00:00:00
most people will experience tremendous reductions in anxiety within 3 Days To 3 weeks of starting a ketogenic diet in
00:00:06
fact we did a study where patients with bipolar disorder major depression or schizophrenia tried the ketogenic diet
00:00:11
and 43% achieved clinical remission from their chronic mental illness and 64% of
00:00:17
them left un less psychiatric medication because it improves the balance of chemicals in the brain but the question
00:00:23
is what's causing those chemical imbalances in the first place and so let's start there Dr Georgia e is a
00:00:29
Harvard train psychiatrist who specializes in nutritional science and mental health she was one of the first psychiatrists to offer nutrition-based
00:00:35
approaches as an alternative to psychiatric medications to optimize brain function and enhance performance
00:00:40
people need to know how powerful nutrition strategies can be for the brain because if you're feeding at the wrong way things will go wrong and
00:00:47
that's exactly what happened to me my health was declining in my early 40s in ways that is true for a lot of my
00:00:52
patients chronic fatigue and IBS being really anxious and depressed and so I did all kinds of tests they said there's
00:00:58
nothing wrong of course there was something wrong so I instinctively started experimenting with my diet and
00:01:04
the diet that I ended up on was backwards from what we're told is healthy for us it should theoretically kill me but it result every single one
00:01:10
of my symptoms and so I studied for years learning things about food that most people don't know and which foods
00:01:16
contain the nutrients the brain needs or the ingredients that damage the brain and found three principles of nutrition
00:01:21
they can help you in ways no medicine can as well as improved mood memory concentration stamina productivity so
00:01:28
let's unpack that this has always blown my mind a little bit 53% of you that listen to the show
00:01:34
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00:01:58
much Dr Georg
00:02:03
Eid how do you define what what it is you do I am a psychiatrist specializing in
00:02:11
nutritional and metabolic Psychiatry so how food affects the brain and how food
00:02:16
affects brain metabolism and how brain metabolism affects our mental health this is a fairly new phrase metabolic
00:02:23
Psychiatry am I right in thinking that yes it's a really it's a very new field
00:02:28
and really exciting field uh the the term itself was coined by Dr Shabani
00:02:33
Sethi who's a metabolic psychiatrist at Stanford University and maybe five years
00:02:39
ago or so maybe a little longer than that so it's a very very new field it's even newer than the other exciting New
00:02:45
Field in Psychiatry which is nutritional Psychiatry and so and this is a really
00:02:50
exciting time to be a psychiatrist uh and it's also a really exciting time or a hopeful time an
00:02:57
empowering time for people with mental health conditions because we're finally able to explore um root causes the real
00:03:06
root causes the deeper root causes of mental health conditions that go beyond things like what we're told all the time
00:03:12
which are these mysterious chemical imbalances you know that need to be addressed with medication We Now
00:03:18
understand that the real drivers the primary drivers of mental health conditions are inflammation of the brain
00:03:26
something called oxidative stress which is why we're always told to eat more anti oxidants and insulin resistance or
00:03:32
pre-diabetes which is now affects more than 90% of Americans in your work you
00:03:38
talk a lot about the ketogenic diet why is that so prevalent in your work was
00:03:43
the ketogenic diet energizes the brain differently so it it really fundamentally changes the brain's
00:03:49
operating system so when you switch from a high carbohydrate High insulin diet to a low
00:03:58
insulin which is us a low carbohydrate diet ketogenic diet the way that
00:04:05
cells uh receive energy the the mixture of fuels that they're using changes and that has
00:04:12
profound influences on just about every pathway just about every chemical
00:04:18
pathway inside of that cell so it is as though you are fundamentally changing the brain's operating system uh in very
00:04:25
healthy ways that allow not brain cells not only to work better but for uh but
00:04:32
for brain cells to heal so the longer you stay on a ketogenic diet the more
00:04:38
healing the more brain healing can take place and what is your sort of academic and career experience what's that can
00:04:44
you run me through that sort of timeline yeah so I uh got a degree an
00:04:49
undergraduate degree at Carlton College in Minnesota in biology so I always have loved science and biology understanding
00:04:56
how things work and uh then for years I worked as a laboratory research assistant different types of research
00:05:02
labs around the world Boston Munich including in diabetes research until
00:05:09
I figured out what I wanted to do and I decided that I wanted to go to medical school so then four years of medical
00:05:16
school at the University of Vermont in Burlington Vermont which is a great place to go to medical school and then
00:05:22
four years of Psychiatry residency training um at a Harvard program called Cambridge hospital in Cambridge
00:05:28
Massachusetts and then so that was 25 years ago that I finished my Psychiatry residency
00:05:34
training and I've been practicing uh Psychiatry ense and what does practicing Psychiatry
00:05:40
involve what it usually involves for most psychiatrists is psychotherapy and
00:05:45
medications and for some psychiatrists only medications some psychiatrists prefer to focus exclusively on
00:05:52
psychopharmacology or medication management there are some psychiatrists who choose to focus only on
00:05:58
psychotherapy and and and don't prescribe medications but the vast majority of psychiatrists offer a
00:06:04
combination of both medications and Psychotherapy and when did nutrition become part of your career well I I
00:06:12
never thought about the relationship between food and the Brain once um
00:06:17
during medical school we had maybe two or three hours worth of nutrition
00:06:22
lectures in four years and in four years of Psychiatry residency we didn't talk
00:06:28
about food in the brain once so I honestly had no idea how important it was to to brain health uh so I practiced
00:06:35
conventionally as I was saying you know medications and Psychotherapy for the first 10 years of my practice and as
00:06:43
much as I loved my work I it was becoming painfully obvious that most
00:06:49
people in my practice were just not getting that much better like no matter how hard I tried um and and it wasn't
00:06:56
just true for me you know it wasn't as though I was thinking well you know I don't have an maybe I don't have enough
00:07:02
experience or maybe I not reading enough or maybe I need more supervision um when
00:07:07
am I going to be able to really be able to help people because when I looked around even very senior psychiatrists
00:07:14
who had been in practice for decades the same was true for them I mean we had we've been taught to think of mental
00:07:22
illnesses as chronic mysterious and incurable and that the best way you can help people is to support them with
00:07:29
medications and Psychotherapy and uh but but that these are lifelong illnesses that we really
00:07:35
don't understand very well and that we can do very little about because you there's like a significant social
00:07:42
component to mental illnesses as well right absolutely I mean the brain the brain is a very responsive organ and
00:07:47
it's listening to uh it's not just paying attention to the food you eat it's paying attention to every aspect of
00:07:54
your life how much light the brain receives how much love you have in your life how how much you love your work
00:08:00
what kinds of people are around you um how you use your body exercise stress um
00:08:07
everything everything matters to the brain but most people are led to believe
00:08:13
that food doesn't matter that much to the brain and that's partly because
00:08:18
we've only recently started to think about it but the other piece um is that
00:08:24
the information that we're given about how to feed the brain and the body properly is incorrect and so when people
00:08:31
are trying their best to improve their mental health using nutritional strategies those strategies fail most
00:08:37
people because those strategies are grounded in the wrong information and so a lot of people just think oh well you
00:08:43
know I I tried eating more Whole Foods or right I tried uh you know I tried putting blueberries on my oatmeal or
00:08:49
making my flax seed smoothie every morning or uh eating more plants than animals I tried all of those things and
00:08:55
they just didn't help very much so I'm just going to go back to eating everything in moderation um because it doesn't seem to
00:09:02
matter but what's really great about you inviting me here to talk with you today
00:09:08
is that people need to know how powerful and intervention uh these nutrition
00:09:14
strategies can be they can help you in ways no medicine can in days to weeks in
00:09:20
many cases people can experience meaningful Improvement to their mood their memory their concentration their
00:09:26
stamina their productivity um and and their their mental stability their their
00:09:32
effectiveness in their lives if they have the right information about how to change their diet so you have to know
00:09:40
which changes are the ones that are worth making and they're not the ones we're used to hearing about is there a
00:09:46
particular case study that comes to mind when you think about this is there a most prominent case study or a first case study that was a Eureka moment
00:09:54
VI I wouldn't say there was a Eureka moment case in my life because I came to it a in a different way uh my Eureka
00:10:01
moment really came through my own personal experience I think a lot of Physicians who uh practice nutritional
00:10:09
and metabolic strategies most of us stumble into this
00:10:14
work accidentally because we're not taught it and most of us stumble into it
00:10:19
either because a patient comes to us and says hey you know I've tried this new way of eating and that's why I'm so much
00:10:25
healthier than when you saw me a year ago or the The Physician themselves
00:10:31
encounters their own health challenges you know uses the conventional nutrition approaches they don't help and they find
00:10:38
that they're kind of left to their own devices to solve their own health problems and that's exactly what happened to me so when I was
00:10:46
experiencing all kinds of uh health issues in my early 40s
00:10:51
despite doing everything correctly you know eating uh low fat low cholesterol
00:10:58
calorie restricted diet um uh that was high in fiber uh mostly Whole Foods and
00:11:06
exercising religiously despite doing all of those things my health was declining
00:11:12
in my early 40s in ways that was true for a lot of my patients as well and I had no idea how to help my patients with
00:11:18
these issues these were things like chronic fatigue and IBS and fibromyalgia and migrain headaches very common in
00:11:25
middle-aged people and older and even younger people nowadays so when I encountered those issues and I
00:11:32
was working at Harvard at the time I had access to all kinds of Specialists caring intelligent thorough they did all
00:11:40
kinds of tests all kinds of tests and they said everything is normal there's nothing wrong of course there was
00:11:46
something wrong but I I so I instinctively
00:11:53
started experimenting with my diet uh and long story short short 6
00:11:59
months later trial and error changes food and symptom Journal at the end of 6 months and this was back in
00:12:06
[Music] 2007 um the diet that I ended up on
00:12:11
Purely by trial and error was almost upside down and backwards from what we're told as healthy for us and that
00:12:17
was the diet that resolved every single one of my physical health symptoms but as a psychiatrist what
00:12:23
really got my attention was that it improved my mental health significantly and I wasn't even trying I wasn't even
00:12:31
aware that my mental health needed that much attention I think like most people
00:12:36
I was walking around with suboptimal mental health you know more anxiety than was necessary than was I you know I
00:12:46
slumping in the middle of the day brain energy you know faltering a couple of hours after lunch coming home at the end
00:12:53
of the day and and being completely spent and not being able to get anything else done after 5:00 being really
00:12:58
anxious on Sunday night before Monday morning work um you know being depressed in the winter time I mean all of these
00:13:05
things we think of as really normal we've come to expect so little of our
00:13:12
mental health we've come to expect poor mental health as normal and it
00:13:17
isn't uh if you feed the brain properly it works better and you can expect so
00:13:24
much more of yourself so when that happened to me I thought well that's interesting this diet seems to be good
00:13:30
for the brain which diet was that this was a mostly meat low carbohydrate low fiber low
00:13:37
cholesterol high fat diet no whole grains no legumes very few plant Foods mostly
00:13:46
Seafood meat poultry non-starchy vegetables and fats from Whole Foods it
00:13:53
really was as simple as that and a Diet similar to that is um uh one of the
00:14:00
starting places in the book so I have a variety of different dietary strategies people can explore in the book not just
00:14:05
one so it's different places for people to grab on depending on what they feel comfortable doing but that but that way
00:14:12
of eating resolved all of my physical issues and mental health issues I wasn't
00:14:17
even aware needed attention and that that
00:14:23
really was what inspired me to begin studying nutrition I certainly did not
00:14:29
out and start recommending this dietary pattern to my patients that would have been Reckless I didn't know the first
00:14:36
thing about nutrition and based on the little that I did know the diet that I had ended up on should theoretically
00:14:42
kill me so it could be dangerous for people and so I studied for years
00:14:47
independently took a graduate course at the Harvard School of Public Health and studied independently read everything I
00:14:53
get my hands on studied the the primary literature the actual scientific studies to try to understand okay why why is red
00:15:00
meat bad for us what's the difference between red meat and white meat why are whole grains good for us why are whole
00:15:06
grains good for us but refined grains are bad for us why do we need a rainbow of fruits and vegetables uh are some of them more
00:15:13
important than others are they all equally beneficial I mean all I just became so curious about food I really
00:15:21
wanted to get to the bottom of it so for years I studied nutrition and fell in
00:15:26
love with nutrition science and um it's a lot of what I share in the book is all these fascinating things about food that
00:15:32
most people don't know um and that can really such as that it's interesting
00:15:38
it's useful it's empowering because if you understand which foods contain the
00:15:44
nutrients the brain needs which foods contain the ingredients that damage the brain which foods are going to damage
00:15:51
brain metabolism and cause inflammation and cause oxidative stress cause all
00:15:56
these things that we're told we need to fight with supplements and
00:16:02
superfoods um that's the real power the real power in dietary change is not
00:16:08
adding special things to the diet it's actually subtracting the things that are harming the brain and working against
00:16:15
your best efforts it's it's it's just like anything you know you don't make
00:16:20
money by spending money you make money by by not spending money right so it it's the power of subtraction what are
00:16:26
you not doing um and that's really Step One is first Do no harm understand where
00:16:33
the harm is coming from in the diet because it's not where you think it's coming from it's not coming from the red meat it's not coming from the
00:16:39
cholesterol it's not coming from the saturated fat so if you understand where
00:16:45
the damage is coming from then you can turn things around very quickly you used a word there you used
00:16:51
the word explore um as it relates to different diets that you've written about in your book and that you know
00:16:57
that are available online I from what I understood there you're not saying that one diet is the right
00:17:03
diet for everybody you're saying that it's almost the word explore suggests sort of experimentation personal
00:17:10
experimentation and what worked for you in that case might not necessarily work for someone else in a different situation is that accurate that's
00:17:17
exactly right and you're bringing up a really important Point Stephen which is that there are two levels of
00:17:22
dietary knowledge so one is that there are fundamental nutrition principles
00:17:28
that apply to all human beings these are the rules the cells require these nutrients um and you must consume foods
00:17:35
that provide those nutrients to those cells and you must exclude these certain ingredients that can damage those cells
00:17:41
and you must keep your glucose and insulin levels in in the right range for your personal metabolism you have to you
00:17:47
have to nourish protect and energize yourselves you must do that but then
00:17:53
beyond that so so those rules and and the rules that you have to follow to to get there are not are not not commonly
00:17:59
known but then beyond that there's the personalization right because we are all different we're not different in what
00:18:05
our cells need but we're different in what we can tolerate we're different in our metabolic Health we we're different
00:18:10
in how old we are how active we are what um what conditions we we already have
00:18:17
what conditions we're most at risk for what our goals are what our preferences are what and and whether we have food
00:18:24
sensitivities for example um and so all of those pieces
00:18:29
you know food intolerances and and different different goals and different aspects of our of Our Lives that's where
00:18:36
the personalization comes in and I teach people in the book how to take these fundamental principles so I teach them
00:18:42
what the fundamental principles are which are very simple nutrition is not rocket science um and and then show them
00:18:50
how to personalize it to their metabolism to their preferences to their goals what are the fundamental
00:18:55
principles let's start there so the fundamental principles are nourish protect energize so nourish what does a brain
00:19:03
healthy diet look like and by brain healthy uh we are talking about what's
00:19:09
healthy for all cells because it wouldn't make any sense to uh for the human body to require different diet for
00:19:15
every organ you possess so a brain healthy diet is a diet that's healthy for every organ in the body so it's good
00:19:21
for the brain it's good for the heart it's good for the liver Etc so what is a brain healthy diet it needs to nourish
00:19:27
protect and energize nourish it must contain and be able to
00:19:33
safely deliver all essential nutrients to your cells so you have to know where
00:19:38
those nutrients are you cannot and using Whole Food principles and not including
00:19:45
supplements or specially fortified processed foods you cannot meet that goal without including some animal Foods
00:19:50
in your diet that's just the truth of our biology
00:19:55
protect protect the brain from damaging ingredients so what damages the brain
00:20:01
inflammation which you can't see or feel it's not as so the brain is red or swollen or sore you we the brain doesn't
00:20:07
have nerve endings but many many people have brain inflammation without being aware of it that's a main driver of
00:20:14
depression and all kinds of other brain conditions so you need to exclude
00:20:20
protection is not about addition it's about subtraction you need to subtract the foods from your diet that cause
00:20:28
inflammation that caus something called oxidative stress which is why we're always told to
00:20:33
eat more antioxidants what we really need to be told is what's causing all that oxidative stress in the first place and
00:20:40
remove those things because the antioxidant strategy really doesn't work and energize nourish protect
00:20:48
energize the third principle is energize which means the brain which is a very
00:20:53
high energy electrical organ it needs a constant supply of high quality Quality
00:20:59
Clean burning energy and if you're eating the wrong way your brain will not
00:21:04
will gradually lose its ability over time to generate energy that's primarily
00:21:10
about getting your glucose and insulin levels into a healthy range not just
00:21:15
your glucose although getting your glucose levels in a healthy range is extremely
00:21:20
important you have to go one step further because underneath that glucose you need to know what's happening with
00:21:26
insulin and that's that's a really EMP powering strategy sort of Next Level
00:21:32
right so getting your glucose and insulin levels down will allow your brain to uh uh to energize itself in the
00:21:41
most clean efficient um and reliable way possible nourish protect and
00:21:48
energize and then beyond there you said there's a level above there so that's the sort of fundamental level Beyond
00:21:53
there you go into sort of personalization what's best for you and is that where the sort of trial and error comes into play exactly so these
00:22:02
principles nourish protect energize the nourish you need to include some animal Foods the protect you need to exclude
00:22:07
things like refined carbohydrates and vegetable oils uh which are the signature ingredients of the standard
00:22:13
American diet or standard Western diet um and the the energize is is the the
00:22:19
glucose and insulin levels which for some people this is some a level of personalization begins here at the
00:22:25
energized piece because if you have excellent metabolic health and we can talk about what that means then you may
00:22:32
not need to eat a ketogenic diet to to properly n to to really get those glucose and insulin levels under control
00:22:39
and thoroughly energize your brain cells but if you have significant metabolic damage if you're sedentary if you're
00:22:46
older if you have pre-diabetes or type 2 diabetes um then you may need to reduce
00:22:54
the amount of carbohydrate in your diet even from Whole Foods you may even need to go to a ketogenic level and and
00:23:02
that's where that's where assessing your metabolic Health understanding where you
00:23:07
stand on the insulin resistant Spectrum the spectrum of metabolic Health that's
00:23:13
the empowering piece because if you know where you stand on the insulin resistance spectrum and you can get your
00:23:19
glucose and insulin levels into a healthy range you then you have tremendous power
00:23:25
over your emotional intellectual and your and your physical health future
00:23:30
it's really the number one risk factor for almost all chronic diseases mental and physical so personalization starts
00:23:37
with a metabolic personalization so how much carbohydrate can you safely tolerate that's one example but then
00:23:45
there's another level of personalization that has to do with how well does your immune system work how how good is how
00:23:51
how robust is your gut function your gut barrier many of us have lost our ability
00:23:57
to safely and comfortably tolerate a wide variety of foods that we should be
00:24:02
able to tolerate and that's because our environment multiple multiple toxins in the
00:24:09
environment are have broken down a lot of our defenses our gut barrier bloodb brain barrier uh and and our immune
00:24:17
system has become overwhelmed by trying to process lots of toxic ingredients in
00:24:23
our environment so these are things like Plastics and pesticides and antibiotics
00:24:28
and um and and food additives and and all kinds of you know ultr processed
00:24:35
foods that we were never designed to handle these are really stressful on the human body and they do
00:24:42
break down our defenses over time so this level of personalization is very much about trial and error but to save
00:24:49
people some of that frustration of trial and error approaches I I give them very
00:24:57
specific lists of foods um that that are more likely to be
00:25:03
culprits than others and so that helps cut back on some of the trial and error
00:25:10
elimination this keto diet you um you did a study on the ketogenic diet got
00:25:16
the study here the ketogenic diet for refractory mental illness a resp a retrospective analysis of 31 in
00:25:24
patients what is the ketogenic diet for someone that might not know so a lot of
00:25:29
people think or they've heard about a ketogenic diet as a weight loss diet um they think of it may maybe it's a fad
00:25:35
weight loss diet um they think of it as a very very low carbohydrate diet they might think of it as a diet that's very
00:25:40
high in meat and dairy products um and but actually the ketogenic diet was
00:25:46
originally created in 1921 more than a hundred years ago to
00:25:52
stabilize brain chemistry in children with severe seizures um and this was
00:25:58
long before the availability of useful seizure medications so these were
00:26:04
children who um uh were having multiple seizures per day in many cases and so
00:26:10
the ketogenic diet was designed back then created back then a very strict version of the ketogenic diet um to get
00:26:17
as close as possible to to fasting without Starving Children to death
00:26:23
because for Millennia people had noticed that those
00:26:28
with epilepsy would often improve if they were fasting but you can't fast
00:26:34
forever so how do you get close to fasting this is the original fasting mimicking diet how do you get as close
00:26:40
to fasting as you can while still providing some nutrition so that was the original goal of the ketogenic diet and
00:26:45
was very successful for seizures more than 50% of children had more than 50%
00:26:53
and and adults as well it's it's since been shown more than 50% response rate in children and and adults and 10 to 20%
00:27:00
completely uh free of seizures following a ketogenic diet how is it acting on the
00:27:06
brain what's it doing to the brain the ketogenic diet does many many things it's like a multi-purpose tool for brain
00:27:13
health so one thing it does because we talked about how uh some of the root
00:27:18
causes of mental illnesses which are only relatively recently a focus of
00:27:24
research are inflammation and oxidative stress and insulin resistance the
00:27:30
ketogenic diet reduces inflammation it reduces oxidative stress and it reduces
00:27:36
insulin resistance uh it also improves the balance of chemicals in the brain so
00:27:41
a lot of people think of um uh mental illnesses as problems with chemical
00:27:48
imbalances in the brain and these are the chemicals that they're talking about you might have heard of Serotonin or
00:27:54
dopamine or norepinephrine there are others glutamate Gaba many different chemicals in the brain are uh associated
00:28:01
with or in some cases even very much uh causing mental health symptoms but the
00:28:08
question is what's causing those chemical imbalances in the first place and uh one of the things that's causing
00:28:16
those chemical imbalances is that inflammation and oxitive stress but another thing is that the brain is uh if
00:28:22
you're feeding it the wrong way it will not be able to in many cases prod
00:28:28
produce energy reliably and if it can't produce energy reliably all kinds of
00:28:33
things will go wrong and in quite spectacular fashion what actually goes wrong is
00:28:39
going to depend on who you are and that's where our individual differences come in so if I eat the if you and I
00:28:45
exactly the same bad diet depending what runs in your family and how you've lived your life to this point you might
00:28:52
develop Alzheimer's disease you might develop bipolar disorder you might develop type 2 diabetes you might
00:28:57
develop fatty Li disease um I might develop completely different conditions
00:29:02
I might I might develop um cardiovascular disease I might develop depression um I might develop um ADHD it
00:29:10
and that's where the individual differences are but all of these conditions are just uh metabolic
00:29:17
malfunction really at at the heart of it that's what's going on if cells aren't
00:29:23
functioning properly you will develop a disease physical and mental diseases and
00:29:28
which ones you get it's really kind of luck of the draw um but you have tremendous control over what you are at
00:29:35
risk for if you understand how to help yourselves operate at their personal
00:29:41
best can you tell me about what you learned in this study and what this study concluded yes so this was the work
00:29:50
of my friend and colleague Dr Alber Dena he's a psychiatrist who's been
00:29:55
practicing in tulo France for more than 35 years so after witnessing a young family
00:30:04
member someone in his extended family with autism and seizures improve within weeks of adopting a ketogenic diet he
00:30:12
thought well I wonder if this diet could help my patients especially my patients
00:30:19
who are not responding to anything else that I have tried to help them
00:30:25
Psychotherapy medications hospitalization and so he invited 31 of his most
00:30:32
treatment resistant patients with bipolar disorder major depression or
00:30:38
schizophrenia to come into the hospital and voluntarily try a very mildly
00:30:45
ketogenic Whole Foods diet in the hospital under his supervision to see
00:30:50
whether or not they would respond and this was these were folks who these are all adults these were people who had
00:30:58
been ill for an average of 10 years some for as long as 30 years these were
00:31:03
people who were taking when they came into the hospital at the beginning of the study an average of five psychiatric
00:31:10
medications not at all unusual for people with chronic mental illness and all of them had one or more markers of
00:31:18
poor metabolic health obesity high blood pressure high blood sugar things like
00:31:23
that so these were people with poor metabolic health and poor Mental Health heal and they eagerly came into the
00:31:31
hospital to try this intervention because nothing else had helped them and what was remarkable about what he
00:31:38
observed was that of the 31 people 28 were able to stay on the ketogenic diet
00:31:44
for more than two weeks which is what you need to do to start to see benefit every single one of them
00:31:51
improved to the point that 43% of them achieved clinical remission from their
00:31:57
primary psychiatric treatment resistant chronic mental illness and 64% of them left the
00:32:05
hospital unless psychiatric medication and all of them improved metabolically as well and that you do
00:32:13
not see results like this in conventional psychiatric care so there's a few things that spring to mind when
00:32:19
you talk about the study the first is that they were inside a hospital yes so I guess that's a confounding Factor potentially oh yeah well a blessing and
00:32:26
a curse yeah so a blessing is that um the diet was fair was was very carefully
00:32:31
supervised six days out of seven they were allowed to go home on Sundays okay and which still I'm I'm just mentioning
00:32:37
but that but they had tremendous amount of support and supervision and and that's that's really really helpful when
00:32:44
you're switching from a standard High carbohydrate diet to a low carbohydrate diet they also had very careful medical
00:32:51
and psychiatric supervision which is also really important uh because when you when you change to a ketogenic diet
00:32:58
brain chemistry fundamentally changes in ways that can at first when you're
00:33:04
transitioning from one operating mode to another operating mode it's it's
00:33:10
stressful and sometimes you can feel worse before you feel better MH and medications can be affected so
00:33:17
medications need to be monitored and everything everything changes these are
00:33:22
all really healthy CH your blood sugar can drop your blood pressure can drop especially if you're taking blood sugar
00:33:29
lowering medications or blood pressure lowering medications if you switch to a ketogenic diet it's so effective at
00:33:36
lowering blood sugar many Physicians who prescribe blood sugar lowering
00:33:41
medications for diabetes need to cut the diabetes medication in half on day one
00:33:47
in order to prevent dangerously low blood sugar because you've got a medication that's lowering blood sugar
00:33:53
now you've added a diet that lowers blood sugar and this could be potentially dangerous
00:33:58
the diet on its own is not dangerous it's the diet in combination with
00:34:03
medications so you need to know what you're doing and so yes in the case of these um 31 adults so a certain
00:34:10
proportion of them was it 28 that managed to see 28 31 283 had I just
00:34:16
restricted their calories for example but kept them on whatever diet they were on would I have seen an improvement as
00:34:22
well that study has not been done to the best of my knowledge however you're bringing up a really interesting point
00:34:28
so what a ketogenic diet is it's really not about carbohydrate the definition of a ketogenic diet is any diet that lowers
00:34:35
insulin levels uh to the fat burning point so that if your insulin you can't
00:34:41
burn fat if your insulin levels are too high and most people are walking around with insulin levels that are high 24
00:34:48
hours a day they don't even come down overnight because people are just eating too much too frequently in the wrong
00:34:54
foods to get into ketosis or generate ketones you need to lower your insulin
00:34:59
levels to the fat burning point and when you and if and if you're burning fat vigorously the liver will turn some of
00:35:06
that fat chop that fat into ketones which are very small fragments of ready
00:35:11
to burn fat and these cross easily into the into the brain and can be burned for energy and they can Bridge any energy
00:35:18
gaps that may be there which many of us have if these people had done the Mediterranean diet would they have seen
00:35:24
the same consequences the medit oh sorry say I imagine they were probably on the
00:35:29
western diet that like the American diet which is ultra processed high sugar so
00:35:35
bringing them into a controlled environment and just depriving them of that would have surely caused just that
00:35:42
on its own would have been beneficial yes so I wrote in the paper I I I and I I mentioned this you're making a really
00:35:48
excellent point and I addressed this in the paper is that because when you when you change from a standard junky modern
00:35:56
diet to through a ketogenic diet that's Whole Foods you're changing a lot of variables right so how do we know that
00:36:03
it had anything to do with the ketones right and and this is a good question and a fair question and we don't know
00:36:08
the answer but new studies are helping us to understand that but before we get to that I just wanted to say the point
00:36:15
you're making is so important because there are lots of ways to lower your insulin levels so you can lower your
00:36:22
insulin levels through fasting intermittent fasting you can lower your insulin levels through exercise you can
00:36:28
lower your insulin levels through calorie restriction if you restrict your calories below 750 gram per day many
00:36:35
people will go into ketosis that's another version of a fasting mimicking diet made Popular by Dr wter Longo so
00:36:43
there are many ways to lower your insulin levels um the ketogenic diet is just one way to do that but the
00:36:50
ketogenic diet is the only way to safely sustainably maintain a state of ketosis
00:36:56
longterm ter so you can initiate you can get into ketosis using these other strategies but it's it you can't fast
00:37:04
forever you can't exercise all day long you can't restrict calories below 750 for the rest of your life but you can
00:37:11
safely and comfortably eat a a well formulated ketogenic diet which is very low in carbohydrate moderate in protein
00:37:18
not excessive in protein and relatively higher in fat depending on your energy
00:37:24
needs indefinitely sustainably use the word sustainably that that's kind of
00:37:29
always been my challenge with the keto diet is being able to stay on it I mean you saw in this particular study that
00:37:36
even trying to get people to do it for two weeks resulted in some portion of them dropping out yes um why is it so
00:37:42
hard to stay on the ketogenic diet I've managed to do it for I I was saying to you before we started recording once a
00:37:47
year around this time of year I do it for about eight weeks and it has a really profound impact on a lot of my
00:37:54
life it helps me feel more focused um my body composition radically changes faster than any other diet or thing that
00:38:02
I've ever tried faster than just exercise Alone um I I sleep a little bit
00:38:07
better as well I noticed but you've been doing it for a long time you've been doing it for
00:38:12
roughly almost 10 years for the better part of TW I mean more often I'll say
00:38:18
I've been following a ketogenic diet for 12 years and I agree with you it's not
00:38:23
always easy I'm not perfect about it myself but I have been on the kog giant diet The Lion Share of the last 12 years
00:38:30
it being hard is an important factor yes because when you're trying to prescribe it to somebody who is got you know
00:38:35
treatment resistant depression or is really suffering in some way I imagine they'll find it even harder than I do
00:38:41
yes and no okay so uh it's well it's definitely there's no question about it
00:38:46
that's hard to eat a low carbohydrate diet in a high carbohydrate world yeah
00:38:51
so there's that there's the environmental Temptations and the social Temptations and the habits and the
00:38:58
addiction sugar addiction is a very real biochemical phenomenon so there's that
00:39:04
but but it I mean I've been I I had a weight issue growing up everyone in my family
00:39:10
did um and I've been on lots of different diets in my life this is the
00:39:16
easiest one to stay on I can't say about any other diet that I've follow for 12 years and the reason why is this diet
00:39:24
really stabilizes appetite hormones so your cells are getting energized in
00:39:30
between meals you're not getting those spikes and crashes in glucose which cause spikes and crashes in appetite
00:39:36
hormones satiety hormones stress hormones reproductive hormones uh brain
00:39:42
chemistry um you're not getting you're not on that roller coaster anymore so
00:39:48
your cells are are are being satisfied they're getting the energy needs satisfied in between meals and
00:39:53
everything is quiet and calm on the inside it doesn't mean you're 100% protected against Temptation uh so I
00:40:00
describe it to my patients with food addiction I describe being in ketosis as a suit of armor you know the sword can
00:40:08
still get you but you but you know you're not 100% protected but you've got a real fighting chance and for for
00:40:14
anybody who's never tried a ketogenic diet and been on it for at least I would say six to 12
00:40:20
weeks it most people have no idea how much easier it is um to follow
00:40:28
to follow a healthy eating plan when their appetite is in good control a lot of people know they've shifted into
00:40:34
ketosis without even checking their Ketone meter because they can go for so
00:40:39
long without eating without even thinking about food they can work through lunch and not even realize that
00:40:45
they've missed a meal most people the way we eat most of us now are thinking about food all the
00:40:52
time you haven't even finished breakfast and you're already thinking what what can I have for lunch you're carrying food around with you everywhere you go
00:40:58
you're eating at least six times a day in many cases this is not the I mean we would never have survived as a species
00:41:05
if we needed to eat six times a day so we're not eating in a way that is that
00:41:10
is nourishing us and and satisfying us we're eating in a way that's making us hungry I find what you've said there to
00:41:18
be sort of true in my experience especially in the context of the roller
00:41:23
coaster analogy so when I'm not on key ketosis I do feel like sometimes I'm in a bit of a roller coaster of like
00:41:31
Temptation craving Etc and then when I do ketosis and I get past the first week
00:41:36
or two the the roller coaster seems to stop right I'm I'm off the roller
00:41:42
coaster it's then maybe six eight weeks later you're busy life happens you're traveling you're tired that Temptation
00:41:50
Creeps in and it just takes that one moment of weakness in my head to then
00:41:55
fling me off ketosis and all my effort is gone and in my head the way I've always thought about it and I'm sure
00:42:00
this is wrong but I've thought about it like it takes a couple of days to get into a state of ketosis and then once
00:42:07
you're in and I usually get a headache yeah on my way into ketosis I feel a little little bit bad on the way in and
00:42:13
then once I'm in there it's fine so when I have something that breaks my keto this is what I refer to me and my girlfriend talk about I've broken my
00:42:19
keto whatever I think oh my god I've got to go through another headache and another five days of you know uh getting
00:42:26
back into it what is that correct it's a very common
00:42:31
experience because there are these adjustments uh that happen inside uh
00:42:36
with your physiology uh as you're shifting from one operating system to another when you're shifting from carbohydrate burning system to a more
00:42:44
you're shifting your ratio of your fuels so the body and the brain are hybrid engines so we're never burning 100% fat
00:42:51
um we're burning a mixture of of fat and carbohydrate when you're shifting from a
00:42:56
from a system system that's fueled almost entirely by carbohydrate almost all the time to a system where you're
00:43:02
burning more fat than carbohydrate um that's uncomfortable for some people shifting back and forth
00:43:09
especially if what they have if if the reason why you've quote broken your keto
00:43:15
is because you've had something um that has a lot of refined carbohydrate in a lot of sugar or flour in it for example
00:43:22
um so it depends on what you've eaten and how much and for how long um but but
00:43:29
many people do experience the so-called keto flu when they are shifting from a carbohydrate based system to a fat-based
00:43:37
metabolism and some of this can be uh much of this can be prevented in a couple of different ways one is with
00:43:43
electrolyte supplementation supplementing electrolytes to keep your your salt balance even as you're
00:43:49
transitioning and another uh is by transitioning slowly onto the ketogenic
00:43:55
diet rather than all at once and so and there are many there are other tips in the book about how to do this more
00:44:00
comfortably but those are the two big ones uh and going slowly so in the book I don't recommend that people start on a
00:44:07
ketogenic diet just straight away like learn about it on a Monday started on a Tuesday but ease into ketosis over a
00:44:15
week or two and uh there's a there's a kind of a moderate carbohydrate plan in
00:44:21
the book that allows people to do this so you you follow that plan for a couple of weeks to gradually lower those
00:44:27
glucose and insulin levels it's going to be a lot more comfortable it's be a lot less of a shock to the brain and body um
00:44:34
and and if you're supplementing electrolytes and going slowly most of these quote keto flu symptoms will uh
00:44:42
will not occur or they'll be very brief and Mild so um again these are posit
00:44:48
it's a positive change to have these electrolyte changes and um it's it's all
00:44:53
of these things are are good but there is this transition period which can
00:44:58
sometimes be uncomfortable and this is um not to say that it's dangerous again
00:45:04
it's a very we're designed our biology is designed for us to be able to shift
00:45:10
back and forth between fat and carbohydrate as fuel sources but many of us have lost some of our metabolic
00:45:16
flexibility because we've done some damage to our metabolic engines by eating the wrong way for too long so we
00:45:22
don't shift as comfortably back and forth as we used to be able to I guess most people don't even know what foods
00:45:28
are included in a keto diet because most diets are restrictive to the point that you know people think they just make
00:45:33
your life miserable but what are the sort of big misconceptions you've seen with the foods you're able to eat on a ketogenic diet yeah so because a
00:45:40
ketogenic diet it because the definition of a ketogenic diet is any way of eating
00:45:46
okay that lowers insulin levels enough to turn on fat burning and generate ketones in the
00:45:51
blood because because it's about insulin it the it's not a food list so you can
00:46:00
you can it's not about plants and animals it's not even about fat or carbohydrate it's about understanding
00:46:05
how to lower your insulin levels which you can do with a vegan dietary pattern
00:46:11
with a vegetarian dietary pattern uh with an omnivore dietary pattern um uh
00:46:17
with or even with a carnivore dietary pattern so whatever your dietary preferences are you can get the benefits
00:46:24
the brain healing benefits of of ketosis so it's not about the foods you're eating um it's it's more about
00:46:31
understanding what raises and lowers insulin the things that raise and lower insulin are refined carbohydrates Whole
00:46:37
Foods carbohydrates refined proteins like protein powders whole food sources
00:46:42
of protein and guess what barely touches insulin at all fat fat is metabolically
00:46:49
the quietest and safest macronutrient you can eat because it barely stimulates insulin is ketosis a state like do I is
00:46:58
it like a binary State like now I'm in ketosis and now I'm not so yes but there's there's a yes um
00:47:06
let me put it this way that most experts will agree
00:47:12
that um in order to be quote in ketosis um your level of beta hydroxy
00:47:19
butter rate on a blood Ketone meter uh a blood Ketone meter U um is PR finger and
00:47:28
and put a drop of blood on this little test strip and it will read the amount of a particular Ketone in the blood
00:47:34
called beta hydroxate and it it will give you a reading if that reading is point is 0.5
00:47:40
Millo or higher you are in ketosis in ketosis so what does that mean why why
00:47:46
is the cut off 0 five because three things have to happen for you to get to
00:47:51
at least 0. five one is your glucose levels have to come down the second
00:47:56
thing is is your insulin levels have to come down the third thing is you have to burn off a certain amount of the stored
00:48:03
starch in your liver we have a a storage tank for carbohydrate in our liver it's
00:48:08
not very big it holds less than a day's worth of carbohydrate because really as animals we're designed to store energy
00:48:16
as fat carbohydrates there for quick Energy emergency short-term um the fat
00:48:22
we For Better or For Worse we have almost an unlimited capability to store fat we can store months and months and
00:48:30
months wor of fat and so um but we can only store a very small amount of carbohydrate so if your storage tank in
00:48:37
the liver is full your body will not switch to fat burning because it says oh we've got plenty of starch to burn let's
00:48:43
start there once it comes down to a certain point the body goes oh running out of energy let's go to fat now and
00:48:51
that's when the the liver will start breaking fat down whether it's fat on your body or fat from your plate
00:48:57
and start chopping it up into these ketones and uh but so those three things
00:49:02
have to happen and once that happens that you'll see the Ketone levels rise on the meter so most people who are not
00:49:08
eating a ketogenic diet are walking around with Ketone levels either undetectable or they're 0 2 or they're
00:49:14
three they might they might float up into above 05 every once in a while if they're not eating for a long time or um
00:49:22
uh or if they've just exercised but for the most part most people uh eating a typical diet are not in ketosis and when
00:49:29
you get above 0.5 a lot of metabolic magic starts to happen because there are
00:49:35
lots of Pathways in the body and brain that uh are not very active unless
00:49:40
you're in ketosis and those are the healing Pathways the recycling and maintenance and cleanup Pathways the
00:49:47
recovery Pathways all of us this is something that I I came to
00:49:53
appreciate a number of years ago as I've been studying this is that there are many people unfortunately or
00:49:59
fortunately there are many people who discover with mental health issues that
00:50:05
they need to be in ketosis long term in order to be well but I've become convinced by the
00:50:11
science that all of us need to be in ketosis um at least intermittently all
00:50:19
of us need to spend some time in ketosis on a regular basis or else we can't heal
00:50:26
we'll only be it it's like a it's like a manufacturing plant where the plant is
00:50:32
just running 24/7 12 months a year and and they never take time to replace the
00:50:38
parts or clean up the floor or you know they never do any maintenance work or repair work and So eventually everything
00:50:45
breaks down and when you say ketosis again you're not saying the the keto diet you're saying the low levels of
00:50:52
glucose um and Insulin exactly in the blood and that can be achieved by calorie restriction potentially fasting
00:50:58
I guess you could achieve it and other diets like the Mediterranean diet if administered in the right sort of doses
00:51:04
right well um we we should come back to the Mediterranean diet a minute but first the first part of your question is
00:51:10
important because ketosis is you can as you said you can get into ketosis a variety of different ways if you're
00:51:17
eating properly and this would have been our evolutionary Heritage our ancestors
00:51:22
especially our prehistoric ancestors um they have access to these
00:51:29
lots and lots of refined carbohydrates a long time ago um they were eating carbohydrates from uh Whole Foods uh
00:51:37
fruits and starchy root vegetables right and uh and so even grains and beans are
00:51:42
very very relative relatively much newer sources of carbohydrate so let's think about fruits and vegetables but so they
00:51:50
they would have been we can only guess B look looking at their diets we don't have proof of this but think about it if
00:51:56
you're eating in a way where your insulin levels are allowed to come down overnight if you're eating if you're
00:52:01
eating a a balanced diet so to speak but it's got everything it needs in it and it's not giving you exaggerated spikes
00:52:08
in your glucose and exaggerated spikes in your insulin and you're not eating six times a day or all day long your
00:52:14
insulin levels will naturally come down overnight and that will that will allow you to go into a healing mode so I
00:52:20
believe that if people have the right information about what a healthy diet is supposed to look like they may may not
00:52:27
even need to in many cases especially if you're younger or athletic or don't have
00:52:32
a lot of metabolic damage already um you may not need to you may not need to
00:52:38
lower your carbohydrate intake during the day you might just need to be careful about what kinds of carbohydrate
00:52:43
you eat and how often um so for example
00:52:48
it's known that in children um they're who are eating a regular diet many of
00:52:54
them wake up the next morning in ketosis they're metabolically much healthier
00:52:59
than uh we are as we get older so they're much more metabolically flexible um and uh so now they didn't go on a
00:53:07
ketogenic diet they were eating a regular diet they slept overnight didn't eat anything the next morning they're in
00:53:13
ketosis that's not true for all children but it's true for enough children that we know it's possible most adults it
00:53:19
takes them several days at least to get into ketosis even if they're not eating anything at all so f fasting can take 2
00:53:27
to 3 days at a minimum for most people to get into ketosis but some people it can take a whole week and you talked
00:53:34
about children there one of the big conversations at the moment around children is the the rise in ADHD
00:53:41
diagnosis and there's a lot of different sort of thoughts on the causal factors of this and what is it that's making
00:53:47
children be diagnosed at higher and higher rates with these sort of neurod Divergent
00:53:52
disorders is there any evidence to suggest that what we're eating is playing a role in these neurod Divergent
00:53:59
disorders yes the first thing I would like to tell you about is that there were studies
00:54:06
quite a few studies back in in 80s 90s and early 2000s in Europe by variety of
00:54:11
different research teams that explored exactly the question you're asking and
00:54:16
what they did um was they placed children with ADHD some quite severe
00:54:23
ADHD even Hospital level ADHD and put them on something called a few
00:54:29
Foods diet this is uh the scientists call it an oligo antigenic diet which
00:54:34
just means it's kind of a low allergen diet so it's they removed all of the common culprits and they focus mostly on
00:54:41
just a few Whole Foods uh and and and a few extras so very specifically
00:54:47
describing this diet most of these diets were um chicken lamb fruits vegetables
00:54:54
um and sometimes they throw in some apple juice and margarine because they couldn't use butter because Dairy is a common allergen so but these were mostly
00:55:02
Whole Foods diets you know uh uh poultry red meat fruits vegetables um and there
00:55:10
62 to 82% response rate to these diets no matter which study you looked at and
00:55:16
in some of these studies there was a 70% cure rate within weeks of changing the diet to a few Foods diet so what does
00:55:24
this tell us it doesn't tell us which foods were the problem it tells us that food can be the
00:55:32
problem that if you make diet the right dietary changes it's possible for
00:55:38
children even with very severe ADHD to improve within weeks to the point that they no longer qualify for having ADHD
00:55:45
anymore because there's a change in the symptoms oh yes um the children's uh Behavior as rated by parents and
00:55:52
teachers um and the researchers themselves so just uh did some research
00:55:58
to find some stats on this sure diet modification isn't widely prescribed as
00:56:03
a way to alleviate ADHD symptoms is it it says as of 2019 major health organizations including the American um
00:56:10
Academy of Pediatrics and the National Institute of Health and Care Excellence do not recommend dietary modifications
00:56:16
as standard treatment for ADHD due to insufficient evidence a 2014 review found elimination
00:56:22
diets might offer minor benefits in sub in a subset of children particularly those with food sensitivities or allergies however these benefits are not
00:56:28
substantial enough to advocate for widespread dietary changes in ADHD
00:56:33
management so what I would say to that is uh there are multiple studies all
00:56:40
pointing in the same direction that I think give parents and families and children tremendous hope with really no
00:56:47
risk MH what are we doing instead we're medicating children we're
00:56:54
giving children stimulants which can stunt their growth make them anxious um and and cost money
00:57:01
MH and is I mean I I'm one of the reasons I do this work is
00:57:08
because I really don't think that for most people the right thing to do is to
00:57:14
medicate our way out of this situation I mean just about every mental and
00:57:20
physical health issue we have is we think about we've just kind of been
00:57:26
condition to think about medications as the solution but medications don't solve problems they cover them up and what we
00:57:33
really want to do is want to get to the root of these problems and not just treat them which nutrition interventions
00:57:39
can do in many cases but perhaps even prevent them from happening in the first place can they
00:57:46
all be treated by because you know I I was I guess technically diagnosed with ADHD but I don't take any medication for
00:57:53
it I'm it's a personal choice I personally just um don't think that the
00:57:59
net impact has on my life is worth taking any medication I also have friends with ADHD who have significantly
00:58:05
worse symptoms when I say worse I mean more pronounced symptoms than I do so my
00:58:11
personal decision was just not to take the medication however I sat here with a guy called Dr aan Who has a daughter who
00:58:17
had ADHD she got the medication and it turned her life around like she went on to become super successful but was like
00:58:23
struggling in school so it's really difficult isn't it because it's such a personalized sort of
00:58:30
personal decision and some people have it more extreme and
00:58:37
in a way that makes their life more dysfunctional than others you know and
00:58:42
my some some of my friends do really say they say I took this medication for my ADHD or my my tension issues whatever
00:58:49
and it's been revolutionary for me they just like they they just offload on me how profound it's been for them
00:58:57
so I guess it goes back to being a personal it does but you
00:59:04
know so I have a lot of experience treating ADHD because I worked for two
00:59:10
years at an ADHD Specialty Clinic called the Hallowell Center outside Boston I also worked for 13 years in college
00:59:16
mental health at Harvard and at Smith college and saw lots and lots and lots of students with ADHD most of who
00:59:24
actually had it some of who didn't who're just looking for stimulants but I
00:59:29
I can tell you as a psychiatrist who's prescribed medications for 25 years the stimulants are some of the most
00:59:35
effective medicines we have in our toolbox for the people it works for it
00:59:40
works very very well so and it can be life-changing a lot of people think of
00:59:46
ADHD as oh a minor issue oh you can't concentrate or or maybe you're Daydream
00:59:51
or maybe you're fidgety or you know maybe you get distracted 8 HD can be a
00:59:56
really serious condition just like all mental health conditions it exists on a spectrum of mild to very severe and so
01:00:05
people with ADHD are at much higher risk for suicidal ideation they're much higher risk for substance abuse they're
01:00:11
at much higher risk for accidents they're much higher risk for depression for anxiety these and and twice the twice
01:00:19
the rate of divorce in people with with adults with ADHD these are serious can
01:00:24
be for some people really disabling conditions people
01:00:29
cannot function in their lives they can't function in their relationships they can't hold a job you know they they
01:00:35
feel so frustrated and Powerless I mean I was telling you that I worked with students in in in you know
01:00:43
these Elite universities right these are very intelligent people who were
01:00:48
struggling 10 times harder than their peers in in classes they had to work so
01:00:54
much harder they had to stay up four or five hours later than everybody else and
01:00:59
and and they did because they were hardworking but they're really suffering and this discrepancy
01:01:05
between how smart I am and how much I think I should be able to do and how much I'm actually able to do makes me
01:01:11
feel bad about myself right they feel bad about themselves and because they know they're capable of more but they
01:01:18
can't get there and it's a real biological condition now the great thing
01:01:23
about this is a perfect example that you could we could have this conversation about any mental health condition but
01:01:28
ADHD is a great example because there's always a risk benefit
01:01:34
analysis when you're thinking about how are we going to treat this condition uh so do you want to take medication what
01:01:39
are the pros and cons of that does the medication work for you does it give you side effects can you access the
01:01:46
medication uh can you afford the medication um how hard is is lifestyle
01:01:51
change for you one of the most powerful interventions for edhd and I think probably the a just maybe one of the
01:01:58
most Stellar examples I can think of is this change your lifestyle to suit your
01:02:04
strengths play to your strengths and don't try to swim upstream against your
01:02:10
weaknesses people with ADHD often have tremendous talents in certain areas and
01:02:15
are tremendously gifted in certain ways because they can make connections because they don't always think in a
01:02:21
straight line because they they often have very diverse interests and they can pull different kinds of information
01:02:28
together and you know given the right path they can be hugely successful right
01:02:36
but that's not possible for everybody and for more severe cases of ADHD it's not possible at all has there been any
01:02:42
studies on the link between the ketogenic diet and ADHD so not yet but
01:02:47
I'm I'm very excited to to to be involved in two brand new studies of the
01:02:53
ketogenic diet for ADHD so one is a uh ketogenic diet for uh adults with ADHD
01:02:58
and depression that's getting started at Oxford University in 2025 and the other is a study of uh
01:03:06
ketogenic diets for ADHD and adults at the University of Michigan it's also going to be starting in 2025 we have no
01:03:13
data on ketogenic diets and ADHD but we have good reason to believe the reason we were able to get funding for these
01:03:20
studies is because there's there's reason to believe that it could be useful and because when you look at ADHD
01:03:28
you see Clues to poor metabolic health so for example children with obesity are
01:03:33
twice as likely to have ADHD obesity is a marker for insulin resistance adults
01:03:39
with type 2 diabetes are twice as likely to have ADHD type two diabetes is severe
01:03:44
endstage insulin resistance and the ketogenic diet is the most effective way
01:03:50
to address insulin resistance that we have at our disposal is it hard to establish cause and effect there
01:03:56
I was thinking about the the diabetes one where if you've had ADHD maybe your life has been harder again I don't know
01:04:01
what I'm talking about here but maybe your life has been harder and if your life has been harder you're more likely to be obese potentially if you've been
01:04:08
gone had more stress and you've you know you've had a a worse a worse more challenging job and so is it you
01:04:16
know and will will a test be able to exclude these sort of confounding factors to the point that we'll know for
01:04:22
sure I think that would be a very difficult study to to design but I think what I can tell you from my clinical
01:04:28
work CU I work I'm a general psychiatrist so I see adults of all ages
01:04:35
and with all psychiatric conditions from major to minor and I've worked as I said
01:04:40
with people with ADHD of you know hundreds and hundreds of patients with ADHD what I can tell you is that it's
01:04:47
the same with medication um if someone comes in and says to me uh I can't tell
01:04:52
if this medication is working um uh so should I keep taking it and I'll say
01:04:58
well you know if you can't feel it working then it's not working uh so when
01:05:04
the diet works it works regardless of what's going on around the person so and
01:05:09
this is true for all conditions that I've worked with so people with bipolar disorder people with depression people
01:05:15
with ADHD people with PTSD people with anxiety as you have said we talked about
01:05:21
the ketogenic diet is not easy to stick to right people fall off the ketogenic diet all the time uh sometimes
01:05:27
accidentally sometimes intentionally right and you can see their symptoms come back within often 24 hours even
01:05:36
though their external factors have not changed so life hasn't changed it's the diet and when you follow the actual
01:05:42
Ketone levels daily you can make that correlation so what's really exciting
01:05:47
about both of these studies is it's not just getting somebody into ketosis it's
01:05:53
it's tracking um on a data to-day basis their Ketone level and their attention
01:05:59
symptoms and seeing if we can see them go up and down together and we've always get a little bit of data already from a
01:06:06
pilot study at U um uh um by Ali Houston at uh at Oxford University we're
01:06:12
starting to see some signals there but it's too early really uh we need to
01:06:18
actually launch the official study so in my patients it's it's a phenomenon I've
01:06:25
seen over over and over and over again um a great example is I have a
01:06:30
patient um that I worked with for a couple of years who had a a condition called bipolar disorder type two so it's
01:06:38
a it's a form of bipolar disorder uh bipolar disorder people used to call manic depression you've got periods of
01:06:45
mania often followed by periods of deep depression bipolar type 2 is a milder
01:06:51
form where you don't get quite as manic um and but you still can can get very depressed so he had bipolar to um and
01:07:01
whenever so so uh he came to me because he wanted to try a ketogenic diet for bipolar disorder because um uh uh he had
01:07:09
heard it might help so the other issue he was dealing with was that he um and
01:07:14
his wife were having some difficulties some difficulty in their relationship that had started up a few years before
01:07:19
and you know every time they got into an argument he would want to die and he would start to think about ways of killing himself
01:07:26
self every single time he went on the ketogenic diet the suicidal ideation went away even though his wife had not
01:07:34
so he used to associate the depression with the marriage but he learned over
01:07:40
time to associate it with his metabolic state that when he was in ketosis he
01:07:45
could then imagine other ways of coping with the stress in his marriage other than just killing himself so he it a lot
01:07:53
of people say to me that the ketogenic diet gives this space it allows them to pull back and see things from a
01:08:00
different perspective it buys them time perspective it's like a buffer so that
01:08:06
people people aren't reacting as reflexively to difficult situation
01:08:12
situation hasn't changed but people are able to deal with the situation in a more effective way they feel they have
01:08:19
more control not just over their emotions but also over their behaviors and how they react to situations
01:08:27
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01:08:33
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below and for people that have food addictions and binge eating
01:09:29
problems the ketogenic diet I guess it's knocking you off that roller coaster what well being in a state of ketosis is
01:09:35
knocking you off that roller coaster of craving eating craving eating craving eating is that accurate is that what
01:09:41
it's doing yes so um the ketogenic diet by lowering and stabilizing glucose and
01:09:47
insulin levels the thing about insulin is that a lot of people think about
01:09:53
insulin as a blood sugar regul later they think of it as oh you know it uh when your glucose goes up the insulin
01:09:58
brings it down and and that's true but that's it's just one of many important
01:10:04
roles that insulin has it's the one it's most famous for but the thing that uh
01:10:10
what is not well known is that insulin is so much more than a blood sugar regulator it's actually a master
01:10:16
metabolic hormone and it's regulating the activity of every cell in the body
01:10:22
every cell has an insulin receptor on its surface multiple insulin receptors
01:10:27
to pay attention to the insulin level in the blood and so uh when you're on a glucose and
01:10:35
Insulin roller coaster that's just where the trouble begins insulin is talking to and
01:10:41
controlling the behavior and levels and activity of many other hormones in the
01:10:47
blood including stress hormones like adrenaline and cortisol um reproductive
01:10:53
hormones like estrogen and testost cherone your blood pressure regulating hormones your satiety hormones the
01:11:00
hormones that make you feel full after you eat your hunger hormones so many other hormones are on this roller
01:11:06
coaster uh that you're unstable from within and people often will think well
01:11:13
I'm stressed and that's why I'm eating I I I feel really anxious um I get
01:11:18
irritable I get stressed I'm hungry I need to eat and then I feel better and that's true they will they will feel
01:11:24
better for a few hours but what what happens four to five hours later if they've eaten something that's
01:11:30
spiked their glucose and Insulin again is they're going to get there's this great study with um healthy teenage boys
01:11:36
they took healthy teenage boys and they gave them either a sugar-free
01:11:42
Cola uh caffeine-free or a caffeine-free Cola sweetened with sugar and the boys
01:11:49
who had the sugar sweetened Cola their adrenaline levels their stress hormone levels of adrenaline
01:11:56
quadrupled four to five hours after drinking the soda and the boys who drank
01:12:01
the other soda stayed flat it's the food that's causing the stress that's causing
01:12:07
the food eating you so there's this vicious cycle if people understood that
01:12:13
most of what's happening there it's not your fault that you want to overeat those Foods they are designed to be
01:12:20
overeaten like chemical Engineers these this is very very intelligent um
01:12:25
engineering that's going on very clever and uh you will sell more of a product
01:12:31
if you make it irresistible and if you make it unsatisfying how many people feel that
01:12:37
they can't control their consumption of certain foods that's by Design if you if
01:12:42
you want to keep eating it you'll buy more of it if you eat real food you have to stop after a little
01:12:49
while they're so satisfying things like meat Seafood poultry eggs fruit veget
01:12:55
Veges even fruits fruits some people will overeat fruit but but fruit has
01:13:00
fiber it has water it's really hard to eat you know 10 pieces of
01:13:06
fruit very easy to drink you know a bottle of several bottles of fruit juice
01:13:12
very easy um to eat multiple packages of candy because those what happens with
01:13:19
ultr processed carbohydrates these refined carbohydrates they blow past your hormonal stop signs and that's not
01:13:26
your fault but if you understand that that's what's happening then you can
01:13:31
takes a few days you got to step away from them but but on the other side is
01:13:36
tremendous freedom and control the gentleman you mentioned in that case study a second ago you
01:13:42
referred to as Carl which I guess is a cloaked name um he's the one that had the bipolar disorder uh no Carl is a
01:13:49
different case ah okay tell me about Co yeah so I opened the book with the story ofl Carl who has you know generously
01:13:56
allowed me to share his story um a gentleman great guy in his
01:14:02
mid-60s who had had lifelong depression and
01:14:07
anxiety and uh for years he he didn't seek any treatment and then maybe about
01:14:13
15 years or so before he consulted with me he went to an A A psychiat A
01:14:19
Psychiatry specialty clinic for some specialized brain Imaging and uh
01:14:25
extensive evaluation and lots and lots of specialized tests and he left the
01:14:30
clinic with thousands of dollars later with three diagnosis depression anxiety
01:14:37
and ADHD and three prescriptions one for depression one for anxiety one for ADHD
01:14:44
so he started those medications and his depression got a lot better but he then uh had a brand new
01:14:51
problem on his hands which was he was becoming Manic and he had never had Mania before so he was been
01:14:58
uncharacteristically um energetic and uh um uh irritable and unpleasant and so it
01:15:06
was changing it was changing his character his personality a certain his behavior in a certain way that was becoming very unpleasant at work and at
01:15:12
home so he then turned to marijuana to try to take the edge off developed a
01:15:19
marijuana addiction now he's got another problem and so he thought to himself you
01:15:25
know this isn't this isn't what I signed up for I was trying to solve a problem and now I've got two new problems on my
01:15:30
hands so he took himself off the medications and said you know I I I
01:15:36
can't use medication medications is not for me I'm going to try to manage my
01:15:42
mood issues my depression anxiety with rigorous exercise I'm going to let
01:15:48
exercise be my medicine and he started cycling uh bikes over a 100 miles a week
01:15:55
and it actually helped a lot it didn't completely resolve all of the symptoms
01:16:01
but it brought them down to um a very manageable level uh for years so
01:16:08
exercise was his medicine exercise improves metabolic health and so he was
01:16:13
still eating a standard American diet he'd never tried any dietary changes before and then um what happened is as
01:16:21
he entered his 60s the depression anxiety started to rise in the background exercise wasn't working quite
01:16:27
as well as it had and then uh just before he met with me something
01:16:32
stressful it happened at work and it was essentially a shift in his job description which was making him anxious
01:16:39
and he started experiencing very suddenly these bouts of um agitation and
01:16:46
anxiety and restlessness and exercise being his medicine he would he would
01:16:53
cycle on the weekends and at night if it was a if it was it was happening on a week night a work
01:16:59
night he would be walking because he couldn't bike at night when it was dark he would walk sometimes eight even 25
01:17:06
miles to try to get rid of this excess energy and he said I don't have time for this I can't exercise enough to keep my
01:17:13
symptoms under control he didn't know what else to do he starts searching online for Solutions came across
01:17:19
information about carnivore diets and mental health contacted me for a consult
01:17:25
and said I want to try the carnivore diet for my for my anxiety and I mean there were lots of
01:17:32
other things we could have done uh to improve the quality of his diet but this
01:17:37
is what he wanted to do because he was hoping that would bring him the most the the fastest relief so switched to a
01:17:44
carnivore diet 3 to four pounds of fatty meat per day mostly pork and beef this was dairy free no plants and uh he
01:17:52
checked his ketones using urine testing which Which is less expensive than blood testing uh he's in mild ketosis every
01:17:59
day using urine strips and uh he started to improve by week three by week six his
01:18:06
score was zero on all his depression and anxiety scales he had no symptoms at all of of depression anxiety
01:18:13
not just of those recent extreme symptoms that he was experiencing but
01:18:19
the symptoms that went back his entire life that had never completely resolved before so he said you know I I this is
01:18:24
the I've never felt this well in my entire life and so this is the power of
01:18:30
these strategies is they don't just reduce symptoms a little bit they actually have the power to heal the
01:18:38
underlying problem in ways that I mean this is a phrase I've heard so many times I feel better than I've ever felt
01:18:45
in my entire life you don't hear that when you prescribe medications for people generally that was in
01:18:51
2019 was it uh I couldn't tell you what year but that sounds right how is he
01:18:56
doing now yeah I mean we we are still we we still talk with each other uh several times a year he's doing very well in
01:19:03
fact so he one of the interesting things about what happened with this diet is that during that long period of of
01:19:09
intermittent agitation uh he you know he's a very physically fit guy because of all the
01:19:14
exercise and he and he was lean he lost 10 pounds during that period of
01:19:20
agitation that he could not afford to lose when he first started working with me he was underweight and despite eating four pounds of fatty
01:19:28
meat per day he couldn't regain that 10 pounds unless we added uh back some
01:19:33
carbohydrate into the diet this is really this is a subtle point but for athletes sometimes especially in the
01:19:40
early phase of the transition um there needs to be a certain amount of carbohydrate in the
01:19:46
diet um to support high performance he didn't stay on the carnivore diet no he
01:19:51
did not so he was on the car carnivore diet for many months and then be but because he couldn't regain that weight I
01:19:58
asked him I said well you know I think we need to put some carbohydrate in to help you uh regain this weight and so I
01:20:04
asked him which foods he missed the most gave him a list of Whole Foods to choose from and the things he missed most were
01:20:10
uh potatoes and yogurt so some starchy root vegetables some plain unsweetened yogurt um up to about 100 grams of
01:20:18
carbohydrate per day seemed to be about right for the days when he was e excuse me exercising on the days when he wasn't
01:20:25
exercising he would cut it back so he was tailoring it to his personal energy needs and so so this is another um uh
01:20:34
interesting thing about what happened for him is that um I mean his his scales
01:20:40
are still at zero but he has been uh as we've talked to each other on and off over the years he has been able to make
01:20:47
adjustments to his diet understanding the principles if you understand the principles then you know which changes
01:20:53
you can get away with and which changes you can't and he has stayed well there's a couple of key things people always
01:20:59
talk about when they hear the carnival diet the first is they say there's nutritional deficiencies to the diet
01:21:04
that aren't like sustainable so if you eliminate certain food groups like fibers vitamin C's vitamin E magnesiums
01:21:11
Etc then which are essential nutrients then you're going to have
01:21:16
problems so a carnivore diet theoretically does provide all essential
01:21:22
nutrients so if you look at what is inside animal Foods you will find all essential nutrients you can't say that
01:21:28
of any plant food there's not a plant food on Earth that can that provides all essential nutrients animal foods can uh
01:21:36
I would say meet Seafood poultry eggs are missing a couple of nutrients and dairy is missing even more um but uh
01:21:43
meat seafood and poultry contain every nutrient we need the question is how much do you need like fiber oh well
01:21:52
fiber is not a nutrient oh okay but do you get fibr in a carnivore diet there are different definitions of carnivore
01:21:58
but the strictest sort of purest definition of carnivore is animal Foods
01:22:03
only and fiber comes from plants so it's fiber free a true carnivore diet is fiber free so could you lost on a true
01:22:12
carnivore diet without getting some kind of like microbiome issue or some kind of because you need fiber right why thought
01:22:20
it was good for like digestion and your microbiome and stuff like that what does it do a lot of people tell me that it
01:22:27
prevents glucose going into the blood or something where's the glucose coming from so you don't need it fiber fiber is
01:22:35
very helpful and I spell this out in the book so because there's we have a lot of Hal truths in our minds about food um
01:22:42
even people who are paying really close attention to the to nutrition
01:22:49
science have a lot of half-truths in their minds about food so yes fiber for
01:22:54
example you're exactly right lowers glucose spikes but the glucose is coming
01:23:00
from a diet that's too high and sugar and so you won't get glucose spikes if
01:23:05
you regulate your glucose levels um so so that's one uh interesting thing about
01:23:11
fiber so if you're eating a high carbohydrate diet fiber can soften your glucose spikes and that's a plus but
01:23:17
there's a more effective way to lower your glucose spikes is to not get a glucose spike in the first place um and
01:23:24
that may not require taking all the carbohydrate out of your diet it might just mean lowering it to your personal
01:23:31
tolerance um another thing people often say about fiber is that it sweeps your colon clean of toxins and kind of um um
01:23:39
and uh that might otherwise build up and cause problems but fiber um there's no
01:23:44
evidence that fiber is sweeping anything clean or there's never been a study that demonstrates this it's really just a
01:23:50
belief about what we imagine fibers being like the broom of the intestines but there's no that that's just a belief
01:23:57
there's no science behind that whatsoever um the the intestines clean themselves the lining sheds regularly
01:24:04
actually very frequently and has and the border of the intestines um sweep themselves clean so they the intestine
01:24:11
knows how to take care of itself that way but the biggest myth about fiber is that it's good for digestion because
01:24:18
fiber by definition is indigestible by humans so there are two
01:24:25
kinds of fiber there's soluble and insoluble and the soluble is um you know
01:24:30
the kind that holds water it's like in an apple and the insoluble is the kind of tough stringy Woody stuff that you
01:24:36
might find in like broccoli for example so the soluble fiber the bacteria and
01:24:43
the lower parts of our intestine can ferment that to a certain extent um but
01:24:49
uh but then we but then we can't make use of the sugars that it's releasing um right here fiber traditionally
01:24:55
considered essential for feeding beneficial gut bacteria and promoting regular bowel movements yes okay so a
01:25:02
couple of things to unpack there so one is that the uh a lot of people uh there are quite a few papers on this uh
01:25:09
claiming that we need fiber because we need to feed our cells butyrate which is a breakdown product of fiber but
01:25:17
butyrate if you think about what a ketone is it's beta hydroxy vate feeds the intestinal cells just as well so you
01:25:23
don't need to eat fiber to feed your cell's butyrate if you think that the cells need butyrate then you can get it
01:25:29
from a ketogenic diet um so I explained that in the book too is that there's
01:25:35
more than one way to generate that molecule can someone exist on the
01:25:42
carnivore diet like the extreme version of the carnivore diet for a long time without any
01:25:48
supplementation so you we really don't know and we really don't have any long-term data on on any dietary pattern
01:25:56
I think this is really important for people to understand is it's very common criticism of diets that we feel
01:26:02
uncomfortable with or might be worried about like ketogenic diets or carnivore diets because they're so different from
01:26:09
what we're told we're supposed to eat there's a lot of fear and worry uh about them and so think well okay it's it's um
01:26:18
it's normalized my blood sugar level I used to have type two diabetes um you I've lost 50 pounds um my depression
01:26:24
went away um my uh I normalized my coronary artery calcium scores I'm at lower risk for cardiovascular disease my
01:26:31
triglycerides came down um you know I feel better I'm I in every way like all
01:26:37
of my health markers have improved and so when you show people study after study after study of a ketogenic diet um
01:26:45
improving multiple aspects of metabolic health and physical health and mental health it's cured my seizures it's cured
01:26:51
my bipo whatever it was the only the only last sort of the last thing
01:26:57
somebody could say is well well yes okay it's made you extraordinarily healthy now but I wonder what's going to happen
01:27:04
20 years from now MH nobody can tell you that because there's no way you could
01:27:09
design a 20 year long study of any diet so you could say this about the Mediterranean diet you could say this
01:27:14
about a carnivore diet you could say this about a vegan diet well vegan diet unsupplemented is is fatal um it's it
01:27:21
has dangerous nutritional holes so why aren't we saying this about vegan diets
01:27:27
when we can look at a vegan diet and see that it that that it's incompatible with
01:27:32
human life unless you eat fortified processed foods or supplement which most people in the world cannot do um we look
01:27:39
at a carnivore diet and you can actually find all of the nutrients in these animal foods and that's the diet that
01:27:46
you're more worried about because theoretically longterm something bad might happen now
01:27:52
I am not at all saying that a carnivore diet is the right diet for everybody um or that it's even the
01:27:59
right approach for everybody to consider but I think we have to keep an open mind
01:28:04
and stay curious and look at the biology of food and allow people to make their
01:28:10
own I'm nutritionally pro-choice which means I would if you came to me with a
01:28:18
mental health issue um I would support you in optimizing the diet of your
01:28:23
choice and making it as brain healthy as I possibly could because I because uh
01:28:29
it's very important that you feel comfortable with the diet that you're eating and so there are lots of ways to
01:28:35
do that but I think it's really important and one thing I encourage people to do in my work and in my book
01:28:42
is to open our minds and get curious about food the biology of food the
01:28:47
biology of the brain because most of what we hear about nutrition doesn't come from biology it doesn't come from
01:28:56
Clinical experiments or uh information about how cells work or about what's
01:29:01
actually inside food it comes from this type of study called A nutrition
01:29:08
epidemiology study which is just questionnaire based guesswork untested theories about what we should eat most
01:29:15
of what we believe about nutrition is untested theories wild guesses and
01:29:20
Wishful Thinking many of the people that choose a keto diet do it for very sort of
01:29:26
superficial reasons sure you know I think it's probably one of the reasons why I do it once a year um for a couple
01:29:32
of weeks um why does it help you to lose weight is that again just because of
01:29:37
calorie restriction so it's insulin so it it everybody out there who's trying to lose
01:29:43
weight they need to know one thing and it works if you cannot burn fat if your
01:29:50
insulin levels are too high so if you know what rais insulin you can lo you can turn that
01:29:57
insulin knob down if you know how to do that you will lose weight it's a biological fact so when you turn down
01:30:05
insulin you will burn fat so a ketogenic diet you can't produce ketones unless
01:30:11
your insulin is low enough so a ketogen the ketones on that meter are showing you that you are burning fat you can't
01:30:18
make ketones unless you're burning fat so you can't you really cannot burn fat unless you're in ketosis you don't
01:30:25
necessar have to be in ketosis all the time you don't necessarily have to have very high Ketone levels but if you're
01:30:31
not in ketosis you're not burning fat so um if you're not in ketosis the brain
01:30:37
can't even see that you've got energy spare energy to burn you might have 200
01:30:43
300 pounds of stored energy as fat the brain will still ask you to eat to eat
01:30:50
more carbohydrate because it's not in fat burning mode so it's in car carbohydrate burning mode when it's
01:30:55
hungry it's going to look for more carbohydrate you have to you have to teach it you have to bring your body
01:31:01
into fat burning mode and and train your body give your cell some time a few
01:31:06
weeks to learn how to burn fat again and stay there my mother is 91 years old she
01:31:13
has lost 50 pounds on a ketogenic diet it is never too late to all she has to
01:31:20
do is make sure those there are ketones on her meter when her glucose meter was nice and stable she wasn't losing
01:31:28
weight because the insulin was still too high the ketones tell you the ketones are essentially a mirror image of your
01:31:36
insulin level so we don't have a home insulin level test yet we have fabulous continuous glucose
01:31:43
monitors which I recommend anybody out there with a mental health issue or physical anybody out there who can
01:31:49
afford $5 or $50 for a single two week glucose sensor which are now available
01:31:56
in the United States over the counter which they weren't before um I think you've had them in the UK for a lot
01:32:02
longer you can see what your glucose levels are doing in response to your lifestyle your food choices your
01:32:08
exercise Etc they can't it can't tell you what's going on with your insulin level so you can have a nice beautiful
01:32:15
stable glucose level nice in the healthy range your insulin can still be too high and you still might just be you're
01:32:20
burning all that glucose for energy a ketone meter will tell you if you're
01:32:25
burning fat I'm on Amazon now it says sort of $50 or yeah there's ones for $40
01:32:31
as well yeah one for $30 as well yeah interesting okay think I'm going to try
01:32:36
one I've never actually done one before so I I guess I didn't really know if I was in ktis ketosis or not but I just oh
01:32:42
it's so useful because um uh if you're if you're following a ketogenic diet um
01:32:49
the thing that makes it ketogenic is the ketones yeah and so I you were telling me before before we started recording
01:32:55
that um you're always looking up okay which foods are keto which foods aren't keto and it's really not so much about
01:33:01
that you could eat almost anything on a ketogenic diet if you if you understand
01:33:06
you know how much to have and when um and but uh uh in any case um the Ketone
01:33:14
meter will tell you you're in ketosis and if you're not in ketosis you can tweak your your plant so all of this is
01:33:20
in the book but um but you can the really the the most important thing
01:33:26
about a ketogenic diet is getting into good consistent daily ketosis for at
01:33:32
least six weeks straight that sends the daily signal to your cells we're burning fat now we're
01:33:39
burning fat now we need to learn how to burn fat there are enzyme systems and Pathways and cells that need to ramp
01:33:47
up and and that takes time so it takes a while for the body and brain to kind of
01:33:53
learn how to burn fat again and uh it doesn't happen
01:33:59
overnight in terms of energy there are so many reasons why I'm a big matcha fan if you don't already know by now and so
01:34:05
much so that I actually invested in the UK's leading matcha company called perfect Ted and one of my favorite perfect T products is these delicious
01:34:12
matcha pouches that come in every flavor from salted caramel to Peach flavor to mint flavor to Berry flavor one of my
01:34:19
favorites is this vanilla flavor which I'm going to make in just just two seconds you just take this mixer here
01:34:26
get a little bit of the powder pop it on top of the shaker like that put the lid
01:34:33
on shake shake shake delicious if you haven't tried
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this yet you can find perfect Ted at Tesco and Holland Barrett stores or online where you can get 40% off with my
01:34:46
code diary 40 head to perfect ted.com and put in code diary 40 to try this
01:34:52
delicious multi-flavored match now highly recommend and if you do it please tag me send me a message
01:34:58
online what part of your work sort of overlays with psychology you know when
01:35:04
someone comes to you and they they're experiencing some anxiety or depression or something and they they're describing
01:35:11
their life and their life is full of trauma and hard things and they got fired from their job it seems a little
01:35:17
bit peculiar to talk to them about diet in that moment it seems peculiar
01:35:23
did do you ever think first about like some kind of psychological
01:35:30
prescription oh you know I got some my training at Cambridge hospital uh in
01:35:37
psychiatric residency is very Psychotherapy focused I got really
01:35:42
excellent training in Psychotherapy and I still use it every day in my work it
01:35:48
we're not throwing the baby out with the bath water here in fact the psychology of people's relationship with food is
01:35:55
really important to address I mean most of what I do I mean I could I could teach you in an hour um everything you
01:36:02
needed to know about why you should switch to a ketogenic diet for mental health and and I could give you a little
01:36:08
sheet and you could go off and do it right I would I would be rapidly
01:36:13
obsolete um which would be a good problem to have right um but what actually is happening most of the work
01:36:21
I'm doing is not about here's the science here's why you need to do it here's what's happening in your brain here's the food list it would be so easy
01:36:28
if that's what it were we are human beings and we have really complicated relationships with food we have history
01:36:34
with food we have spiritual attachments to food cultural attachments to food
01:36:39
political ATT beliefs about food and and a lot of us have addictions and
01:36:44
attachments to food that go back a long way so most of it is about helping
01:36:49
people understand and and sort of hold their hand through that proc process of making that behavior change and it's and
01:36:57
whatever is going on in their life is also important so how did you approach that with your patients so in the first
01:37:05
in the first interview with somebody I usually take 90 minutes to two hours when I'm first uh working with a patient
01:37:12
and I might do that two or three times before we actually begin uh discussing
01:37:18
what to do with diet because I really want to understand um all of the different
01:37:23
pieces of the puzzle not just oh what are you eating here's what you should eat M that doesn't work for most people
01:37:31
and because there are going to be challenges that come up and if the better I know that person the better I
01:37:39
can help them through those challenges so it's not it's definitely not um it's
01:37:45
not like I hand them a prescription for a diet and send them out the door I love
01:37:50
understanding where people are coming from they're you know the the challenges they're facing in their lives and how
01:37:56
that all intersects with their metabolic Health their their exercise you know why
01:38:01
are they not exercising um how is their sleep how are their relationships who in
01:38:07
their life is supportive of them changing their diet um is who in their life is skeptical and worried and
01:38:13
because that could be a major factor for people if one person in the family wants or needs to go on a ketogenic diet for
01:38:20
mental health and nobody else in the family thinks it's a good idea that's really tough for people you
01:38:26
you've got to plan for all of that and talk it through say okay here are the roadblocks we might face how are we
01:38:31
going to how are we're going to deal with these when they come up so I could give many many examples but the
01:38:37
Psychotherapy the psychology of it is why using ketogenic diets to treat
01:38:42
mental health conditions is usually best done as a team ideally if you can a keto dietician
01:38:51
or nutrition therapist who's very skilled skill at using ketogenic diets designing them and personalizing for
01:38:56
whatever you like to eat um so you'll have an enjoyable diverse diet that
01:39:02
meets your needs and your desires um so you won't get bored and you'll enjoy the food you're eating um and a prescriber
01:39:10
if you're especially if you're taking medication or have any mental or physical health issues you'll need a prescribing professional primary care
01:39:17
doctor um or a psychiatrist or both depending what's going on for you to manage the medications and help you
01:39:24
through that transition period where there are so many different things changing in your physiology that can sometimes be uncomfortable if you don't
01:39:31
plan properly um and set the person up for Success um and a coach a therapist a
01:39:38
psychologist or a coach to for motivation and support and it could be a
01:39:43
cheerleader but also to reflect back to you how things are going and and and
01:39:49
keep you moving forward because the first few weeks are the hardest and once you get past about week three week three
01:39:54
is a real turning point for a lot of people your cells just kind of settle in
01:40:00
to a new way of operating and it's this very noticeable shift that takes place
01:40:06
in people's bodies and brains and that many people have never experienced
01:40:11
before as it relates to anxiety um what does the research say about the role
01:40:17
that keto can play in reducing someone's anxiety yes so anxiety uh if you talk to
01:40:25
any practitioner who has been using ketogenic diets in their work um whether it's a a psychiatric practitioner or a
01:40:33
medical practitioner there are a couple of things they'll tell you that are most U the most predictable benefits of a
01:40:41
ketogenic diet one is reduced anxiety and the other is mental Clarity so most
01:40:48
people will experience tremendous reductions in anxiety um Within often
01:40:53
within three days to three weeks of starting a ketogenic diet and the mental Clarity is is one of those things that
01:41:00
you hear almost from almost everybody so the anxiety is uh remember we're talking
01:41:06
about this roller coaster those stress hormones are on a roller coaster life can cause stress and stress can
01:41:12
unbalance your your Chemistry there's no question about that but your food can also do that your diet can also
01:41:18
unbalance your stress hormones so and this is comes back to your question about you know life stressors you don't
01:41:24
want to ignore those because they still count and they're still affecting your metabolic Health stress raises your
01:41:31
cortisol levels and cortisol levels are dangerous for long-term brain health High cortisol levels most mental health
01:41:38
conditions come along with disregulated or poor regulation of cortisol levels in
01:41:43
the brain and too much cortisol can over time damage the brain including uh the
01:41:49
hippocampus which is the brain's learning and memory Center so Str add whether it's coming from inside the body
01:41:55
from the foods you're eating or outside the body from your life both of those need to be addressed not just the
01:42:01
dietary stress there's some studies that I just found um a 2023 systemic review examine the E efficacy of low
01:42:08
carbohydrate ketogenic diets and treating mood and anxiety disorders the review highlighted potential benefits
01:42:13
but emphasized the ne necessity for randomized control trials to establish definitive conclusions that was the
01:42:19
Cambridge University press and slightly separate to that um on serious mental illnesses I think you talk about this in your work as well a 2024 pilot study
01:42:26
conducted by Stanford medicine investigated the effects of a ketogenic diet on participants with schizophrenia and bipolar and participants reported
01:42:33
improvements in energy sleep mood and quality of life suggesting that ketogenic diet May stabilize brain functions in serious mental illnesses as
01:42:41
well really really fascinating really fascinating I never really thought about the ketogenic diet's impact on my mental
01:42:47
health I used to think I be honest the reason I do it is um helps me become
01:42:52
more focused it changes my body composition and really at the end of the year for me or at the start of the year it's a nice way
01:42:58
to kind of reset that's the kind of how I see it I want to come into the year feeling good and strong and focused so I
01:43:07
do it over sort of Christmas New Year January time every year with my partner um but I never really considered the
01:43:12
downstream consequences things like mental health and those other things but it it makes sense we have a closing
01:43:18
tradition on this podcast where the last guest leaves a question for the next guest not knowing who they're leaving it for
01:43:23
and the question that's been left for you is what would you say to someone who
01:43:30
wanted to have less regret and more contentment and peace on their
01:43:42
deathbed I'm trying to think about what for myself personally what I would have
01:43:50
regretted um you know you might want me to say that I would have regretted not having
01:43:56
written this book and that's true but honestly it's about finding a really good healthy relationship in your life I
01:44:03
mean if I hadn't accomplished that in my life I would have more regrets than not writing this
01:44:08
book Thank you thank you for writing this book because it's such a comprehensive analysis of this poorly
01:44:16
understood link between the things we put in our mouth and the impact it has on our mind holistically and I don't
01:44:21
think enough people especially if we think back decades even thought to really uncover this sort of link I never
01:44:27
I think before even starting this podcast never really understood the concept of metabolic and metabolic
01:44:33
Psychiatry and that there was an association between the two the great thing about your book is that you don't
01:44:38
need to be a scientist to understand it it's clearly written for people like me
01:44:43
who are don't have a profound knowledge of Science and um medicine and Psychiatry but are able to learn in
01:44:51
advance the decisions we make just by reading your book it has been such a Smash Hit for so many people I was
01:44:58
looking at some of the reviews earlier on and people really really love it you wrote it you published it this year January January January and uh I highly
01:45:05
recommend anyone that is intrigued by any of the subject matters that we spoke about today to go and get a copy I'll link it below um and it has some
01:45:12
extraordinary people on the back who some of which I've interviewed at least one of which I've interviewed um in
01:45:18
Jason um is there anything else you wanted to say about who this book is for
01:45:24
yeah I mean I really want people with mental health conditions even if they think they've tried everything if you
01:45:30
know if you're willing to try one more thing hope is on the menu a powerful plan to improve mood overcome anxiety
01:45:36
and protect memory for a lifetime of optimal mental health thank you so much
01:45:41
for the work that you do thank you very much Stephen for your
01:45:47
work do you know that 80% of New Year's resolutions fail by February it's because we focus too much on the end
01:45:53
goal and we forget the small daily actions that actually move us forward those actions that are easy to do are
01:45:59
also easy not to do in life it's easy to save a dollar so it's also easy not to making one small Improvement each day
01:46:05
one tiny step in the right direction has a big difference over time and that is the 1% mindset which is why we created
01:46:12
the 1% diary a 90day journal designed to help you stay consistent and focus on the small wins and make real progress
01:46:19
over time it also gives you access to the 1% community a space where you can stay accountable motivated inspired
01:46:26
along with many others on the same Journey we launched the 1% diary in November and it sold out so now we're
01:46:31
doing a second drop join the wait list at theed diary.com and you'll be the first to know as soon as it's back in
01:46:37
stock I'll put the link below [Music]
01:46:53
oh
01:46:59
[Music]