The Wellness Scoop - How Our Food Affects Our Mood

Episode Date: July 2, 2019

Is there a proven link between our diets and our mental health? Could our diets be connected to the rise of anxiety and depression? Are there foods that boost your mood? Can we really eat for happiness? How does your gut health play into your mental health? We’re joined today by Felice Jacka, who gives us a clear insight into the most recent science, definitively answering whether there is a proven link between diet and mental health and separating myth from fact. We look at all the key questions posed above, as well as the role of our gut and our immune system, the relevance of pregnancy nutrition, the extent to which what we eat as children can impact on us later on and answer all your questions on sugar, caffeine, supplements and alcohol. See acast.com/privacy for privacy and opt-out information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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So the question today is are there foods that boost your mood? Can we really eat for happiness? How does our gut health play into our mental health? And is there a link between anxiety, depression and diet? I have so many questions for our guest today and cannot wait to delve into this topic with a brilliant pioneer who's been studying the links between diet and mental health with a big focus on gut health. So today it's just me hosting the podcast. Matt is in the US, which is incredibly exciting because we can officially say that we're going to be launching our Nut Butter Balls in the US in October. So he is not here for good reason, but I wanted to say a big welcome to Felice Jacker, who is our brilliant guest today. And I'm sure you all know by now what bookworm I am. I am obsessed with reading so my

favorite thing about doing the podcast is that I get to dive into all these amazing books written by our brilliant guests and I get to learn as much as I can about health and wellness and I was really really struck by the start of Felice's book because she starts by saying that whilst it's really easy to assume our modern diet is better than those of 100 years or so ago and maybe even Victorian times and those are things that I feel like we say a lot I was actually shocked to read that in Victorian times so the end of the 19th century rates of degenerative diseases like strokes and cancer were actually about 10% of what they are today and we've reached an insane point in our history in which poor diet

is now the leading risk factor for early death in developed countries we're also seeing an increased number of us struggle with our mental health so i know in the uk the charity mind says that one in four of us will suffer with our mental health this year and the global economic cost of mental health disorders is about 2..5 trillion right now, but that's expected to rise to almost $16 trillion over the next two decades. And half of all mental disorders start before the age of 14. So it really is a scary situation. And the question is, what can we do about this?

Are there lifestyle factors that make a difference? And what is the link between the way we eat and the way we feel? So can we start with the basics today? Is there a proven link between our diet, the way we're living and our mental health? Yes, we can say definitively yes. And so it's less than 10 years since the first major studies in this field were published. My PhD was published in 2010, and that was the first study to look in detail at the links between diet quality and what we call the common mental disorders, which is depression and anxiety in women. And we showed that independent of all sorts of other things that might explain that link, such as their education or income or their

body weight or other health behaviours, there was a clear link between the quality of women's diets and whether or not they had these common mental disorders. And these were clinically assessed. That actually had quite a big impact. It was published on the front cover of the American Journal of Psychiatry. And there were a couple of other really key studies published around the same time, one in Britain and one in Spain. And it kick-started a lot of interest in the field.

And so we went on to look at this in great detail right across the lifespan. So from mother's diets during pregnancy, children's diets in the first few years, adolescent's diets, older people's diets. And again and again, we see this very clear link between the quality of people's diets and their risk for depression in particular. We've started to make headway in understanding how this might work. So we've looked and seen that what's true in animal studies is true in human studies in that the quality of people's diets is linked to the size of their hippocampus, which is a really key area in the brain for learning and memory and also for mental health.

And of course, now we're very focused on gut health. But in 2017, we published the first clinical trial because, of course, correlation doesn't equal causation. You have to actually test whether changing people's diets has an impact on their mental health. And we did that and we found that it had a really substantial impact on their mental health and that it was also a very cost-effective approach to treating depression. And this is really important because, as you noted, mental disorders are the leading cause of global

disability. At the same time, poor diet is the leading cause of early death in men and number two in women. The fact that the two things are linked is really important. But when you have depression, you're also at much greater risk of things like obesity and cardiovascular disease, diabetes, these sorts of chronic diseases. And they in turn increase the risk of depression. And so there's these underlying pathways that feed into the risk for both. So interesting. Exactly. So it's quite hard to separate out completely the mental and physical side. So I wanted to ask, in those studies, what in particular were you guys looking at? What were the diet changes that you were using versus, say, a placebo or something? So in the SMILES trial, which was the randomized control trial, we tested what we called a modified

Mediterranean diet. So we took all the good things of the Mediterranean diet, but then we also had some aspects of the Australian dietary guidelines. So a moderate intake of unprocessed red meat and some dairy. And that was compared to social support, which we already know is really helpful for people with depression. And that was designed to sort of control for the interaction that you would have with a dietician. Another study came after ours in a larger sample of people with depression, and they did that in a group-based setting. And they adopted a more traditional Mediterranean diet, which was lower in meat and dairy, and found, similar to us, a really pronounced impact on depression that was also really cost-effective because people were losing less time out of their

roles. They were seeing other health professionals less often. So in all the work that we and others have done, there are many, many forms of healthy diet. There's a healthy Norwegian or a healthy Japanese or healthy Australian. They all differ slightly, but at the base of them, they have a plant-predominant diet. They have a lot of vegetables, fruits, but ideally also whole grain cereals, lentils, legumes, nuts and seeds. And it's all very fresh. Yeah, that's right. So not the processed stuff. And this is a really key understanding is that if you have a diet high in junk and processed foods, that's independently linked to mental

health. So they're not just the opposite of each other because a lot of, for example, young people will have lots of good food at home, but then they'll be going and before, during or after school having a lot of junk and processed foods. It's still problematic even if they're getting the good stuff. And on the other hand, you'll see sometimes older people who are not necessarily having a lot of junk and processed foods, but they're also having a very limited sort of white bland diet that doesn't give them the nutrients and the fiber and polyphenols that they need. And both of them are independently linked to a greater risk for depression and anxiety. Yeah, because that's what I wanted to ask. Is it about what we are eating or what we're not eating, if that makes sense? And it's a really

good question that we don't know yet, and it probably varies enormously from one person to another. But certainly in all the studies, we see that those two factors, a healthy diet and an unhealthy diet, are quite independent of each other. And too much of an unhealthy diet or not enough of a healthy diet are both independently problematic for mental health. It's absolutely fascinating. And another question, I guess, similar is, does it matter when you're eating? Because I think one of the things that often comes up is, is it balancing blood sugar and things like that on a slightly kind of lesser scale? Is that important, having kind of regular meals, or is it really solely about what you're actually eating

at those meals? We haven't looked at that. I think the research is so new, the whole field of nutritional psychiatry is so new that we haven't got to those more shorter term studies really. We're really focused more on long-term dietary habits, but it's a really good question. And again, I think it's going to vary enormously from one person to another because we know that people's blood glucose responds to the same foods really differently and we are all different in the way we respond to food, which I think is a really fascinating insight. It's a relatively new insight and it seems to be very much driven by our gut microbiota. Leads me on so perfectly to my next question. So I think in the UK, gut health is a

huge topic at the moment. You kind of can't move but for fermented drinks here and kombucha there and we're we're all quite obsessed with it and it's a really interesting area we did an episode actually in season one on gut health which I absolutely loved and it's yeah an area that fascinates me and I know it's a big area of research for you what is the connection between our gut health and our mental health because obviously I know the the brain and the gut connected by the gut brain access and I think I'm right in saying most of our serotonin is created in our gut and that's obviously the happy hormone so we'd love to kind of understand from your perspective a bit more about that it's it's

obviously really complex and most of what we know so far is coming from animal studies. So we need a lot more studies in humans. And that's what we're doing because our interest is in diet and nutrition and how that affects mental and brain health. The starting point for those studies is really the understanding that your immune system is incredibly important in mental health. And why is that? If you have a really major injury or a virus or something like that, your immune system will kick into action in an acute way to heal the injury or to attack the virus. That's great.

There's these mediators of that immune process, such as cytokines, these inflammatory mediators. But your immune system is not supposed to be activated all the time at this sort of low-level chronic sort of ongoing state. But many, many things in our current Western environment prompt this low-grade what's called inflammation. And those inflammatory mediators, those cytokines, there's a number of lines of evidence that tell us that they can be risk factors for depression, but they're also about half of people with clinical depression will have elevated cytokines because of their illness. So it's a bidirectional relationship.

So that was an understanding that really came out in maybe the early 2000s. An understanding that diet is really important for inflammation, that was one of the first clues that diet may be important for mental health. The second was this idea of brain plasticity in this area of the hippocampus that I mentioned before. Around the same time, scientists were starting to realize that your brain didn't just have your set of neurons that you lost over the life course. There are actually a couple of regions in the brain where you grow new neurons all the time. And this is really intrinsic to the ability of the brain to learn and remember, et cetera. And they were finding in animal studies that diet and exercise had a really profound impact on this brain plasticity. But what we

now know about the gut microbiota is that it profoundly influences the immune system and inflammation and brain plasticity. But now we know that the microbiota that live in the gut, they have a huge number of actions, and we're only really just starting to understand them. Very simply speaking, when you eat dietary fiber that your body, your own enzymes can't break down, the gut microbiota break down that fiber through a process of fermentation. And in that process, they release a lot of metabolites and many different types of metabolites. Now, some of them we're starting to study and they're things such as short-chain fatty acids. Now, they interact with the immune system really profoundly,

but also with every cell in the body body influencing the way genes actually work, the neurotransmitters that are produced by the bacteria, but they're also prompted by the bacteria. There are many of those. We don't know whether they directly influence the brain because it's likely that they don't cross the blood-brain barrier. But the bacteria in the gut definitely do influence how much serotonin we have in our brain by affecting the metabolism of what we call tryptophan. So the bacteria interact with the body in many different ways.

And as I said, we're still just at the beginning of understanding this. And most of what we know comes from animal studies. But it's a really exciting area of research because what we know is that diet, at this point, is the most important thing that influences the gut microbiota. And you can change your gut health very quickly by changing your diet. And that's a really powerful understanding. So again, that's about focusing on lots of plant foods because they're so rich in fiber. That's exactly right. And we need a diversity. We need different sorts of fiber. There's a fermentable, there's moderately fermentable, there's non-fermentable fibers.

They all do different things and they're all important. Also polyphenols, which are the things that are in colorful plant foods, they seem to be really important and they seem to mitigate weight gain. So they may actually prevent us gaining weight as well because we know that the gut microbiota influence our body weight quite profoundly. So it's really the high fiber foods, fruits and vegetables, whole grain cereals, lots of different types, and the nuts and seeds and the legumes. I just live on beans and they are great food for your gut.

Yeah. And they're so cheap as well. They're so cheap. I know in your book, you have a whole chapter saying that there's such a preconception that healthy food has to be expensive. And to make a change like this it would be expensive but actually if you're focusing on beans and legumes and things like that I mean lentils are so inexpensive and you can make delicious lentil dolls and things like that which are great for you as you're saying. So one of the things I think as you said is incredibly empowering is that actually you can make a change quite quickly and And actually, your gut can really respond very

quickly to a diet change. How quickly are we talking? Well, there's been a few studies done in humans, not a huge number, but one that I think was really fascinating. They took African Americans on a typical Western diet, standard American diet, which is called the SAD diet. I know, I love it. What does that technically compose of? Lots of meat and processed meat, lots of processed foods, lots of added sugars, added salts, those sorts of things, you know, so not whole foods and lots of animal protein and saturated fat, that sort of thing. And then they looked at their gut microbiome and also markers of inflammation in the bowel, which we know are really key indicators for bowel cancer.

And then they did the same in rural South Africans who were eating a far more traditional diet with lots and lots of plant fibre and far lower levels of, you know, those nasties. And they found that the diversity and the health of the gut in the South Africans was far better than that in the African-Americans, which is what you would expect.

Their markers of inflammation were far lower. But then what they did is they swapped their diets for two weeks. So the African Americans started to eat a whole lot more plant fiber and a whole lot more whole foods and reduced all the other nasties. And the poor South Africans started to have a lot more animal foods, saturated fat and processed foods. And they found within two weeks really profound changes in their microbiota. A drop in these levels of short-chain fatty acids that we know are really important

in inflammatory processes, increases in those colon cancer risk markers in the South Africans, and they dropped in the African-Americans. So within two weeks, there was a really rapid change. And then there was another study that was done just looking for five days where they took 10 people, put five of them on a sort of a meat and heavy saturated fat animal protein diet and five on a plant diet and showed very similarly within five days that they could see a very pronounced difference in the gut microbiome. It's absolutely incredible. As you said,

it's so empowering because it's a change we could all make right now. And that's what we see too. A lot of people, and I think psychiatrists and people who deal with mental illnesses, they are a bit fatalistic thinking that patients won't want to or won't be able to make positive changes to their diet or exercise. And actually, our experience is quite the opposite, that people really love that this is something that's under their own control. There's so many things in their life that they may not be able to fix or change, but this is something they can do. And as you noted, we did a really detailed cost analysis and showed that the diet that we were advocating was actually cheaper than the

junk food diet people were eating when they came into the study. So it doesn't have to be expensive and it doesn't have to be difficult either at all. You don't need to be doing really complicated recipes and things. I mean, I never have time to cook properly. I just do really quick stuff, but it can still be really good and really inexpensive. Yeah, I couldn't agree more. No, most of what I eat takes 10 minutes and it's still delicious and it is a lot cheaper. And also just wanted to add to that, I found the exact same thing. So I changed my diet because I was ill with a physical illness, but I really struggled mentally with being ill. And I'd been on all kinds of drugs and I felt that things were completely outside of my control. And when I changed my diet and started looking at all of that, I felt so empowered because I felt,

just as you said, that there was something that I could do that was tangible, that I could do right here, right now. And that allowed me to feel like I was taking back an element of control. And it was one of the best things I've ever done. And that definitely had a positive impact on my mental wellbeing as well. And we often find too that people then, it flows onto other areas of their life. So because they're eating well, they start to exercise more, they stop smoking, they stop drinking so much. So they start to just have a greater sense of self-efficacy, I guess, and make these positive changes across the board. There are a few things that came up quite a lot in

terms of specific foods, and I don't know how much information you have on that. But I think one of the things people are really curious about is something like sugar, for example, which we read about a lot. Are there specific foods that have specific impacts on our mental well-being? You'd be surprised to know that there's been very little research done on sugar in particular. It's too early to say whether sugar, we assume that it might not be good for the gut, but anything that we do know in relation to the gut has come from animal studies. So we don't know if it's true in humans. But in animal studies, high blood glucose definitely has an impact on the health of

the gut lining, which is really important. And you create high blood glucose by eating foods that spike your blood sugar levels. That's exactly right. And we've already known for a long time that high blood glucose, even in the normal range, so even if you're not even in the pre-diabetic range, is a risk factor for dementia and also for stroke and other cardiac illnesses. But we need to do more research on it. Interestingly, in animal studies, there's also evidence that artificial sugars

have a noxious impact on the gut microbiota as well. But again, we need more research in humans. But what we're saying as well is even with those animal studies, that's looking at, for example, table sugar, that's not looking at an apple, for example. Because I think, again, there's a lot of, because sugar is quite a confusing topic and, you know, we could probably do about 10 podcasts just on that alone. I worry sometimes that people then think like a banana or an apple could have that impact. always have my public health hat on. And also as a scientist who really is very keen on rigorous science, it drives me nuts the amount of misinformation that comes out about diet.

A lot of it's coming out of the US where their food supply is just so absolutely broken and so completely weird that almost any change you'd make to that sad, this standard American diet is going to have a benefit. And there's a lot of people with MD after their name who are making a lot of pronouncements about really extreme diets and on the basis of very little evidence or very cherry-picked evidence. So we know that fruit has a whole lot of dietary fiber and it has polyphenols and it has all sorts of nutrients in it. And we cannot equate that to things with added sugar where you will much more likely get a big blood glucose spike and it doesn't have all the nutrients and the fiber and the polyphenols that are positive.

Amazing. Thank you for saying that as well because I think it's such a difficult balance because I feel like it's so important to have these conversations and understand how the way that we look after ourselves and the way we live can genuinely really impact on our mental and physical health and that it does matter. But it's about creating the balance between understanding that it does matter and also living life, enjoying life and not becoming afraid of things because I think it is a difficult balance to strike. Yes. And I talk about that a lot in the book. And it's one of the key reasons I wanted to write the book was to give evidence-based information. There is so much misinformation out there. There's a lot of people making a lot of money from books and really extreme diets. And as I said, they have medical qualifications. So people don't know how to interpret that. They consider, well, if they're a medical person, then they must know what they're talking about.

They're not researchers. They don't look at the evidence in totality. They pick out the bits of evidence that support their arguments, and they're making some really unfortunate recommendations. And in the book, I do a whole chapter on sort of research evidence. How do you understand what is good evidence and what's poor evidence? And I talk about that quite a lot throughout the book. But, you know, big food, which is much bigger than big tobacco or, you know, it's massively influential across the world, has been extremely successful at muddying the waters and making people really confused about what they should and shouldn't eat. And they have a vested interest in doing that. And people need to understand that when they get all sorts of information that is contradictory, it's very often coming from big food who are trying to confuse the issue. And it doesn't need to be, as you said, perfect. Being

too obsessed with clean food and clean eating, that is a form of eating disorder and it's really bad for your mental health. I have the 80-20 rule really, where 80% of my diet's pretty good and 20%, I'll have a treat on the weekend and I won't be that fussed. So people don't need to have a perfect diet to reap the benefits. Yeah, so exactly. It's about what you do as a total. It's not about what you do minute by minute, day by day. And that's what's going to have a big impact on your gut health, your mental health, your physical health. It's about trying to have a balance across any given week, any given year, where you are getting a very rich number of different coloured fruit,

veg, beans, loads of fibre basically to look after yourself. And to put it into context, I think this is critical, the public health context, where in the US, for example, nearly 60% of daily energy intake is coming from ultra-processed foods. So in Australia... I think it's just over 50% in the UK now. Yeah, yeah. It's about 40% in Australia. But Australian adolescents have on average seven serves of junk food a day, a day, not a week, a day, and less than half a percent. And what constitutes junk food?

So ice cream, soft drinks, chips, crisps, those sorts of things. But less than half a percent of children are getting their intake of, the recommended intake of vegetables and legumes. So less than half a percent, and it's less than five percent of adults so you know against that backdrop if people got to the 80 good 20 bad gee they'd be doing a hell of a lot better than most of the population yeah and i think it is isn't it it's about doing more and you know small changes rather than feeling you've got to change everything at once so a couple of the other things that people asked about were things like alcohol and caffeine, but also about whether or not moving away from food,

does things like your water intake make a difference, you know, making sure you're hydrated? Look, I think so, and I'm not across that, but I know that, you know, if you don't drink enough water, you get low blood pressure, and so you can feel a bit tired and washed out. And I certainly find that because I have naturally low blood pressure, so I have to keep my hydration up. So it probably does feed into it. And again, that's more of the short-term association. Caffeine, it really varies. Some people can have quite a lot of coffee and other people find that they're very sensitive to it and can increase

anxiety symptoms. But coffee is often a good source of antioxidants. So I drink coffee. I love coffee. Alcohol is problematic. There's some positive things in alcohol, except for the alcohol. So like, for example, red wine has got lots of polyphenols in it, but the alcohol is really poisonous. There's no other way of putting it, unfortunately. And I'm saying that as someone who has always loved wine. And I've had to, I guess, as I've gotten older, I've stopped drinking because it just has such a negative impact on my liver, which is very much connected to your gut health. Certainly binge drinking has a really noxious impact on your gut health. And the very interesting data coming out in the last 12 months,

looking at this link between diet quality and hippocampal size and function, one of the strongest predictors of hippocampal size is whether or not you drink alcohol. So you're worse off if you do drink alcohol. So whilst it's very difficult to do a randomized controlled trial to look at the impact of alcohol on the gut or on the brain, The large body of evidence suggests that unless you're just really adhering to those tiny amounts, which is, you know, the recommendations are for one or two standard drinks, which is actually very little alcohol, very little wine,

if you're exceeding that, you're probably not doing yourself any good. And then there was, you know, I guess, again, coming back to sometimes the confusion around food, you read a lot like headlines saying, you know, these are the mood boosting foods. And it's often things like Brazil nuts, chocolate seems to go in there. I think maybe it's the same polyphenol conversation around wine that can be a bit confusing.

Sometimes like bananas, oats, which always feels a tiny bit random. What do you think about the kind of focus on specific foods rather than food groups as a whole, say vegetables? There's really no good evidence to support it. It's really driven by journalists who need to have a different, well, they try and have a different angle for their stories. But, you know, there's no magic pill and there's no magic food. And it's not just one thing or another. And often the ideas put forward are very simplistic. You know, like this food has lots of tryptophan. Tryptophan's a precursor for serotonin.

So if you eat lots of tryptophan, then you'll have more serotonin and you'll be happier. It doesn't work like that. It's much more complex and there's no evidence to support that. So it's about having a diversity of food because that's really good for your gut. And it's about having lots of the things that we know the gut and the immune system really like, which is your fiber, your polyphenols, but also your healthy fats, like your mono and polyunsaturated fats, good quality proteins. So whether you eat fish or a bit of red meat or whether you stick to plant-based proteins,

you know, we know what a healthy diet comprises and it's actually not that difficult and it doesn't need to be complicated. Okay, and so don't get hung up on those specific... No, no. Yeah, because some readers said, you know, if I'm feeling low, is there one thing I can eat? And it's not about that, is it? It's about the kind of bigger picture. Yeah, that's right. It's much more around the long-term impact of what you put in your mouth and one of the other questions which I think I know the answer

to already but it was are there any particular kind of vitamins minerals or sort of supplements that are positive for supporting your mental health and your brain but I'm imagining just like what you're saying what it's really about is that, unfortunately, no, there's not one magic pill, one magic answer. Yeah. And I work, I head up the International Society for Nutritional Psychiatry Research. So I work with a lot of people around the world who look at nutraceuticals. I mean, I really focus on diet and food and public health. But colleagues of mine who've done a lot of really great work,

they're just about to publish what we call a mega-analysis. So they do a meta-analysis of all the meta-analyses. They basically bring everything we know together around nutraceuticals in psychiatry. And basically what we find is that when you look at all of the things together, there's only good evidence for a couple of things. One is not just fish oil, but the fish oil is made up of EPA and DHA, two different forms of these long-chain omega-3 fatty acids. The EPA seems to help some people, particularly if they've got high levels of inflammation. And that makes sense because when you have inflammation, you have oxidative stress. And oxidative stress can reduce the amount of these long-chain omega-3 fatty acids that are really important in our neuronal structure, in the brain cell. So for some people,

EPA can be helpful during an episode of major depression. And there's also evidence for what we call methylfolate. It's a form of folate, but there's very little evidence for any other supplements. Supplements just don't work the same way that food does. And sometimes they can do more harm than good. Okay, that's really interesting. So I wanted to also circle back to something you said at the beginning, but also on a personal level really interested me in your book is, I'm pregnant at the moment,

but you talked a lot about actually diet and pregnancy and then also those early years of our lives and our children's lives and how important that is for setting us up for good mental health. Can you tell us a little bit more about that? Sure. So we've known for probably since the 1980s that early life nutrition, so the nutrition that you get in the womb and in the first few years of life, it's very clearly linked to your risk for chronic disease over the life course. But I wanted to know whether this was true also for mental health. And I was fortunate enough to receive some funding from America to go to Norway, where

I do a lot of work, and to look at data from more than 23,000 mothers and their children. And so they had very detailed information about mothers' diets during pregnancy, as well as their mental health and a whole lot of other factors. And then children from 18 months to five years where they'd measured what they call emotional regulation. And... What is emotional regulation? Well, it's sort of measured...

Because with a child, you can't give them an assessment or, you know, ask them how they're feeling. So what you do is you look at their behaviours and there's two constructs, internalising and externalising. Internalising is, you know, being fearful and crying and nightmares and anxiety. Externalising is, you know, anger and tantrums and, I don't know, pulling the cat's tail and that sort of thing. And those together, they're behavioural markers that tell us something about the risk for later mental disorders. It doesn't mean that if they've got high levels of those, they're definitely going to go on and have it.

But it just is a marker of vulnerability and it's how we look at emotional health in young children. And so I wanted to know whether mother's diets during pregnancy and also children's diets during those first few years were linked to this emotional regulation. And what we found was that it is. So mothers, particularly mothers who had diets that were high in junk and processed foods, the kids had more of these externalizing behaviors across those 18 months to five years. But independent of that, what the kids ate was also important. So the ones who are having too much junk food had higher internalizing and externalizing, and also the ones who are having too much junk food had higher internalizing and externalizing, and also the ones who weren't getting enough of the good stuff, it was the same.

And that was when we took into account a whole lot of factors that could have affected that. Now, since then, there've been a number of other studies that have looked at this and found pretty much the same thing. And there's been a meta-analysis bringing all the information together and saying, yes, mother's diet during pregnancy does seem to be linked to children's cognitive outcomes. So, you know, learning and remembering and those sorts of things, and also their emotional regulation. And of course, that makes sense. If you look at the animal studies, if you feed a pregnant rodent, for example, a junk food or western type diet, you will see changes in behavior of the offspring, more anxiety, more aggression. You'll see changes to their neurotransmitter systems, big changes to their immune system and their mitochondrial function and their brain plasticity and all of these things that we know are linked to the risk for mental disorders in humans. So, you know, what we see in animals, again,

the science is saying it's also true in humans. God, that's absolutely fascinating. It really is. It's real food for thought. And again, it's what you're saying. It's not just about what you are eating. Say you're eating more processed food. It's also about ensuring that you're not just missing out

and not having a kind of very beige diet. You've got to get that fruit and vegetables in. It's no good just not having the highly processed food. You've got to have the good stuff as well. That's exactly right. And were there anything in particular in pregnancy? Because I know it's a difficult time. And I know you said it in the book and I've been very open about it.

Like the first trimester, I mean, could not eat vegetables. Disaster. I normally eat a really healthy diet and all I wanted to eat was chips and ice cream. It was just horrible because it was like having a massive hangover the whole time. Yeah. No, I felt the exact same way. And I remember feeling a little bit guilty and trying to make like a vegetable soup. I think it was like potato and broccoli or something. And I just remember just gagging and gagging and thinking, no, it's got to go in the bin. That's not going to happen. I know. And I really make the point in the book that, you know, mothers have enough to feel guilty about.

And really what we need to be talking about is the fact that public health and public policy doesn't set up our food environment to just support healthy eating in general. Yeah. You know, we're in a situation where these foods that are so noxious to our physical and our mental health are the cheapest. They're the most readily available. They're the most heavily marketed.

And of course, they're the most socially acceptable. And there is no policies or legislation or anything to try and tackle the food environment. So let's definitely not blame mothers and individuals, but rather look at what we can do to make healthy eating a much easier option for people. Yeah, 100%. I mean, that's our big passion, because if it's not easy and it's not delicious and you're not excited about it, you're not going to do it. It's no good just hearing this and knowing that it's a good idea. And I think, obviously, that's going to be a lot of people's challenges. How do I get my three-year-old to want to eat broccoli? Yeah. And you just basically, I think a lot of going to be a lot of people's challenge is how do I get my three-year-old to want to eat broccoli?

Yeah, and you just basically, I think a lot of the mistake that many parents make is not recognizing that kids need about six exposures to a new flavor to get used to it. But also being so worried that if they don't eat it, then they need to eat something. So, okay, you haven't eaten your healthy food that I've made for you. So here's a piece of white bread or, white bread or white rice or ice cream or whatever. And if you don't have it in the house, kids just don't think of it as normal. We were not a particularly strict household, but we just didn't have junk food in the house and the kids just ate whatever. And they used to fight over the broccoli. They just got used to it and they got used to it pretty quickly, but you've got to do it from the outset and make it normal. Yeah, exactly. Which I think is the challenge. challenge okay so having kind of got an overview of this whole space and and as you said the issue of the fact that actually it's it's really challenging

to blame individuals when actually this is an issue of the western world and now increasingly more so the entire world and our environment in which we live what what can we actually do like what are the changes you as a pioneer in this field feels like that we we really really need to make that fundamental difference to you know to shift all those stats that we said at the beginning where half of all mental disorders are going to start by the age of 14 and we're going to be spending 16 trillion dollars in 20 years' time. Yeah, that's right. Actually, $30 trillion will be the cost of poor diet to the global economy and public health. So that's combining the mental and physical. No, this is just the physical because this is the thing. Nutritional psychiatry

is such a new field that they haven't yet taken into account the impact on mental and brain health when they make the calculations. But the WHO has said very clearly it's only heads of state governments that have the power to change things because big food is so powerful and has so much money. But thus far, there's been almost no action around the world. What we do have, we're starting to have is taxes on drinks with added sugar. And that's really good. It's a great start because we know that that's where the large majority of our added sugars in the food supply are in these sugary drinks. But that's just the start. We really need to be overhauling the whole system.

I completely agree. I feel like it's really important to applaud every change. That being said, the skeptic in me still looks at it and thinks, what about all the other ingredients in there? That's right. So it's only very much the start. So if you look, for example, in Australia, smoking rates were 40% and now they're down to 12%. And with that, you've had a really huge reduction in cardiovascular disease. And that's come along with statins and those sorts of things as well. But it's had a big impact on public health. But to get there, it took a very, very long time and it took both carrots and sticks. So it took taxation and in Australia, cigarettes are taxed to the tune of about 400%. So when you think about a 10% tax

on a sugar sweetened beverage, it's really just fiddling around the edges and legislation about not smoking in pubs and restaurants and all those sorts of things. So it took a very, very long time. So this is not something that's going to happen overnight. And cigarettes in a way are a much easier target because they're just a single target. The one thing exactly that people often say, which I think is so valid with the challenge with food is that you don't have to smoke. Now I know it's challenging because it isn't obviously chemically addictive, but we have to eat. We need to eat three times a day you know snack or whatever it is that you need for yourself and so you have to navigate this unbelievably complex environment and it's

also quite time consuming you know because you've got to go and buy new things and change your habits and that that for me feels like a challenge as well. It's a big challenge. And I think we have to come at it from both the grassroots level, but also from the government legislation policy level as well. So in Australia, there's a big push for a proper obesity prevention strategy and blueprint. Now, it's really important though, to understand that, you know, because our focus has been so much on obesity for such a long time, in a way, I think it's been problematic and it possibly hasn't helped things. And that's because whilst obesity is a huge problem, something like 60% of children alive

today in the US will be clinically obese by the time they're 35. Like it's just staggering. But the links that we see between diet quality and mental health are independent of body weight. And we know from the animal studies that you get a direct detrimental impact on the brain and behavior way before there's any change in weight. And the reason why it can be problematic to focus on weight is that once you've got weight on, extra weight, it's almost impossible to lose it and keep it off. Your body has all of these mechanisms to keep that weight on. And so what happens is that people give up. They think, well, I can't keep weight off, so I might as well just keep eating the burgers and fries. And they're not recognizing that actually it's around diet quality and that actually you need to not think about weight. You need to be thinking about nurturing your body and your gut and your brain with good foods. So the obesity problem is obviously massive and the impact on

health is also massive, but we also need to be recognizing that there are other very negative outcomes that come from eating the wrong foods that are quite independent of obesity. So what would you do? I mean, if someone said, okay, you can make three policy changes across the whole world tomorrow, what would you do? Oof, that's a really difficult one. I mean, I look to my colleagues in public health and some of the recommendations they make are obviously around taxation of junk and processed foods. Very important, I think, is to limit marketing. You know, at the moment in Australia, it's a voluntary code to not advertise junk foods during children's television hours, but they get around it and they support sports and the Olympics.

And I mean, there are just so many ways in which big food markets to the whole population and to children. And I've always thought it was so ironic that like McDonald's can sponsor the Olympics. It's just mind-blowing and that happens across the board during junior sports and adult sports and so limiting marketing would be another. I think giving communities the ability to say no to junk food purveyors being set up in their community. You know I know in Australia that many, many small towns have pushed back against having McDonald's come into the town and they always lose because the

planning laws don't allow the community to say, no, we don't want this. So starting to make those changes to the environment and having good data, having a really good understanding of the scope of the problem. And then of course, more research to look at what is the impact of this, not just on our physical health, but our mental and brain health as well. Yeah. For me, that education piece feels so important. Like I always say to everyone, you know, you're told from day one that you should eat five portions of fruit and veg a day. And in the UK, one in four adults do it, one in five kids do it. And I'm completely convinced that it's twofold I think first of all it's often because the association is that those things don't taste good or that they're too expensive too complicated not easy to get hold of but that

secondly you don't understand why and if you don't understand why what is the implication like until you understand that actually if you eat x or you don't eat y that will actually impact on your gut and then you know that will then impact on your brain and that will impact on the next thing next thing next thing and you start to understand oh right okay there is a reason to eat the broccoli actually it's going to genuinely make my life better rather than just being told something with a full stop at the end of it and having no understanding about why that could possibly make a tangible difference to you and your life and I think everyone wants to be happier and healthier but until you're given really good as you said concrete data concrete evidence and a really clear completely understandable sense of why it would genuinely impact you your

family your children why are you going to bother making a change when it's hard, as you said, given the environment that we live in to make that change? Yeah, that's exactly right. And particularly for young people, if you tell them that if you eat that way, you might have a heart attack one day or develop cancer or, you know, it's too far off in the future. That doesn't feel real to them. If you say this is going to have an impact on your ability to learn and remember very, very soon, like possibly even within days. It's going to have an impact on your mood and well-being. That cuts through.

And I really like, you know, this idea about the gut as something very concrete that people can understand. My husband and I have actually, we've written a kid's book, which will be published next year, and it's called There's a Zoo in My Poo. That is the best potato ever. Isn't it? And the idea is that you let kids know that they're the zookeeper for the zoo in their poo and that they have to feed it properly, you know,

and it's something that I hope is really accessible to them and they can go, oh, that's why I wouldn't drink that drink or eat that donut and choose this instead. It's because I've got to feed the bugs that live in my gut. I love it. Well, that will be our daughter's first birth. I can see it already. I love it. So, thank you.

I mean, honestly, as I said, for me, I'm so passionate about trying to learn as much as I can and our community for a sense of education because I think it helps us implement the changes and this has been unbelievable and we really like to close each episode with kind of five take-homes for our listeners so if they were going to remember and implement five things from what you've said from today what would they be? What you put in your mouth matters to your mental and brain health, and it probably matters quite quickly. The gut is your seat of health, really, your immune function, your physical health, your brain health.

So feed your gut and you will be feeding your health. Three would be that you can make changes and have a benefit very, very quickly. Four would be that what your children eat and what they learn to eat is really critical for their long-term health. And five would be it doesn't need to be difficult and it doesn't need to be expensive. I love it. Well, Felisa, thank you so, so, so much. And the book is absolutely fascinating for anyone wanting to learn more. It's called Brain Changer. I certainly learned a huge amount from it and really, really enjoyed it. And thank you so, so much for sharing so much wisdom with us.

We'll be back again next Tuesday. Have a lovely day, everyone. Thank you. You're a podcast listener, and this is a podcast ad heard only in Canada. Reach great Canadian listeners like yourself with podcast advertising from Libsyn Ads. Choose from hundreds of top podcasts offering host endorsements or run a pre-produced ad like this one across thousands of shows to reach your target audience with Libsyn Ads. Email bob at libsyn.com to learn more. That's B-O-B at L-I-B-S-Y-N dot com.