0:00

My name's Josh. I'm a co-host on The Imperfects

0:02

and the son of Sri Lankan and English immigrants

0:04

and I call Australia home. I'd

0:06

like to recognise the traditional peoples of this continent whose

0:08

land was stolen nearly 250 years

0:10

ago. In particular, we at The Imperfects

0:13

would like to acknowledge the Wurundjeri people of the

0:15

Kulin nation as the traditional owners of the land

0:17

on which this podcast was recorded and we extend

0:19

our respect to all Aboriginal and Torres Strait Islander

0:21

peoples. I'm inspired by the world's

0:24

oldest living culture and we at The Imperfects pay

0:26

homage to the traditions of story when we share

0:28

stories on our podcast. This

0:30

episode of The Imperfects is a discussion about food

0:33

and the way it relates to our mental health.

0:35

During this conversation, we touch

0:37

on topics of disordered eating. So

0:39

if this is a topic that you don't feel like you can engage

0:42

with today, then please skip it

0:44

for now. But I do encourage you to come back when

0:46

you're ready. Hello and

0:48

welcome to the Academy

0:50

of Imperfection, a conversational

0:53

lecture series where experts in

0:55

their field share their wisdom

0:57

on the subject of imperfection.

1:00

Today, we hear from one of

1:02

the world's leading scientific researchers

1:04

in nutrition and food,

1:06

Professor Felice Jakka. What

1:09

you eat influences the microbes that are in

1:11

your gut, but then there's this

1:13

direct link via the vagus nerve to the brain.

1:16

For people trying to get their

1:18

head around why what they eat might be

1:21

linked to their mental and brain health. That's

1:23

probably the most concrete way of thinking about

1:25

it. So you've got your eggs

1:27

and join students Hugh, Ryan

1:29

and Josh in the Academy

1:32

of Imperfection. Well,

1:34

very, very exciting and

1:36

I'm sure it'll be extremely

1:38

informative. Academy of Imperfection today,

1:41

guest lecturer Felice

1:44

Jakka, Dr Felice Jakka. Professor.

1:47

Professor, excuse me. Take

1:49

that back. How offensive. What

1:51

is the difference between a professor and a doctor? Well,

1:54

in Australia you have, it's like a promotion

1:56

thing. You start off as a doctor and

1:58

then you go up to senior lecturer, then

2:00

you go up to associate

2:02

professor, and then you become a professor. And in

2:05

my case, I'm an Alfred Deakin professor, which means

2:07

I'm sort of top of the food chain at

2:09

our university. But

2:11

very few people actually make that progression

2:13

to full professor, because it's very, very

2:16

tough to survive in research in Australia.

2:19

In America, it has a different meaning.

2:21

Professor in America just means you're like

2:23

a teacher or a lecturer, but I

2:26

don't actually do any teaching. I, you

2:28

know, pure research. Good

2:30

for us. So I had

2:32

a dream last night. Is it contextual to this? I

2:36

was just like, walk it, and I couldn't run. You know, like my

2:38

legs were heavy. No,

2:41

it's very contextual. I

2:43

was thinking about the interview before I went to bed, and then I

2:45

had a dream that I kept calling Felice Jacka throughout the interview. And

2:48

you were really upset that I was calling

2:50

you Jacka, which is probably fair enough. We

2:52

have a joke in our team because myself

2:54

and one of my senior team members, his

2:56

name's Wolfgang, and everybody gets our names wrong.

2:59

We have, you know, Felicia, he got Wulwang

3:01

once, so he was hot and Wulwang around

3:03

the office. It's like, it's not

3:05

that hard. So what do we call you? Do

3:07

we call you professor? Or is that the- Yeah,

3:09

well, that's my title, but just call me Felice.

3:11

Okay, so go with your name. Yeah, yeah. How

3:13

novel. For

3:15

the uninitiated here, who is Professor Felice Jacka? Okay,

3:17

well, I've got quite a few things here, and

3:19

I'm not gonna go through it all because it

3:22

would take a long time because you are an

3:24

extremely accomplished individual. So it's gonna take forever to

3:26

do that. So let me just, a couple of

3:28

the highlights. In 2021,

3:30

Felice was awarded a medal of the Order

3:33

of Australia for her services to nutritional psychiatry.

3:35

She is the founder and president of

3:38

the International Society for Nutritional Psychiatry Research.

3:40

No longer president, actually. No longer president.

3:42

Yeah, as of last year. Oh, right,

3:44

okay. Yes, yeah, but I'm the founder

3:47

and immediate past president. Immediate past president.

3:49

The official term in it. Just to

3:51

let that sink in, founder of the

3:53

International, what was it called? Society for

3:56

Nutritional Psychiatry Research. We

3:58

now know a lot about, I mean, I hear

4:00

you. I'm sure you're going to go into this,

4:02

but I feel like we know some, we know

4:04

more and more about nutritional, um, the links between

4:06

nutrition and mental health. But the fact that you

4:08

were the founder of that is quite extraordinary. Yep.

4:10

Fliese's research focuses on how diet and nutrition impacts

4:13

on our mental health. Fliese

4:15

began work as a researcher. She became keenly interested

4:17

in why there was a lack of data on

4:19

whether diet and nutrition had

4:21

any significance on prevention or treatment

4:24

of mental disorder. It set out to

4:26

change this and in the process became

4:28

a pioneer in the field of nutritional

4:30

psychiatry. It is so exciting to

4:32

have you here. I mean, this is a mental health

4:35

podcast. I myself, I would say in the last two

4:38

or three years have, have really felt the impact of

4:40

eating really well and the impact it's had on my

4:43

mental health. And so I can't

4:45

believe it's taken this long to have a conversation with you,

4:47

but it is just so great to have you here. Oh,

4:49

it's great to be here. Before we

4:51

get going, just I'm interested in your

4:53

history with health and mental health. It's obviously

4:55

had a really big impact on the work

4:58

that you do. Yeah. Yeah.

5:01

I've had a really interesting life. My background, my

5:03

father was sort of the

5:05

father of naturopathy in Australia, Alf Jacker,

5:07

and he founded the Naturopathic College,

5:10

Southern School of Naturopathy. And

5:12

so I grew up in a family that

5:14

was very unconventional in relation to medicine and

5:16

food. And some of that

5:18

stuff was really not good. A lot of

5:20

non-evidence based approaches, you know, no vaccines, for

5:22

example, because, hey, they give you autism, you

5:24

know, that sort of non-evidence

5:26

based stuff. But it did

5:28

allow me to develop this idea of this

5:31

paradigm of food as being very important to

5:33

health in general. But

5:35

then when I was in my early

5:38

teens, I developed very severe panic

5:41

disorder. Genetics plays such

5:43

an important role. And I've

5:45

got a very strong genetic history of

5:47

severe major depression, bipolar disorder, which many

5:49

families do. You know, this is not

5:51

uncommon. And what complicated things

5:53

too, I think, was at the time that

5:56

I was very anemic because I've been brought

5:58

up on extremely strict vegetarian diet. that was

6:00

not very diverse, it just didn't, I think

6:02

it was probably quite limited in its nutrient

6:04

profile. And that anemia,

6:06

once you start menstruating, really, you

6:09

know, it had such a major impact. And

6:11

then I developed major depression, really quite severe.

6:13

That was... Is it in your 10 years?

6:16

Yeah. Yeah. So

6:18

from the age of 12 and then when I was 19, you

6:20

know, after many years of dealing with quite

6:22

severe anxiety and a major depressive disorder. And

6:24

of course, this is back in the

6:26

day where we didn't know what these things were, there

6:28

was no medical treatment. And it just wasn't discussed, I

6:30

had no idea what was going on. About

6:34

19, I had a very severe episode that lasted for

6:37

months and months and months. And the way I got

6:39

myself out of it was I started running. And

6:41

I would run every day. And that really started

6:44

to help me to turn a corner. So

6:48

I was always very interested in

6:50

mental health and brain health. And

6:52

but probably my major interest was

6:54

in food. But I went

6:56

on, I was studying fine art. My first

6:58

degree was in fine art. And

7:01

I was only in my early 30s

7:03

that I went back to study psychology

7:05

because of my history with mental disorder.

7:07

And I was increasingly interested in just

7:10

what was it that could help

7:12

people or prevent, you know,

7:15

these issues. And

7:17

I really knew nothing about research

7:19

or science or anything. But

7:22

while I had my kids, I did

7:24

my psychology degree part time. And

7:26

then I ended up doing an

7:28

honors degree in medical science and

7:30

epidemiology, looking at depression and bone

7:32

health. But it

7:34

was then when I was exposed to

7:36

psychiatric research, because I was in a

7:39

psychiatric research unit, that I looked around

7:41

and thought, hang on, there's no research

7:43

on diet and mental and

7:45

brain health. Not really, not any good quality

7:47

stuff, nothing comprehensive. This has been directly looked

7:49

at. I would really like

7:51

to do this. And so I presented

7:53

this idea to the head of the

7:56

unit. And he, bless him,

7:58

was like, I don't know

8:00

anything. about diet, but if you think it's

8:02

worth investigating, off you go. So I did.

8:05

Amazing. And here we are. Yeah, exactly.

8:07

Do you think, is there, the

8:10

running, do you think you had an epiphany

8:12

at the time or it just sort of looks like it looking

8:14

back that there was the relationship

8:18

between your body and inputs to your

8:20

body as in food and running can

8:22

have an impact on your mental health? Not at

8:25

all. I was completely clueless. You know, I

8:27

just, you know, there's so many things happening

8:29

in my life at that time as they

8:31

are in 19 and, you know, relationships and

8:33

friends and movement and travel and everything else

8:35

that I didn't connect that,

8:38

but I did feel this strong urge to

8:40

move. And I did, it

8:43

just became increasingly something that I needed to

8:45

do. And then I gradually came out of

8:47

that episode, but then lots of other things

8:49

were changing my life. So I never connected

8:52

those dots. Yeah. Okay. But

8:55

now of course we know much

8:57

more about how important physical movement

8:59

is to mental health, both for

9:01

prevention and for treatment. Yeah. I

9:03

know a little bit about you Felice because my

9:06

cousin is, you're her supervisor, Jess

9:09

Green. PhD supervisor, yeah. PhD supervisor. And

9:11

she'll tell me about you. But what

9:13

I thought was just amazing is that

9:15

before you started doing research, and correct

9:18

me if I'm wrong, before you started

9:20

doing research on the link between nutrition

9:22

and mental health, there was

9:24

no research on it. Is that true? There

9:27

was very little. So what there was, was some

9:29

very limited and in many cases, not

9:32

all cases, pretty poorly run trials that

9:34

have looked at individual nutrients like supplements,

9:36

you know, so I don't know, folate

9:38

and omega-3 fatty acids and things like

9:41

that. But of course we don't eat just

9:44

those individual nutrients. And it's

9:47

increasingly clear that taking particular substances

9:49

out of food or whatever and just

9:51

focusing on them is a really flawed

9:53

thing because the, I mean,

9:55

food is the most complex exposure that you

9:58

can think of. be

10:00

now, we think, as many

10:02

as 150,000 different types of

10:04

phytochemicals in plant foods, then

10:07

you've got all the macro. So what is that for? So

10:10

phytochemicals are chemicals that are produced

10:12

by plants, particularly if they're in

10:14

healthy soils. But those

10:16

phytochemicals are something that

10:19

plants produce to

10:21

help their survival. But because

10:24

we've developed as humans, as

10:26

a species, consuming plants, we've

10:29

adapted to our body

10:31

response to those phytochemicals in all

10:33

sorts of ways. And it's so

10:35

complex, we haven't even begun to

10:38

start mapping that properly. We

10:40

know about 8 to 10,000 of

10:42

those, and that's the flavanols, polyphenols,

10:44

people who know them as antioxidants.

10:47

And we know something about those. But that's

10:49

just a little tiny component. And

10:51

then you've got the food matrix,

10:54

you've got the macronutrients, so that's

10:56

your different sorts of carbohydrates and

10:58

fats and sugars and things like

11:00

that. The micronutrients, so all the

11:02

vitamins and minerals. All

11:04

of these things, it's just so complex

11:06

that the idea that you could

11:08

just pick out one little bit of that

11:10

and somehow consider

11:13

that an important element in and of itself

11:15

is a flawed approach, is very reductionist. And

11:17

that's where the field really was when

11:20

I came into it. And there

11:22

were also quite a few, what we call

11:24

observational studies. So this is when you look

11:26

at big groups of people in a population

11:28

and you go, oh well, the people within

11:30

this population who eat lots of fish

11:34

tend to have lower levels of mood

11:36

disorders, for example. But again, we don't

11:38

eat just fish, so they hadn't taken

11:40

into account the whole of diet. When

11:44

I came into psychiatry research, which was

11:46

kind of accidental really, I

11:49

was increasingly interested in, there was a

11:51

new field that was

11:54

opening up called psychoneuroimmunology.

11:56

And basically this was just this understanding

11:58

and increasing. data that told us that

12:00

our immune system was really important in

12:02

our mental and brain health and there

12:04

was this bi-directional relationship between our immune

12:06

system and our mental and brain health

12:08

and of course our immune system is

12:10

very heavily influenced by the quality of

12:12

the diets we eat. We now know

12:14

quite a bit more about why that

12:16

might be in the gut microbiome but

12:19

we can talk about that later. There

12:21

were also new data coming out of

12:23

the animal research at UCLA in America

12:26

that neuroscientists identified

12:28

towards the end of the you

12:31

know 1990s early 2000s that there's

12:33

this key region of the brain

12:35

called the hippocampus that actually grows

12:37

new neurons throughout life. So

12:40

I remember when I was younger the prevailing

12:42

wisdom was that you know we were born

12:44

with our full complement of brain cells and

12:46

neurons and we only lost them over the

12:49

life course which is kind of depressing but

12:52

then it started to become clear and

12:55

it's not 100% there's still a little

12:57

bit of controversy about it but most people

13:00

agree that this part of the

13:02

brain the hippocampus can lay down new

13:04

brain cells quite quickly and

13:06

because this is a really central part

13:08

of the brain for learning and memory

13:10

but also seems to be really involved

13:12

in mental health and also appetite regulation

13:15

it was really important to

13:17

start to study this and then neuroscientists

13:19

had been doing these animal studies where

13:21

they fed animals you know things like

13:23

blueberries things that are very high in

13:25

these antioxidants or saturated

13:27

fat or sugar and showed that

13:30

it had a really obvious impact

13:32

on this key region of the

13:34

brain. So there were two bits

13:36

of information that made me think

13:38

hang on why are we not looking at people's

13:40

diets I mean we look at it in every

13:43

other area of medicine and health we

13:45

know that what you eat is very clearly linked

13:47

to you know heart

13:49

disease, cancer, diabetes, your risk

13:51

of death but

13:54

nobody was looking at it in relation to mental

13:56

health and that I think

13:58

is mainly because in psychiatry Certainly,

14:01

over the last hundred years or so, there's been this

14:03

sort of split between the mind and the body,

14:05

and it's like psychiatry hasn't been particularly interested in

14:08

anything that happens below the neck. But

14:10

of course, we're highly integrated, very, very

14:12

complex systems, and everything that happens here

14:15

also affects the brain and vice versa.

14:18

So why this gap was there, I

14:20

think, was very puzzling to me because

14:22

I'd long been interested in food as

14:25

the sort of foundation of health because

14:27

really, it's food we eat that powers pretty

14:29

much every process in our body and brain.

14:33

So no one had really looked at this as a

14:35

whole. And around

14:37

this time, there was a lot of interesting

14:39

research going on in the nutrition field where

14:42

they were developing new statistical methods for looking

14:44

at the whole of diet. They're certainly not

14:46

perfect, but it was a much better way

14:48

where you're trying to capture dietary patterns and

14:51

the whole of diet, not just individual bits of

14:53

diet. And so I

14:55

was able with my PhD to

14:57

employ those methods to look

14:59

at the relationship between the

15:02

habitual diets of this large group

15:04

of women who were Australian, they

15:07

were deemed to be very representative

15:09

of the Australian female population from

15:12

the age of 20 right up into their 90s. Of

15:15

course, taking into account those

15:18

really important factors that can

15:20

influence both diet and mental

15:22

health, things like people's income,

15:24

education, how much they exercise,

15:27

these types of things, but also their body weight.

15:31

And then we looked at their clinical depressive

15:33

and anxiety disorders. So we did clinical assessments

15:35

on them. I think I did something like

15:39

over 500 for my PhD and then

15:41

some more after that. And

15:44

then putting them together, what I saw

15:46

was that women who had healthier diets,

15:48

even when we took into account all

15:50

those other factors, they were

15:53

much less likely to have a

15:55

clinical depressive or an anxiety disorder

15:57

that had unhealthier diets. There was

15:59

a relationship. there with more mental

16:01

health problems. And

16:03

because this hadn't really been looked

16:06

at before in psychiatry, this was

16:08

my main PhD study, it

16:10

was published on the front cover of the American

16:12

Journal of Psychiatry, which was a really big deal.

16:14

That's a big deal. And it was nominated like

16:16

the most important study in psychiatry in 2010, and

16:18

blah, blah, blah. And

16:21

it was really that it was just novel.

16:23

And then on the basis of that, I

16:25

was able to then go and work with

16:27

all of these fantastic groups all around the

16:30

world who had these epidemiological data. So again,

16:32

from these big population based surveys and things,

16:35

information on people's diets, their mental

16:37

health, all these other factors that

16:39

we needed to consider. And

16:41

right across the life course from what

16:43

mums eat during pregnancy, what kids eat

16:45

in the first part of life, adolescence,

16:48

which isn't the primary age of onset for

16:50

mental disorders, like half of all mental disorders

16:53

start before the age of 14. And

16:56

then right up to the other end

16:58

of life and aging and people often

17:00

develop depression, for example,

17:02

in the later stages of their life, there

17:05

was this very clear and consistent

17:07

link that diets seem to really

17:09

matter to the risk for

17:12

mental disorders. And then I was

17:14

crazy enough as an early postdoc to go and

17:17

do the first randomised control trial to

17:19

say, okay, well, if someone

17:22

already has a serious mental disorder, in

17:24

this case, moderate

17:27

to severe major depressive disorder, if

17:29

we intervene to help them to improve their diet,

17:32

does that actually help? And

17:34

I was absolutely staggered to see the

17:36

results because there was a

17:38

massive improvement on average in the people

17:40

who got the dietary support and

17:43

the people who, the more they changed their

17:45

diet, the more they improved. And

17:47

these were people often who'd been sick for

17:50

many, many years. Most of them were on

17:52

other forms of treatment, antidepressants, psychotherapy, etc. But

17:55

this seemed for many people to be an

17:57

absolute game changer and we saw that a

17:59

full of them went on to

18:01

have complete remission of their depression, which is

18:03

amazing. So that's the SMILES trial

18:05

and that's actually been a very famous trial,

18:07

even though it was certainly imperfect and it

18:09

was smaller and everything else. And there's been

18:12

several trials since then that have

18:15

shown the same thing, even in

18:17

young males, which is a

18:19

really difficult population to get them to

18:21

change their diet, in as

18:24

little as three weeks in some cases. So

18:26

the change being in their mental health?

18:29

In their mental health, generally we've looked

18:31

at depression and anxiety and the field,

18:33

that's where most of the information is

18:35

so far, but we're certainly starting to

18:37

look in other clinical disorders as well.

18:39

So before you're saying that like, you know, half

18:41

of all mental disorders start before the age of

18:43

14, is that male and female? Yes. Yeah.

18:46

And so it would make sense to

18:48

me that then you would try and

18:50

target like younger people in terms of like

18:52

how to change diet from an earlier age?

18:55

Prevention. And what you want

18:57

in mental disorders or any disorder really is

18:59

to identify factors that can be modified. So

19:02

so many of the things that influence the

19:04

risk for developing mental disorders are things that

19:06

are really hard to modify. They're things like

19:08

genetics, early life trauma,

19:10

life stress, poverty, disadvantage, all

19:12

of these things are risk

19:14

factors for developing mental disorder.

19:16

Genetics probably the most important,

19:20

but those are really kind of hard to

19:22

change. Whereas diet and you

19:24

know, how much you move, these are

19:26

things that can be changed, arguably. How

19:29

much you move, I like move your body. Yeah,

19:31

yeah, like physical activity. What

19:33

did you think she meant by that? Like move house. Oh,

19:35

I love it. I

19:38

was like, how much you move, obviously, if

19:40

you move too many times, it can be

19:42

a bit of an effect. I think that

19:44

would be, yeah, it is, it's really stressful.

19:47

So sort of being able to focus on

19:49

these things is really important. But you

19:52

know, it shouldn't be up to individuals. And

19:54

that's where I'm really coming from with most of

19:56

my conversations is about this is about

19:58

our food environment. Yeah. And the

20:00

Western industrialised food system is the

20:02

leading cause of illness and early

20:04

death across the globe. Because

20:06

it shouldn't be up to individuals to have

20:09

to try every day to avoid

20:11

those ultra processed foods that

20:13

are designed to interact

20:15

with the reward systems of the

20:17

brain that really prompt us to

20:19

overeat and that make up in

20:21

the UK and the US about 60% of average

20:24

energy intake, it's a bit less in Australia,

20:27

but that we're increasingly seeing are

20:29

super problematic and then of course

20:31

at the population level almost no

20:34

one is eating anywhere near enough

20:36

vegetables, legumes, fibre, etc. I

20:38

feel like it would be more professional of me to tease the audience

20:40

and say at the end you're going to tell us what we should

20:42

eat but I just want to know now. Like

20:46

what foods would you be recommending people eat? It's

20:49

really just the same as we know for

20:51

any other health

20:54

outcome, heart disease, diabetes, whatever

20:57

that you really try and maximise the

20:59

number and the diversity of plants in

21:02

your diet and plants isn't just vegetables

21:04

and different types of veggies and fruit

21:06

but things like whole

21:09

grains, so oats, barley, rye,

21:11

quinoa, etc. Legumes

21:13

are critically important to my mind because

21:15

they are just such a wonderful source

21:18

of protein and fibre, so all of

21:20

the different beans, black beans, broad beans,

21:22

chickpeas, lentils, etc. Herbs

21:25

and spices, they have a lot of

21:27

those phytochemicals that I talked about before,

21:30

healthy fats like extra virgin

21:32

olive oil also has a lot of

21:34

those polyphenols and it's like we

21:37

would think about extra virgin olive

21:39

oil like medicine, it's just

21:41

such an incredible book. But

21:44

basically foods that are just unprocessed.

21:48

I have a little bit of red meat in the form of

21:52

wild deer because deer in Victoria

21:54

are a huge environmental pest and

21:57

they're really flourishing and so they're There are

21:59

people who have the license to go out

22:02

and shoot them humanely and butcher them and

22:04

bring them to market. And you can buy

22:06

them online and in farmer's markets. But to

22:09

me, that's a great option because it's environmentally

22:11

sound, it's ethical. I

22:13

tend not to eat a lot of like chicken

22:15

and fish and things like that because of environmental

22:17

and ethical reasons. So mainly

22:19

focusing on plants, but the really key

22:22

thing is avoiding those ultra processed foods.

22:24

Yeah. And so the fish interests me

22:27

because I feel like I've always been told that a

22:29

little bit of fish is really important for Omega Omega

22:31

3. It is. So what

22:33

would you have to replace that if you're

22:35

not eating fish? It's a really tricky thing. I

22:37

know people are talking now about algae supplements. It's

22:41

unclear, I think, as to whether

22:44

they can replace the

22:46

long chain Omega 3 fatty acids that you get

22:48

in seafood. I do have things like

22:52

oysters, mussels, things

22:54

that have got those Omega 3 fatty

22:56

acids, but they don't have a nervous

22:58

system. Technically vegan, I just

23:00

realized I found out about oysters. Yeah,

23:03

technically. Yeah. So a lot

23:05

of vegans do eat oysters and those bivalves. You

23:07

know, what's a bivalve? I

23:10

don't know. Those things that come

23:12

in shells. Sounds like something I nod

23:14

to at a mechanics like, oh yeah,

23:16

go fix the bivalve. Yeah,

23:19

that bloody bivalve keeps going. Just as someone who,

23:21

so I train a lot for running and it's

23:23

always been driven through me, I need to have

23:25

a lot of protein in my diet. I

23:28

certainly notice a difference in my energy levels

23:30

when I do have protein, a lot of protein when I

23:32

don't. So how would you

23:34

be saying I should be getting my protein in

23:37

according to everything that you've studied? Look,

23:39

I think people have a lot, there's

23:41

a lot of misinformation about protein. People

23:43

think, oh, unless it's an animal based

23:45

protein, it just doesn't cut it. But

23:47

you know, plants. I saw a pretty

23:49

good M&M flavored protein powder. I don't

23:51

know if you think that would... That

23:53

would fall into the ultra-process for a

23:55

category. I really wouldn't be going there.

24:00

You know, I think that wild venison

24:02

is a good option. There's a couple

24:04

of companies in Victoria that sell it

24:06

and I think that's

24:08

a decent option. But again, you want to keep,

24:10

you know, if you look at the ideal plate,

24:13

very simply half of the plate

24:15

is vegetables and, you know, plants,

24:17

salad. A quarter of the

24:19

plate is a whole grain of some sort and

24:21

a quarter of the plate is a protein source.

24:24

I mean, I eat a lot of tofu

24:26

and tempeh. Tempeh is great, it's a fermented

24:28

soybean. Nuts

24:31

are also really fantastic. Like, I eat

24:33

nuts every day. So things like cashews

24:35

and walnuts and pecans and, you know,

24:37

one of my team who's a dietician

24:39

said put them in the microwave for

24:41

one minute and they roast them. So

24:43

they're really good. I put them on

24:45

salads and my breakfast and everything. They're

24:48

really good sources of protein. So

24:51

really mixing it up is important. You certainly don't

24:53

want to be having meat seven days

24:55

a week. What we know

24:57

is that the diversity of the plant

24:59

foods that you take in very clearly

25:01

influences the diversity of your gut microbes.

25:04

And you want your gut microbes to

25:06

be diverse because it means that they're

25:08

resilient. It's a bit like a rainforest

25:10

where it's very diverse, lots of different

25:12

bacteria and fungi in the soil and,

25:15

you know, all sorts of insects and

25:17

different types of plants and they all

25:19

work synergistically and mutualistically. But

25:21

if you have a monoculture, they're very,

25:23

very vulnerable to a particular virus or

25:26

some pathogen coming through. So your gut

25:28

microbiome is like that. The

25:30

more diverse it is, certainly with

25:32

healthy microbes, the more resilient it

25:34

is. And we're increasingly seeing that,

25:36

for example, people who have

25:38

a more diverse gut microbiome will

25:41

have better outcomes for cancer

25:43

treatment. And

25:46

it's related to all sorts of things,

25:48

including things like frailty and cognitive decline

25:50

as we get older. Many

25:53

different health outcomes are associated with the

25:55

diversity of the gut microbes and

25:58

having a very diverse diet. So not

26:00

eating the same thing every day. I

26:02

mean, as hunter-gatherer humans, we used to

26:05

eat hundreds, thousands of different types of

26:07

plant foods, and now we eat, I

26:09

don't know, about five in general, you know.

26:12

Our industrialized food system has made our

26:14

food pipeline

26:16

extremely mono,

26:19

and that is showing up

26:21

in this absolute epidemic

26:25

of immune-related disorders, because

26:27

70% of your immune cells are in your gut. So

26:29

your gut microbiome, which influences

26:31

virtually every process in your body, profoundly

26:35

involved in your immune system. So

26:38

mix it up, that's the take home. I'm

26:40

getting really caught into practical. I just wanna see

26:42

what my plate should look like at breakfast, lunch,

26:44

and dinner. That's what I'm really... How

26:48

many lettuce plates? No, and

26:50

there's a danger with getting too hung up

26:53

on it, you know, and what we see

26:55

in the literature is that there's a very

26:57

clear linear relationship between the quality of people's

26:59

diets and their likelihood of having or developing

27:02

depression. But that

27:04

relationship with anxiety is slightly different.

27:06

It's J-shaped, which means that people

27:08

who are highly anxious often also

27:10

have highly, really good diets. And

27:14

we know this also from the literature is

27:16

that people who are very anxious, they

27:19

actually tend to have longer lifespans because

27:21

they go to the doctor, and they

27:23

do the prescribed amount of exercise, and they eat

27:25

according to what they're supposed to be eating, and

27:27

they do all the things, and they take all

27:29

the medications, and they're really good, but

27:31

they're very, very anxious. And what you

27:34

have there is a bit of a fine

27:36

line because that can very easily tip over

27:38

into things like orthorexia, which are eating disorders

27:41

that are very common where people think, oh

27:43

my God, I ate a chip, this is

27:45

terrible. And it's really not

27:47

like that. Your body and your microbes

27:49

are incredibly resilient. If you're in general

27:51

just feeding them what they

27:53

eat. This might be

27:56

a dumb question because it's probably

27:58

got a very complex answer, but. I've

28:00

always sort of wondered when you hear people talk

28:02

about the microbiome and you're talking about the link

28:04

to mental health from food. Is

28:06

the pipeline that how

28:09

it works in your body to improve your mental health

28:11

is that it's food in,

28:13

microbiome better, brain better or is there

28:15

a separate mechanism that's going on as

28:17

well as the microbiome? Yeah, you're asking

28:19

the $64 million question. Okay.

28:22

This is great. For those who are interested in

28:24

the science, we've got a really great review on

28:26

this in Molecular Psychiatry that we published a couple

28:28

of years ago. No one

28:31

really knows for sure because this is so

28:33

complex and also there's been so few studies

28:35

that have really looked at this to try

28:37

and answer this question and that's something we're

28:39

trying to get funding for so that we

28:41

can start to answer it. But we think

28:44

that probably a really important or if not

28:46

the main pathway is that link that you

28:48

consume food. If it's got

28:50

these polyphenols, photochemicals, if it's got high

28:52

fiber, then it will make its way

28:54

to your gut. Your microbes

28:57

will ferment it and produce thousands of

28:59

different molecules that interact with every kind

29:02

of cell pretty much in the body. Influences

29:06

your metabolism, body weight, influences your immune

29:08

system, but also seems to influence your

29:10

mental health by a number of pathways.

29:12

So if we think about the mechanisms

29:15

that might link diet to

29:17

mental health, I mentioned before the

29:19

hippocampus. Now, part of that could

29:21

work through the microbiome. We know that there is

29:23

a link between the microbiome and the hippocampus, but

29:25

we don't know if that's the only link. There

29:27

might be a direct link. You've

29:30

got your neurotransmitters, things like

29:32

serotonin. Now the gut microbes

29:35

really influence how much serotonin you have

29:37

in your brain because they metabolize

29:39

tryptophan from your diet and

29:42

in that way they... What's tryptophan? Oh, it's an

29:44

amino acid. It's a protein that sounds... It sounds

29:46

a lot like something you'd have in your car

29:48

as well. Tryptophan, stop working. Do

29:51

not have supplements. But it will... If

29:56

you've got a... Do you say do not have supplements? I

29:58

would be saying things... that you'd

30:01

be very cautious about supplements, put it

30:03

that way. I know that they- This is

30:05

like multivitamins and things like that, is what

30:07

we're talking about? Look, some of my colleagues

30:09

would disagree vociferously with me about that. And

30:12

there is some really interesting evidence that in

30:15

some conditions, and we hear we're talking about

30:17

things like ADHD, there's clinical

30:19

trial evidence to suggest that

30:21

really high dose, good quality,

30:23

vitamin mineral supplements might

30:25

be helpful. And that

30:27

to me might point to

30:29

a problem with metabolising

30:32

nutrients from food or that their microbes

30:34

for some reason are not able to

30:36

use what's in food properly and therefore

30:38

a supplement might be useful. But

30:41

often supplements can cause problems. There's

30:43

clinical trial evidence to suggest that

30:46

people who took multivitamin supplements, for

30:48

example, had a worse outcome compared

30:50

to placebo in mental health trials.

30:53

I know, for example, that I'm

30:55

really super sensitive to vitamin B

30:58

supplements, and that can actually trigger

31:00

depression and anxiety in me. And

31:04

there's many cases in which I think you have

31:06

to be really careful. When

31:09

you take foods out of their

31:11

environment, I'm talking here

31:14

about their food matrix and all of those other

31:16

things that go with it, you're

31:19

rolling the dice. You don't know how

31:21

that's gonna be interacting with all these

31:23

very, very complex systems in the body.

31:25

So you've got to keep in mind,

31:27

we evolved as hunter-gatherers to

31:30

consume the foods around us. And

31:33

those foods are incredibly complex. As

31:35

I said, tens of thousands of

31:37

all sorts of macromicro nutrients, phytochemicals.

31:40

Our bodies are so complex. Our

31:42

brains are so complex. They're much

31:44

more complex than everything

31:46

we know about in the universe. We know

31:48

more about far deep space and

31:52

everything out there than we do understand

31:54

the brain. I mean, even psychiatric medications,

31:57

in most cases, we don't really know

31:59

how they work. work. So

32:01

it's just so complicated that to

32:03

take something out of such a

32:05

complex system and consume it

32:07

on its own, occasionally,

32:09

like if obviously if someone's got a

32:11

frank deficiency, then obviously that can be

32:13

really useful. But in general,

32:16

I would say have the food,

32:18

don't have the supplement. It just,

32:20

it's always, because this

32:22

is probably what they want you to think, but I

32:25

think like, oh, well, if that particular food, the

32:27

good thing in that is vitamin B, it's

32:29

like, I'll just have the vitamin B in

32:31

a pill. It's way easier. I'll just have

32:34

that. It makes so much sense. And

32:36

of course, it's actually working with... Well, it's not

32:38

just the vitamin B. I mean, any given food

32:40

that has, say, for example, a whole lot of

32:42

vitamin B will have all these other things as

32:44

well. And they're all working together and

32:47

then they're working, interacting with all

32:49

these complex systems and the microbes.

32:52

They're really messing with a lot of complexity

32:55

there. Yeah. Interesting. I

32:58

feel like we got, I think you were

33:00

halfway through talking about the other mechanisms because

33:02

there's the serotonin and the... Yeah, there's the

33:04

neurotransmitters, the sekippocampus, there's the mitochondria, you know,

33:07

these little engines in your cells that produce

33:09

energy and that we increasingly think are involved

33:11

in bipolar disorder and those sorts of things.

33:14

There's inflammation and oxidative stress, which is

33:17

your immune system and what happens when

33:19

you have too many reactive oxygen species,

33:21

they're sort of related. There's

33:24

epigenetics, which we really only just

33:26

starting to understand, but probably are

33:28

extremely important, certainly in any aspect

33:30

of health, so presumably also mental

33:32

health. We don't really know a

33:34

lot about it yet, but the

33:37

foods you eat or anything in your environment

33:39

influences how your genes are turned on and

33:42

off. So we come with our set of

33:44

genes, but whether

33:46

or not they're active and what they

33:48

do, epigenetics, which is

33:50

like the bits that play the keyboard

33:52

of your genes, that

33:55

is kind of determining whether or not they're

33:57

switched on or off and what they do.

34:00

So, the environment,

34:02

including diet, influences those

34:04

epigenetic processes. But we're very

34:06

much in our early stages of understanding that.

34:10

Your stress response system, so your

34:12

HPA axis, it's called, hypothalabic proturatory

34:16

adrenal axis, the

34:19

gut microbes and the gut-brain axis are

34:21

very much part of that. But

34:24

then the gut microbes themselves, they actually

34:26

interact with all of those other things.

34:29

So, gene expression, they're closely involved in

34:31

our immune system. They influence

34:33

our neurotransmitter levels. They produce hosts

34:36

of neurotransmitters themselves. Even

34:38

that remedy, kombucha, I was drinking when

34:41

I came in this morning, would have

34:43

neurotransmitters in it that had been

34:45

produced by the bugs that are in that

34:47

drink. Now, we don't

34:49

know if they interact directly with the

34:51

brain. We're still very much trying to figure

34:54

that out because, again, it's complicated and you've got

34:56

the blood-brain barrier that stops a lot of things.

34:58

So when people say, oh, you

35:00

know, your gut bugs produce serotonin, well,

35:02

yes, they might, but they're probably not

35:04

directly influencing your brain's serotonin. They're interacting

35:07

with other things. But

35:09

the gut microbes, as I said, influence

35:11

how much serotonin is produced for the

35:13

brain by influencing the metabolism of tryptophan.

35:19

Mitochondrial function increasingly understood to be

35:21

important and increasingly we're seeing that

35:23

the gut microbes are involved in that.

35:25

So what's that, the engine of the

35:27

cell? Yeah, that's the little energy engine

35:29

of the cell. Very good. Thanks.

35:32

Yeah. I'll just copy

35:34

what she said before. But

35:36

it's increasingly clear that diet influences all

35:38

of those pathways. All of those are

35:40

involved in mental and brain health. And

35:43

the gut microbiota seems to be a

35:45

really central thing that connects them all.

35:48

And it's also a really concrete and easy way

35:50

for people to think about food. It's like, okay,

35:52

food goes in, it goes down. But

35:55

if it's the right type of food, it makes its

35:57

way to the large bowel, the gut. And

36:00

then the bacteria and not just

36:02

bacteria, like there are viruses

36:05

and fungi and parasites and all

36:07

sorts of things all working together.

36:11

But the bacteria we know a bit about

36:13

and they break down the food, produce these

36:15

thousands of different molecules that influence all those

36:17

systems that we just discussed. And

36:19

in that way, mental and brain health, as

36:21

far as we know so far, is

36:24

affected. What's really interesting too,

36:26

though, is that we've just recently seen a

36:28

new study. I don't even know if it's

36:30

been officially published yet, but it was on

36:33

what we call a preprint. There's

36:36

this really important highway between the gut

36:39

and the brain called the vagus nerve.

36:41

And we've known about that forever. So

36:43

when people talk about the gut-brain axis,

36:45

that's actually what they're talking about, this

36:47

major highway of nerves and hormones and

36:50

everything that allows the brain and

36:52

the gut to speak to each other in a

36:54

bi-directional way. Most of the signals are

36:56

going from the gut to the brain, but about 10% go

36:58

from the brain to the gut. That

37:01

vagus nerve is like a highway.

37:04

And in a recent, really interesting study

37:06

from the US, they showed that in

37:09

animals, and again, it's very difficult to

37:11

do neuroscience without using animals because you

37:13

can't chop people's heads off and have

37:15

a look at what's happening inside. Please

37:18

don't do that. They

37:20

showed that then when there was

37:22

pathogenic or unhealthy bacteria in the

37:25

gush of the animal, it

37:27

was also present in the brain and

37:29

in the vagus nerve. And

37:32

then when they cut, well, they can only

37:34

cut half of the vagus nerve without killing the

37:36

animal, when they did that, most

37:38

of that pathogenic bacteria in

37:40

the brain was no longer evident. So

37:43

what it's saying is that there

37:45

seems to be potentially a direct

37:48

route between the bacteria in your

37:50

gut and your brain

37:52

via the vagus nerve. It's actually using it

37:54

like a highway. So what you put in

37:57

your gut will directly affect what's

37:59

going on. going on in your brain. This

38:01

is what this research suggests that what

38:04

you eat influences the microbes that are in

38:06

your gut. And it's not just

38:08

what you eat and that

38:10

direct link to your gut, but we're increasingly

38:13

understanding that the microbes that maybe we breathe

38:15

in and that are in our lungs, the

38:18

microbes in our mouth that we're swallowing

38:20

all the time, they're all making their

38:22

way to the gut. But

38:24

then there's this direct link via the

38:26

vagus nerve to the brain. And there's

38:28

an increasing amount of research that's focusing

38:30

on how maybe

38:33

pathogenic microbes in the brain,

38:35

viruses and bacteria might be

38:37

influencing Alzheimer's disease. Wow. So

38:40

it's super, super interesting. But for people

38:43

trying to get their head around why what

38:45

they eat might be linked to their mental

38:47

and brain health, that's probably the most concrete

38:51

way of thinking about it. So

38:53

without wanting to be like too fear

38:55

mongering or anything like that, like we don't do anything

38:57

to do that. But on

38:59

the flip side, and this

39:01

is not to shame anyone or to judge,

39:05

but what are the effects on your mental

39:07

health if you're consistently

39:10

eating like heavily processed food? Well,

39:13

what we know from, again, the observational literature

39:15

is if you look at people who eat

39:17

a lot of these types of ultra processed

39:19

foods and again, taking

39:22

into account all those important things like

39:24

their income and education and body weight

39:26

and... And the fact that your kids

39:28

won't eat anything else. They

39:33

have an increased risk of developing depression. We

39:35

know that as well as an increased risk

39:38

of cardiovascular disease and all sorts of other

39:40

things and shorter life spans. Increased

39:42

by how much do we know? In the

39:45

case of depression, on average, it's about 20

39:47

odd percent. Wow. Yeah. That's

39:50

huge. Yeah. So we're going to

39:52

do experimental studies because it's kind of difficult getting... Well,

39:54

A, it's difficult getting funding, but B, it's really hard

39:56

to get ethics approval to give a whole lot of

39:59

attention. a lot of junk food to people and see

40:01

what happens to their mental health. But

40:03

that has been looked at. So colleagues

40:05

of ours up in Sydney did two

40:07

really important studies where they got young,

40:09

healthy university students who generally had a

40:11

pretty healthy diet and they were in

40:14

the healthy weight range, you know, healthy,

40:16

I say in inverted commas, but you

40:18

know, that BMI range that's considered to

40:20

be optimal. And

40:22

they put them on, in the first case, they

40:24

just gave them a high saturated fat, high sugar

40:27

breakfast for four days in a row and then

40:29

they had a control group. Can you give an example

40:32

of what that would be? It was like a milkshake

40:34

and a toasty, like with, you know, ham cheese. I

40:36

don't know exactly what was in it, but lots of

40:38

saturated fat. Which incidentally is what I had every day

40:40

when I went to uni. So that's... Yeah,

40:43

yeah, yeah, okay. So lots of fat, lots

40:45

of sugar and then they had a

40:48

control condition who got sort of a milkshake

40:50

and a toasty, but it wasn't an unhealthy

40:52

version like that. And over four

40:54

days, just four days, they did cognitive testing on

40:57

them. Now remember that the

40:59

hippocampus, this key region of the brain

41:01

is very plastic. It grows and shrinks,

41:03

it grows new neurons, but it can

41:05

also lose neurons and lose size. And

41:09

they did cognitive tests that looked at

41:12

the types of memory tasks that are linked

41:14

to the hippocampus and they showed that in

41:16

just four days, there was a negative impact

41:18

on cognition in these young people who got

41:21

that, just the breakfast. And then

41:23

they expanded it and they did a week and

41:25

it wasn't just breakfast. It was like, here's some

41:27

vouchers, go and eat at Macca's and blah, blah,

41:29

blah. And they again saw

41:31

the same impact. They followed them up, I

41:33

think three months later and found that they'd

41:36

reverted. They went back to baseline because they'd

41:38

reverted back to their healthier diet. But

41:41

that suggests that you can have

41:43

a negative impact on cognition,

41:45

memory, everything else pretty

41:48

quickly by eating junk food. Now

41:50

I say junk food, those foods

41:53

weren't necessarily ultra processed. And

41:55

this is one of the key discussions in the

41:57

field and there's a lot of contention which is

41:59

very much being fed by big industry.

42:02

Is it just

42:04

the salt sugar fat in ultra-processed

42:07

foods at the problem, or

42:09

is there something else about the

42:11

processing that's problematic in and of

42:14

itself? As far as preservatives and things like that?

42:16

Not just preservatives. There's so many

42:18

things, if you think in ultra-processed

42:20

foods, there's often preservatives. There's emulsifiers.

42:23

Now, in animal studies, we see

42:25

that emulsifiers can affect the lining of

42:28

the gut. A healthy gut has this

42:30

nice, thick mucus layer that kind of

42:32

protects, it

42:35

keeps whatever's in the gut

42:37

and stops it getting out into the bloodstream.

42:39

Many people have heard of this leaky gut

42:41

idea. But it is actually a thing where

42:44

the tight junctions are

42:46

wider and contents of

42:48

the gut, including bacteria that

42:50

can promote inflammation, so that's

42:52

a detriment to the immune

42:54

system. All sorts of

42:57

things can escape into the bloodstream and the body

42:59

mounts this immune response to them. It

43:01

does look like there might be an impact directly on the

43:03

brain and that it also might be a

43:06

pathway by which the blood-brain

43:09

barrier becomes more leaky as well, which would

43:12

allow things to get into the brain that

43:14

potentially are not great. All of

43:16

this is very early research being done in animals.

43:19

But we know that emulsifiers, which

43:21

are just everywhere in processed foods,

43:25

they actually affect that

43:27

mucus lining of the gut. And

43:29

in animal studies, they promote this leaky

43:31

gut. Artificial

43:34

sugars also from the animal studies

43:36

suggest that they have a problematic

43:38

impact on the gut. But

43:41

there was a key study published a couple of years ago

43:43

by one of the real gurus in

43:45

nutrition research internationally. So

43:48

Kevin Hall's at NIH in Washington,

43:50

DC, and they have

43:52

this incredible facility where they can

43:54

basically get people and lock them

43:56

up voluntarily, obviously. Incredible. And

43:59

feed them. and study them like guinea

44:01

pigs for a few weeks. And

44:04

he was very interested in and

44:06

quite skeptical of this idea that

44:08

there's something specific about ultra-processed foods

44:11

that makes them problematic, apart from

44:13

their fat, sugar, salt content. And

44:16

so he designed a study where people came

44:18

in and it was a crossover study. So

44:21

people were split into two groups. And

44:24

one group got food

44:27

and a diet, a menu every day that

44:30

wasn't ultra-processed. So it was things

44:32

like pasta with tomato sauce and

44:35

bread and a snack and

44:37

things like that, drinks that

44:39

weren't ultra-processed, but they weren't particularly healthy.

44:42

They were just standard food that

44:45

people would consider quite common. And

44:48

then the other group got the same

44:50

thing, like pasta or a bit of

44:52

pizza or drinks or snacks or whatever

44:54

that were also, they were kind

44:56

of matched energy wise, more or less, as

44:59

much as they could be matched in terms

45:01

of the macro and micronutrients, because often you'll

45:04

see on ultra-processed foods, they'll say, it's got

45:07

vitamins and it's got minerals, it's got fiber,

45:09

but they're kind of added back in. And

45:13

people rated both diets as equally palatable,

45:15

which means that they thought both of

45:18

them were equally yummy. And

45:20

then people were swapped over, over

45:23

a period of time. And

45:25

what he found was that when

45:27

people were having the ultra-processed version

45:29

of the diet. Also one of

45:31

those meals was an ultra, like

45:33

packaged pasta. That's right, packaged pastas,

45:35

packaged pizzas, things that have got

45:38

an ultra-processed food is where it

45:41

originally started off as food, but it

45:43

was just completely pulled apart and then

45:45

reconstituted. For shelf life. With all sorts

45:47

of other stuff in it to make

45:49

it more appealing. Okay,

45:52

not just shelf life, but also more appealing.

45:54

That's all right. Yeah, okay. When

45:57

people were on the ultra-processed version, they

45:59

ate... 500 calories

46:01

a day more on average, even

46:04

though they'd rated both diets as

46:06

being equally appealing. Satisfying. They

46:09

ate more. There's something about, we think,

46:11

there's something about the ultra-processed foods that's

46:13

bypassing the body's natural, very complex systems

46:16

of appetite regulation. And this makes sense

46:18

in relation to the gut microbes, because

46:21

the gut microbes are interpreting this food

46:23

and they're going, oh, that's not food.

46:26

That's not food as I recognized

46:28

it, that I have evolved symbiotically

46:30

with this organism, the human, over

46:32

millennia. What the hell is

46:34

this? And that because they influence

46:37

all of these complex systems and it

46:39

looks like appetite, but they also influence

46:41

the hippocampus, which is also involved in

46:43

satiety, which is that feeling of fullness.

46:46

And that's what the research studies

46:48

in Sydney with the young people

46:50

from university also showed, is

46:53

that people were more hungry. It seemed to influence

46:56

their satiety. So I

46:58

did intermittent fasting for about a year. I

47:00

did it for, and so

47:02

my last meal was around about seven

47:05

o'clock at night. And if I had a

47:08

meal that we have discussed

47:10

today to be a healthy choice, so salad, small

47:12

amount of red meat. And intermittent fasting for

47:14

those who don't know is like you don't eat for how many hours

47:16

a day? It was 16,

47:18

sorry, I would have a 16 hour fasting

47:20

break overnight. And so,

47:23

let's say, I mean, if

47:25

I ate at six o'clock at night, I wouldn't eat until 10, 10

47:28

the next day. So if I

47:30

ate salad and had

47:33

a small bit of red meat, I wouldn't

47:35

be hungry the next morning. But if I

47:37

had a burger, or for

47:39

example, when we go on our tour, after we do our

47:42

live shows, we have a tradition of having McDonald's after us.

47:44

I was hoping you wouldn't tell us. Oh gosh. Throw us

47:46

under the bus please. Thanks for dubbing. If

47:49

we had McDonald's. We

47:53

did have that tradition. Yeah. Often

47:55

I try and get the wrap. Doing

47:58

my best. And so

48:00

if we're McDonald's the night before and much more food

48:02

would go in and the salad and a bit of

48:04

red meat, I would be so hungry the next morning.

48:06

Oh yeah. And I couldn't believe, and that to me

48:08

was just a sign of that told me everything I

48:10

needed to know. Not, I'm

48:13

not just having a go at McDonald's here. It was, if

48:15

I had, you know, a sausage roll off a

48:17

dinner, if it was processed, I would be starving

48:20

the next morning and it was so difficult. Well,

48:22

that's what the emerging data literature suggests is going

48:24

on, is that it's affecting the

48:26

satiety signaling in the body differently.

48:29

And we think the hippocampus is probably involved

48:31

because the hippocampus is affected by what you

48:34

eat, it's affected by your microbes, and

48:36

it seems to play a

48:38

role in satiety and appetite regulation. So,

48:41

yeah, you will eat more. And

48:43

of course this is what big food

48:45

wants. So all of those

48:48

big companies, Unilever and PepsiCo and Nestle,

48:50

et cetera, et cetera, don't make these

48:52

ultra, ultra processed foods. Hey,

48:54

they're going to maximize their profits if you go

48:56

back for more and more and more. Do

48:59

you think that within those companies and

49:01

without wanting to become

49:04

a conspiracy theorist or anything, but do you think

49:06

within those companies, they know what they're

49:08

doing to make that happen to

49:11

their foods? It's a really good question. I

49:13

think, you know, these companies are massive. The

49:16

largest companies in the world in many cases,

49:19

certainly in that top,

49:21

I don't know, 10 or something. I've

49:25

worked with them. I'm on the steering

49:27

committee for the World Economic Forum's New

49:29

Frontiers and Nutrition Initiative, which has these

49:31

people. I think it's

49:34

not like people are going, ha, ha, ha,

49:36

ha, ha, you know, there may be people

49:38

who do that. But

49:42

there's also a sort of a paradigm. Like

49:44

if you're in the US and,

49:46

you know, I go there for work, it's

49:49

been several generations now of

49:52

a completely distorted food

49:54

system such that

49:56

people don't actually see that what they

49:59

can do. is ultra-processed food. They just

50:01

think it's food. You know,

50:03

I was invited to this sort of small

50:05

roundtable set of workshops at the equivalent

50:08

to the EPA over in Chapel

50:11

Hill, North Carolina. So in the US,

50:14

looking at environmental, things in the

50:16

environment that have an effect on

50:18

mental and brain health. So

50:21

there's 10 of us or so in the room, scientists

50:23

from all over the world. Many

50:25

of them were focusing on things like air pollution that

50:28

we know has an impact on the developing

50:30

brain and other environmental

50:32

toxins and things like that. And

50:35

I sort of got up and presented the data and

50:37

I said, well, based on the data so

50:40

far, the most

50:42

problematic exposure is Western

50:44

industrialized foods. And

50:46

they were just kind of stunned because they're all sitting

50:48

there with their healthy – well,

50:50

no, not McDonald's, but things that

50:53

are supposedly healthy, like their

50:55

diet cokes and their high

50:58

protein snack that's in

51:01

a package and their

51:03

grain-based chips and things

51:06

that they think are healthy because on the

51:08

packet it says it's high protein or it's

51:10

high fiber or it's low this or low

51:12

that. And to

51:14

them it's like, but that's food, that's healthy

51:16

for me because they don't recognize

51:19

any more because there's been several

51:21

generations now that that

51:23

isn't food and that that's abnormal. Is

51:25

money generally speaking an issue? Because like

51:27

I think I naturally, you

51:30

do hear that if you are

51:32

in a lower socioeconomic group and

51:34

particularly at the moment where it's

51:36

like people are really struggling with

51:38

money, I

51:41

can absolutely understand if people would hear this and go

51:43

like, I've

51:45

got other things to worry about other than

51:47

like me changing my diet. Absolutely. And it's

51:49

a huge issue, particularly in places like the

51:52

US where you get these food deserts and

51:54

food swamps and it's very

51:56

difficult to access whole healthy food and

51:58

it's very expensive. But

52:01

we did this, we've done it with two trials

52:03

now, detailed economic evaluation. So

52:05

in the SMILES trial where we help

52:07

people to change their diet from one

52:09

that was pretty heavy on the junk

52:12

food in inverted commas and

52:14

low on vegetables, fruits, legumes, fish,

52:17

olive oil, et cetera, et cetera. And

52:20

we helped them to improve their diet. We

52:23

did a very, very detailed cost analysis. So

52:25

we had health economists working on it where

52:28

we looked at the everything

52:30

that people were eating, that they had detailed

52:32

food diaries when they came into the study,

52:35

costed every single item, costed

52:37

every single item that we were recommending

52:39

that they consume. And we were

52:42

saying things like frozen vegetables,

52:44

fantastic, tinned and dried legumes,

52:46

brilliant, tin fish, absolutely fine.

52:48

You know, like stuff that

52:50

is not expensive, our

52:53

diet was actually significantly cheaper.

52:56

Fascinating. So you can eat

52:58

cheaply and even

53:01

in places where, say for example, people might

53:03

not be able to even

53:05

access a supermarket where they have fresh food

53:07

because they don't have a car.

53:10

But if you've got a freezer, frozen

53:12

vegetables, fantastic. As I said, dried

53:15

beans and tinned beans, they're so

53:17

cheap. And I mean, they're

53:19

the basis of my diet. You can eat so

53:21

cheaply if you're eating a sort of mainly plant-based

53:23

diet. So it doesn't

53:26

have to be expensive. It doesn't have

53:28

to be organic. I mean, ideally it's

53:30

not just organic, but from regen farms. But

53:32

that's really getting to the

53:34

nice to have top of things when

53:37

you consider that only about 5% of

53:40

adults in Australia eat even the basics

53:43

of the dietary guidelines. Less

53:45

than 1% of young people, like

53:47

toddlers in Australia, consume

53:49

the recommended amount of fibre-full

53:52

foods, so vegetables, legumes. Everybody's

53:55

eating badly, not just poor people, not just

53:57

people who don't have an education, everyone. Yeah,

54:01

there's so many things I want to ask. Which

54:04

cross on camo house? One

54:07

of the things that I find quite empowering about looking

54:10

at this through a mental health

54:13

lens is that every time I

54:15

think about what I ate under the traditional

54:20

health lens of like causing diabetes

54:22

or cancer or heart disease, it's such

54:24

a prolonged outcome. Yeah. Whereas I feel

54:26

like mental health is such a powerful

54:29

way to talk about this because you

54:31

feel it straight away. One

54:33

hundred percent. And this is what our

54:35

data show as well, that even young

54:37

men who are just traditionally really resistant

54:39

to health messaging, you know, tradies, if

54:41

you like, will change their

54:43

diet. No problem at all.

54:45

If you tell them it's going to influence their

54:47

mental and brain health, their ability to think, learn,

54:50

remember their mental health. And you experience it so

54:52

quickly. And you experience it so quickly. I think

54:54

men do respond to that, you're saying. Yeah, this

54:56

is what we've seen in one of the four

54:58

trials that have been done. It was done in

55:00

young men and they did change

55:02

their diet and they did

55:05

show profound benefit. So is there, is

55:07

there, because it's, you know, I'm sure

55:09

there's never enough funding for research for

55:11

what you do. Especially not in Australia.

55:13

Yeah. But is there is

55:16

there enough then? Is it a marketing thing then

55:18

as much as it is a research thing? Well,

55:20

it's one of the reasons that I'm always out

55:22

on the hustings doing a lot of media and

55:25

everything, because the more people understand these, the more

55:27

they go, oh, it's like a light bulb moment

55:29

where they go, OK, because people, you know, humans

55:31

are terrible at thinking about future consequences. I mean,

55:34

look at what's happening with climate change. If

55:37

it's something that, oh, maybe in the future

55:39

I might have a heart attack, it's not

55:41

going to do anything. And also our whole

55:43

messaging for decades has been around bloody obesity

55:46

and body size. It's just

55:48

ridiculous. And it's a really stigmatizing thing

55:50

to focus on. It's really

55:52

difficult to change. People's genes play a

55:54

major role in their body size. And

55:56

if they're in an environment where they

55:58

can have untrammeled access. to food, they're

56:01

generally going to reach a large body size

56:03

if their genetics are inclined that

56:05

way. Once you've

56:07

got a larger body size, it's very difficult

56:09

to reverse that. So people

56:12

just give up and they go, oh God, I've tried every

56:14

diet in the book. I

56:16

might as well just eat the chips. And then they're binging

56:18

too. They're going, next week I'm going to be good, but

56:20

this weekend I'll do this because it's all in the future.

56:23

But once they understand, and this is

56:25

what our research tells us and the

56:27

emerging research in the area overall, is

56:30

that once people understand that it affects

56:32

their mental and brain health, and that

56:34

happens pretty quickly, they really respond and

56:36

they do find that very empowering because

56:38

it's something that they can do for

56:40

themselves. So my husband and

56:42

I wrote a book called There's a Zoo in My Poo, and

56:45

it's for kids because kids

56:47

are really cluey. So

56:49

I was fortunate enough to lead the first

56:52

study that looked at that diet hippocampus link

56:54

in humans. So as I said, there'd been

56:56

lots of work that had been done in

56:59

animals, but I was working with

57:01

a team up at the ANU in Canberra. We'd

57:03

already shown in this big cohort of people

57:05

that people who had a

57:07

healthier diet were less likely to develop depression

57:10

in older age. It's

57:12

in older age, your hippocampus starts to shrink. So

57:15

when you start to lose your keys and forget your grandkids' names

57:17

and all that sort of stuff. So

57:20

we looked, there was a subgroup of

57:22

about 250 of these older adults who we

57:24

had MRI data on. And

57:27

even when we took into account,

57:29

not just depression, but very detailed

57:31

measures of their socioeconomic status, life

57:33

events, all sorts of things that

57:35

might affect the hippocampus, we

57:38

saw that there was a very strong

57:40

relationship between the quality of their diets

57:42

and the size of their hippocampus. People

57:45

who had better quality diets had much

57:48

larger hippocampal, it was a

57:50

really pronounced relationship. That's

57:52

since been shown in another couple of

57:54

much larger studies. So we think what

57:56

is true in animals is true in

57:59

humans. And people, everyone's

58:01

so worried about getting dementia,

58:03

obviously. Everybody really wants their

58:05

kids to be able to function well at school and

58:07

learn and remember. Everyone wants their brains to work well

58:09

and not to have brain fog. If

58:12

we know, if people understand that the quality

58:14

of what they're eating is going to influence

58:16

the size and the functioning of their hippocampus

58:18

pretty fast, that is

58:20

very powerful. It's powerful knowledge. I

58:23

find myself feeling that there's a

58:25

real inherent tragedy in something that

58:27

you've brought up. I find it

58:30

often in the room because in our family

58:32

we had an eating disorder

58:34

enter our house for quite

58:36

a long time. I don't know if that's the right way

58:38

to phrase it or disordered eating and

58:40

in the form of anorexia. Yeah.

58:42

I just feel so sorry for

58:45

people who find

58:47

themselves in that situation because it seems that

58:49

the disordered eating

58:51

is a self-fulfilling prophecy that would

58:53

enhance the intensity of the mental

58:56

illness. Yeah, it does. What

58:58

then makes it harder and harder and

59:01

harder to break out of that cycle?

59:03

It's very complex, the eating disorder, neurophysiology,

59:05

what's going on in the brain. I'm

59:07

certainly not an expert, although we have

59:09

done some work in our unit looking

59:12

at the gut microbes in anorexicals. We

59:14

think that they're definitely involved

59:16

in some way. If you take, not

59:19

you, but somebody, scientists take

59:22

a poo from a child

59:24

with severe malnutrition.

59:28

They can actually transplant and cause malnutrition

59:30

in an animal. When

59:33

people go into hospital for re-feeding, if they

59:35

have anorexia, they're often fed foods that

59:37

we think will probably not be the greatest for the

59:40

microbes, which may

59:43

exacerbate some aspects of their psychiatry.

59:46

Very early days we don't know for sure, but

59:48

more broadly speaking it's something that we are

59:51

critically aware of. When we talk about diet

59:53

quality and mental health, the mental disorder thing

59:55

is such an issue because people can, and

59:57

it goes back to what I was talking

1:00:00

about before. with anxiety, they

1:00:02

can get really hung up on the details and they go,

1:00:04

oh my God, I didn't eat my 10 different

1:00:07

types of veggies today. You know,

1:00:09

I'm going to be unwell. It's

1:00:11

really the evidence does not support that

1:00:13

in any way, shape or form. But

1:00:16

the critical thing is in every bit

1:00:18

of research that we and others have

1:00:20

done, body weight just

1:00:22

is not involved. So many

1:00:24

people will assume, too, that the quality

1:00:27

of people's diets affects their

1:00:29

body weight, which affects them into health.

1:00:32

Now, there's no doubt that what you eat

1:00:34

can have an influence on your body size

1:00:37

and weight. And on average, people who eat

1:00:39

a less healthy diet will have a larger

1:00:41

body size, but it's not always true. And

1:00:44

there's no doubt that there's a bidirectional

1:00:46

relationship between body weight

1:00:48

and things like depression. When

1:00:51

people are depressed, they have more of these stress

1:00:53

hormones which tend to make you put on more

1:00:55

weight around your stomach, more weight

1:00:58

around your stomach can be quite

1:01:00

pro-inflammatory. And we think

1:01:02

these inflammatory molecules can prompt depression.

1:01:04

So there's this bidirectional relationship there.

1:01:07

But if you look at the observational

1:01:09

research, so big populations, what people eat,

1:01:11

their mental health, we take into account

1:01:14

their body weight and we

1:01:16

see no matter what the body weight

1:01:18

is, that relationship exists. It doesn't work

1:01:20

through body weight. So the body weight

1:01:22

by itself is almost a meaningless figure.

1:01:24

Yeah, well, in this context,

1:01:27

in terms of diet and mental health,

1:01:29

it's not the pathway by

1:01:31

which diet is influencing mental health. It

1:01:33

looks like because in our SMARS trial,

1:01:35

the average body mass index of people

1:01:38

coming into the trial was about 30,

1:01:40

so they were in the overweight obese

1:01:42

category. And

1:01:44

that didn't change. The diet we were

1:01:47

advocating was not a weight loss diet

1:01:49

by any means. So people's body weight

1:01:51

stayed pretty stable, but still they experienced

1:01:53

a massive improvement in their mental health.

1:01:55

I think that's just so important to

1:01:57

make a point of because. I

1:02:00

always sort of like tense up and

1:02:02

get worried when we're talking about weight and

1:02:04

body weight because it is such a subjective

1:02:06

thing. I just think we bloody ignore it, you

1:02:08

know? Honestly, and growing up

1:02:10

as a female, particularly in places

1:02:12

like Australia, such as sexist culture,

1:02:15

and during the 70s and everything else, I mean,

1:02:17

myself and my peers are all being so inculcated

1:02:19

into this thing about, oh

1:02:22

my God, you must be thin, and

1:02:24

you know, and it's really been around

1:02:26

advertisers driving insecurity to sell more stuff. And,

1:02:28

you know, we know all the reasons why that

1:02:30

happens. It doesn't stop it affecting

1:02:33

your internal view of yourself.

1:02:36

But for younger poets coming up, I'm

1:02:38

starting to see much more acceptance of

1:02:40

different shapes and diversity and everything else,

1:02:43

and a recognition of how they've been played

1:02:46

and what absolute crap this is, which

1:02:48

is fantastic. But if

1:02:50

people have a healthy diet and they've

1:02:52

got, you know, some physical

1:02:55

activity that they enjoy and they've

1:02:57

got decent sleep happening,

1:02:59

their body size is kind of

1:03:02

irrelevant. I mean, you know, it's not about

1:03:04

that. It also feels like if you've got

1:03:06

those, that structure in place of

1:03:08

a healthy diet and sleep and movement,

1:03:10

you would be better placed to fight

1:03:13

against in your own head the

1:03:15

pressures of be

1:03:18

skinny or be all that kind of stuff. You're better placed to

1:03:20

battle that on an individual basis. I mean, this

1:03:23

whole internal thing every day of, oh my God, I've

1:03:25

eaten too much and so many calories and all that

1:03:27

meal was a bit too big or I shouldn't have

1:03:29

had that. I mean, what a waste of time. What

1:03:31

a waste of mental energy. If

1:03:34

you're feeding yourself beautiful nourishing food

1:03:36

and that's full of all those phytochemicals, certainly

1:03:39

if you're lucky enough to have access to,

1:03:41

you know, organic regenerative farms that are just

1:03:43

full of all the good

1:03:45

microbes and everything else, you've extra virgin

1:03:47

olive oil, you know, things that are

1:03:49

full of fiber and lots of different

1:03:51

types of fiber and all of those

1:03:53

things, you're nurturing your body, you're nurturing

1:03:55

your mind, you're nurturing your brain, you're

1:03:57

nurturing your joy. It's

1:04:00

just your body weight. Just forget about it. Well

1:04:04

said. Yeah. Well said. I'd

1:04:07

love to ask you about alcohol. It's such, it's so embedded

1:04:09

in our culture here in Australia that it's alcohol

1:04:13

with meals at night and then all celebrations. It's

1:04:15

such a big part of the Australian identity and

1:04:17

that's not, I mean, every country claims that it's

1:04:19

like the, the, you can't look, it's a big

1:04:21

part of, so it's a big part of, you

1:04:24

know, all over the world. Bloody Irish

1:04:26

heritage. Yeah. I can't blame them. Like

1:04:28

my Irish colleagues. Oh

1:04:31

God, it's my weak spot and my bugbear

1:04:33

as well. I find it very difficult to

1:04:35

manage my relationship with alcohol. I mean, it's

1:04:37

certainly gotten a lot better over the last

1:04:39

20 years or so, but it

1:04:42

is so pervasive. It's

1:04:44

so everywhere you go, like it's

1:04:46

impossible to avoid and

1:04:49

it's really not good. Alcohol

1:04:51

is a neurotoxin and we

1:04:53

know from studies that I've

1:04:55

discussed around looking at the hip

1:04:57

diet and the hippocampus, there's

1:05:00

been three studies done and one of

1:05:02

those sort of picked apart the aspects

1:05:04

of diet that most closely related to

1:05:06

hippocampal size, alcohol was the

1:05:09

big one. The good news

1:05:11

is it looks like if you

1:05:13

stop drinking or dramatically reduce that

1:05:15

you can fix that aspect

1:05:17

of your brain, essentially, but we don't

1:05:19

really know for sure. Change

1:05:22

drinking, which is, you

1:05:24

know, very common, that has a

1:05:26

detrimental impact on the gut microbes

1:05:28

and the gut lining, which is

1:05:30

as you would expect. On

1:05:33

the other hand, small amounts of red wine and

1:05:35

in the Mediterranean, I mean, ideally, certainly

1:05:37

as part of a traditional Mediterranean diet, which doesn't

1:05:40

really exist that much anymore, but tiny

1:05:42

little amounts, like we're talking 100 mils this much

1:05:44

with a meal, is good.

1:05:47

It reduces stress, which is good for your

1:05:49

microbes, good for your mental health. There

1:05:52

are polyphenols and things in red wine,

1:05:54

so it may be that a little

1:05:56

bit is okay from your gut point

1:05:58

of view, but from things like cancer.

1:06:00

cancer, there's no safe level of consumption.

1:06:03

And I think, you know, to my mind, I've

1:06:05

had breast cancer twice, I've had my breasts removed,

1:06:08

awful experience, chemo, everything else, and

1:06:10

I really directly attribute that to

1:06:13

my younger years. My husband was

1:06:15

abandoned, you know, like alcohol

1:06:18

was such a big part of our

1:06:20

lives. And

1:06:22

that thing of, you know, in the evening you

1:06:24

get home, you open the bottle of wine because

1:06:26

that just provides that instant stress relief and

1:06:29

enjoyment and reward and everything else. I

1:06:32

don't have any doubt that that was a major

1:06:34

contributor to my breast cancer. And that's

1:06:36

why I really try and limit alcohol now. So

1:06:40

in short, really fun, but really,

1:06:43

really not good for you. Yeah, yeah.

1:06:45

Very hard to avoid though. There's a

1:06:48

lot of fantastic non-alcoholic drinks now that

1:06:50

I find really helpful, particularly the beers.

1:06:52

You know, some of the beers are just great.

1:06:55

So those beers, so obviously that is an, that's

1:06:57

a processed product, I imagine.

1:07:00

I don't know that it would fall into the

1:07:02

category of ultra-processed. So that would actually be not

1:07:04

a bad... I actually wonder whether

1:07:06

they've got those fermentation products a bit similar to

1:07:09

Kombucha. I don't know if anyone's actually looked at

1:07:11

that, but it makes sense to me that they

1:07:13

would. Yeah, yeah. Because,

1:07:15

you know, I mean, even just last

1:07:17

night I went to the pub and I had

1:07:20

like two beers. And

1:07:23

then I remember thinking afterwards, I was like, I probably

1:07:25

didn't need to have like those beers. It's just such

1:07:27

a thing of like, well, I'm at the pub. Yeah.

1:07:30

It's like, I want one. Social thing and

1:07:32

the gathering. But then I did think afterwards,

1:07:34

like, what if I had the non-alcoholic ones?

1:07:36

It probably would have had the exact same

1:07:39

impact on like my sense of like

1:07:42

being at the pub. We

1:07:45

didn't see each other. And I had two non-alcoholic beers just

1:07:47

to show off. Did you enjoy yourself as much as right?

1:07:49

You lived my dream life. I had a wonderful time. But

1:07:53

yeah, I think that we actually

1:07:55

have to just be a bit

1:07:57

realistic about the fact that again,

1:07:59

industry promotes alcohol consumption. consumption as

1:08:01

it goes hand in hand with

1:08:03

family occasions, with social occasions, with

1:08:05

celebrations, commiserations. Industry

1:08:08

is making a huge amount of money out

1:08:10

of a hell of a lot of misery

1:08:12

and a detriment to our health, to

1:08:15

cancer, to our brain, to our gut.

1:08:19

So as much fun as it is

1:08:21

and kills me to say this because

1:08:23

I really love wine, but you

1:08:25

just can't kind of get away with it.

1:08:27

And you know, I drank a lot when

1:08:29

I was young because I had severe anxiety,

1:08:31

depression. It would give me a break from

1:08:33

that. Yeah. You know, and

1:08:35

it's so wonderful to just go, oh,

1:08:37

thank God, and just lose yourself in that. But

1:08:40

then you're so much worse the

1:08:42

next day and you don't even

1:08:44

realise until you stop just how

1:08:46

miserable it can make you if

1:08:48

you're inclined to having depression, anxiety.

1:08:51

Yeah. It only occurred to

1:08:53

me recently when I've really, from having kids and

1:08:55

getting a bit older and just having a lot

1:08:57

more on, I couldn't really afford to be feel

1:08:59

hungover. Yeah. My mental conversation,

1:09:02

because I just find it so difficult to

1:09:04

not have that, you

1:09:06

know, spritz or whatever, you know, and I'm

1:09:09

beautiful, warm, Melbourne night, and you're out and

1:09:11

everything else. But is to

1:09:13

switch it around, not that this is really bad for

1:09:15

my health or my gut or my brain,

1:09:18

but I'm going to get a benefit if I

1:09:20

don't have it. I'm going to feel so much

1:09:22

better. I love that feeling in the morning. You

1:09:24

wake up with energy and clear head and

1:09:27

the difference is massive. And it's only when you

1:09:29

stop that you realise what a difference there is.

1:09:31

What you're missing out on. Yeah. Yeah,

1:09:34

absolutely. Can I ask about fermented foods? The

1:09:36

fermented stuff is really interesting. If you can

1:09:38

get those in. That was

1:09:40

after Tim Spector's podcast, I started reading

1:09:42

that every day. So sauerkraut, kimchi,

1:09:45

but you know, there's lots of other

1:09:47

sorts of fermented foods. There's like tempeh

1:09:49

and miso and obviously

1:09:51

kefir and kombucha and things like that.

1:09:53

But there was a really fascinating study

1:09:55

published a couple of years ago and

1:09:57

it was only a small study. be

1:10:00

expanded upon. I'm sure that's happening now.

1:10:02

But in the

1:10:04

US, you've got what we call a

1:10:07

sad, the standard American diet. It's absolutely

1:10:09

shit full. Like it could not be

1:10:11

worse. It's so heavily on

1:10:13

ultra-processed foods, so low in fiber, so

1:10:15

low in every macro and micro nutrient.

1:10:17

I mean, it's not surprising that this

1:10:19

generation has a shorter lifespan than the

1:10:22

one before. And it's almost like they're

1:10:24

eating their way out of existence. But

1:10:28

people recommend that to improve

1:10:30

your microbiome diversity and reduce

1:10:32

inflammation, which is a marker

1:10:34

of immune function, you

1:10:36

should increase fiber in the diet. So

1:10:40

basically, this study wanted to actually test

1:10:42

head to head what a good strategy

1:10:44

might be for improving diversity of the

1:10:47

microbiome and reducing inflammation. And

1:10:49

so one group got this high fiber diet,

1:10:52

where they were gradually over a period of, I think,

1:10:54

three weeks encouraged to eat more fibrous

1:10:56

foods, more fiber in their diet. And

1:10:59

the other group got a fermented foods diet.

1:11:01

So they over three weeks again, they gradually

1:11:04

increased their consumption of fermented foods

1:11:06

such that they were having six

1:11:08

serves a day, but they're tiny. So if you say

1:11:11

you were having three meals

1:11:13

a day, you were having a fermented food of some

1:11:15

sort. So whether it was

1:11:17

a yogurt, kefir, you know, sauerkraut,

1:11:19

kimchi, those sorts of things. And

1:11:22

at the end of the study, they

1:11:25

showed that the people who had the

1:11:27

high fermented foods diet, they increase their

1:11:29

microbiome diversity, and they

1:11:31

reduced inflammation. So yay, that's

1:11:33

great. In the high fiber group,

1:11:36

quite a different set of outcomes. Some

1:11:39

people did really well, increased diversity,

1:11:41

reduced inflammation, others did really badly,

1:11:43

and ended up with horrible stomach

1:11:45

aches and more inflammation. And

1:11:48

I thought, why would this be? And

1:11:50

I thought, well, actually, if they've got a

1:11:52

really like a microbiome, like a desert, which

1:11:54

so many do in the US, and you see

1:11:56

this in the data that when people immigrate

1:11:59

from areas where there's

1:12:01

much better food culture into the US, their

1:12:03

microbiome becomes less and less diverse and they

1:12:05

get sicker and sicker. Maybe

1:12:08

if they don't have the microbes that can

1:12:10

break down all these different types of fiber,

1:12:13

they're not gonna do so well and they're gonna feel pretty

1:12:15

terrible. So they looked and they

1:12:17

saw undigested fiber in their stool. So

1:12:20

it's saying that it was the

1:12:22

people who had the low level of diversity

1:12:24

to start with, they couldn't quite cope with

1:12:27

adding fiber backing because they just didn't have

1:12:29

the microbes that were able to break it

1:12:31

down. You have to like build it back up. Yeah,

1:12:33

and how you do that is unclear at

1:12:35

this stage. The research hasn't been done. I

1:12:37

would really love to get funding to do

1:12:39

this because I've got a lot of really

1:12:42

great dietician researchers in my team. I

1:12:45

suspect that if it's done gradually with

1:12:47

fermented foods, so with the fermented foods,

1:12:49

they didn't see increases in microbes

1:12:52

that were directly in those fermented

1:12:54

foods. So you might get a, you know, a kombucha or

1:12:56

something and go, oh, it's got these particular

1:12:58

bacteria, drink the kombucha, let's look

1:13:01

in the stool and see if those microbes

1:13:03

exist there. What seems to

1:13:05

happen is fermented food seems to provide

1:13:07

a good environment for the microbes that might

1:13:10

be living in minuscule numbers in your gut

1:13:12

to sort of flourish. And

1:13:14

it might be, and we don't know,

1:13:17

it's not yet tested, but to

1:13:19

increase the fiber gradually in

1:13:21

your diet for those people who say, when

1:13:24

I cut out foods and went onto

1:13:26

a carnivore diet, I felt so much better.

1:13:28

Well, it's like, yeah, because your microbes are

1:13:30

not able to break down the fiber. So

1:13:32

you're getting stomach aches, IBS, whatever, to

1:13:35

gradually increase fiber with

1:13:37

fermented foods. I

1:13:39

think that that might be what comes

1:13:42

out of the literature over time, but

1:13:44

it is super fascinating because from the

1:13:46

animal studies, after four

1:13:48

generations of low fiber diets

1:13:51

in animals, they've lost so much

1:13:53

diversity that even when fiber is

1:13:56

reintroduced, they can't get it back.

1:13:58

The only way they can get back the divis. is

1:14:00

through fecal microbial transplants, poo transplants.

1:14:02

Okay. Gosh. I

1:14:05

feel like I experienced a microcosm of what you're

1:14:07

talking about a few weeks ago, because I got

1:14:09

gastro. Oh, yuck. Awful.

1:14:12

It was about the sickest I've ever felt in

1:14:14

my life, apart from a food poisoning incident in

1:14:16

Bangladesh, which was one step worse. But this was

1:14:18

as bad

1:14:20

as I felt. But I had this, and I

1:14:23

get really, whenever I got sick, I get really

1:14:25

depressed pretty quickly. It really

1:14:27

hits me hard. I often get this

1:14:29

inflammation and that we think that these

1:14:31

pro-inflammatory molecules, these cytokines actually promote depression.

1:14:34

Right. Very interesting. I've always wondered

1:14:36

why that was the case. But then I

1:14:38

had this thing of like, all right, well, I want to, I

1:14:41

gradually feel like I could probably start eating here.

1:14:43

And in the back of my head, I'm like, well, the advice

1:14:46

is a bit of white bread, like

1:14:49

really plain foods that your stomach can handle

1:14:51

when you're coming back from it. And I

1:14:53

was just thinking, well, I'm just

1:14:55

going to feel crap because of what I'm

1:14:57

starting to learn about this stuff. It's just

1:14:59

going to prolong my feeling of depression. Like

1:15:01

when can I start to get back into

1:15:04

eating more complex foods coming out of gastro?

1:15:06

And it just feels like that experience is

1:15:08

like a microcosm of what you're talking about

1:15:10

on a grand scale. And those big disturbances

1:15:12

to the gut, like the course of antibiotics,

1:15:14

severe gastro, something like that, you really do

1:15:16

want to kind of try to replenish that

1:15:19

micro diversity and really support your gut. So

1:15:21

I, you know,

1:15:23

not just fibrous foods, but the fermented

1:15:25

foods are really important. I think

1:15:27

it's really interesting. You know, my cousin was

1:15:30

unexpectedly, she was very healthy fit

1:15:32

person, but in her early 60s

1:15:35

was diagnosed quite unexpectedly with advanced

1:15:37

ovarian cancer. And they

1:15:39

found that it had spread to her bowel and

1:15:41

everything else. It was really bad. And she wasn't

1:15:43

expected to live and she was super sick. Anyway,

1:15:46

they took her bowel, you

1:15:48

know, so she's got like a colostomy

1:15:50

bag, whatever. And

1:15:52

she is still alive, healthy,

1:15:55

kicking years later. But

1:15:58

when she was going through cancer, she was very, very sick. chemo, she

1:16:02

said to me, what can I do

1:16:04

to improve my chances of responding to

1:16:07

the chemo? And I said, well, everything

1:16:09

we know about the gut, the gut

1:16:12

microbiome, everything suggests that you should be

1:16:14

making sure that you have these diverse

1:16:16

high-fiber foods and things. It's like, oh,

1:16:18

hang on, you don't have a gut.

1:16:21

What about fermented foods, things that

1:16:24

you consume that have got these

1:16:26

fermentation products in them? What's

1:16:28

going on in the gut, kind of in a simpler

1:16:30

form, happens in the jar or the bottle. You

1:16:33

provide the microbes with a substrate, they

1:16:35

ferment them, and all of those, well,

1:16:37

a lot of those molecules are produced.

1:16:39

So if you're just having fermented foods

1:16:42

and something that, for

1:16:45

her, would be drinking like a kombucha type

1:16:47

thing, you're still getting these

1:16:50

fermentation products. And so as commonly

1:16:52

happens with chemo, you have to, and

1:16:55

I've had chemo, you have

1:16:57

to, they check your neutrophils,

1:16:59

this marker of immune function before they

1:17:01

give you each next dose, because you

1:17:03

really have to have a happy

1:17:06

immune system to be able to cope with it. And

1:17:09

what often happens is that people's immune

1:17:11

function gets worse over the course of

1:17:13

chemo, and that delays their chemo treatment,

1:17:15

which really has implications for their outcomes.

1:17:18

And this is what was happening to her. And

1:17:22

then I'd suggested this, you know,

1:17:24

consuming fermented foods and blah, blah,

1:17:26

blah. She did that. And when

1:17:28

she went back to the oncologist a couple of

1:17:30

weeks later to have her neutrophils checked, they

1:17:33

said, oh my God, they're fantastic. What did you

1:17:35

do? And she said, well,

1:17:37

this is what I've done. And they said, oh

1:17:39

yes, well, that would make sense based on what we

1:17:41

know so far. And she said, but nobody told me

1:17:43

this. And they said, well,

1:17:46

that's not, it's because we don't have enough evidence

1:17:48

to put them into the clinical guidelines. And this

1:17:50

is a big issue everywhere. The

1:17:54

work that we've done has influenced now

1:17:56

the clinical practice guidelines of the Royal

1:17:58

Australian New Zealand College of Science. psychiatry

1:18:01

in Australia, first time anywhere

1:18:03

in the world where they've

1:18:05

put what is essentially lifestyle medicine

1:18:07

as the foundation of treatment. So

1:18:09

lifestyle medicine being food, essentially? Not

1:18:11

just food, food, physical

1:18:13

activity, sleep and smoking and

1:18:15

other substances so those, you

1:18:17

know, that foundation and they've

1:18:19

said it's foundational,

1:18:22

it's essentially non-negotiable.

1:18:26

You've got to do this because it doesn't mean you

1:18:28

do that instead of other treatments, but it's like that

1:18:30

you've got to get that right. So

1:18:32

it's food, sleep, activity.

1:18:35

Physical activity, smoking, cessation and other

1:18:38

substances, obviously that would include

1:18:40

excessive alcohol consumption because

1:18:42

they're finally going, oh, actually all

1:18:44

of these things are necessary for

1:18:46

any organism to function well. And

1:18:49

if we get that right, then other treatments we give

1:18:51

them are going to work better as well. Certainly

1:18:54

in cancer, we see that,

1:18:56

for example, the really interesting thing is

1:18:58

in these new immunotherapies. Now

1:19:01

they're showing miraculous results, just mind-blowing

1:19:03

really how much the whole cancer

1:19:05

treatment field is being transformed by

1:19:08

immunotherapy. But only about

1:19:10

40% of people on average respond to

1:19:12

immunotherapy. So there's actually

1:19:14

studies underway at the moment where they're

1:19:17

taking poo transplants from people who have

1:19:19

responded and putting into people

1:19:21

who haven't responded to see if they

1:19:23

can improve their outcomes. But

1:19:25

on the other hand, people who have a course

1:19:27

of antibiotics within a month or two of immunotherapy

1:19:29

are twice as likely to die. Your

1:19:32

gut is central. If you want to survive

1:19:34

cancer, you've got to be looking after the

1:19:36

health and diversity of your gut. Our

1:19:39

food and mood centre at Deakin

1:19:42

is unique in the world. It's the

1:19:44

only research institute in the world that

1:19:46

looks at nutritional psychiatry across the spectrum.

1:19:48

We look everything from mechanisms right

1:19:50

through to these large-scale effectiveness trials,

1:19:52

which are kind of real-world clinical

1:19:54

trials. We look at

1:19:56

early life stuff. We're doing a lot

1:19:59

of work now and around, you know,

1:20:01

what mums eat during pregnancy, how that

1:20:03

influences their microbiome, how that influences the

1:20:06

infant's microbiome, because we know that the

1:20:08

microbiome of infants is not only very

1:20:10

important for their immune development, but

1:20:13

increasingly we see seems to be involved

1:20:15

in brain development. So how

1:20:17

do we optimize that? So we

1:20:19

did a trial at the Royal Children's

1:20:21

Hospital, showed that a gut-focused intervention were

1:20:23

explained to mums who were pregnant, why

1:20:25

the gut was important, what they should

1:20:27

do to improve their gut. The

1:20:30

infants had a different microbiome profile, but what

1:20:32

we saw was that that way

1:20:34

of talking about diet that had nothing to

1:20:37

do with body weight or gestational

1:20:39

diabetes or all the things that are normally

1:20:41

discussed really helped

1:20:43

the women to shift their diet and

1:20:46

become more healthy. And so now

1:20:48

we're doing a big scaled up version of that trial

1:20:50

that's just about to start, but we're doing a lot

1:20:52

of studies. So seems that way. Belise,

1:20:56

I mean, so, so fascinating. That

1:20:58

was just amazing. Thank you

1:21:00

so much. There's so much that I haven't even discussed.

1:21:02

So you have to look at the Food and Food

1:21:04

Centre website and our socials to see the

1:21:07

new studies that will be coming out this year, because they're

1:21:09

pretty cool. Yeah. I

1:21:11

mean, just thank you for all the work

1:21:13

you've done. It's truly life changing for so

1:21:15

many people. It's just incredible. I

1:21:17

feel incredibly privileged to have been able to

1:21:20

do what I've done. And

1:21:22

it comes from a very deep

1:21:24

seated anger at our current

1:21:26

food system, industrialised food system,

1:21:29

which costs the planet and the humans

1:21:31

in it at least 20

1:21:34

trillion dollars a year.

1:21:37

Now, that's the bare minimum. This is not taking

1:21:39

into account a host of other things that should

1:21:42

or could be included. But

1:21:44

11 trillion in the cost of human health,

1:21:46

leading cause of illness and early death, seven

1:21:48

trillion in the cost to the environment. It's

1:21:51

a leading cause of biodiversity loss. And

1:21:53

those two things are linked. Monoculture

1:21:56

that destroys the microbes in the

1:21:58

soil and the micro- nutrient

1:22:00

content, phytochemical content

1:22:02

in food, that

1:22:04

loss of biodiversity is directly affecting our

1:22:07

biodiversity and loss of biodiversity in our

1:22:09

gut. We

1:22:11

are organisms that need a

1:22:14

healthy environment and the food that we eat to be

1:22:16

as nature intended.

1:22:19

The industrialised food system has done

1:22:21

anything but herbicides, pesticides,

1:22:23

fungicides, monocropping, intense cropping, destroying all

1:22:25

the microbes in the soil, the

1:22:28

bacteria, the fungi that get all

1:22:30

those nutrients into the foods. The

1:22:33

foods themselves are so limited, such

1:22:35

poor quality, then you've got the

1:22:37

ultra-process food. So our

1:22:39

global industrialised food system is absolutely

1:22:41

killing us and the planet. So

1:22:45

that's the anger for me is

1:22:47

that nothing is being done really

1:22:49

to change this and in the

1:22:52

same way that climate change scientists

1:22:54

get so frustrated at, like, hello,

1:22:57

we're looking at the end of the human

1:22:59

race and you're just sitting there worrying about

1:23:01

your profit margins. I feel

1:23:03

the same about the industrialised food system. When

1:23:05

I go to fill up my car with

1:23:08

petrol and I walk in to pay and

1:23:10

there are just walls and walls and walls

1:23:12

of ultra-process foods, that

1:23:15

just makes me furious. It's

1:23:17

not right that that is the way

1:23:20

things are at the moment. Yeah.

1:23:24

Yeah. Unbelievable. Thank

1:23:26

you so much. You clearly have so much going on.

1:23:28

You've studied taking place. The fact you can take time

1:23:30

for us today, it means a lot. So

1:23:33

thank you so much. It's lunchtime, so

1:23:35

we're going to fill our bowl with

1:23:37

three quarters salad, some grains. I wouldn't

1:23:39

get hung up on the proportions. Thank

1:23:42

you so much for joining us. Oh, it's

1:23:45

been such a pleasure. Thanks for having me.

1:23:47

It was fun. The Imperfects is hosted and

1:23:49

produced by Hugh van Carlenberg, Ryan Shelton and

1:23:51

Josh Van Carlenberg. Our executive producer is Bridgette

1:23:54

North East. Researcher, Isabella North East, sound design

1:23:56

by Nick van Carlenberg. This episode is filmed

1:23:58

and edited by George Barton. The Imperfects is

1:24:01

not a licensed mental health service and is

1:24:03

not a substitute for professional mental health advice,

1:24:05

treatment or assessment. The advice given in this

1:24:07

episode is general in nature, but if you're

1:24:10

struggling, please see a healthcare professional or call

1:24:12

Lifeline on 13 11 14.