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You find three times the vitamin E

0:48

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F-A-R-M-A-C-Y. Now, let's get back to

3:13

this week's episode of The Dr.

3:15

Pharmacy. Hey,

3:18

everyone. Dr. Mark here. Brain disorders for so

3:20

long have been made to feel out of

3:22

our control. But there's so much we can

3:24

do to prevent and reverse the range of

3:27

signs and symptoms that steal our brains, our

3:29

bodies, and our health as we age. Now,

3:31

one very potent way of supporting our brain

3:33

is through food. A diet rich in healthy

3:35

fats like omega-3s, quality protein, and anti-inflammatory spices

3:37

will do the trick. In today's episode, we

3:39

feature three clips from The Dr. Pharmacy about

3:41

how food that we ingest at least three

3:44

times a day can have a massive effect

3:46

on our brain health. Max Lugavere Takes us

3:48

through all of the healthiest brain foods. And

3:50

I Forewarn you about the foods you shouldn't

3:52

eat, encourage you to eat the ones you

3:55

should, and remind you that you can't forget

3:57

hydration. And Finally, I Talk with Dr. Uma

3:59

Naidoo. The about our food impact the

4:01

microbiome which has a direct effect on

4:03

Brinkley. She's like anxiety and depression so

4:05

let's jump right in. I looked through

4:07

the medical literature and I determined foods

4:09

that were going to be the most

4:11

accessible. The. Most available to people.

4:14

That. Are listening to this and watching this. That.

4:16

Are going to serve a narrow protective effect.

4:19

Foods that are literally superfoods for the brain.

4:21

And I coined the term genius Foods which

4:23

is not a scientific term, but I love

4:25

it. It's the term that I've applied to

4:27

the foods that are gonna give your brain

4:29

the most bang for it's buck with regard

4:31

to neuro protection. With. Regard to

4:33

promoting neuroplasticity by providing important builder

4:36

block molecules like Nikos a hack

4:38

see know it Acid or Tha

4:40

Fat. Which. We Know is one

4:42

of the most important and yet under consumed

4:44

structural building blocks of mine. And.

4:46

So we can look to certain foods like. I'm

4:49

avocados, for example. Avocados

4:51

at this point are pretty widely available.

4:54

And avocados or a fruit that

4:56

provide the highest concentration of bat

4:58

protecting antioxidants. Have any other fruit

5:00

or vegetable. While. Yeah.

5:03

Like this, this is of relevance to the brink of. The

5:05

brain is made of fat right after I'm in. The brain

5:07

is made of fat, but not just any fat. It's.

5:09

Rare is made of a type of

5:11

fat that is most prone to oxidation

5:13

most vulnerable to it's called oxidative stress

5:16

and will eat, and avocado which is

5:18

rich in vitamin E, a fat soluble

5:20

antioxidant. It. Literally is one of the

5:22

most powerful. Brain. Anti aging

5:25

foods that you can consume. It's

5:28

also loaded with. Biber. Which

5:30

makes it's a shooting in and it helps

5:32

support gut bacteria which is promote of have

5:34

a healthy gut microbiome. It contains potassium which

5:36

we know is really important for helping. I'm

5:39

maintain a healthy a level of.

5:41

Blood. Pressure. And it also

5:43

contains compounds called ah current noise

5:46

which we know protect neural tissue.

5:48

Both. In our eyes and in our brains.

5:50

One of the reasons why avocados and dark

5:53

leafy greens are protected against age related macular

5:55

degeneration, the continue to run noise, Which.

5:57

We now know also Protect brain. So.

6:00

That's one of my favorite foods, avocados. Yeah,

6:02

the thing, my problem with that is it often

6:04

comes in the form of guacamole and

6:06

unless you order the vegetable sticks instead of the chips,

6:08

it's a danger zone for me because I can just

6:10

kind of like those chips or I don't like crack.

6:12

I don't know why but if anybody

6:15

has had those corn chip thing, it's like I can't

6:17

eat them because I just can't stop. Yeah,

6:19

I'm the same way. I think it's better

6:22

to, for me, well, it's that slogan

6:24

once you pop, you can't stop. We

6:27

know now, thanks to scientific research,

6:29

that's a slogan with scientific backing

6:32

at this point. That is a truism

6:34

at this point because foods like

6:37

tortilla chips are hyper palatable.

6:39

They combine salt, fat,

6:42

flour and they're

6:44

so calorie dense

6:46

that it would have actually

6:48

been a life-saving food potentially for a hunter-gatherer.

6:51

Well, that's

6:53

why I actually am afraid of Mexican restaurants

6:55

now. And

6:57

then someone orders, I don't order that, I usually don't order

6:59

the chips and guacamole. Then someone's like, bring the chips and

7:01

I'm like, oh no. I'm

7:04

the same way. I'm the same way. It's like

7:06

giving a crack addict some crack. Yeah,

7:09

I mean, the thing is we feel as

7:11

though we, I feel like there's this innate

7:13

sense that we should be able to moderate

7:15

our consumption of those foods, right? That's part

7:17

of having a healthy relationship with food. However,

7:19

I think what most people

7:21

fail to realize and what's certainly not

7:25

acknowledged by even

7:27

our most esteemed healthcare professionals

7:30

and those in the nutritional orthodoxy, it's that

7:32

these foods are not designed to be consumed

7:34

in moderation. They're hyper palatable and

7:36

by the time you've filled yourself up on them, you've

7:39

already over consumed them. Unfortunately, people

7:41

tend to experience a sense

7:44

of moral failure when they're not able to

7:46

stop eating the chips, right? Yeah.

7:49

They're at a reasonable level of

7:51

consumption, but that's because your brain has been honed

7:54

by millennia where

7:56

food scarcity was

7:58

a real problem, right? We didn't have food

8:00

security the way that we have now for the

8:03

vast majority of our evolution. So, as

8:05

I mentioned, those chips, as calorie dense

8:07

as they are, would have been an amazing food

8:09

for a hunter-gatherer who didn't have access

8:12

to grubhub on their phones or a supermarket

8:14

on every corner. And that's

8:16

why it's easy to eat an entire

8:18

bag of corn chips,

8:20

but no one's going to be binging on

8:22

12 avocados, right? There you go. Because

8:26

avocados are satiating in a

8:28

way that ultra-processed

8:30

foods simply aren't. Another

8:32

example of a brain food. Before

8:36

you jump on the next example, I just want to highlight

8:38

what you just said because there's

8:40

been an elegant study done by Kevin

8:42

Hall looking at feeding people

8:45

an unlimited amount of ultra-processed food

8:47

or nourishing whole foods. And

8:50

they let them eat whatever they want and they

8:52

track over a few weeks, they track their consumption

8:54

and their actual weight

8:57

gain. And they found that the

9:00

ultra-processed food group essentially

9:03

ate about 500 calories more a

9:06

day than the people eating

9:08

whole foods and they gained obviously more weight.

9:11

So, it really speaks

9:13

to this whole idea that there's some

9:15

nutritional intelligence that we have that causes

9:18

us to seek nutrients in our diet. The

9:20

problem is when we don't find them, we keep

9:23

eating more. Like looking for

9:25

love in all the wrong places. And

9:28

we end up just over-consuming because we're not getting the

9:30

nutrients we need. And we see this like with kids,

9:32

for example, we've talked about this on the podcast, who

9:35

are iron deficient, they'll eat dirt. They'll

9:38

eat dirt because dirt has iron. In

9:42

animal studies and we've had Fred Provenza on

9:44

the podcast, there's an innate nutritional wisdom where

9:46

they're sampling maybe up to 50 to

9:48

100 different plants to get the medicinal

9:51

properties of each of these plants to heal their body, to

9:53

make it work properly and they know when to stop. We

9:56

don't have that nutritional intelligence anymore. And there was a

9:58

study done decades ago, I think

10:01

in the 20s maybe, of orphans. I've talked about

10:03

this in the podcast too, but the orphans were

10:06

led to eat whatever they want,

10:08

brain, kidney, liver, weird vegetables. Kind

10:12

of give them an array of foods that were nutritionally dense

10:15

that you think kids wouldn't eat, right? What kids

10:17

are going to eat liver on their own

10:19

or kidney. Then they

10:21

kind of track what they did and these kids

10:23

were far at the end of the

10:26

study were far more healthy and far

10:28

more robust because they chose all this variety

10:30

of weird foods that actually their body's own

10:32

nutritional intelligence told them to eat. But

10:35

we lose that as we get older because our

10:37

brain chemistry, metabolism, immune

10:40

system, microbiome, all of it's been high hormones

10:42

have been hijacked by the food industry deliberately.

10:46

So when you have that deliberate usurping

10:49

of your own internal

10:52

guidance system and wisdom about what you

10:54

eat, we end up in this

10:57

chaotic state of constantly searching for ingredients

10:59

and nutrients and compounds that we're needing to survive

11:01

that we can't get from the food. So we

11:03

just give you any more and more and more.

11:05

That's really the problem. Yeah,

11:08

the movement towards what's been

11:11

called intuitive eating. That's why I think that

11:13

that's such a short-sighted and

11:16

not very evidence

11:18

based initiative because

11:20

when I sample

11:23

the pint of ice cream that's sitting in my freezer

11:25

right now, intuitively what my body wants is to eat

11:27

the whole pint. Oh yeah.

11:31

So I agree with you that we need to

11:33

get back to

11:35

foods that are less

11:38

industrially processed and you

11:40

bring up an interesting point. I mean the

11:43

tendency to over consume ultra processed foods. I think

11:45

it's really important for people to know the three

11:48

things that make a food satiating because

11:51

then they can use this as a tool in their own lives.

11:53

The first thing that makes a food satiating is its

11:55

protein content. So there's actually the

11:58

protein leverage hypothesis which stipulates that our

12:00

hunger mechanisms are driven in large part

12:02

by our necessity for protein, an essential

12:04

nutrient, right? And not just any type

12:06

of protein, high quality protein. And

12:09

the protein leverage hypothesis, I mean, people should

12:11

remember that protein can be used powerfully to

12:13

leverage as a way to kill

12:16

hunger. And unfortunately, ultra

12:18

processed foods are depleted of

12:20

protein, in part because

12:22

protein is the most expensive macronutrient.

12:25

So typically with all processed foods, what you

12:27

get is just carbs and fat, some combination

12:29

of energy, rich carbs and fat, right? And

12:32

so protein is crucially important. One of

12:34

the major factors that makes a food satiating,

12:36

the second aspect would be its fiber content.

12:39

Because fiber mechanically stretches out the stomach.

12:41

It's not an essential nutrient, but it

12:43

does draw water, it does

12:45

absorb water. And so it stretches out the stomach, which

12:47

turns off the release of

12:49

the hormone ghrelin, which is the

12:51

hunger hormone. Usually, ultra processed foods

12:54

are depleted of fiber, right? It's one of

12:56

the reasons why your average American today consumes

12:59

between six to 10 grams

13:01

of fiber every day. Whereas one

13:03

of our hunter-gatherer ancestors probably consumed about 150 grams a

13:05

day. Yeah, that

13:07

reminds me of that study by Dennis

13:09

Birker, where he looked at hunter-gatherers who'd

13:11

moved to the city, it became urbanized

13:13

in Africa compared to their hunter-gatherer neighbors.

13:17

And the hunter-gatherers had stool weights

13:19

of two pounds, and

13:22

the city-gatherers had stool weights of four ounces. So

13:24

their poop was just a little hard poop. And

13:26

the reason is all the fiber and the tubers and

13:29

the nutrient-dense food. So you said fiber is not an

13:31

essential nutrient. It isn't for

13:33

us, but it's essential for the

13:35

microbiome. Yeah, microbiome is essential for us

13:37

to stay healthy. So in a sense, it is

13:39

really an essential nutrient. It

13:42

is, yeah, through the lens of

13:44

the microbiome, absolutely. It is, and

13:46

it certainly makes a lot better. Studies show

13:48

that people who consume more fiber have

13:51

reduced inflammation, they live longer.

13:54

So it's definitely, I would

13:56

call it a conditionally essential

13:58

nutrient. Absolutely. that we

14:00

definitely want to look to consume more of. And

14:02

then the third factor that makes a food safety

14:05

rating is its water content. Because when water

14:07

seems to be available for hunter-gatherer, the second best

14:09

place that they would look to get there, to

14:12

meet their requirements for hydration would be

14:14

food, right? Food is actually a viable source

14:16

of water. And shelf stable

14:18

ultra-processed foods are depleted of

14:21

water. Because water impedes a

14:23

food's shelf stability because it allows

14:25

mold to grow. And

14:27

so these are the three factors that are

14:29

all but missing in ultra-processed foods. And

14:33

always very present in minimally

14:35

processed whole foods. So

14:37

definitely worth seeking out

14:40

any of those nutrients I do all the time.

14:42

Didn't you miss the most satiating nutrient of all?

14:45

And our favorite? Fat. Fat

14:48

is satiating, yeah. It slows the

14:50

absorption of food. It

14:54

slows gastric emptying. So

14:57

that's why, well, most high protein foods are gonna

14:59

come with, are gonna have a fat source, right?

15:02

Grass-fed beef, for example, is a good source

15:04

of healthful fat. Wild

15:06

fatty fish, great source of fat. And

15:08

so fat is, fat basically, here's what

15:10

fat does. Fat prolongs

15:13

the satiety of fat. The

15:15

protein and fiber are very satiating, but fat prolongs

15:17

that effect so that you're not hungry 30 minutes

15:19

later. So it's definitely

15:21

good to look and find

15:23

healthful sources of fat. And

15:26

by the way, the thing that makes you

15:28

hungry is sugar. It's

15:31

basically, when you eat

15:33

a lot of carbs and sugar, you just get hungrier

15:35

and hungrier as you produce more

15:37

insulin, which triggers all these secondary downstream

15:40

biochemical challenges, changes that actually

15:42

lead to increased hunger. So

15:44

the more you, carbs you eat, the more

15:46

you wanna eat. And the less you eat, the less

15:49

you wanna eat. I mean, you know that from your own experience, so do

15:51

I, it's like, wow, God, that bagel doesn't look

15:53

like food to me anymore. Or that muffin

15:55

doesn't look like food or cookie. Why would I ever eat

15:57

a cookie? It's not that you're depriving yourself. It's

15:59

just, looking appealing. Yeah,

16:02

you're absolutely right. Dr. Hyman, there is this

16:04

really fascinating study that I'm sure you're familiar

16:07

with. You might have even talked about

16:09

it on your podcast, but they basically took

16:11

scientists took two porridges. They

16:13

were controlled for carbohydrate content

16:16

and calorie content. It was just two wheat

16:18

porridges that were identical in terms of their

16:20

overall nutrition facts. But the difference was

16:22

the degree of processing. So one was a

16:25

more coarsely ground porridge and the

16:27

other was a more finely ground porridge. And

16:29

it's the finely ground porridge that sent subjects

16:31

blood sugar through the roof and led to

16:33

a higher release of insulin. But

16:37

what was most interesting about that study

16:39

was that in the post-absorptive state, so

16:42

after they consumed the more finely ground

16:44

porridge, the finely ground porridge

16:46

sent their blood sugar below baseline, which

16:49

the more coarsely ground porridge

16:51

didn't do. And when

16:53

your blood sugar goes below baseline, what

16:55

that is is reactive hypoglycemia. And

16:57

that can trigger in people that are susceptible

17:00

to anxiety, it can trigger anxiety, it can

17:02

increase hunger, that sensation of anger. And

17:04

that was the

17:07

capacity for the food to do that was

17:09

driven purely by the degree of processing that

17:11

the food had undergone. The more finely ground

17:13

porridge was more akin to a sugar, right?

17:16

Because it was just so easy for the

17:18

subject's bodies to assimilate. Whereas the more

17:20

coarsely ground, the less processed version

17:22

of the porridge actually brought

17:25

subjects blood sugar back down to

17:27

baseline, really smoothly and evenly. So

17:29

that's why you definitely want to avoid added

17:32

sugar to the best of your ability and

17:36

also reach for foods that are less processed.

17:38

Because this is not about

17:40

calories, this is not about carbohydrate content, this

17:42

was purely about the degree of processing that

17:44

that food has undergone. Yeah. So

17:47

it's a great point. Yeah. I mean,

17:49

you know, yeah, I mean, it goes without saying

17:51

people listening to the podcast understand by now that,

17:53

you know, the ultra processed food is

17:56

the number one killer on the planet. Like

17:58

if you want to do one thing to improve the

18:00

quality of your health is never eat ultra processed food.

18:02

What is ultra processed food? It's basically anything

18:05

that comes from a factory, unless

18:07

you recognize the ingredients. The

18:10

rule is if you can basically cover the front

18:12

of the package and just read the ingredient list

18:14

and know what it is, it's probably okay to

18:16

eat. If it says tomatoes, water, and salt, or

18:18

sardines, olive oil, and salt, you know what's in

18:20

the can. But if it's got

18:22

45 ingredients, most of which you can't pronounce are in

18:24

Latin, and you have no idea what it

18:26

is, we can't tell if it's a corn dog or

18:28

a Pop-Tart from the label, then you shouldn't eat

18:30

it. Absolutely. Real

18:33

foods don't have extensive ingredients lists.

18:35

They are the ingredients. Exactly.

18:40

An avocado doesn't have a nutrition facts label or

18:42

an ingredient list, it's an avocado. No. It

18:45

should have an ingredient list of phytochemicals, so people can

18:48

see what they're actually getting. It

18:50

should. You're right. But I mean, the

18:52

biggest irony is that they don't make

18:54

health claims either. Like avocados, grass-fed beef,

18:56

wild salmon, eggs, they

18:58

don't make health claims. It's the ultra-processed foods, the kinds

19:01

of foods that have ads on TV. Those

19:03

are the ones that are making all the health claims, and yet those

19:05

are the worst foods for you. It's generally

19:07

true. Modern

19:17

foods aren't nearly as nutrient-dense as they

19:19

used to be, so we all need

19:21

a little help from supplements if we

19:23

want to function and feel our best.

19:26

But supplements can also be tricky. Some

19:28

use low-quality ingredients that are difficult for

19:30

the body to absorb, and others add

19:32

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20:44

So we've got a really beautiful insight here which

20:47

is one, that

20:49

we should be eating phytonutrient dense food. We're going

20:51

to talk about some more genius foods. But two,

20:53

the quality of our food and

20:56

the ability to understand what

20:58

makes us feel satisfied really

21:00

are key principles. So protein,

21:02

fiber, water, fat

21:05

are kind of the secrets to keeping

21:07

your metabolism healthy. And you said that

21:09

you know there's no biological requirement

21:12

for grains. It's even a step

21:14

further. I would say there's no actual

21:17

biological requirement for carbohydrates. There's

21:19

no essential carbohydrates. So there's essential

21:21

fatty acids, essential amino acids, but

21:24

there's no essential carbohydrates. So you

21:26

literally don't have to eat any

21:28

carbohydrates. But with that said,

21:30

I often also say that carbohydrates are

21:32

the single most important food for long-term

21:34

health and longevity. And what I mean

21:36

by that is that vegetables are

21:38

carbohydrates. They

21:41

do contain some protein and sometimes fat

21:43

depending on the vegetable but essentially they're

21:45

phytochemically rich foods. So the phytochemical richness

21:48

is such a key principle that most

21:50

of us don't pay attention to. And when you

21:52

talk about a genius foods, you're often talking about

21:54

the phytochemical richness of the food. So

21:56

tell us some more about other genius foods that we

21:58

should be focused on. particular in terms

22:01

of the brain. Yeah. So, I mean,

22:03

phytochemicals are abundant in avocados, dark leafy

22:05

greens, but because we already talked about

22:07

avocados, I feel like we should

22:09

ping pong and talk about a good protein

22:11

source like a grass-finished beef, I

22:14

think is a powerful brain food for

22:17

people. It's actually one of the more

22:19

controversial recommendations, but when you look at

22:21

grass-fed and finished beef, it's a great

22:23

source of vitamin E, which I

22:25

talked about as being a powerful fat-protecting

22:28

antioxidant. You find three times the vitamin

22:30

E in grass-finished beef as you find

22:32

in grain-finished beef. It's also a great

22:34

source of a compound called creatine, which

22:36

supports brain energy metabolism. So, people who

22:39

don't regularly consume creatine, which is found

22:41

naturally in beef, fish, and you give

22:43

them supplemental creatine, you see an improvement

22:45

in their cognitive function. So, we know

22:47

that dietary creatine plays an

22:49

important role in good brain health and good

22:51

brain function. Our

22:54

brain's level of creatine tends to decline with

22:56

age and is also apparently

22:58

depleted in carriers of the ApoE4 allele,

23:01

which is the most

23:03

well-defined Alzheimer's risk gene. So,

23:06

I'm a big advocate of, in

23:09

general, foods that contain creatine naturally,

23:11

and grass-fed beef is a viable source.

23:14

So, let's pause there for a minute because, you

23:17

know, I agree with you. Just

23:19

putting it out there. I think there's

23:21

so much confusion about meat. And as

23:23

we were joking before the podcast, it's not the cow,

23:25

it's the how. Can you

23:28

break down first the conversation that

23:31

is raging today, which is that, one, meat,

23:34

if we eat it, is going to cause heart

23:36

attacks, cancer, and death,

23:39

and shorten your life. And two,

23:41

that it's the worst possible thing we can do for

23:43

the planet. And it's

23:46

obviously very inhumane. So, how do we

23:48

tackle those three arguments

23:50

against meat? Because you just said something that

23:53

was really important, which is that meat

23:55

is an essential part of our diet for keeping

23:57

us healthy, particularly our brain health and

23:59

our mind. muscle health and so many other things in our

24:01

immune system. How do

24:04

you navigate this mind

24:07

field of controversy between meat

24:10

eating and veganism? Yeah,

24:13

it's a great question and it's a question

24:15

that requires a

24:17

nuanced answer but the reality is

24:20

that we have

24:22

no good evidence to say that

24:24

beef is unhealthy, right? We have

24:26

lots of evidence to the contrary.

24:28

We have mechanistic plausibility suggesting that

24:30

beef provides very important nutrients.

24:32

Nutrients that in particular tend to be

24:34

under consumed today like vitamin

24:36

B12, zinc. The problem

24:39

is that much of our nutritional recommendations

24:41

come from their origins are

24:43

what's called nutritional epidemiology which is one

24:45

of the primary tools

24:48

used in nutrition science because getting

24:51

people to adhere to various

24:53

diets as

24:55

part of clinical trials is just not feasible

24:57

for the human animal, right? So that's not a

25:00

tool that's

25:02

very viable with regard to nutrition science. So

25:04

instead what we look at is nutritional epidemiology,

25:06

observational studies. We look at populations, we see

25:08

what they eat and then we

25:11

associate those observations with their health outcomes.

25:13

And the problem with meat is that it's

25:15

mired by the observations associated with meat

25:17

consumption is mired by what's called healthy

25:20

user bias. So people

25:22

who consume more meat tend

25:24

to smoke

25:26

more. They tend to be more sedentary. And

25:28

this is true with all

25:30

meat but it's certainly true

25:33

and especially true rather with processed

25:35

meat consumption. So processed meat consumption,

25:37

if you would imagine what processed

25:40

meat, the form that processed meat takes

25:42

in the standard American diet. It's

25:44

hot dogs, it's chicken nuggets,

25:46

it's Subway sandwich. That's

25:48

processed meat, right? So you

25:51

take a meal. What is there 38 different

25:53

ingredients in a chicken nugget or something? Yeah.

25:56

Most of which are not chicken. And people

25:58

are consuming these food. products, right?

26:00

These food-like products with an

26:03

abundance of white refined flour with

26:05

a soft drink, with a large

26:07

fries. They're doing unhealthy things in

26:09

their lives generally speaking because I mean somebody

26:11

who's eating fast food on a regular basis,

26:14

I mean, is probably not adhering to

26:16

the most optimized lifestyle, right? So

26:19

that's observationally, that's what we

26:21

tend to see. But now observational research is

26:24

getting better and better and better and we're

26:26

able to control for those different variables. And

26:28

what you see is that when people consume

26:30

meat and overall diet quality is high, meat

26:34

consumption is not associated with any of

26:36

those bad things, heart disease, cancer, diabetes,

26:38

nothing like that. Yeah.

26:41

And that makes perfect sense because meat is a

26:44

pristine source of protein, an abundance

26:47

of micronutrients which we know support

26:49

metabolic health which only

26:51

1 in 10% of the US population has

26:54

metabolic health, right? Because 9 in 10 have some

26:56

degree of metabolic illness. To

27:01

cap it, there has been no randomized control

27:03

trial to show us that

27:05

meat consumption is causally

27:07

related to any negative health outcome.

27:10

Again, the opposite is true. I

27:12

mean, the only mechanistic thing that's

27:14

been looked at is TMAO which

27:17

is looking at a metabolite

27:19

that comes from eating certain

27:21

compounds in meat that are produced by certain bacteria in

27:23

the gut that seem to be linked to increased risk

27:26

of heart attack on a mechanistic level.

27:28

What do you think of that data? TMAO

27:30

is also abundant in fish

27:32

and fish consumption is associated

27:34

with better cardiovascular health and

27:36

certainly better neurological health. So

27:39

we can't just isolate these

27:41

mechanisms and then make

27:43

these leaps in terms

27:45

of our assumptions about those foods. Well, Cleveland

27:47

Clinic when they did this study was fascinating because they

27:49

looked at what happened when they fed

27:52

vegans meat like nothing happened because

27:54

their microbiome was already pre-built

27:56

up with healthy microbiome because

27:59

they're eating lot of plant roots and

28:01

fiber which is good. And

28:04

also he found that if you drink wine and

28:07

have vinegar and

28:09

olive oil, you actually mitigate the effects

28:11

of meat on TMAO production because

28:14

of all the various kinds of phytochemicals in there.

28:17

Also, if you marinate meat, it actually decreases

28:19

some of the compounds that can

28:21

happen when you grill it, although grilling isn't probably a

28:23

good idea in general around meat. Slow

28:25

cooking is better. And also the data

28:27

really ignores some of the, sort

28:30

of the conversations ignore some of the data

28:32

that really is contrary to what we're hearing

28:34

around the badness of meat. For example, there

28:36

was a large study looking at 11,000 people, half

28:39

of who are vegetarians, half meat eaters who

28:41

all shop at health food stores. So

28:44

if you're shopping at a health food store, you're

28:46

more health conscious, you probably have better health habits.

28:48

You also are eating more plant

28:51

foods. And within a plant-rich

28:53

diet, meat actually isn't

28:55

harmful. And they found that the risk of death

28:57

for both groups was reduced in half. The

29:00

peer study also was done that looked at large

29:02

meat consumption of a protein. It was the carbohydrates

29:04

that really were driving so much

29:06

of the problem. And so the problem

29:08

with these observational studies is they're one,

29:10

they're not causative in terms of their

29:13

conclusions and they're often

29:15

confounded by a lot of problems that make it look

29:17

like there's a problem but there isn't. And in these

29:19

studies, we've had problems before like

29:21

the nurses health study that showed that all women

29:23

who took hormones, premarin, had

29:25

reduced heart attacks and

29:27

strokes and didn't

29:30

have an increased risk of cancer. And when

29:32

they actually did a randomized controlled trial, the WINS Health

29:34

Initiative, which was a billion dollar study over 100,000 women,

29:37

they found that, gosh, it was the opposite,

29:39

that actually the hormones were killing women. They

29:42

were causing cancer, heart attack, strokes at dramatic

29:44

rates. And all the

29:46

earlier data from the observational study was completely overturned.

29:48

But I think we have to be really cautious. They can

29:51

often point to problems

29:53

but the effect

29:55

size has to be big. For example,

29:57

smoking, the effect size for smoking and lung

29:59

cancer. cancer was a hazard ratio of 20

30:01

to 1, which means a 2000% increase. When

30:06

we talk about changes in meat, you're

30:08

talking about for colon cancer for example, you're talking

30:10

about with processed meat only, you're talking about

30:13

a 1% absolute increase in

30:15

risk, 1%. And if you

30:17

go from 5 to 6, you go, oh, that's a

30:19

20% increased risk. It sounds bad,

30:22

but 20% is meaningless unless

30:24

the hazard ratio is at least 200%

30:26

increase, that's

30:30

pretty much garbage and I wouldn't pay attention to it.

30:33

Yeah, it's relative versus absolute risk

30:35

and you see these studies or

30:37

you see the headlines all the

30:39

time that egg consumption is associated

30:41

with a 14% increased risk of

30:44

cancer for example. And

30:46

so that puts people on high

30:48

alert about egg consumption. But as you mentioned,

30:50

I mean, that leads to such

30:53

a tiny increased risk of absolute

30:56

in terms of their with regard to their absolute

30:58

risk that we almost can't take it seriously, right?

31:01

Because nutrition, because the tools of nutrition science aren't

31:03

foolproof, right? We use food frequency questionnaires,

31:05

which are not the most reliable way

31:07

to ascertain this kind of data to

31:09

begin with. So it's

31:12

very tenuous at best and that's

31:14

why I think it makes more

31:17

sense to integrate a food that we know

31:19

that our ancestors have been consuming since

31:22

we've had ancestors, right? And

31:25

so that's why we're talking about the humanity,

31:27

humans have been omnivorous. And also

31:29

I would add that beef consumption, the dreaded

31:31

beef consumption has actually declined

31:35

in the United States over the past 40, 50 years and yet... Chicken

31:38

consumption has gone up, which

31:41

makes me worse for you actually. Yeah, I mean,

31:43

it's... Factory farm chicken is high in omega-6s, it's

31:45

full of antibiotics, it's full of arsenic, it's

31:49

not healthy. Yeah, and most people consume it

31:51

as fried chicken, right? Who

31:54

knows what constitutes a chicken dish,

31:56

but rates of obesity, rates of type

31:58

2 diabetes, rates of Alzheimer's disease... Keep

32:00

climbing. One of

32:02

the best ways to access brain health is through

32:04

our diet. Both what we

32:06

eat and what we don't eat. Let's start

32:09

with the don'ts. The

32:11

most dangerous thing for your brain is

32:14

sugar and starch. Those

32:16

cause inflammation in the brain. They

32:19

cause dementia. They cause depression. They

32:21

cause behavior issues. They're really nasty for the

32:24

brain. So it doesn't mean you can't ever

32:26

eat them. But think

32:28

about those things as recreational drugs as I've said.

32:30

So starch and sugar. The third

32:32

thing you really want to get rid of is bad fats. So

32:36

trans fats are very dangerous. They're still in our

32:38

food supply even though they've been regulated as not safe

32:40

to eat. They're still out there. And

32:43

a lot of refined processed oils. So those would

32:45

be the things that I would avoid, number one.

32:47

And of course processed food. That just kind of

32:49

goes without saying. 10% of our calories

32:51

come from soybean oil. It's increased 1,000% in our diet. It

32:54

didn't even exist as a real food

32:57

in our diet until probably 1900, early 1900.

33:00

So we really entered an era where

33:03

we are eating a diet that is so

33:05

different than we have for almost

33:07

all of our human evolution. And

33:10

those fats tend to drive inflammation. They're

33:12

easily oxidized. They go rancid. They're

33:15

made with extraction processes that

33:17

have hexane. And they're

33:19

often causing significant inflammation and damage in the body. And

33:22

I think that's the issue. No one's in it. Like

33:24

I mean if you have to have a list of

33:26

ingredients. I mean yes there's some packaged

33:28

food that's fine. But if you have to know what it's in it. So

33:30

if it says some big chemical words. You

33:32

can't recognize it or you've got 14,000 things on

33:34

the label. Probably not what you should

33:36

be eating anyway. Most people don't know this but your

33:38

brain is mostly fat. You know we really

33:41

are all fat heads. And

33:43

about 60% of our brain is made of

33:45

fat. And most of that is what we

33:47

call DHA or Dicosa hexanoic acid. Sounds

33:50

like a big chemical name. But essentially it's fish oil. It

33:53

comes from algae too. You can get it from algae.

33:55

So if you're plant based you can get it from

33:57

algae. But it is the main ingredient for a healthy

33:59

brain. And so we need to be eating

34:02

fatty fish that's low in mercury. We

34:04

need to be eating algae. We need to be doing

34:06

things that actually help boost our DHA levels. The second

34:08

thing is good fats in general because our brain actually

34:11

responds really well to fat. MC2,

34:13

for example, is the derivative of coconut oil.

34:15

It's really great for the brain's energy system

34:17

and can help improve cognitive function. It also

34:19

improves athletic performance. The

34:22

third category of foods we should be focused

34:24

on are phytochemicals. There's

34:26

25,000 compounds in plants, maybe more. The

34:29

Rockefeller Foundation is now doing the

34:31

periodic table of phytochemicals. There's

34:33

spending hundreds of millions of dollars to map

34:36

out the medicinal properties in these foods. But

34:38

it's really easy when you think about it. Just eat the rainbow. If

34:41

it's colorful and it's not Skittles, it's okay to eat.

34:44

So all the dark

34:46

colored vegetables, greens, blues, purples, reds,

34:48

yellows, those foods that

34:50

contain these pigments are full

34:53

of these phytochemicals. And they're really extraordinarily

34:55

helpful in regulating brain function in

34:57

so many different ways. One

34:59

of the things that often people forget about is

35:02

the bottom of the matrix in functional medicine, which

35:04

is the map we

35:06

use to figure out what's out of balance for people.

35:09

And hydration is really, really important

35:11

because most of us walk around

35:13

dehydrated. Most of us don't

35:15

drink enough water. We have other fluids like

35:18

sodas and juices and coffees and teas, but

35:20

we don't really have enough water. And often

35:23

when we do, we're not getting into a

35:25

cellular hydration, which is so critical. So not

35:27

only in your bloodstream, but inside your cells,

35:29

which is what makes you feel good. So

35:31

it gives you energy and performance. So my

35:34

favorite athletic performer is

35:36

Tom Brady and he never

35:38

drinks water without electrolytes. Maybe

35:41

that's explained to seven Super Bowl rates. I don't

35:43

know, but I agree. I've

35:46

used electrolytes in your water is so important and

35:48

not the kind with tons of sugar and all

35:51

kinds of weird stuff. My

35:53

favorite one, I have no affiliation with this brand. It's

35:55

called light show, L Y T E show, but it's

35:57

simply liquid drops. You can put it in a glass

35:59

of water. And every time I drink, I try to add

36:01

those in and there's a portable container you can

36:03

take your little drops with you. So intracellular hydration is

36:05

really, really important and it's important for your cognitive function,

36:08

it's important for energy, it's important for everything. Examples

36:11

of things like the sick anxiety and I

36:13

always think about that because it's one

36:16

point my clients are coming in most

36:18

commonly with right now. The uncertainty, the

36:20

fear, loss of jobs, quarantine,

36:23

you know, the situation is

36:25

changing and going back

36:27

the next day is really creating an immense

36:29

amount of anxiety. And what the studies have

36:32

shown is that there are certain things

36:34

that, the way that I look

36:36

at it is the things that you, in terms of food that

36:38

you need to embrace and the things that you need to avoid.

36:41

And the things that seem to worsen

36:43

anxiety include foods with gluten

36:45

in them. And it's

36:48

not necessarily people who have

36:50

celiac disease or non-celiac glucose

36:53

sensitivity, but there

36:55

seems to be a correlation in the

36:57

studies around the level of anxiety

37:00

and eat and

37:02

consume in gluten. So

37:06

things that are positive are the

37:08

use of things like turmeric with

37:10

black pepper. Well, what makes

37:13

the gluten become a problem? What is

37:15

the mechanism? Has anybody figured that out?

37:17

So we think that from what the

37:19

studies have shown that it's that

37:21

there's some sort of disruption that occurs

37:23

in microbiome that leads to

37:26

dysbiosis in individuals who have anxiety.

37:29

So I have patients

37:31

who can tolerate gluten, but if I

37:33

really give a general recommendation to someone

37:35

based on what they've learned, we try

37:37

to have them avoided. With

37:41

the turmeric and black pepper, you

37:43

know, we know that curcumin in turmeric

37:46

is activated by the cuprene in black

37:48

pepper. And it actually increases the absorption

37:50

by significant success. And

37:53

the study also showed that where omega-3s

37:55

are involved, that can enhance

37:58

the absorption. combination and

38:00

the work that's been done on

38:03

omega-3 in both anxiety and depression.

38:05

For example, there was a study

38:07

of medical students then that

38:09

looked at treatment

38:12

of anxiety using omega-3 and

38:15

we've heard about omega-3 since people know about

38:17

using it for mood but it's top of

38:19

anxiety as well and the

38:21

combination of trimid back pepper as well

38:23

as omega-3 and I'm talking mostly about

38:26

food sources of omega-3s Some

38:28

people do take supplements and as positive they

38:31

find actually is quite powerful for

38:34

knowing anxiety levels. So

38:36

those right there are things you know that

38:38

people should move toward So

38:41

maybe like a sardine curry with a little black

38:43

pepper Exactly, exactly, you know

38:47

Or you know some sort of like very

38:49

fancy glaze that you put on on

38:52

seven, you know, and it could be other those should it

38:54

could be baked and You

38:56

know using all the the healthy oils

38:58

and Trimid and less pepper,

39:00

you know as well some other things. So so

39:02

that's that you know that those would be a

39:04

good way to go With

39:07

depression the Trials

39:11

that were done using folate and

39:13

mucafole decades ago by some of my mentors

39:15

at Hash channel But you know

39:18

adding them in a leafy green before

39:20

to be helpful. And so there's a

39:22

real Logical way in

39:24

which adding, you know simple recommendations that

39:27

we make about fruits and vegetables Adding

39:30

that fiber back into your diet

39:32

actually drives down any type of

39:34

information in the fat And

39:36

therefore with the gut brain connection

39:39

those any type of potential your

39:41

information the thing that many many

39:44

People and I think I'm more aware of these

39:46

types of things that Serotonin

39:48

the happy hormone 90%

39:51

or more for serotonin receptors and the gut So

39:54

it really does make a difference what

39:56

you eat because if you're eating poorly

39:58

the serotonin receptor is effective And

40:00

the opposite is so atonement and the health of

40:02

the baby, back and forth. You know, it all

40:04

depends on what's being transported via the vagus nerve

40:07

to the brain. And by

40:10

eating the whole food and creating

40:12

this biosis in your fat, you're

40:14

driving the mechanism in the wrong

40:16

direction for you. So

40:19

one of the things you said, which I want

40:21

to back up on, which is so important, you

40:23

kind of glossed over it, which is this whole

40:25

idea of neuroinflammation. Now, when

40:28

your joint hurts,

40:30

you get arthritis, it's inflammation in the joint.

40:33

It hurts. If you have a sore

40:35

throat, it's inflammation in your throat, it hurts. If

40:38

your brain's inflamed, it doesn't hurt, but

40:40

it shows up as

40:42

depression, anxiety, ADD, dementia,

40:45

OCD, whatever, right? Autism, these are

40:47

all inflammatory disease of the brain.

40:50

And what you're saying is that

40:52

a lot of the source of

40:54

the inflammation comes from imbalances in

40:56

the microbiome, in the bacteria

40:58

in the gut, which you call dysbiosis, which

41:01

is the difference between symbiosis, which is a

41:03

nice balance of your gut flora, which is

41:06

dysbiosis, which is really bad bugs

41:08

that are growing that drive inflammation.

41:11

And when you're eating different foods, you're

41:13

feeding different bugs, and that may

41:15

be how the mechanism of this works with mental health. Is

41:17

that what you're saying? Exactly. So a

41:20

few different things. And thank you for

41:22

backing up on the neuroinflammation, because it

41:24

is such an important point. I'll

41:26

give you an example of a patient. A

41:29

guys from Toronto just referred to a patient who is

41:31

having severe panic. For the first time, it's

41:33

a stage in life that you wouldn't expect

41:35

someone to develop anxiety, panic disorders going by

41:37

the DSM-5 care for each other. And

41:40

after he took a piece of history and spent

41:42

time with him, in terms of

41:44

his actual, even though

41:47

he was presenting with the panic to

41:49

me, what was distressing him

41:51

was his irritable bowel. He

41:54

was very uncomfortable. He had developed these symptoms

41:56

over time. And as we took product

41:59

more information. He had moved to

42:01

a new job, highly stressed, eating

42:04

very few meals at home, eating either

42:06

in the afternoon from the vending machine,

42:08

eating lunch out, getting takeout, and getting

42:10

fast food on the way home. From

42:13

being a relatively healthy

42:16

weight and from being someone

42:18

who was eating, I would say, probably from

42:20

what I remember, three to five meals at

42:22

home in the evening, his diet had changed

42:24

over the period of 18 months. He

42:27

developed discomfort in his bowel. He

42:31

had bouts of diarrhea and constipation,

42:33

but he does not have to do that. Rather

42:37

than do that, as we tried to figure out

42:39

the details and placed him

42:41

on the proper diet, these symptoms took

42:44

time, but these symptoms evaded

42:46

over time so much so that he

42:48

didn't need clonazepam or Xanax or a

42:51

sertraline for his symptoms of panic.

42:55

You're saying you fixed his gut and

42:57

that fixed his anxiety and his panic

42:59

attacks. You and I

43:01

went to medical school. We're old enough. We went to

43:03

medical school and we were taught

43:06

that there's something called functional bowel disease

43:08

or irritable bowel syndrome, which

43:10

we had a pejorative way of talking

43:12

about as a super-tentorial phenomena, which in

43:14

English means it's all in your head.

43:18

Maybe it's actually something else. Maybe it's an infrared

43:20

diaphragmatic phenomena, meaning it's below

43:22

your diaphragm or in your

43:26

stomach. Yet as psychiatrists, how much did

43:28

you learn about the gut? Zero,

43:30

right? Exactly. As long as

43:32

nutrition, these are not things where we've

43:34

made the connections here. There are treatments

43:37

for depression like vagal nerve stimulation.

43:40

There are things that actively talk to vagus

43:42

nerve that will help to treat depression. We

43:46

sort of know some of the science around it, but

43:48

we haven't put this in. Some of the ghost

43:50

facts are something you said at the beginning of

43:52

this. Going back

43:54

to my story of the Dunkin' Donuts country, from there

43:56

I just began to have more of an open mind

43:58

around these questions. And

44:01

I didn't know when I tried

44:03

to help him evolve and change his diet

44:05

that it would work. Part of it

44:07

was trying to see if it would. And

44:10

this was also someone who had developed these

44:12

symptoms also in the context of that poor

44:14

diet. He had not early on in

44:17

his life, you know, for want of a better name

44:19

for the syndrome, that was what

44:21

his gastroenterologist called it. But

44:23

as that evolved and he ate

44:25

healthy and it just took time, it

44:28

seemed like he encouraged the better bacteria

44:30

to grow and, you know, some

44:32

of that really kicked in. So I do

44:35

feel that that brute cause part

44:38

of it may take time, but we just

44:40

have to figure out where it is. Well,

44:42

this whole gut connection is so fascinating because

44:45

what you're saying is the type of food

44:47

we eat changes the type of bacteria. How

44:50

do you do that? And mine is important that

44:52

we focus on that. So,

44:56

you know, if you take a

44:58

typical, you know, standard American

45:00

diet that unfortunately is the diet used

45:02

as a point of comparison in a

45:05

lot of nutrition studies, you

45:07

know, it's generally here are

45:10

some facts. A

45:12

lot of fast food French fries have sugar in them. We

45:15

know the sugar. And gluten. I

45:18

don't know the story, but I had this patient who

45:20

was like going to get some French fries

45:22

at a fast food place. And it's like, you

45:24

know, I want to make sure the French fries don't have any

45:26

wheat in them. And they're like, oh, no, no, they don't have

45:28

any wheat. We just dip them in gluten and then we fry

45:30

them. There you go. So

45:34

since it's up to you, they have a lot of stuff

45:36

that we don't realize is in them. Because you're just thinking

45:38

it's a potato. But no, it's

45:40

very far from that. And it's made through

45:42

a whole process of extrusion to make it

45:45

a truly processed food. But

45:47

the point being that it's a simple thing. You

45:50

think, oh, I'll get some dinner on the

45:52

way home, as a particular patient is doing.

45:54

But there's so many added

45:56

just bad ingredients in foods that you

45:59

don't realize. you know, you're familiar with

46:01

sort of the added sugars and savory foods,

46:04

salad dressings, ketchup, you know, fruit

46:06

and yogurt and stuff. That's just

46:08

one element of it. Then there's

46:10

the added gluten in people who are

46:12

gluten sensitive. Then, you know, it's

46:15

the unhealthy fact that you don't

46:17

realize that they're, you know, the last time I

46:19

checked there was 61 other names

46:22

for sugar. I think it's 250. I

46:24

think it's 250. I'm sure there

46:26

are. By now I'm sure there are.

46:28

And so I will teach people to

46:30

just think about four grams of sugar,

46:32

one teaspoon. Look at the food label.

46:34

See what's in it. Because any of

46:36

those four foods, you know,

46:38

the foods to avoid are the things

46:40

that are going to disrupt those guys'

46:43

pictures. So basically, the imbalance is going to

46:45

be the bad bacteria having a party, and

46:47

the good guys are, you

46:49

know, not doing well because they're being overrun.

46:51

And that imbalance is what leads

46:53

to the leaky gut or the

46:55

intestinal permeability. And you

46:58

know, that's when it really starts to

47:00

back up and also then for the

47:02

new information. Well, yeah, this music is

47:05

my ears because 20 years ago, I

47:07

remember having conversations with physicians talking about

47:09

intestinal permeability and dysbiosis and leaky gut.

47:12

And they just and gluten and they just looked at me

47:14

like I was from Mars, like I was some kind of

47:17

quack that didn't know who's talking about. I'm like, all

47:20

I know is what I'm seeing. And I see when

47:22

patients change their diet, when we fix their gut, they

47:25

get better from all sorts of things. Thanks

47:27

for listening today. If you love this podcast,

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48:12

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48:17

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