The Zac Clark Show - This Doctor Believes Diet Could Heal Mental Health Disorders and Addiction | Dr. Matt Bernstein

Episode Date: May 27, 2025

Dr. Matt Bernstein isn’t just a psychiatrist—he’s on the frontlines of a quiet revolution in mental health care. In this episode, Zac and Jay sit down with the founder of Accord, a pioneering residential program in Massachusetts that treats serious mental health conditions by healing the body first. The conversation starts with the question: What is metabolic psychiatry?—and opens into a raw, deeply personal, and paradigm-shifting journey.We talk about why food, sleep, movement, and mindfulness aren’t just wellness buzzwords but powerful interventions for anxiety, depression, OCD, bipolar disorder, and even addiction. Dr. Bernstein shares the story of his own children’s mental health collapse and the grueling search for answers that led him to understand the gut-brain connection, the ketogenic diet as a medical tool, and why most mental health diagnoses might be missing the real root causes.If you’ve ever felt stuck in the mental health system, burned out by meds, or overwhelmed by a diagnosis—this conversation might change the way you think about healing.Topics include:What is metabolic psychiatry?What’s the real buzz around the ketogenic diet and how ketones fuel the brain.PANDAS, long COVID, and immune-related psychiatric symptoms.Why most mental health diagnoses are missing the bigger picture.Can diet replace medication for serious mental health conditions and addiction?What Dr. Bernstein wishes every parent knew about processed food, stress, and their kids' brains.The immersive approach at Accord and why it’s giving people hope again.For more information about Accord, Dr. Matt Bernstein’s innovative mental health program that focuses on metabolic and mental well-being, please click here: https://accordmh.com/Connect with Zachttps://www.instagram.com/zwclark/https://www.linkedin.com/in/zac-c-746b96254/https://www.tiktok.com/@zacwclarkhttps://www.strava.com/athletes/55697553https://twitter.com/zacwclarkIf you or anyone you know is struggling, please do not hesitate to contact Release:[phone]releaserecovery.com@releaserecovery

All right, welcome back to the Zach Clark show. We are here today. So just a little backdrop on how we got Dr. Bernstein here. I've worked in behavioral health care for 13 years. About a month ago, one of his colleagues, he was in the city, texted and said, can we stop by the office here at release recovery? Our kind of business development person said, sure, I happen to have a window I stopped in and Dr. Bernstein was there.

And it is very rare these days to walk out of a meeting and have the content of that meeting stick with me. But in this case, it did because the meeting ended up being an hour talking about how food and what we put in our bodies affects our mental health, which Dr. Bernstein is an expert on. He's the CEO and founder of Accord, which is a fascinating kind of pioneering residential program up in Massachusetts. centered around metabolic psychiatry and so one welcome to the show and two tell people what metabolic psychiatry even is because that's going to you know be a jumping off point for us sure well first thanks for having me it's great to be here in person with you and call me matt also i'm really informal so cool yeah easy um so yeah i mean metabolic psychiatry is this idea that our metabolic health in our bodies in every one of our cells affects our brain health and our mental health and that

we are in the midst of a metabolic pandemic epidemic in our country and a mental health problem acute problem it's been going on and building for decades but it's accelerating the the graph is getting steeper and steeper in the wrong direction and these things affect each other profoundly and we can intervene with metabolic treatments to improve brain health and mental health, which is the really exciting part. That's what gets me super jazzed. For the person that is sitting there listening, the word metabolic, can you break, can you just break that down for people? Yeah, yeah, because I, yeah. Yeah. So, I mean, metabolism is the idea of every nutrient that we take in, mostly food we're talking about, but there are other nutrients, things like light are a nutrient as well. All these

nutrients are used by our cells to make energy in the cells energy is made in the form of this stuff called ATP it's like you know the US dollar essentially can be used for anything right and so it's making energy and making building blocks things like neurotransmitters or cell membranes or whatever that cell does you know it's powered by metabolism so it's all of these chemical reactions turning nutrients into energy and building blocks So it's really like fundamental to the health and life of a cell, essentially. Fascinating. How new is this connection of what you put in your body can affect your mental health?

Well, you know, in some ways it's very old. And then in terms of really applying it in mental health and psychiatry, more new. But it goes back really to the time of Hippocrates, Fifth Central. BC, they were using fasting to treat seizures. They knew that if someone was having seizures all the time or nonstop, they could have them stop eating, and within a couple of days, their seizures would stop, and they could keep them fasted for some period of time, and their seizures would be better for a while. Now, the problem with that is you need to eat to live, so you can't maintain fasting for

too long. It's not a good health strategy. But basically when someone fast, they make ketones. That's our body's adaptation to not having food evolutionarily when we were, you know, millions of years ago, when there was food scarce environments. That's how we evolved. We needed to be able to hunt and cooperate with each other to work together even if we hadn't eaten in days. And ketones are what powers our brains when there's no food around.

And they're really good for our brains. They're a signal to our brain to do lots of good things, essentially. So then way back in 1921 at the Mayo Clinic, there was this very clever doctor who said, we need to make a diet that sort of mimics what fasting does. Can we do that? And he came up with this diet called the ketogenic diet. So people think keto and they think, oh, it's all about losing weight and there's a million things on the internet.

It's a medical diet that was invented in 1921 at the Mayo Clinic to treat a brain health disorder epilepsy in kids. And it was incredibly effective. So it took off, literally lots of papers. This was the main treatment for pediatric epilepsy. There's now been 12 randomized controlled trials showing that ketogenic diets work in child and adult epilepsy. And it not only works, it works when the medications don't work. Is it still being used?

Oh, yeah. Oh, yeah. So that's like my, and that is the cornerstone of why the conversation we had a month ago in the conference room next to where we're sitting stayed with me. and why I'm proud to call you a colleague. And I, look, I understand the value of medications. I understand that medications play a role in health care. You know, when I was getting sober, I went on medication.

You know, so I get that. I've heard of only medications to treat epilepsy. I've heard of only medications to treat seizures. I have never heard before talking to you that the idea of a keto diet might be the most effective or one of the most effective ways to treat. So, well, it blew by mine, too, when I first heard about it. And I didn't hear about it in medical school. When did you first hear about it?

About six or seven years ago. Wow. I was sitting in a lecture hall at McLean Hospital and listening to a grand round from Dr. Chris Palmer, who's really, you know, one of the world experts in eugenic diets for mental health. And he was talking about not only this data in epilepsy, but he was talking about using it in drug-resistant psychotic disorders and bipolar disorder. And I was blown away.

I couldn't believe what I was hearing. But the story and the argument and the data was so compelling. And I just needed to learn more about it. So, Matt, but at that moment in time, right, this is six or seven years ago before you've went on this journey. And Chris Palmer's there talking about this, is do you have a conscious thought that, like, hey, if I'm going to go down this road, I might be going again. traditional psychiatry today as we know it and how that might affect your relationship with your peers how that might affect your career like that that's a very interesting yeah moment yeah it is I mean I think you know there's a lot of

backstory about why that didn't bother me I mean number one I've always been a bit rebellious and I love it don't care about what the powers that be think on some level. So, I mean, that dates back to when I was, you know, a teenager, you know, I was the one breaking all the rules. So, you know, I have that in my personality. But, you know, not in medicine. Medicine's a little different. So, you know, when you do medical training, it's very hierarchical. It's very by the book. And there is a lot of, you know, sort of shaming that goes on if you're not following the rules. And you can get in trouble, for sure, in the medical world. In many ways you can lose your reputation. And, you know, I spent a lot of years working on my reputation

as a doctor, so I definitely cared about that. But at the time, I was pretty disillusioned with what regular medicine could do because I had my own personal story with two of my three kids who had gotten sick and the regular medical treatments. And we were getting the best, I mean, because the kids really had what looked like a neuropsychiatric problem, which turns out to have been much deeper than that and really physical. Can we go there? Yeah, of course. So you have three kids.

Yeah. I want to talk about the two that this kind of happened. And then the third because I always, in substance abuse and mental health, there's always the other kids. Yes. And I want to talk about how you were able to support him or her while the other two were kind of struggling as well because they're oftentimes forgotten. Yeah.

Yeah. So yeah, the story is, you know, we're living outside of Boston. I'm a psychiatrist working in all these nice settings. Your wife's a psychologist, right? My wife's a psychologist. Kids are doing great. We're living this nice life in the suburbs.

They're going to school and doing well and doing sports and friends and music. So we have twins who were 14 at the time and another one who was 12 at the time, all boys. And so the 12-year-old and one of the twins literally overnight, everything fell apart. And it was not a little bit, it was not subtle,

it was dramatic. I mean, they went from happy, well-adjusted kids to literally not being able to go to school, not being able to read a book, not being able to spend time with friends, wanting to die, you know, we were contemplating, you know, hospitalizations, lots of treatment. I mean, you know, we were well-resourced and connected.

I got the best psychiatrists and consultants and medical doctors, no one could help them. So overnight they experienced significant mood altering across the board. Mood, yeah, I mean, depression, really bad intrusive OCD, cognitive problems, could not think, like they couldn't read, they couldn't focus enough to read,

intrusive thoughts about not wanting to be around anymore. I mean, it was just like as bad as it can get, as bad as you can imagine, literally, you know, within weeks. It all, you know, we went from happy, well adjusted to, you know, it's like a bomb went off in our lives, literally within it. And it becomes a full-time job, right? I mean, it was, yeah, my wife had to, you know, significantly reduce her work.

She was working extremely part-time, and I was essentially working two jobs because I was, you know, I needed to keep working to pay the bills. And then my entire second job was researching, trying to figure out what was going on, how can we help them, you know, what are the potential routes we can go down? Every new treatment that someone was proposing, you know, I was trying to research and figure out and then doing my own research to try to figure out what is this and how can we help them. What did you think it was? Like what were the steps you took to try to figure it out? Well, at first it looked so psychiatric and that's, you know, what we were thinking it was.

It looked like, you know, severe OCD, rapid onset OCD and depression. And that's the road we were going down. So, you know, those types of medication treatments and psychotherapies, they couldn't do psychotherapy. I mean, like the traditional psychotherapy for OCD would be CBT, this version called exposure response prevention therapy. They literally couldn't even sit in the room with the CBT therapist trying to tell them, you know, how to do these various things. It was, you know, just untouchable by these treatments. The medications were not helpful and often making them worse. So the needle is not being moved.

not I mean it was getting worse I mean yeah is there any reason why I mean like one kid I like but like both at the same time is there any yeah yeah I mean so it made us concern that there was something environmental going you know there's that was a clue that this wasn't you know I mean we we even went down the road like did we do something as parents you know oh was there some traumatic did we yeah yeah were we doing something wrong we went to a couple a couple's therapists ourselves just tell the story and say you know, is it possible that we're doing something here that cause this? And, you know, after a couple sessions, he was just like, no, this is not, you know,

there's something going on biologically, like you guys got to figure it out, you guys are fine, there's nothing wrong with you to, you know, get to work and figure out what's going on. And I credit my wife, who was, you know, before me realized this is not psychiatric, you know, not solely psychiatric. She was the one who said, you know, we need to look at other things. There's something medical going on. There's something environmental going on.

There is this diagnosis called pandas, and it's now called pans. Essentially, it's acute onset autoimmune encephalitis. The immune system is attacking the brain, usually due to an infection. The classic one is a strep infection, but it can be other infections, lime and co-infections. It can be toxin mediated as well. Things like mold toxins can set it off. and other environmental toxins, or some soup of infections and toxins

and an immune system that just sort of gets overloaded and can't handle it, eventually malfunctions and starts attacking parts of the brain. Is this a common? It's not that common, although there are research groups that are looking into this and doing a lot in publishing about it.

There's a research group at Stanford that does a lot of clinical work and research work about it. So it's known. It's known, and there are certainly families out there who know that, you know, this fits. And it's any really acute onset, neuropsychiatric syndrome, especially if it occurs after an infection, or it seems to get worse after an infection, or some exposure. But what's the cocktail? Because, you know, I have two kids.

They're sick all the time. Yeah. You know, Strep was running through our house. Right. You know, my wife got it twice. I got it once. My son, you know, it's, I don't want to, it's not necessarily that any time someone gets a virus or bacterial infection, they, this could, you know, trigger the, the, you know, autoimmune

system. There is something genetic mixing together that your sons, because it's crazy that the other twin didn't have that. Yes, yes. There is clearly genetic predisposition for this. There's certain families where it seems to happen more than others. Now, it's hard to tease out genetics from environment because, you know, we share some of the same genetics in our family, just like any family. Or most families that, you know, are biological.

But we also share the same environment. Yeah. Right. So which is it? We lived in a very old house when the kids were young. Okay. In New England colonial from 1817. Love it.

Where there was literally like, you know, a basement that was, you know, had been flooded. Who knows how many times. Because we lived near a, there was like. like a creek running through the backyard. And at one point, towards the end of us living there, it completely flooded. So we realized, all right, well, we had moved out of that house by then, but that basement must have flooded how many millions of times

over the 200 years or whatever that it had been around. So lots of mold down there, for sure. We ended up getting the house we were living at the time tested, and it had mold as well. Toxins in the food, toxins in the air, you know. There's just so many things that we get exposed to these days. And, you know, you combine enough of that with the wrong infection, the wrong genetics, and this can happen. It's not, I mean, thankfully, not super common.

But, you know, I started to wonder how many of the people in my practice as a professional actually have some version of autoimmune encephalitis or some other medically caused neuropsychiatric syndrome. And, you know, this idea that we've ruled that out. now it's just a psychiatric diagnosis, you know, really is, is kind of absurd. I mean, I can talk about that all day. But, you know, we just sort of say, you get a couple of lab work and say, okay, you're medically fine. Now it's just some something in your brain.

But we've never really known what those root causes of what these, you know, mental health conditions are. What is depression? What is schizophrenia? What is bipolar? You know, it's, you know, the brain is connected to the body, right? What's coming up from me is like, and you're a doctor. Yeah.

I mean, I was at an event two weeks ago and one of the honorees got up there and I know her well, Jennifer Bandeer, she ran a successful kind of women's clothing line here in New York City and she's been MIA. She's been sick for several years and she basically said that she was diagnosed with long COVID and it ended up being MS. Right. You know, and like how many, as a doctor, it's like this. You got to listen to your patients.

Right. Like your kids, they were not getting better. So, you know, had you not been a doctor, you kind of just like kept, when did the shift come where you were like, okay, or what was the breakthrough moment, I guess? Yeah, well, I'll answer that. But I'm glad you brought up long COVID because that's a way people can really understand because a lot of people have long COVID or know someone that has long COVID. And it's very similar.

It's this idea that you've had an infection and now you've got these long term consequences your body's not working right your brain's not working right some people are completely debilitated and have never gotten back to work from long COVID right so it's very similar to what you know it's happening in pans for kids it's just maybe a little bit you know different infections but very very similar so you know people I think can understand this a little more if they think about long COVID and I think it's in some ways you know going to bring some more attention and research towards this idea that you know anything you know infectious can then present as brain health problem or a whole, you know, systemic problem that can last a very long time.

I want to, I'm just saying this out loud now so that we can go back to it because what has been coming up on this show is this idea of not really, it's not misdiagnosing, but it's, it's, uh, diagnosing without thorough evaluation and investigation of what the, the full picture is of the patient. Right. So with kids and ADHD, you know, not really understanding like maybe there's something else going on. And you just said, we don't really know the root or what is depression or bipolar disorder

or borderline personality disorder. And so my question really is here we are diagnosing and prescribing, you know, drugs without fully knowing perhaps what is the cause. That's right. So how does that become such a, you know, such a normal transaction in the field? I mean, is that the pharmaceutical industry being like, oh, we're doing our trials here and we know we got our doctors who are, you know, in our pockets saying, you know, go ahead, I see you on. Yeah.

I mean, I think it's a great question. You know, how did it become this way? And it's tough because, you know, we don't know the root causes of all these things. I can't even tell you the root cause of my kids' illness with 100% certainty either. We did all these investigations, tons of tests, you know, and we got some causes. We knew this was positive and this was positive and this was positive. And we did a bunch of things to help them. But, you know, do we really know exactly what was going on?

I mean, so the human body is incredibly complicated and mysterious. Meanwhile, there are people suffering with these conditions, whether it looks like depression and we call it depression, or it looks like OCD, or it looks like schizophrenia, or it's addiction, you know, and we have to do something to try to help them, and the medications can help. So it's not to say that we need to, you know, abandon treatment. And so that's the challenge that we're in is it's very hard to figure out what is the root cause, and yet we have to try to do things to try to help people. But I think it's important for all of us in the medical field to have humility that we don't

really know what's causing this. And we don't really know what's going to help and that we should be open-minded about the causes and the treatments that might help someone. And we should really listen to the individual who's coming to us and the families who know this person really well, especially if it's a kid. Because, you know, we don't know everything, especially in the mental health world. I mean, in medicine, that's true as well. But in psychiatry and mental health, we really don't know what's causing. these things so sorry to be a downer no i think that that's honest yeah that's honest i mean i you know my fear is that we just all get into this machine of health care and and we just turn and burn and

to a certain degree you know the thing that i've been thinking about a lot about in my career is like what does insurance get you what does all the money in the world get you what like like doesn't everyone deserve right this this care and compassion that you're approaching the world with around some of these things. And what got you to this point is the fact that, you know, you had two kids that rocked your world for an extended period of time. And so what, I'll go back to my other question. Like, what was the breakthrough?

What was the moment where, you know, you found out this connection between their health and the way that they were fueling themselves? So, or did that happen? I don't, yeah. Yeah, I don't know there was a specific moment. I mean, so we were already down the road of alternative ways of looking at this, by the time I heard that lecture about ketogenic diets, we were already working with functional medicine doctors and environmental medicine doctors and hearing what they had to say and offer.

And that world is a whole other world to itself in that, you know, there are people trying to look at root causes of things and they often can find root causes. And I think we did with our kids in many ways. But there's also a million blind alleys that you can go down and hundreds of thousands of that you can spend on out-of-pocket testing and treatments and consultations and most people can't do that. You know, we were privileged to be able to have the resources, both time and money, to be able to devote to finding all of this.

And we found, you know, mold toxins. We found Lyme and other co-infections. They definitely had very high strep titers, both of them, meaning that they had been exposed to strep many times. And for a lot of people, that is indicative of that strep was a cause. And then we ended up doing all kinds of alternative treatments. I mean, you know, lots of intravenous antibiotics and supplements and other alternative treatments like hyperbaric oxygen and all kinds of things to try to get them better.

And that's when we made the most progress, when we were doing the most aggressive, full, complete version of all of those things at the same time. Two things that are coming up. One is you, obviously, you are a doctor, your wife as well, or she's a psychologist. Yes, yeah. You know, you have access, you have knowledge. How the hell is someone out there who is just a normal person with a family on a day-to-day? How can they figure this out?

How can they be helped? And secondly, is, you know, I have two young kids. My in-laws have a house upstate. The whole house, you know, built in 1800, lead everywhere, right? Lead everywhere, right? My son has had, he was speech delayed, you know, exposure to lead could be, we've had his levels checked, we're in the country, ticks everywhere, you know, Lyme disease. Are you anxious?

Well, this is a thing that. Are you running home and you're going to go? Well, no, I do that. I do that. my wife has to check me because I'm you know I don't want to make my kids not want to go outside and play right you know but at the same time I've you hear horror stories and you know it's there is like the like the black cloud just like he is convinced that yet he will like you know smoke a cigarette and do the nicotine you know like he's like he's like he's a very mysterious

figure in the way that he like he'll wash his hands a thousand times that's true you're right you're 100% right like there are things I care about and then other things I don't care about But, you know, for me, I guess the question really is, is how do you walk the line of being careful and cautious without, you know, strangling your kids and their freedom? Yeah, I think just as you said, you're walking a line. I mean, I think, you know, you need to be, have some concern about certain things. I think, you know, things we know are a big deal. Like you mentioned lead, we know is a big deal. We know a tick bite is a big deal. You know, and so if there is a tick, you know, I live in New England. I've gotten bit by ticks. You know, I have a dog. I love going in the woods. I haven't stopped doing that even though this all happened. But when I get a tick bite, I send the tick off and get it. tested to make sure it doesn't have various things in it. And, you know, I will take antibiotics if it does. And so there are, you know, various ways you can be cautious and still live your life, which is, you know, you have to be able to live your life. It's so, it's so good for us to be out in the woods, right? So you don't want to give that up, right? Is your, are you more of like,

this is what we need to do? And your wife is like, let's talk about what we need to do. No, no, no. She's, she's pretty, uh, she knows what we need to do. She knows what we need to do. to do maybe more than I do. Yeah. So you go through this and we'll get back maybe in a little bit to how your kids are doing today because we'll want the update. But you have this experience, this personal experience, which is how life a lot of times works.

Then you hear this guy, Chris Palmer, who is really an expert in metabolic psychiatry, right? And that starts kind of, you know, making your mind go a little bit. When tell me about like the next, from that six years ago to today where you have this treatment program right this world like like like extremely innovative our team was just up there a couple weeks ago touring doing the open house you're treating patients you know based on the knowledge that you've gathered over the past six or seven years since that talk so can you take us through your findings the science behind it yeah i mean this is for me when you talk about schizophrenia bipolar uh borderline personality disorder mental health in general um and then you know

how that interacts with this keto diet because i also have questions I'm an athlete, and one of the things that's really gotten hot in the last couple years is this idea that you take a ketone shot before you work out. Right. And I don't know if it's real or fancied, or is that going to help mental health? So I want to hear so we can kind of educate the listener on that because I think people are going to be fascinated by your findings. Yeah.

Yeah. So at the time we were in the midst of all this functional medicine stuff, as I said, hearing about the ketogenic diet for these severe, you know, mental health, health disorders. I did not say, we have to put the kids on a ketogenic diet. We were already down a bunch of roads with various diets, gluten-free, dairy-free, whole foods, toxin-free. It felt like enough with food at the time. And the kids were already really complaining about their restrictive diet. Like the one thing they had was like food and we took that away from them in terms of like pletable food. So that would have been a tough cell at the time. So I put

myself on a ketogenic diet at the time felt amazing and then I was thinking to myself well I'm already making you know two dinners sometimes to try to get them to eat healthy food I can't be making myself yet another dinner so you know I just put it on the shelf for a little while we kept going with our kids you know like we were saying full-time job for my wife you know sort of second job for myself made a lot of progress with them and then you know once we were making enough progress with them you know I started thinking to myself you know this is always in the back of my mind like I need to go back to this ketogenic diet for mental health thing. So I started learning all about the biology of it, the mechanisms by which it work, how

powerful is it, how can this really work? I was also studying longevity at the time for myself because I was sort of, I think, having a midlife crisis and, you know, the way I dealt with that was like to try to understand how to be healthy for a long period of time. Yeah. And so the biology. The world is actually, by the way, you're not alone. I mean, the whole world, if you go, I mean, my social media is becoming a huge topic.

My whole feed, and I think we could probably spend an hour talking about the sauna, the cold plants, the diet, the sleep, the circadian rhythm, which I know, you know, like all of this. Yeah, which we try to incorporate, by the way, in this metabolic treatment because what I learned is that the way the ketogenic diet works is so overlapping with all of these other things that I was learning about longevity. The biology is all the same biology. ketones are our survival mechanism, essentially. This is how we survived when there was not enough food.

They're triggering the same types of things in cells that you trigger when you exercise or when you do a sauna or a cold plunge, you know, these things that make us stronger, essentially, that make our cells work better. But you can get that signal three times a day or really all day if you get your ketones up, you know, from a certain way of eating. Can you just explain those real quick, two things. And I know you did, but again, like essentially in a basic way, what is a ketone? And then what is the ketogenic diet?

Yeah, great, great. I'm glad you asked that. Yeah, so just real basically, the ketogenic diet is a diet that's high in fat, moderate protein. That's where people sometimes get tripped up. They think it's a high protein diet. It's not. If you eat too high protein, you won't make ketones.

So it has to be moderate protein. Enough that you can still build muscle. That's very important. So not as low as what the USDA says of 0.8 grams per kilogram, but more like one or 1.2 grams per kilogram is I think ideal for a ketogenic diet and someone who's trying to build muscle, which I think is incredibly important. And then very, very low in carbohydrate. So no simple sugars, no processed flowers, no grains,

not even things like beans and legumes on a strict ketogenic diet. Because you need to convince the cells to make these ketones. And the way you do that is to keep insulin extremely low. So insulin is the hormone that we make when we eat carbohydrates. And to some extent we make some insulin when we eat a lot of protein. That's why we can't eat too much protein on the ketogenic diet. So if we eat in such a way that our insulin stays really low all the time, then our liver will produce ketones, which are essentially, you know, we start burning fat

for fuel instead of carbohydrates when we start eating this way. You know, fat becomes our fuel for ourselves. And the liver will see these fats coming in and we'll chop them up into these little pieces essentially of that are called ketones, these little small fat molecules that can cross into the brain. So there's something, there's something called the blood brain barrier. I don't know how much science we want to get into, but it essentially, you know, keeps the brain pure from all the things circulating in the blood. It keeps it protected, essentially. And you can't get big long-chain fatty acids into the brain for use of fuel,

but you can bring ketones into the brain very easily for fuel. So essentially, our liver is making fuel for the brain in the form of these ketones. When we haven't eaten in a while, we will make them, or if we're burning fat for fuel almost exclusively without having carbohydrates in our diet. And that produces what in the brain? Someone doing this will feel. So what happens? Yeah.

So there's lots of mechanisms by which ketones improve brain health. But I'm just going to focus on two to start, and we can get into more if we want. But the first one is that it's an additional source of fuel for the brain cells. So most brain cells, neurons and the other brain cells, but we'll focus on neurons. They're the ones that are doing the real work. They're the ones that are, you know, making the thoughts and the feelings and movements and everything, you know. So neurons are burning glucose generally, normal metabolism. But what happens is the neurons become insulin-resistant.

And we know by research that all the mental health disorders have brain insulin resistance as part of the mechanism. And so when the neurons are insulin-resistant, they can't get the glucose into the cells to burn as fuel. So there could be glucose all around. Someone could have just had a big bagel and there's glucose everywhere, but the neurons can't get it in to burn as fuel. So they're literally bathed in glucose but starving for energy.

that causes like just in a very basic term like low energy like well it causes malfunction in the neuron so what you know we don't really know sometimes it can make the cell have to it has too low of energy so it can make it you know hypo functional you know like low energy or it can make it get hyper excitable also if it has too low energies it's just going to not function right optimally it could go either direction but ketones come in and they don't need insulin to get into the neuron. So they just go right in and there's a great source of fuel for the neuron and it bypasses that blockade of insulin resistance. So that's a really important mechanism. And for some people, they'll feel benefits from just getting like the first day their ketones go up. They'll say,

whoa, I feel different. Or they'll take an exogenous ketone like you said and their ketones will go up and they'll say, whoa, you know, I really feel something different. Like my brain feels clear, more focused and that's that additional source of fuel coming in for some for an insulin resistant brain essentially so can we go there for a second yeah yeah i'm laughing because i had okay i'll share this i take this brand it's called ketones IQ they're they're great i mean like i met their founder you know a lot of endurance athletes are taking it i don't know if it's placebo or not but like i ran the london marathon last weekend took ketones before i have some feeling of euphoria i remember though they sent me a package one point and there was a bottle and it had 10 doses in it.

Yeah. And I thought it was a drink. Oh, so you took all 10? I took like eight of the doses and I felt like what, what happened to me? I mean, I felt your ketones were really high. Yes, I was not well. I mean, I was like, oh, I mean like. Yeah, that would like it was not good.

I did not feel good. Can you overdose on ketones? Is that? Yes. I mean, so in therapeutic ketosis, we do measure people's level. So it's also very different than most psychiatry. where I'm prescribing something. I can't check a meaningful blood level

on most of the medications I prescribe. With this, I'm checking ketones. I want people to measure them every day. And I know that if I can get their ketone level above 0.5, that's considered therapeutic ketosis. For more severe conditions, I really want to get their ketones higher than that, more like 1.5 or 2 and above for weeks or months on end

before they're really going to start to feel all the benefits. So, yeah, I mean, it's... But how does that just... just relating back to marathon man here because you know you will load up yeah on carbs right well that's yeah what's the interact like can you manufacture ketosis but has it relate to if you're spending the whole day you know eating pasta and donuts and whatever you know so you're not so if you're spending all day eating carbs you're not going to naturally make ketones unless you go out and exercise long enough like when you run a marathon you're going to make some ketones

towards the end of that unless you're you know eating carbs the whole time you're running Some people do that. You know, you'll just carve up every hour, a certain amount. So, you know, but exercise creates ketones as well. So if someone's metabolically healthy, they run out of their glycogen storage and their muscles and they're not eating more carbs, they'll start burning fat for fuel, and they'll start making some ketones. And, but it's not the same as being in medical ketosis, therapeutic ketosis from the diet.

Because the difference there is that the ketone levels are high all day long, 20,000. 24-7. And so that gets us to our next mechanism, which is that these ketones are a signaling molecule. They're not just this additional source of fuel, but they're a signal to the cell to improve mitochondrial health. And mitochondria's are, you know, incredibly important for health. The powerhouse? It's the powerhouse. Only thing I remember from, yeah, that's what most people remember. And that's really important. Even if that was all they did, they're super important because they're the one making all that ATP. They're producing ATP from either the glucose or the fats.

And so they're the energy factory. They're making all this energy. We need that. That's super important. But they're doing so much more than that. They're involved in, they huddle around the end of a neuron when they're about to release neurotransmitters. They seem to be involved in signaling neurotransmitter release.

They're involved in the production of hormones. They're involved in the immune system, inflammation and the resolution of inflammation. So mitochondria doing all these things, they have this intelligence, we're in a symbiotic relationship. Mitochondria used to be bacteria that a cell engulfed essentially and then has become this part of our cells. We could not exist without mitochondria. And so energy factory for sure. And so we're now going to make more of these mitochondria and take apart the ones that aren't functioning. These old non-functioning mitochondria get broken down and the parts get used to.

rebuild new better functioning mitochondria this is called mitophagy it's part again related back to this whole longevity world where people talk about autophagy which is this idea of cellular recycling well we do that with mitochondria and we call it mitophagy but ketones signal ourselves to do that and to make more mitochondria called mitochondrial biogenesis so i want i want to get to the root of your work yeah because you started at because i don't want to miss i don't want to miss the main thing here like like which is you started the episode and you said we're in a mental health crisis and we are in a metabolic health crisis yes j then about halfway through this conversation brought up the idea that what is this what is this line that we kind of walk in terms of you know being a patient

in america and struggling with mental health and not having access to care my mind actually goes to this might be a wide-ranging solution for mental health because what will happen with me is I will get a lot of direct messages on social media of people that are struggling with their mental health and there typically isn't something that I can hand them right you know it goes into okay what's going on let's do an assessment do you need therapy do you need treatment now what I really want to say is have you are you drinking water are you fueling are you getting outside are you like connecting with other people and how are you fueling so I say all that to say at what point can I start telling those people like have you ever done a ketogenic diet like have you ever

this might sound crazy right but something you have access to and everyone has access is to to do this diet and then I also want to hear what you're doing specifically at a cord because I'm sure it's not just yeah you know there is some other therapies and things that you're instilling into your patients there yeah i mean i'm glad you're bringing this up because on the one hand this is an incredibly empowering thing for people to know that they can take control over their health their mental health and their metabolic health their physical health through their lifestyle it is possible people do it all the time they say all right you know i'm now i know i'm metabolically unhealthy i'm going to you know start this program i'm going to do low carb and fasting and

I'm going to turn it around and you see, you know, on, you know, people are writing their comments about their own story on internet, you know, posts or on YouTube posts all the time. You know, I've lost 80 pounds. I've never felt better. I've now exercise. I never could before. So it's incredibly empowering. The part that's a little tricky is that if you're using a ketogenic diet for mental health, it's a little bit specialized in that, you know, it's not, so it's not quite the same thing as just, you know, eating low carb and exercising for overall health. But what I would say is that anyone can do those things.

Anyone can reduce their carbohydrates, get rid of ultra-processed foods, eat a whole foods diet, exercise, work on their sleep, work on their mindfulness, and get tremendous overall benefits. I just don't want to say that anyone can treat themselves for a mental health disorder. Correct. Which, you know, I can't say that. But it is empowering. And for the people that I've worked with in my private practice and at Accord, people feel very empowered. They're like, now I have much more control over how this is going to go.

I can eat the right things and do my exercise and follow this plan and feel amazing. And I don't need to rely on someone else to fix me in the same way. So I love that about this in that it takes it out of the hands of only the professionals can fix people. I just think about the human experience, right? I mean, like, and I'll be, I'll be honest, my, my, if there was one area of my life 13 and a half years into my sobriety that I fail pretty, pretty miserably on a daily basis, it's my diet, you know, and it's because I have no, no guy, I mean, I woke up this morning. I ate this, you know, meal that I got at the gym last night, and then I met someone for coffee and there was a donut that looked good. And then on the way out, I grabbed the baguette with a ham and cheese and a digital, I mean, it's like, it's 11 o'clock in the morning, you know, and I'm just. And so. It doesn't need fruit. Exactly. But do you think. But do you think, because you run so much, you exercise so much, that you give yourself an excuse to like go wild on your diet? I don't really, I don't go wild. I mean, I also will starve myself for 12 hours as an entrepreneur and a CEO. Like I will wake up at seven and it'll be seven o'clock at night

and I'll be talking to a friend and be like, I haven't eaten a bite of food today. Right. And so the feeling of taking this power back from, like it's speaking to me. Yeah. Well, I mean, the lesson is that food really matters. You know, what you put in your body, really matters. Even if you're doing all the other things right, you can become metabolically unhealthy by eating the wrong things. There's a great story. There's a company. But what does that mean though? Does that mean? Yeah, let me tell you the story. I think it illustrates the point. So there's this founder of this company called Verda Health. They're now like a $2 billion company. They reverse type two diabetes. Wow. And this is a guy who was like a serial entrepreneur. Before he

founded this company, he was in between, you know, companies and he was running triathlons. And he was fueling up with these like, you know, gels, these like, you know, straight sugar, essentially. And so he won, you know, some, you know, triathlon in his age category, like super competitor. And at the same time, he was getting diagnosed with pre-diabetes, meaning he was really metabolically unhealthy. And so he, you know, goes to, you know, some expert doctor and says, how can this be? You know, I'm training all the time. I'm super fit. I'm doing the best I've ever done. And they looked at it and said, oh, it's, it's all that sugar. you're eating. You're eating a bunch of sugar while you're training. And so you're, you're not getting

all the benefits of the exercise because you're eating so much sugar. And people overdo it. You only, you only need to, you know, fuel up with about 10 grams of sugar per hour of exercise. And people are taking in, you know, four or five times that amount. And so all that excess is not good for the metabolic health of cells. So that's what I mean to say that, like, you know, you can be doing all the right things and still get type two diabetes, but you're not really doing all the right things because you're eating all this sugar essentially. And that inspired him, I think, to be part of this company that has now, like I said, reverses type 2 diabetes and almost anyone that comes through their doors. And it's an online company. Everyone should know about it. This should be

on the front page of the newspapers. Type 2 diabetes is completely reversible. And do people with type 2 diabetes know that? No. So is part of you and your career and where you are in this moment in time, like you're putting this flag in the ground and saying a little bit of like, we got to go back to the basics? Oh, yeah. Yeah. I mean, it's, I mean, my mind was blown, you know, by this experience with my kids. And now I can't unsee what I see, which is that we're not doing health right here. And it's all about prevention. I mean, really. I mean, in the end, we wouldn't have this metabolic health crisis and mental health crisis if people weren't eating the way that they're eating. We're, you know, food pyramid is really not serving us.

We've had this metabolic crisis brewing since 1980 when the food pyramid first came out. And it's teaching us to eat, you know, most of our calories from carbohydrates, which is really not good for us. And what do you trace that back to? You know, fast food, you know, companies, processed foods, you know, just a cheaper, easier way to eat your meals and get your food. Yeah, I mean, it is. It's very good for the food companies.

You know, they make much more profit on, you know, a box of cereal. You know, that's, you know, when they ultra-processed food, they take, you know, cheap grains and turn it into a, you know, I don't even know how much cereal these days because I haven't bought a box of cereal in many years. But, you know, whatever, because your $8 box of cereal or whatever. And that's almost all profit. No one makes that kind of profit on meat and eggs and fish and broccoli, right? So, you know, when they process the food, that's where all the profit comes in. And that's, you know, 90% of the grocery stores, those interior shelves that are, you know, shelf-stable food. I mean, I mean, we're even generous to call it food, some of it.

It's not really food. Yeah. So what, so you want to go? what happened so can we let's go back to your kids first like yeah well then i am going to go because i'm going to do this i'm going to there's like kind of three things that i want to close a loop on here yeah and i want because i want got a lot of loop closing i'm so inspired by this conversation and it is so aligned with the way i kind of think about it in the addiction recovery space is there are a lot of new methods coming online yeah and i'm not to say those things don't work

but there are traditional methods AA being one of them from the 1930s that is proven to work and that's not that's not rooted in it has to be AA but it is rooted in

community for someone who is alone is very important right so like a good diet for someone that has a bad diet is probably really important so I digress on that

but one I'm only throw three questions at you you can answer them in any order that you want one is your college what are the holes they are poking in this and how are you responding to that because I know I have brought you up in conversations to and I've sent your information to people because I was

as I mentioned like I was very inspired by that conversation two I want the update on your children yeah and then three just the the assessment and how you're treating people at a cord like really fundamentally so people can hear that because I think it's important sure so in terms of colleagues. So the state... And I can remind you if you lose track. Yeah, yeah. The state of the evidence

in ketogenic diets and mental health is that we have right now large case series. They're incredibly impressive. So like a case series of 31 inpatients and an inpatient unit in France with schizophrenia and bipolar and major depression.

Case series that came out of Stanford, people with bipolar disorder and major depression. We have case series or a pilot study in University of Edinburgh, but these are not yet controlled, randomized controlled trials. And so in medicine, we have sort of fetishized the randomized controlled trial in a way that it's not that's not important. Randomized controlled trials are very important, but it's only one type of evidence. And there are certain things that don't, you know, are not amenable to randomized controlled trials in the same way. All these lifestyle things, for example, like diet and exercise, it's very hard to do a randomized controlled trial on those things.

It's very easy to do a randomized control trial on a pill. And so, you know, medicine has now come to this level of saying, we only care about randomized control trials, which means we're getting rid of anything that doesn't do well in a randomized controlled trial, which is really problematic. that because it sort of excludes these other things that are really important and really powerful that are harder to study in a simple randomized control trial design. And so a lot of my colleagues are sort of saying, well, there's no randomized control trials, which I get. There are randomized trials happening right now in ketogenic diets for mental health.

So we will get some of that data in the next couple of years, which I'm very excited about. And so some of that argument will go away. However, you know, I think there's a bigger issue, which is that doctors, you know, I was this way until I learned, until my mind was blown, you know, doctors want to do things that only doctors can do. And prescribing a diet or a nutritional plan or an exercise program or a mindfulness program or circadian rhythm program is not something that doctors really feel comfortable doing, most of them. because you didn't have to learn all of that in medical school. And you're not, I mean, to be honest, it's like, you know, you're in a privileged position. You can write a prescription as a doctor. No one else can or, you know, only, you know, PAs and nurse practitioners and doctors can in our country, right?

And so they like to do things that only they can do. I was the same way. So I understand the mindset. And we didn't learn nutrition in medical school either. So it's also this whole thing that they would have to learn that's different from what they've learned and what they were taught in medical school. And if it wasn't taught in medical school, how important could it be anyway? So there's a lot of that.

And I think that's going to be the main response from the psychiatric and mental health community for the foreseeable future. I mean, until we get some of these more randomized trials coming out. But the fascinating thing is that there's a huge grassroots movement going on on metabolic treatments and mental health. The families, the individuals are totally observable. by this, you know, to use a bad pun, they're sort of, you know, eating it up. You know, there's these, you know, videos on YouTube and, you know, podcasts that people are going on and

books that have come out, Chris Palmer and Dr. Georgia Ead have both have these great books about metabolic psychiatry. And people are gravitating towards this because they're not getting help. Right. They're not getting enough help. And this is something that makes sense. It's intuitive and it's doable. And the stories and the case series and these pilot studies are dramatic how much people are getting better. I mean, it's like your jaw hits the floor when you hear these things. You know, people go from being on five medications and not feeling well and not doing well to, you know, after a year or two on ketogenic diets, some of them are on no medications

and thriving and never felt better. And it's as if they're in complete remission from a severe mental health disorder like bipolar disorder or a schizoaffective disorder or severe depressive. or OCD and I can't do that with medications right I can't make people in remission in that way and functioning in that way and so you know so you know so the tide will turn I don't know how long it will take believe what our eyes are telling us exactly I mean that's right and it's so low risk too so I mean that's what you know the argument that sometimes doctors make is well there's not enough evidence but you don't need a solid of evidence to do an intervention

that has such a little risk everything's a risk benefit calculation in medicine in life maybe you could say too right but you know if the risks are very low and the benefits are potentially very high that seems to be to me a no-brainer and I think a lot of people out there agree with me maybe not all my colleagues but a lot of people who are suffering from this or families that are you know dealing with this agree that this is really worth trying yeah is it not just because you you say metabolic psychiatry you don't say keto psychiatry right so so I mean yes so I mean, the term metabolic psychiatry is, you know, just one term that people use for all of this. It was coined by one of the researchers at Stanford who published that pilot trial, Shabani Sethi, came up with that term.

I think it's a nice term because it does link together this idea of metabolism and psychiatry. Some people don't like the term because it includes psychiatry in it, which is so infused with this idea of, you know, using medications and other treatments. So you could say metabolism for mental health or ketogenic metabolic therapy. I mean, there's lots of different terms people can use. But keto is at the center of it. Keto's really important. It's the most powerful way to really change metabolism. And so it's really, you know, for someone who has a more severe condition.

And addiction, I include, that's definitely part of this as well. There's actually some data about addiction that I can talk about. You know, ketogenic diet is really an important part of the program. It's sort of the centerpiece of the program. And then we add on things. So this sort of gets to what we do at Accord. we do this very thorough lab evaluation. We put them on an individualized ketogenic diet from our dietician and our chef is making

that food for them and it's delicious so people don't miss what they were having before and they don't feel cravings and withdrawals and stuff as much because they're eating this really delicious food. But then we get them exercising as well, walking after each meal, getting them in the gym and doing some resistance training. We get them doing mindfulness, which is really important as part of the of metabolic health actually because so what we see we have continuous glucose monitors on people and what we will wear them the whole time yeah would you like

should everybody wear one I think everyone should wear a continuous glucose monitor for two weeks and see what's going on with their blood glucose it's incredibly in you know insightful into what's going on in your metabolism because you realize that you went and had that you know you just happen to grab that donut and your blood sugar just went to 210 and And your blood sugar should never be 210. I'm just terrified. But maybe it wouldn't.

I mean, if you worked out as well that morning, you might not. I mean, it depends on, I mean, if you have enough muscle, you can, you have a buffer against some poor diet, you know. No, I know. There's a reason, you know, there's like mornings when I feel hung over after I eat like crap. Yeah, absolutely can. So they're there.

So, yeah. So let me just say a little bit more about the mindfulness and the CGMs. Oh, yeah, yeah, yeah, yeah. So they're wearing CGMs. They're eating almost no carbohydrates or low amounts of carbohydrates. And all of a sudden, their blood sugar is spiking. And they'll come to us and say, my glucose is 150. You know, what is going on?

And usually on a ketogenic diet, it's, you know, hanging out in the 80 to 95 range, maybe down to 70. You know, it never goes above 95, you know, if you're eating a ketogenic diet unless you're stressed. and all of a sudden you get ramped up, you're stressed, you're making adrenaline and you're making cortisol and your body thinks it's got to run away. Well, what does your body do when it thinks it's got to run away? It's our primitive responses. It's going to release a bunch of glucose to say,

well, if you need to run from a threat, you need some fuel, so we're going to pump out the glucose. Your liver will just, and muscles will just start releasing it, essentially. And so we'll see that happen. And then we'll say, all right, take some breaths, you know, get grounded, do a mindfulness exercise. Glucose goes right back down to 90. So, you know, we demonstrate that to people, you know, how important. And for some people, they could do the diet and the exercise and get good sleep.

If they're not doing the mindfulness thing and they're not managing their stress, they're not going to get the same benefits. They're not going to make ketones in the same way. Because also when their blood sugar goes up, their cortisol's up, they're not going to make. ketones during that time either and it's 20 like 30 day is it what's so minimum of 30 days some people stay a second month or a third month because we have a huge emphasis on teaching people everything they need to know so that they can keep going with this in the regular lives indefinitely that's the idea it's not just you go and you do this and you feel good and you go back to your regular lifestyle this is a meant to be a permanent change in lifestyle and some people

need more time to learn all that stuff and how are they going to apply it at home And if you break ketosis, like if you break it, is that a relapse? Is that like what, like, I imagine there's some stuff around diet culture with all this too. And, you know, eating disorders, obviously we see a lot of in our work. And yeah, I think of, you know, my sister who's been very vocal about her struggles and, and has it in a good place. But to your point earlier, like, we have to eat. Yeah, we have to eat. The eating disorder community is actually the most resistant to this in the whole mental health community.

Because they say, you know, especially. especially for anorexia, you know, the mantra has always been, all food is good, you're saying like there's some foods that they shouldn't eat and you can't do that. And that's a big problem. Well, it turns out that the ketogenic diet happens to be, it looks looking to be very effective for anorexia nervosa, which is one of the most severe and deadly of all the psychiatric conditions that exist. I mean, you know, people die from anorexia at the highest rate of, I think, all psychiatric diagnoses. It's really lethal. It's really bad. And it's very hard. to treat. We don't have any good medications for it. And the psychotherapies for it are, you know,

not all that effective most of the time. People go to program after program after program and they never get out of it. I've taken care of many people in my career who are chronically anorexic like that. So there was a case series of six people with anorexia that were put into remission with a combination of ketogenic diet and ketamine infusions that was done. And now there's two big trials going on at University of California, San Diego, where I know the invariable. investigator who's doing these trials on teens and adolescents with anorexia, and he's seeing incredible results with the ketogenic diet. Amazing. But how do you, so first question, who can go to a cord? Anyone with a metabolic syndrome or just anyone who's like, I need to

change, you know, my relationship to what I eat or how I... We're pretty open. I mean, we generally say, you know, we want people to come who have some mental health situation. Pretty severe, right? I mean, pretty severe. We have been mostly getting people who have severe conditions. So, You know, we've taken care of people with schizophrenia, schizoaffective disorder, lots of people with bipolar disorder, major depression, OCD, lots of people with comorbid trauma, comorbid addictions. So, you know, we've been doing all of that. But, you know, our criteria for- Do you consider it like a last house on the block? Is that, or is that how people are viewing it? What do you mean?

Someone who's been in mental health treatment 10 times shows up at your doorstep and says, I'm willing to try anything. There is some people where that's the case. Some people where it's just, you know, they've been now in the system for a few years and they're not getting anywhere. You know, things are getting worse, in fact. You know, with all the medications and treatments and they're spending lots of money, some of them are, you know, and they're getting nowhere.

They're not getting any better. I mean, or they're stabilized enough, but, you know, they're not needing to be in a hospital anymore, but they're not really living life. That's so common with these disorders, right? People get on a bunch of medications. and I still prescribe medications. I mean, I'm a big believer. Medications save lives.

I used to work on an inpatient unit where I've saved many lives with medications and even things like ECT. So, yes, people need to get put in these medications. They have a first break of a psychosis or a manic episode or a severe depression. They need something to get them out of that and before they could even entertain something like a cord.

But then they get stuck. They're on these meds. They're not needing to be hospitalized, but they also can't get back to work. They can't get back to their regular social community. They're not back in their roles in life. And they're just living a life as a patient. There's so many people like that.

And I think this is a great option for people like that because they can turn things around over time. And then eventually they may be able to reduce their medications slowly under a doctor's care. I never recommend people take themselves off of their medications. Amazing. What's the barrier for entry? Like, does insurance cover this?

No, so it is a private pay program. I mean, insurance doesn't even cover, I mean, can you believe this? Insurance doesn't even cover a visit with a dietitian for someone with a mental health disorder. Yeah. You have to have diabetes or pre-diabetes to even have insurance cover. Yeah. You're going to blaze the trail. This is definitely new.

And we're the only place that's doing anything quite like this. It's a great question. So, yes, it is a private pay program, but we do have some scholarship money available. So, you know, if someone really thinks this is the right thing for them and they don't have the, you know, ability to pay for the full fee, we can work with people. Well, I mean, look, if we're being realistic about it, anything in early medicine is expensive. Yes.

And the hope is that you are going to do it and do it in a way where people start paying attention, which I think they will. And then we will learn to produce this and manufacture it and roll this treatment out in bigger ways where insurance and other things cover it. So I appreciate your, you know, carrying the sword, if you will. Yeah, I mean, we need to do more research. And then, as you said, there's ways to scale this up to make it much less expensive. There can be a little program in someone's community where they can show up after work,

cook dinner, learn the cooking, learn the diet while they're cooking, they can learn all about it, and then start applying it in their life. And for, you know, three or like an IOP kind of model kind of thing could absolutely be, you know, transformative. And, you know, in the end, it will save insurance companies money because we're making people metabolically healthy. They're no longer going to have pre-diabetes. They're no longer going to have, you know, fatty liver and all of these things that are going to, you know, ultimately cost the insurance companies lots of money. Yeah. Yeah. I have a couple things because we got, I mean like, yeah, a couple things here. One, number one. Because we got to get the kid up. We're going to end with the kids. Yeah,

we're going to end with the kids. But a couple of things. You have children. Yeah. Someone has children. Yeah. What is a healthy diet right for kids. Yeah. Because obviously you're not going to monitor them on the on the ketosis and be measuring. What is a healthy diet for kids today? So the most important thing to think about as a parent who's got kids is think about how much ultra-processed food they're eating. You can't avoid it. But is it 80, 90% of their calories or is it more like 20% of their calories? Huge difference. So that would be the thing that I would focus on as a parent. And ultra-processed foods are things that have, you know, five, you know, generally like five ingredients on the label or more and lots of things that you can't pronounce. So, you know,

All these chemicals and the foods, the things that can sit on a shelf for three years and still be considered, you know, edible, you know, has to have a bunch of chemicals in it. And so if you can get that percentage of ultra-processed foods down much lower, really important. And then, you know, try to avoid sugar all the time. Soda is just not necessary, you know. And so that's where I would start for parents and keep kids moving, you know. There's so much now of, you know, kids getting stuck. in front of screens and not getting outside and not moving their bodies unless they're like on the athlete track in which case they're probably exercising too much for their bodies as kids

right so we we have this like you know you know bipolar way of dealing with us instead everyone should just be getting out and getting some exercise okay second thing i you know a young person who is struggling with substances whether that's alcohol or cocaine or heroin something you know they have a they have a problem they come to you yeah Yeah. You know, how would you treat them? Yeah. So, I mean, are they willing to do this? They're in your office and they're listening to you. They're willing. Okay. Yeah, I would say, look, like we need to, you know, detoxify your body.

You know, are they going to go through withdrawal? You know, I need to, you know, manage that question, number one. If not, if it's something where they're not going to go through withdrawal, the same things. Let's start small with let's try a whole foods, get the ultra-processed foods out of the diet, start moving your body, start doing a bit of mindfulness, start small, you know, and see if they can, you know, with all the other supports that they might need to reduce their use or hopefully stop their use of that substance. But ultimately, we've got to get their, the metabolically healthier, you know, and eventually it may be that, you know, they may want to do a ketogenic diet to really get them to the point where they can do this. But in your, and I know maybe you don't want to say this,

but like in yourself, what you believe, if someone walks into your office, are you thinking, if you do what I say, you will not need any assisted medication treatment, you will be separated from the drugs and the alcohol, you will live a healthy life and you will feel, and you will not need anything other than what I'm telling you to do? I do believe that if someone, you know,

is willing to do all of it, like come to a court and get completely, completely immersed in it. They're willing to put their substance aside, come in and really do the program, we can do that. I really do. Well, I love that. I think it's that powerful.

Anyone who actually does the program, the results are mind-blowing. What's like anything in life? Yeah. You know, if I go to the gym and I'm prescribed a workout. Yeah. And I pick bits and piece. Yeah, well, but on the other hand, if I pick bits and pieces of it, it's probably not going to be as effective.

That's right. No, it's exactly the same thing, as you said. It's like, you know, your trainer tells you to lift this way, eat these things. If you do that, you know, you're going to build the muscle that you want to build. It's that's it. But the hard part is doing it. Like, can you get yourself to do it? That's the challenge.

That's why we made the program, this immersive program where there's supportive staff around and all these other people there. And it's easier to do hard things in a group of people who are also doing hard things with you. Yeah. And so that's that attitude and mindset that we sort of develop within the community there of yeah we're doing we're all doing this hard thing and we are feeling better and we're we're we don't want to go back you know that's that's sort of the attitude okay let my last thing I did want to go into longevity but I will put that to the side I'm just running like my tea I am such a stickler for time and we have a staff meeting and I'm now too okay okay so but I have to

I have to flip it on my anxiety I need I'm sorry I'm sorry I'm sorry I have to but anxiety is the word because I have to flip it on its head for a second you know you started mental health epidemic mental health crisis young people what is the balance of or the risk because there are people who you know this idea of prevalence inflation we talk so much about this stuff that we start to believe it is real or happening in our life so younger more younger people are anxious more younger people are depressed you know therapy is at the same time greatly encouraged and more people are seeking therapy. Like, are we, Ken, do you, is there a risk of manifesting, uh, the problem?

Because we're so aware of analyzing a potential problem. I mean, I, I think I understand what you're asking, um, you know, because we keep talking about a mental health crisis. Are we creating a mental health crisis? I don't think so. I mean, not from where I sit. And I think, you know, the statistics agree with me that they're true. truly is more problems with mental help. There truly is more autism. It's not that we just

change the diagnostic criteria. There truly is more teens with anxiety. It truly is more teen suicide. So I don't think we create that by talking about it. I think we're talking about it because it's happening and we don't know what to do about it. And what we think we are doing to help people isn't helping people enough. And I think this is the missing. peace in that you know the metabolism of our country is getting worse and worse and worse and worse and we're continuing to eat the you know these ways and you know look at screens all night and not get good quality sleep and all these things that you know sound unpopular to get people to try to change but they truly are affecting our biology and our biology is where

you know the root of our mental health yeah yeah amen brother all right What's the update? So my older one, the one who was 14 at the time, he was actually more ill than the younger one. I mean, he was so severe. He couldn't get out of bed for a couple of years. He literally, he was an athlete. He was a soccer player. He used to play soccer six days a week.

I mean, it was just tragic to see him so ill. He couldn't think he couldn't go to school. He was out of school for two years. He missed two years of school. He's now back in college. and studying pre-med and uh he goes to the gym you know he's a healthy kid um has friends you know he's doing great yeah not that this didn't affect him you know he is you know this will you know i think probably are you get emotional is this yeah yeah yeah yeah i know it's very emotional

i mean we went through so much you know and he's so proud of him yeah it makes me tear up so that's so beautiful um unfortunately my younger one he had was not quite as affected he was getting better and actually was he was about 90% recovered and he was in school during the pandemic that when they forced everyone to go back to school and he was very worried about that it was when that omicron wave was happening i think it was 2021 early 21 and he got that and either he has relapse from some version of long covid or it's that plus a combination of just the trauma of getting ill again after he had done all that work to recover and then got set back and the fear that you know all that work can just be taken away from him from just getting exposed to the wrong virus

and so he's really unfortunately you know pretty stuck again right now um and of course you know because his dad is so into this stuff he's not going to do it he's he's 20 years old now so yeah so he's not going to do you know what i'm was you in college or no he's really stuck he's just you know He's at home and he's, you know, in an extended sort of gap year kind of thing. Yeah. So it's really sad. Yeah. And, you know, but we're there. And, you know, he's still, you know, mentally, cognitively sharp. And, you know, at some point he's going to decide that he wants to try again. And I've got all kinds of ideas. Believe me for what he can try. Well, your honesty and emotion is so real and raw. And I, I do not. regret my decision to have you in and to have this conversation because I think that you just hit on so many things that I've been thinking about, the processed foods, the screen

time, the way that we treat our bodies, the way that we sleep, the way that we, you know, wake up. All those things are so, so, so important. And so I'm grateful for you. How do people find you? So I'm not big on social media. I do have a LinkedIn account. So people can always find me there. And if they send me a personal message, I always respond. And then they can find Accord on, we have a website called AccordMH.com, so, you know, people can find us there. And we have all kinds of resources and blogs, and there's a, you know, a video of me doing an academic lecture about all this stuff, talking about all the data. And, you know, I'm, you know, trying to get the word out in every possible way that I can, because I really do think that

so many people can benefit from this. And people don't know about it. And so I just want everyone to hear that this is an option for them so beautiful yeah well you feel like matt more than dr. Bernstein now i appreciate you sharing you know so much and thank you i know jay probably wants to talk to you for another three hours well maybe we'll do a part two at a later point in time yeah we're excited to see what the journey takes you thanks for coming my pleasure thanks for having me thank you yeah