, I'm really blessed. It's still a really hard job.

I'm sitting here with you all. I started my day at about 4.30 a.m. So my first patient starting at 5 a.m. And I've been going since. And I love my work and I love seeing patients. But we're not talking about easy stuff. And so we have to increase capacity. We have to increase access.

Some of us try and do this. I have my e-courses, you know, which is a way to try and access some of the knowledge we've gained about food and mental health. There's a lot of ways to get support in mental health. One of my patients, we're trying to figure out kind of diagnostic clarity and said, you know, it really helped me because then I would know what support community is going to be most helpful to me. But in terms of, you know of the epidemic that you're talking about, part of it is as our physical health declines, right? As we struggle with diabetes, we struggle with obesity, and we struggle with a lack

of emotional awareness and engagement, right? The structures that used to give that to us in a society, whether that was our schools or our churches or our elders, that is just rapidly shifted. So people don't really know where to get mental health. And one of the big concerns we've had and sort of the work we've done most recently is how do we help you build mental health? Like not being this thing like, I'm going to sit here and wait, like maybe I'll get depressed and suicidal in my 50s. That's what happens to most doctors like me, to be honest, right? The number one profession at risk for suiciders, physicians. Physicians and farmers, it kind of goes back

and forth. But, you know, so you don't want to sit around and wait for that, right? I'm sitting looking at that statistically. What do I do in my 40s, right? How do I talk about that? How do you create a system where like, no, that is not going to happen to me? And so that's around what we call mental fitness and this idea that there are a lot of things driving the mental health epidemic. If you're somebody who's got a mental health problem, in some ways, none of that matters because you got it, right? It's about now getting better.

And if you don't have significant mental health symptoms right now, I think it should be on your radar. Everybody's worried about like heart disease and cancer. Like, I don't mean to be like a jerk here, but like, okay, statistically, everybody listening to this is going to die from vascular disease, heart disease, or cancer, statistically, or suicide. And so what mental health asks us to focus on is today. And that's where we're very different than other fields of medicine. You know, the idea that you're going to die in 70 years, 20 years, 30 years, right?

Like, I want to talk about that, but I want to think about today. I want to think about the relationships and the choices you make today and how that then can better insulate you and fuel your mental health and give you the tools that you need to really have a life you're feeling very wonderful about. Tell us a little bit about how you were led into nutritional psychiatry, maybe what nutritional psychiatry is, and what led you to really focus so much of your life's work in that particular area? Yeah, sure. So nutritional psychiatry is looking at mental health through the lens of food. There are not a lot of us on the clinical side. there are just a couple of us in the United States.

I've been really lucky to be early in the movement. I've defined nutritional psychiatry as the use of food. I guess nutrition, but I really, by that, I mean food. Like, what's at the end of your fork? To optimize brain health, right? What should all of us be eating to have super healthy brains? Because with healthier, happier brains, there's, like, less conflict, more love, there's better art, there's more laughter, all the stuff I like, like laughing, eating good stuff, hanging out, human smiling, you know, it's like good stuff

when you feel it, right? We all know that. And the use of nutrition to prevent and treat mental health disorders. And that shouldn't be a controversial statement in 2022. I think a lot of times my field has been in a defensive stance because no one gives us legitimacy, right? If you don't have a medicine to fix it in modern America, you're not legit, right? As a doc, if I don't have my silver bullet, like, of course you have depression, Eric, come on over here, young man, let me give you the bam. Don't you feel amazing now? That's why ketamine has gotten so popular, right? It's the only thing, it's the first thing ever where it's like, hey, I can make you feel better in an hour. Everything else in mental health is like, I can make you feel better in like seven years, seven years of psychotherapy probably. And probably, that doesn't sound nearly as fun.

So helping folks understand their choices that influence mental health risk. And then no matter where you are, what diagnosis you have, you have a brain, you have neurons, they need certain nutrients. And a lot of people aren't getting those nutrients. If you're eating lots of processed foods, if you have a non-joyful relationship with food, it is not nourishing, it's not pleasure, it's a chore, it's calories, it sucks, right? You have a huge opportunity, I would say, in terms of your mental health around nutritional psychiatry and how to think about like what that is and where's the kind, loving, caring person towards the self and what's going on. Is it

knowledge? Is it connection? Is it that you think brain food is gross? Eric, you asked where it came from for me. I grew up on a farm in really rural Indiana. I have kind of hippie foodie parents in a way. So we were always eating like organic stuff and growing our own food. Then when I was younger in college and medical school, I became a low fat vegetarian and it was really like wanting to eat to be a super healthy guy. I was a college athlete, but also, young, like excitable pre-med and wanting to really live by healthy values and a healthy lifestyle. So I tried that diet for a while. I found a lot of fatigue and probably some depression on that that I personally experienced. I started adding in meat and then seafood was a real challenge for

me. But I started really challenging myself to eat seafood when I was a resident in New York. I was there and I realized, you know, Manhattan's an island. There's a lot of great seafood there. And I really had a lot of friends and chef friends. Kind of helped me, like, take little bites. And I really learned a lot about seafood. But, you know, nutritional psychiatry, I think, has evolved rapidly over the past few years because of all the data. My first book, The Happiness Diet, came out in 2011. I think probably it's the first really clear, this is a nutritional psychiatry book.

Eat Complete, which is my third book, is a cookbook. I think it's the first nutritional psychiatry cookbook that really says, hey, this is for your brain health. And the field then rapidly evolved, right? 2017, the SMILES trial comes out. 67 people who have mental health disorders are treated. They're added on a Mediterranean diet. They get some counseling sessions about food, like what our health coach Emily Berner does in our clinic. It's like, hey, these are tips.

These are ways and recipes and meal plans, whatever you need, right, to kind of get you on a more traditional diet. They found 32.3% of patients went into full remission. Most recently, the AMEND trial is like young men in Australia with depression. There were 72 of them in that trial. They just give them two nutritional counseling sessions, a lot of encouragement. These effective trials, they give young folks like olive oil, like here's your jug of olive oil. Go forth, young man, eat vegetables. And 100% of these young men improve the Mediterranean dietary score. On average, eight points. It's a 14-point

scale, so a big jump. But 36% of them went into full remission of their depression. And I spoke with the researcher Jessica Bays. I've got a great interview up with her on our site. But it's her site. Like, Jessica, what did you do? Like, every parent, every mom wants to know. Like, we encouraged olive oil, dipping good bread in olive oil. We encouraged eating plants you like. What plants? I have a list. Here are your five favorite plants. Great. Eat more of those. And then beans and legumes. The young men hadn't really been talked to about beans and legumes. And the one that really resonated with me as a guy interested in male mental health is she said the young men felt seen. They said nobody really seemed to care about their depression. Nobody really seemed to be checking in with them.

And it really meant a lot that she was asking them and telling them about stuff they could do and identifying things and choices in their life were maybe contributing to the depression. So, but that's a long answer, Eric, about why nutritional psychiatry, it was more fun and also tastier. I found that like, you know, there's a way that when I talked about food with patients, it was like, clearly everybody likes food, right? You talked to me about pesto. It's clear I like it. You tell me a few of your favorite things. All of a sudden we're having a little different vibe. And I think along with all that serious stuff

that I always want to talk about with my patients and love talking about, I also want it to be there's some moments that we both really enjoy, where we can both be humans who love some aspect of food or are struggling with some aspect of food or damn it, want another piece of cake. And we can be talking about that humans who love some aspect of food or are struggling with some aspect of food or, damn it, want another piece of cake, you know?

And we can be talking about that and kind of working through that in some way. I could talk about olive oil all day long. I mean, I just have grown to love it and appreciate it. It's health benefits, but then also it makes things delicious. I think it's one of those foods that's so wonderful for us because of the accessibility and also the simplicity. Everybody listening, open up your cabinet. If you see, you know, canola oil and sunflower oil and corn oil and soybean oil, you know, I'd say like, you know, one easy nutritional psychiatry

move is you should get rid of all of those and get yourself a nice, fresh jug of olive oil, about, I don't know, a quarter or so, and get rid of it in the next week, you know, by pouring it on vegetables, by sauteing, you know, veggies in it, by oven roasting them, by cooking your eggs in it, right? That just use olive oil as a primary fat. Focus on that and getting more seafood in your diet. You really, in some ways, have fixed the major cultural shifts that have changed how we eat in terms of fatty acid consumption. I've started sending a couple of text messages after each podcast listener with positive reminders about what's discussed and invitations to apply the wisdom to your life. It's free and listeners have told me that these texts really help to pull them out of autopilot and reconnect them with what's important.

When you get a text from me during your day-to-day life, it's one more thing that helps you further bridge that gap between what you know and what you do. Positive messages when you need them, from me to you. So if you'd like to hear from me a few times a week via text, go to oneufeed.net slash text and sign up for free. I'm Jason Alexander. And I'm Peter Tilden. And together on the Really Know Really podcast, our mission is to get the true answers to life's baffling questions like why they refuse to make the bathroom door go all the way to the floor. We got the answer. Will space junk block your cell signal?

The astronaut who almost drowned during a spacewalk gives us the answer. We talk with the scientist who figured out if your dog truly loves you and the one bringing back the woolly mammoth. Plus, does Tom Cruise really do his own stunts? His stuntman reveals the answer and you never know who's going to drop by mr brian cranson is with us how are you hello my friend wayne knight about jurassic park wayne knight welcome to really no really sir bless you all hello newman and you never know when howie mandel might just stop by to talk about judging

really that's the opening really no really yeah no really go to talk about judging. Really? That's the opening? Really? No, really. Yeah, really. No, really. Go to reallynoreally.com. And register to win $500, a guest spot on our podcast, or a limited edition signed Jason bobblehead. It's called Really? No, Really? And you can find it on the iHeartRadio app, on Apple Podcasts, or wherever you get your podcasts. One of the things you say, I love this line, is that your brain health starts at the end of your fork, which is such a great short phrase that makes a really big point that that choice, you know, is really the beginning of supporting your brain health. I wonder if in your field you run into very often, whether it's from peers or, you know, the public at large, but just the challenges around studying the health benefits

of foods in a longitudinal, well-controlled way. You know, you talk about nutritional psychiatry as an evidence-based approach. I wonder though, with those challenges, I think of really making the trials well-controlled enough based on all the many variables at play in people's lives and trying to isolate for a specific food as having a role that has impact in reducing risk of disease, you know, et cetera. How do you attribute in the research, like how do you address that concern or how do you attribute the consumption or avoidance of specific foods to specific mental health outcomes? Do you see that as evidence that's pretty clear or evidence that could be stronger? I think evidence can always be stronger because it's science. So I think we should definitely

go down the side of more science. I think anybody who's listening who has lots of money, you should donate that to nutritional psychiatry research and mental health research, right? Because when I have evidence and I can look a patient in the eye and say, hey, X percentage of patients get better, right? Whether it's a medicine or psychotherapy, or I can say, hey, 152 people were in this trial with severe depression. And three months later, the majority of them were feeling much better when they adopted a Mediterranean-style diet, right? That's really helpful. You're alluding to the fact that research is hard to do in mental health, right? We have

formal rating scales, which if you've ever filled one out, you know, you're going, wow, today I'm feeling all right. Thank goodness we're doing the rating scales. We did it yesterday. Oof. Food frequency questionnaires usually don't work. Or if they ask you, hey, what did you eat last week? It's not super accurate. These studies tend to use widgets, what they call them in Australia, or apps by which you're going to get a prompt and you're going to record a lot of what you eat.

And, you know, now we can do more of that or take pictures of what you're eating. You also can't double blind food, right? If I'm going to do an experiment with Eric and Jenny, I'm going to give them the same pill. And one of them's getting some wild antidepressant that we're trialing. And the other one's getting a sugar pill. If we give it to a hundred people, we've got a sense, right, of some randomized controlled trial. With food, you know that I'm feeding you salmon and Brussels sprouts. And also, as I often mention in my talks, you know, it's not just the nutrients and the brain foods. I really want you eating it in a joyful context. You know, I want you to look around the table. I want you to take a deep breath. I want you to chew your food. Ideally, I'd like you to think about a time regularly where you can cook for

others. I think you should go to your farmer's market. And I think there are a lot of ways you can kind of flex and build mental health using nutrition as a kind of vehicle for that. There are other patterns like keto. Is keto good for mental health? So you can like, sure, there's like a year-long trial of keto. And it's like, you know, it's definitely like, does it matter to go gluten-free? Well, yeah, if you have gluten sensitivity, right, if you have irritable bowel syndrome and you simplify your diet, yeah, it's going to be great for your mental health. There's huge reduction in anxiety among patients with bowel issues when they get that kind of sorted out with diet. It goes from about 70% of the population back down to normal, about like 15% to 20% of the population. And then we also say, you know, there's also this, the farm boy in me where I'm like, folks, we do not need any more studies or science about

how to treat depression. The first steps should be super obvious and clear to all of us. Everyone listening knows what they are. Everyone listening knows the things you're doing in your life. We are not taking care of your mental health. We all do it. Yes, there are lots of mysteries to the human brain. Yes, we want better treatments. But it's not like when I meet patients, I'm like, wow, what a mystery of how to help you get better. You know, sometimes it takes a little while.

I'm like, ticks as a therapist. You sit and you listen to people who tell you all the ways that they know that. And then they say, you know, I don't know. I was like, with all my patients, I'm like, okay, just like, we got to rewind. You just told me all the things, you know, you know, a lot, like maybe you don't know exactly what to do with it next, but actually it does sound like you do, you know? And so I would just say that the point being, yes, mental health is complex, but when it comes to the research about mental health, right? What is the most powerful antidepressant out there that everybody can do?

Movement and exercise, right? It doesn't mean everyone's doing it, you know? Like, can a third of people with chronic depression probably improve with a more traditional style diet? If you're eating lots of garbage, probably, right? But, you know, what we really hoped in our clinic is to start providing people, you know, tools and encouragement and community around, hey, not a silver bullet, but it's definitely going to help a lot of folks. Let's start getting food right. Let's start getting movement right. Let's start building mental fitness and talking about it in our everyday lives. The silver bullet aspect, right? Because a lot of times when nutrition and holistic therapies are served up, they're served up as just eat kale and all your problems will go away, right? And

I love that your work is not oriented in that way. And that it says, look, nutrition is an important part of overall mental health. It's not the whole game. And I'm kind of curious, how do you think about when you're working with a patient, what levers to pull, you know, knowing that we have a variety of levers, right? We have talk therapy, we have medication, we have nutrition, we have movement. I'm going to add a part B to that question, which is with something like depression, one of the hardest things is that the very things that are best for depression often take a lot of energy, and energy is what we often don't have when we're depressed. So how do you also work through that conundrum with your patients?

I'll start with me personally. The hardest thing for me when I'm struggling with depression is that the motivation to do things doesn't seem so clear because nothing really feels very good. So I don't really get up to it. I don't want to go get a latte or go talk to a friend because I'm not enjoying it. I'm not enjoying what I'm like. The future is not seeming like good and bright. And especially for folks in middle age, I think what particularly sucks about depression is you're looking and you're kind of feeling like, damn, all this effort. And is that how I feel? He's just well said. Are you kidding me? He's just well said. Yeah, it's like, I mean, especially parents in COVID, when you're doing the whole like managing above and managing below,

where, you know, you're dishing up dinners for kids, for aging parents. I mean, it's a tough thing and it's hard to feel good often. And so I think you're really right. I would say that the ways, Eric, that have always worked for me personally, and I find work for my patients is one, when there's partnership with people. When you're alone struggling with any of this stuff, boy, it sucks worse. When you're with somebody, a friend who isn't going to patronize you, isn't going to judge you, but is going to knock on the door and be like, let's go, let's go. You're depressed. Let's go. Come on, let's go for

a walk. Sunny outside. Let's go. Maybe doesn't even talk, but just someone like that or, I don't know, when I'm not doing well, talk to a few friends who also are colleagues. And they're just good about those, texting, how's it going? What are you doing? You started that thing yet? You're still moaning. Or whatever, right? So, you want to share things with people. You want to use groups to motivate you, right? When you've got somebody who's depending on you, you're just that much more likely to go. Also, that's then somebody you can help. Maybe you go knock on their door tomorrow. All of a sudden you're giving. That always feels good. That's always good for depression. Cause when you're going after yourself and being all nasty as people tend to do in depression, you can kind of fight back and be

like, no, you went and knocked on someone's door. Like, you asked them a question. You did something. I think the other part, Eric, is people make it too complicated. Like, when I say brain food, people are like, oh, like 19 superfoods, sauteed, not steamed, right? Don't steam it or microwave it or boil it. Only at 118 degrees, right? You've got to put the black pepper on there to, like, get the this or that out of it and make sure, right? It's like, ah, right. And then all of the misinformation, right.

The misinformation about oxalates is getting spread out there. That's just disgusting, right? This idea that like eating kale is going to cause all kinds of like pains. And I mean, it's just like kale is actually the definition of a low oxalate green just to tell people how bad the misinformation is. Lectins, total garbage misinformation campaign, total bullshit, like literally horseshit. Sorry to be so blunt. And you see people like, oh, wait, maybe it's the lentils that's causing it.

It's like, no, no, it's not. It's the processed foods. It's the sugar. It's the lack of sleep. It's the not moving or loving enough. That's the problem. It's not that you're eating freaking black beans occasionally. I just think it's, so I would say, you know, part of it's where people have gotten pulled into indoctrinated into this cult of misinformation about nutrition, wellness, and food. And they

think it's some mysterious thing that someone else has figured out. And it's not. Everything you need is right in your local grocery store. Everything you need is at the end of your fork in terms of food. You can be a very, very powerful eater going to Walmart. I know I have. I grew up in really, really rural Indiana. Walmart's the closest grocery store to me. Or the IGA. There's not a big organic food section, but there's everything you need. There's wild salmon. There's anchovies. There's, yeah, I'm getting hungry. There's gnocchi. There's broccoli.

There's all the good stuff. So there's kale. Yeah, I recently learned to love canned sardines. Oh, how'd you do that? I went to Portugal. You went to Portugal. Yeah. Now, I haven't been to Portugal yet, so I'm looking forward to that.

Share with everybody how you like sardines because this is a great example. Also, Eric, you're noticing it's complicated. It's like, no, it's not. It's about everybody listening. Just like, let's be straight up honest. Do you have a good sardine game? Do you have a good tinned fish game? Sardine game. Well, my sardine game is strong. Let's hear it. Let's hear it, Jenny. Help us poor sardine deficient people. Yes. Well, I tell you what, and you can probably fill in some of the blanks here, but I just

over and over kept reading about how good they are for your brain. Like there are these tiny little fish that pack this huge beneficial punch. They are a great source of protein and, you know, omega threes. And so I finally was like, you know what? I was going to a retreat where I knew they were going to serve just plant-based meals. And I thought, this is like a plant-based retreat hack, right? Like bring like the tinned fish with you. Yes. And I was like, I'm going to bring some protein. So I brought the sardines and I mean, I, I was like, I opened them like, I'm going to hate this. I'm going to hate these, you know,

these are tiny little fishy and they're going to be fishy. Anyway, so I tasted one. And to me, I was like, you know what? This tastes a lot like canned tuna. Like if you like canned tuna, sardines are not an offensively fishy food. You can get them like filleted and with no skin on them. So then it's just the easiest thing to eat and could not be better for you. Yeah. The reason they're tapenade, you're getting a complete protein. They are the original best source of long-chain omega-3 fats. I mean, they eat this algae and bioconcentrate it for us, but the smaller, tinier fish, not going to have to worry about mercury and as much kind of of the stuff that tends to concern people at fish, right? Pollutants and mercury, small fish,

don't have to worry about that. Lots and lots of omega-3 fats, B12. Actually, those small fish, especially for women who are listening, are amazing because they're one of the top calcium foods because you eat these little small bones. Yeah, yeah. And they're inexpensive. You don't have to worry about them spoiling. Ginny's maybe got a little better palate than, I don't eat a ton of tuna or a ton of sardines out of the can.

I got to cook them up a little bit. And with sardines, I make this gnocchi alla Glenda, which I named after the Aspen Brain Institute founder, Glenda Greenwald. I was about to make her anchovies, and she's like, I don't like anchovies. I was like, I like sardines. I was like, quick run to the pantry. I was in the middle of the pandemic. I was like stocked up.

I was like, I have no idea what I'm going to do with all this stuff, but I eventually figured it out. But if you just like garlic, olive oil, like some oregano, fresh oregano, ideally like a little tomato paste, some pine nuts, and just put in some sardine, kind of mash them in there at a low heat, a little tomato paste, drop that over some gnocchi or something. It's really, really umami, not fishy at all. But yeah, a good sardine game and just tin fish game, I think it's just one of those ways, again, people look to fish oils. They look to that silver bullet, right? And that's not what this is about. It's about eating a dietary pattern and living a lifestyle that supports your mental health.

It means refusing to live under the tyranny of too busy. It means refusing to live under the tyranny that food is going to be super efficient, super cheap, and last forever. Those are false ideals that are going to destroy your mental health. And as about the mental health epidemic, I think in part it's just that we right now do not have a culture that values mental health, right? We're starting to get concerned about it, but it's not like we engage with one another as like, you know, the most powerful thing we can do as a country is support one another's mental health. The most powerful thing I can do after voting, right, is to go and be kind to the person at the left of me and to the right of me in most situations and to support them. Along with

awareness and the need for more treatment, I just think there's also that part that we all have to do that like, okay, do we have a mentally healthy society right now? Well, how are we all contributing to that? It's all of our faults. I would be remiss if I did not bring up our editor, Chris's sardine game. Does he have a sardine game too? He does. He cracks them right open in the can, dumps some mustard in, and just eats them out with a fork. So Chris is an A player when it comes to sardines. So I think, Drew, your approach sounds much better to me. Yeah, I got goals. I hope someday I'll be one of those guys, like, when I'm old and you find me on the mountaintop out here in Jackson, I'll be like, oh, I see

Doc Ramsey over there. I'll be like, hello, everyone. It's like, hmm. But I'm not there yet. I need, like, to cook them. I'm on the mountaintop. I just can't eat sardines yet. Although, you know, the ones I've been eating, the Patagonia, and I don't have any affiliation other than I'm not there yet. I need to cook them. I'm on the mountaintop. I just can't eat sardines yet. Although, you know, the one time I've been eating the Patagonia, and I don't have any affiliation other than I'm a big fan, and Yvonne lives in Jackson. And he's generous. His family and he have been, I think, just a shout out. But the Patagonia Provisions has some amazing, amazing preserved fish and tins of fish. amazing preserved fish and tins of fish. My wife hiked the Grand Teton and climbed it with some friends with the Exum guides. And they brought along this, you know, just amazing wild salmon up there. And so one of the things that's wonderful for eaters today, and I hope everybody

feels a little encouraged, is the access that you have. I mean, and I say this as someone who grew up in a food desert. I'm not from a place where there's fancy grocery stores. There is so much choice. And even now, I mean, food is so expensive right now. The inflation is ridiculous. But even within the food inflation, there's still so many great deals and great choices that everyone has available to them. And if you're struggling with that or you think that's total, you know, baloney of a statement, we've got to resource brain food on a budget, at least to help support that idea and kind of give folks at least some ideas around how a reasonable budget can really put together a great brain food kitchen. I'm Jason Alexander.

And I'm Peter Tilden. And together on the Really Know Really podcast, our mission is to get the true answers to life's baffling questions like why they refuse to make the bathroom door go all the way to the floor. We got the answer. Will space junk block your cell signal? The astronaut who almost drowned during a spacewalk gives us the answer. We talk with the scientist who figured out if your dog truly loves you

and the one bringing back the woolly mammoth. Plus, does Tom Cruise really do his own stunts? His stuntman reveals the answer. And you never know who's going to drop by. Mr. Bryan Cranston is with us today. How are you, too? Hello, my friend. Wayne Knight about Jurassic Park.

Wayne Knight, welcome to Really, No Really, sir. Bless you all. Hello, Newman. And you never know when Howie Mandel might just stop by to talk about judging. Really? That's the opening? Really, No Really. Yeah, sir. Bless you all. Hello, Newman. And you never know when Howie Mandel might just stop by to talk about judging. Really? That's the opening? Really, no really. Yeah, really.

No really. Go to reallynoreally.com. And register to win $500, a guest spot on our podcast, or a limited edition signed Jason Bobblehead. It's called Really, No Really, and you can find it on the iHeartRadio app, on Apple Podcasts, or wherever you get your podcasts. iHeartRadio app on Apple Podcasts or wherever you get your podcasts. You used a phrase just a minute ago that I thought we could go into, and it was nutritional patterns. Can you talk a little bit about what a nutritional pattern is and how that can make

this type of eating easier for us? Yeah, a nutritional pattern, we call it a dietary pattern. So when people say the Mediterranean diet, you know, if you're where I'm from, rural America, Midwest, that means like Italian food, that means Pizza Hut, right? Pizza and pasta. And then, you know, Greek food, that means like a hero. So Mediterranean diet is a dietary pattern. It's dietary pattern, instead of processed grains, they have whole grains, right? They have more seafood and fermented foods. They have more plants. They have more small fish. So if you think about the month, your dietary pattern, I usually do it in week chunks. And in each beat depression and anxiety, there's a six-week plan in the back that each week we go through a food category to really increase what's called the nutrient density of your dietary pattern. It means when you're eating according to brain food rules or Dr. Drew Ramsey's ideas about food, you're seeking out foods that has more nutrients per calorie. So it's where when you're drinking a soda, you're getting 140 calories and you're not really getting any nutrients. You're getting a little phosphorus. When you're eating a small kale salad or, you know, believing the misinformation about kale, so you're on whatever, your bok choy or arugula salad, right?

About 30 calories per cup. Let's give you three cups and a little olive oil, like drizzle it over there, some lemon juice and a little salt. So about 140 calories right there. Just think about all the nutrition I just gave you, right? You're getting like more than a thousand percent of your daily need of vitamin K, a fat soluble nutrient that probably takes care of the brain in ways we're just starting to understand. You're getting like 800% of your daily vitamin A. You're getting probably two or 300%

of your daily need of vitamin C. You're getting fiber. You're getting folate. You're getting phytonutrients. You're getting magnesium. You're getting all this stuff for the same amount of calories as the Coke, right? So that's nutrient density. So we're looking for a dietary pattern and we construct that out of these very nutrient-dense food categories. Leafy greens, rainbow vegetables, the small fish we were just talking about, nuts, beans, and seeds, right? Like almonds, incredible snack, walnuts. We look to things like fermented foods, right? Where it's not going to be nutrient dense, it's going to be dense with live bacteria. And so we're going to, over time, foster a very, what's called diverse microbiome, right? All these organisms that live in our gut, but we're going to have like a whole bunch of different species. There's a lot of correlations

between our microbiome diversity and health and the risk of depression, for example. So that's, I hope, explains a dietary pattern. We haven't mentioned eggs, meat, dairy. These all can be part of your dietary pattern. I think some people would argue should be part of your dietary pattern. A lot of times those foods get vilified. But if you're struggling, let's say you're looking to feed a family of four and you have five bucks for your protein,

a pound of ground beef is pretty incredible because kids love it. You can do a million different things with it and it costs a few dollars. You know, I appreciate all the concerns about conventional meat. I also really think there's a food justice argument that we, you know, oftentimes are talking to folks who, and engaging with people who are struggling with their food security. I've worked at the food bank here and, you know, one of the major populations that head to food banks are teachers because we don't pay them enough. You know, so I just think we want to consider how to improve dietary pattern and how to improve nutrient density. I think, you know, one aspect of that is, you know, as I said, kind of keeping it simple and focusing on the foods that really

make a big impact. Yeah. I'm not really sure why this particular thing kind of made it click for me in my brain in terms of the actual importance of it. But I can remember hearing that or learning that selenium, I'm going to towards your antidepressant food scale, right? So selenium being a, I'm not sure if precursor is the right word, but like at least a building block for serotonin in our bodies and brains. And so our diet's maybe not naturally rich in selenium. I mean, at least, especially if it's a processed food diet, but you can have what, two Brazil nuts and get all the selenium

you need for the day. So I thought to myself, like, well, how am I expecting my body to make enough serotonin for me if I'm not giving it the materials it needs in order to make that serotonin. So like, of course, I need to be supporting my brain health with what's at the end of my fork. You know, it's impossible to ask your body to do something it doesn't have the material to do, you know. So I wonder if you could talk a little bit about that, that antidepressant food scale as selenium is on that list, you know, of things that we need to think about for patients specifically, even with depression. Yeah. So when people are struggling with depression, just their mental health in general, you know, we got into this space early, let's say like 2008 and begin thinking, okay,

everyone just says blueberry, right? Like wild salmon, like what are brain foods and why we all know omega-3s are important for mental health and so is B12. But like what are the foods that are actual brain foods and why? And so we asked the scientific literature. And we was, myself and Dr. Laura Lachance and then Samantha El-Krif also helped out in our office in the brain food clinic. And this is an open source paper called Antidepressant Foods. But the antidepressant food scale was the sort of centerpiece of the paper. And we just said, hey, what nutrients have evidence that they can prevent and treat

clinical depression? So magnesium, for example, if you look at a population that doesn't have much magnesium intake, or you look at people who are magnesium deficient, they get depressed more. And when you look at people who take magnesium and they have an antidepressant, more people get better from depression. So magnesium is on the list. So there are 12 nutrients, things like selenium, omega-3 fats, B12, iron, zinc, and vitamin A. And we just asked, you know, what foods have the most of these per calorie? And we listed both plants and animals as a way of creating a sense of what are the food categories we should focus on. And you realize it's really, you know, what oftentimes people are missing. Most Americans are struggling. 95% of Americans don't eat enough plants every day, fruits and vegetables, right? The average intake of seafood in America is like less than 12 pounds a year,

you know, compared to like 120 to 30 pounds of sugar per year. So there's a lot of room for everybody to really, you know, do a little bit to get more of these foods, more of these nutrients. So the big food categories that was on the antidepressant food scale were leafy greens, herbs, more fresh herbs, more leafy greens, more rainbow vegetables, more cruciferous vegetables. And on the animal side of things were bivalves, mussels, clams, and oysters. If you like mussels, like when was the last time you made them at home? never had super romantic and easy and delicious so romantic babe let me tell you i maybe this is admitting my ignorance but i have not heard

the word bivalve until you and so i i don't know i don't know thank you for that because now i have been intentional about including bivalves you're an intentional bivalve i love that i don't need a lot of bivalves too there's so many it interesting. Like, to me, one of the fun things about seafood is all the exploration of all of the foods, all of the different cultures and how they engage with seafood. I also think, you know, there's a lot of concern about our seas and about the overfishing. Yeah, sure. I find being a seafood eater now, I like that I'm involved in that, not just in the consumption, but in putting my food dollars

towards maybe some systems that are trying to do it better and preserve it. And so it's where, you know, mostly buying wild seafood. If I'm going to buy a farm seafood, really focusing on being really specific. There are only a few kind of situations where that makes sense. Like mussels, for example, makes a lot of sense because they're almost all farmed, but you know, there's ropes that they drop into these bays. So that's kind of, I don't know, pretty minimal. As opposed to, you know, a fish that instead of letting eat seaweed, you're feeding corn to, which is, I don't know, kind of the root of the problem anyway. Yeah.

No, I love mussels and clams. And because of you, I also ventured out while in Portugal on this trip to try oysters. I thought it was going to be unpleasant. Let me tell you. Tell us about it, Jenny. What happened? They were delicious. They were delicious.

And then especially the smaller they are, for me anyway, they just tasted like the ocean in your mouth. I'm the same way. And the small ones is a secret for me. Sometimes in Indiana, like when I went and became a New Yorker and then came back to Indiana, I ordered oysters and I came out with like those Midwest, like it was, you know, it was like a giant, like a ham. I was like, geez, what is it? I was like, you know, and some people like them big like that. No offense if you do,

right. But I like those little small ones where you just can slam them back and they do taste like the sea. And, you know, also lots of people have taught me that I'm not quite there yet, but all kinds of like canned and tinned oysters, right, where you can cook them up, put them on tacos. I mean, there's all kinds of interesting ways. Traditional American food, too, if you look back at traditional American cookbooks, there are these recipes for like 100 oyster stews. And it's really, you know, one of the reasons our country was famous initially was just the plethora of seafood and bivalves that were on our shores and something for us to aspire to return to. My bivalve game is weak. No, well, we should say it's non-existent, but I'm going to work on it. I'd say it's evolving. I think we should say your bivalve

games. You've got, I mean, you're married to a, you know, it looks like a beautiful bivalve enthusiast. It's really the first thing most men need to improve their bivalve game, I would say. So I have high hopes for you, sir. I have high hopes for this treatment, I just want to say. I think so. Yeah. Let's just have a growth mindset around this. That's right. Yeah. Yeah. Yeah. Pasta vongole. That's all I'm going to say. All right. A lot of garlic, a lot of parsley and fish taco. That's not a bivalve, but I just think that helps with more seafood palatability. Yeah. Kind of combo of the salsa and the cabbage and the fish just kind of helps me with my bivalve game somehow.

Good luck. I could talk to you about this all day. This is the most fun. But we realize that, you know, we don't have all day. So before we wrap up, I know you've got a new online course about depending on when this podcast airs, about to come out or just come out called Healing the Modern Brain. Oh, it's just come out.

Thank you so much, Jenny. I really appreciate that, everybody. If you want to check it out, it's a free masterclass actually called Mental Health Breakthroughs. I just found in our clinic, we keep kind of meeting people who don't have some of these new evidence-based concepts

about mental health, like inflammation in the microbiome kind of at their fingertips in terms of how they're thinking about their mental health. And then also these nine breakthroughs that have come out recently. So you can check that out. It's all on my site, drewramseymd.com. And then, yeah, there's a new e-course, Healing the Modern Brain, that you'll see through there, which is sort of our biggest effort to date in terms of trying to really help people feel a lot of encouragement and a lot of resources around improving their mental fitness. And then, you know, if everybody want to please check out Eat to Beat Depression and Anxiety, it's filled with all these wonderful illustrations by a German

graduate student who we met on Instagram and I love her. So it's actually out in Spanish now as well. So please check out the books if you're interested. But mostly, thank you for this conversation. I grew up in Crawford County where we were the wolf pack. And so on our wall, it says the strength of the wolf is the pack and the strength of the pack of the wolf is the wolf. So I appreciate your parable to start us out. And I hope everybody feels some encouragement and hopefulness around how to feed your mental health, that it's not making every bite perfect, but that you really can make better choices. They can fit in anybody's budget. There's a lot of resources and there's a great, I think, community around eating for mental health and feeding your mental health.

So thank you, Eric and Ginny, for this great conversation. And I look forward to seeing you all down the road. Thank you so much, Drew. And we'll have links in the show notes to all the things you just mentioned. And again, thank you. I appreciate it. If what you just heard was helpful to you, please consider making a monthly donation to support the One You Feed podcast. When you join our membership community with this monthly pledge, you get lots of exclusive members-only benefits.

It's our way of saying thank you for your support. Now, we are so grateful for the members of our community. We wouldn't be able to do what we do without their support, and we don't take a single dollar for granted. To learn more, make a donation at any level, and become a member of the One You Feed community, go to oneyoufeed.net slash join. The One You Feed podcast would like to sincerely thank our sponsors for supporting the show. I'm Jason Alexander. And I'm Peter Tilden.

And together, our mission on the Really Know Really podcast is to get the true answers to life's baffling questions like why the bathroom door doesn't go all the way to the floor, what's in the museum of failure, and does your dog truly love you? We have the answer. Go to reallyknowreally.com and register to win $500, a guest spot on our podcast, or a limited edition signed

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