Full Transcript Summit Introduction and Guest Background 0:00 Welcome everyone to the Gut Health and Longevity Summit. 0:03 I am so glad you're here, and I want you to take a deep breath 0:07 right now, because what you're about to hear in this session 0:11 is something that I have personally found a life changing. 0:14 We are going to talk about the most underappreciated relationship in medicine, 0:19 the one between your gut and your brain. 0:23 Most people have been taught that mental health begins and ends in the brain, 0:27 but the science is telling a very different story, 0:30 one that starts in the gut. 0:33 The food on your plate is in constant communication with 100 trillion 0:37 microorganisms that in turn shape your mood, your anxiety levels, 0:42 your resilience, and your cognitive clarity. 0:45 So today's guest has spent her career 0:47 building an entirely new field at that intersection. 0:51 And this conversation is something I have been waiting to have. 0:54 My next guest is called a triple Threat in Medicine and Food. 0:59 And I think that that's an understatement. 1:01 She is a Harvard trained psychiatrist. 1:04 She is a professional chef, 1:05 and she's a founder of the entirely new discipline called culinary psychiatry, 1:10 where the kitchen is a clinic and food is a prescription. 1:14 She is totally speaking my language. 1:16 Doctor Uma Naidoo graduated from Harvard Medical School and holds advanced 1:20 training as a professional chef. 1:22 She is also a clinical professor at Harvard Medical School 1:25 and director of nutritional, lifestyle and Metabolic Psychiatry at Mass General. 1:30 She founded the first hospital based nutritional psychiatric service 1:35 in the United States. So I am so excited. 1:38 She's also the author of two bestsellers, This Is Your Brain on Food 1:43 and Calm Your Mind With Food, and you have probably seen her around on multiple, 1:48 media channels, such as the Today Show, Live with Kelly and Ryan and CNBC. 1:54 Okay, I am going to say I've been waiting to have this conversation 1:58 with you for the past few months since we met a few months in person. 2:02 So I'm going to start with the first question here. 2:05 There is a phrase and I feel it's a really beautiful phrase. 2:09 It's called the gut brain romance. 2:12 And most people understand this story as one way. 2:17 Stress causes a stomach ache, but the brain influences the gut. 2:22 You've now reversed that arrow, and you're saying the gut 2:25 is actually the first author of our mood. 2:28 So can you share with us what is actually happening 2:32 biologically in that other direction? 2:35 And why does this change everything we know about mental health? 2:39 Well, thank you so much for the question and thank you for having me. 2:42 I'm excited to see you and talk with you today. 2:45 You know, the my first book, this is your brain on Food, 2:48 really sort of put nutritional psychiatry on the map for the public. 2:52 And the first chapter of that book is called romance 2:56 because I wanted to share with people that, you know, mental health 2:59 A is not an above the net concept anymore, but be the gut is hugely important. 3:04 And it really starts with the fact that the government brain 3:07 originated from the exact same cells in the human embryo. 3:10 Like you mentioned, they divide apart. 3:13 They are connected by the vagus nerve. 3:15 And there's they also interacting with hundreds, 3:18 you know, trillions of microbes in the gut microbiome. 3:21 But rather than think about this as something originating in the brain, 3:26 there are lots of other things that are going on in this 3:30 that is bidirectional. 3:32 And the vagus nerve allows for communication of neurotransmitters 3:35 like serotonin and others between the gut and brain and brain and gut. 3:39 So this is ongoing communication. 3:41 And that's where food becomes a huge player,
How the Gut-Brain Axis Shapes Mood 3:45 because food is being digested in the same place that we have 3:48 about 99% of serotonin receptors and 90% of cell total production. 3:54 Now, it's also made us weird, but think about the fact 3:57 that so much of it is going on there. 4:01 I've also understood that about 70% of 4:04 the immune system is located in 70 gut cells. 4:07 So there are so many different interactions that are happening. 4:12 And then if we take a step back 4:13 and understand that the research and mental health is telling us 4:17 that the underlying factor for conditions like depression, anxiety, 4:22 cognitive disorders and more is actually inflammation, 4:26 and that the gut becomes a hotbed for inflammation 4:30 when we're eating poorly or be very stressed in other factors. 4:33 So again, food comes into that picture. 4:36 So, you know, even conditions like Parkinson's are now being seen. 4:40 And sure, you've seen the research, as you know, looking at where does it. 4:45 And it's one of those origins that gut. 4:47 So it's a very sending time for this field. 4:50 And so very exciting time to see the direction in which we will unfold. 4:54 Committee and research. Yeah, absolutely. 4:57 I think one of one of the things that, you know, 5:01 always surprises me and I and I'm actually I'm really glad 5:05 this is happening because since you're trained as a psychiatrist, 5:10 I'm sure at some point in your career you have handed out a few, 5:15 you know, antidepressants, anti-anxiety medication, and even in our training, 5:20 there was no conversation of, okay, yes, 5:23 we know the mechanisms of action of SSRI. 5:26 But when I think of an SSRI, which is a selective serotonin 5:32 reuptake inhibitor for the audience is, well, 5:35 it's supposed to allow more serotonin to circulate in the body. 5:38 But as you just mentioned, if most of that serotonin, 90% of 5:44 it is made in the gut, how is it possible for more to possibly circulate? 5:49 Which brings me back to how do we get the gut to work, right? 5:53 So what has been your experience with this shift in this idea, 5:59 now that the gut is also a strong contributor to mental health? 6:04 Like where are you seeing the shift from the clinician perspective, 6:08 especially for the audience who's listening going, oh, my doctor 6:12 just gave me this medication and didn't talk to me about any of this. 6:15 So where can people find hope that, hey, there is a conversation 6:19 happening in the clinical level? 6:21 So that's a great question, and one that I'm working very hard 6:25 in my career to help fix change and sort of move along. 6:29 And the reason I say that is the two things I often hear 6:32 from patients, that they might see a gastroenterologist and be kind of, 6:38 you know, have an eyeball when they talk about a leaky gut or something 6:41 they read, even if it is a magazine or a media or read online. 6:45 But then also in the psychiatry office, people are not necessarily 6:49 talking about the gut. 6:50 They might mention side effects of SSRI, but they don't connect the fact 6:54 that those initial first 5 to 10 days, almost two weeks 6:59 of gut symptoms, nausea, discomforts, maybe sometimes a little bit of diarrhea 7:04 even are related to certain and the SSRI and location. 7:09 So it's an interesting time because honestly 7:13 cannot say that psychiatry is there yet. 7:16 But certainly the fact that the integrated health conferences there's lifestyle 7:21 medicine, lifestyle psychiatry and nutritional psychiatry coming forward 7:26 with the voices that we bring forward in terms of integrating this information. 7:29 People are more aware of conversation, but I'm not sure 7:33 it's happening in the psychiatry office yet. 7:36 I know that there are some private practices trying to adopt this method 7:41 because they have the liberty to do so, but the average hospital practice is 7:45 not necessarily addressing your gut health when you see a mental health doctor. 7:49 So all practitioners. 7:50 So I think it's an important full term for change 7:54 to start to ask the questions 7:57 and for people to feel empowered that there's more information 8:00 they can ask about before they accept that prescription. 8:04 Yeah. Well so let's talk about anxiety then. 8:07 Anxiety is the most prevalent mental health condition 8:10 on the planet, affecting over 284 million people worldwide. 8:14 And the gut as we've already talked about, is almost never part 8:18 of the clinical conversation. 8:19 So what does the research actually show about the role 8:25 of a microbial imbalance driving anxiety? 8:29 And why is this connection so systematically overlooked? 8:34 There are a couple of reasons that it's overlooked. 8:36 One is that even though The Lancet showed, which is a highly respectable journal 8:40 in medicine, that globally anxiety 8:44 increased by 25% during Covid, which is the one of the main reasons 8:49 that I wrote my second
Clinical Gaps in Treating Gut-Related Mental Health 8:51 book, Calm Your Mind With Food, because that's what I was seeing 8:54 in my virtual clinic throughout Covid was a heightened level of anxiety. 8:58 It felt like just everyone was anxious. 9:00 The funny thing, though, is that people don't often identify that they're anxious 9:05 for many different reasons psychological otherwise. 9:09 But sometimes anxiety hides under sleep. 9:12 Sometimes it hides under symptoms like nausea, butterflies in the stomach. 9:16 People not realizing that it actually could stem from. 9:19 Another reason is that 9:22 I think that other conditions, like a depressed mood or a lack of focus, 9:28 a lack of mental capacity, sometimes a little bit more obvious 9:32 because there are ways that people have learned to manage. 9:35 The anxiety may not be something that heals the anxiety, 9:39 but they might exercise more, or they might go for a run, or they might 9:43 meditate, or they might do something that actually helps them manage the anxiety. 9:48 But then there's a break through moment when it continues. 9:52 So I think that sometimes diagnosis 9:54 or identifying enough solves is a little bit challenging. 9:58 But then on a microbial level, we understand more about some microbial 10:03 species that are increased or decreased when people are more anxious. 10:06 And we also understand which is why I put together an anti anxiety eating plan. 10:12 And then a protocol notebook that you can eat a certain way and shop 10:16 a certain way to actually help calm your mind. 10:20 Simple things like choosing those vegetables, you know, 10:23 choosing different types of produce with different colors, but then targeting 10:29 how you can heal your gut in a certain way becomes important too. 10:33 So we do understand a little bit more, and I love the fact that that research 10:36 is ongoing. 10:38 Yeah. 10:38 So I've read that there are certain imbalances in specific bacteria 10:44 like Lactobacillus and Bifidobacterium and populations that have more anxiety. 10:51 And when you have that deficiency or imbalance, 10:53 you're creating that more inflammatory pathway which is going to activate 10:57 the HFPA axis or your hypothalamic pituitary adrenal axis. 11:02 So what have you seen in the 11:06 in your clinical setting with individuals like are you doing any testing. 11:12 Are you or patients bringing you testing. 11:15 Are you making any recommendations based off of that? 11:18 Because if there's something going on in their microbiome, then how? 11:23 Like, yes, the food is great, but how do we actually see what's going on? 11:27 That's a great question. 11:28 Part of the limitation here is that as far as I know, U.S. 11:32 hospitals have not, through the insurance carriers, approved the gut 11:36 microbiome test. 11:37 And this has been a hang up because often patients 11:40 will pay a lot of money to get this privately tested. 11:43 And then it's up to us to sort of interpret that information 11:47 from an outside lab. 11:48 Now, some of the companies that do the testing will then recommendation 11:52 make a recommendation to food is supplements. 11:54 And sometimes those those can be helpful because they might pick up on the fact 11:58 that someone is eating a certain type of food 12:00 which is otherwise healthy, but maybe may not be helping the microbiome. 12:04 So I've had a certain level of assistance from outside testing in that way. 12:09 But I think the fact that in mainstream medicine 12:12 we don't have an approved microbiome test is a massive deficit in the system 12:18 because a, it costs the patient 12:21 more money to go and get it and takes the provider more time. 12:24 So I would love to find a better solution to that. 12:28 Is there any specific testing that you do in the hospital 12:33 from a neurotransmitter standpoint or inflammatory standpoint 12:38 that is worth mentioning, just in case you know, somebody is going to, 12:44 you know, somebody outside of the health care system for their mental health? 12:48 Is there anything that you do recommend? 12:49 So I always work in conjunction with a primary care clinic 12:53 or the primary care physician. 12:54 So metabolic panel making sure the electrolyte, you know, 12:58 simple things like magnesium. 12:59 Many Americans are deficient in magnesium.
Anxiety, Microbiome Imbalance, and Testing Limits 13:01 So things that, you know, are not as as complex as we might think. 13:06 Vitamin panels, depending on where they live 13:09 or what their symptoms are like vitamin D, a lot of people in the northeast, 13:13 maybe vitamin D deficient, someone can actually present 13:17 as prevalently anxious or depressed, and they might be repeated in vitamin D. 13:22 So some of that and then inflammatory markers depending on the situation 13:26 and always in conjunction either with a functional gastroenterologist 13:30 or primary care doctor. 13:31 So there can be more guidance there. 13:33 So these are things we should, you know, 13:35 people can be asking their doctors about and, you know, finding out 13:39 more information and saying, well, should what I benefit from this test. 13:43 You know, maybe I have this deficiency. 13:45 For example, if you know, vegetarians, you know, should be checking the B12 level. 13:51 You know, I have had to do that throughout the course of my life. 13:54 So you'd need to replenish with supplementation or a shot 13:58 or however your doctor chooses to replenish that for you. 14:01 So I think that these these questions become important. 14:04 But again, you know, even from when I first started this work, 14:08 it's become much more personalized, as you might have talked about before. 14:11 So it's who's sitting in front of you, but is there a specific diet? 14:14 What are they actually eating? 14:15 What are the other medical conditions and how do we find 14:18 tune the nutritional psychiatry plan for them? 14:21 So speaking of which, next question. 14:24 But even that, just like my patients, I see almost all of them. 14:29 I mean, I would say unless they're supplementing 14:31 a majority of my patients, both omnivores, carnivores, 14:36 vegetarians, vegans, 14:38 many of them have B12 deficiencies and many of them also, 14:42 even in the state of California and Florida, have vitamin D deficiencies. 14:47 So that brings me to the next question, because I think this is a lot 14:50 of what's going on. 14:51 So when you're thinking about food and what it does to the brain, 14:57 can you walk us through the what happens in the first bite? 15:01 Especially like if we think about what does an ultra processed food meal 15:06 do differently neurologically? 15:09 Microbiology compared to a meal that's rich in polyphenols and fiber. 15:14 Can you kind of walk us through 15:15 what is happening and why people want to listen up? 15:19 Yeah. 15:20 So you know, the one that is not chewing our food 15:23 and the whole process of digestion starts. 15:26 We understand that the food is going through our digestive tract, 15:30 you know, things that we learned in school. 15:31 But when food is being digested, it's being digested in this area 15:37 where these hundreds of thousands of microbes and like in life, 15:41 there are the good microbes and the not good microbes and the band microbes. 15:45 Right. 15:45 And the good microbes love to be fed with healthy foods and fresh vegetables 15:50 and, you know, beans and legumes and nuts and seeds 15:53 and all the great benefits of these foods and different colors of foods, 15:57 the carrots, they flourish when they are fed. 16:02 This way, adequate proteins and healthy fats from avocado or from, 16:07 you know, olive oil. 16:08 And when they're fed this way, they their digestive breakdown 16:13 products are healthy, short chain fatty acids and shortchange fatty 16:17 acids are healthy for the fiber biome they found of inflammation. 16:21 They help rebuild the gut lining because that will sell. 16:24 Lining of the gut is very delicate, 16:26 so they're really helping that gut flourish and thrive. 16:30 But when we're eating things that we, number one, don't identify, 16:34 the names of, the ingredients are so outer processed foods. 16:37 You know, someone said, interestingly, junk. 16:40 The new word for junk food is outer processed foods. 16:42 And it's probably true in a way, if you think about it, 16:45 because algebra houses foods are highly processed, packaged, 16:48 have ingredients that help make them shelf stable, help, 16:52 you know, create flavors and artificial ingredients, and sometimes 16:55 contain artificial sweeteners so things that are just not healthy for our gut. 16:59 Now, does it mean that you can never have a snack? 17:02 No, that's not what I mean. 17:03 But if that's all that you're eating and the major part of your diet, 17:07 then it's going to impact your gut microbiome. 17:11 So what happens in a similar way that the food, you know, 17:14 that's healthy plant poly phenols that is being digested 17:18 the similar way the ultra processed foods get broken down, but they get broken down 17:23 and they attract the negative bad microbes. 17:26 And their breakdown products are toxic polysaccharides, 17:29 which immediately start to damage the single cell lining of the gut. 17:34 Now, you know, eat that offer processed food. 17:36 You you may have some sort of feeling, or you may not feel great, 17:40 or you may feel great. 17:41 Often people feel great, 17:42 need it again, but it's a long term effect that's a problem. 17:45 But over time it's going to damage that single cell line, and over time 17:49 you are likely going to develop from that information. 17:52 You get neuroinflammation or brain information, but you also start 17:56 developing a leaky gut or intestinal permeability. 18:00 And this is where for mental health perspective, 18:03 you see an uptick of symptoms of depression or anxiety of focus. 18:08 And you sort of thrown off by, well, someone's either taking medication 18:11 or they're not, or some new is presenting with these symptoms, 18:14 as I had many times in Covid, because people's diet changed dramatically 18:18 as the given the restrictions on Covid and the fact that, you know, 18:21 for the first time in the US, people think empty grocery store shelves. 18:26 So what did people do? 18:27 They rushed to get processed foods that per package and shelf stable. 18:31 It was a difficult time. 18:32 And so we started eating more of that and that persisted. 18:36 So all of those things do affect the digestive process
How Food Affects the Brain and Gut 18:40 and they affect those negative microbes. 18:42 Yeah. 18:43 And actually what I saw was, yes, the food grocery store shelves were empty. 18:47 But one place that was open is the liquor stores, 18:51 which and I heard of a drive thru liquor store. 18:56 But where I live the first time I witnessed that and I'm like, 19:02 wow, okay, drive thru and delivery, you know, 19:05 which I don't think people had been doing as much of before Covid. 19:09 You know, 19:09 people would go and buy a bottle of wine or something, but it definitely increased. 19:13 So, so let me let me kind of summarize that for the audience. 19:17 Okay. We've got the ultra processed food. 19:19 When you're eating ultra processed food and it's going down in your body, 19:23 you can also create a sugar spike, a glucose spike, which then is going 19:28 to make that inflammatory cascade kind of happen when inflammation happens. 19:34 We're now disrupting the blood brain barrier. 19:36 Right. So that's never good. 19:39 Your dopamine and your cravings and all that is getting hijacked. 19:42 I'm all about like I can see when somebody's body has been hijacked. 19:46 But now if we chose another meal, one that's rich in plants and polyphenols. 19:52 Right. We've got the prebiotics in there. 19:54 We've got the antioxidants in there. 19:56 We're feeding a bacteria, which I love. 19:59 Then we're making more tryptophan. 20:01 If we're making more tryptophan 20:03 we can support our serotonin our feel good neurotransmitter. 20:07 Right. So this is it. 20:08 You know, people just think food I put in my mouth, I eat and then 20:11 but they don't realize there's this whole like 20:14 there's a cascade cascade. 20:16 There's a biochemical factory happening. 20:19 There's like, think of it like this. 20:21 Your next bite is basically like a rain shower on your cells. 20:25 And it's it's all doing all this stuff. You can't see it. 20:27 I can see it because I just spend way too much time living and looking at cells. 20:32 But so is this why we see people who. 20:36 And I tested this like I'm like my own science experiment. 20:39 But when we see people who eat ultra processed food feel worse over time, 20:45 not just heavier, but they get more anxious, 20:47 they get more reactive, they get more cognitively foggy. Yes. 20:52 Yeah. Right. 20:53 So this is exactly right. 20:55 So they develop all of those symptoms because what they're actually doing 20:59 by eating the ultra processed food 21:01 is driving inflammation in the gut, which drives inflammation in the brain. 21:05 Because we now understand this this circuit. 21:07 And when that happens you have a 21:10 you have to spy on imbalance of the gut. 21:13 You may have damaged that cell lining of the gut. 21:16 You have inflammatory cytokines circulating in your body. 21:20 You develop neuroinflammation. 21:22 And all you're doing is experiencing 21:24 something from a mental health perspective. 21:26 Poor sleep have you have cravings, like you mentioned, 21:30 when you're driving those sugar spikes and basically developing resistance? 21:36 We understand from research that when we are consuming foods 21:40 that constantly feed us with sugar and others, 21:44 that simple carbohydrates break down into sugar. 21:47 So when they are not complex so they don't have 21:50 additional fiber in them, they can be problematic. 21:54 And so when you have all of that being driven, we know and understand 21:59 that sugar spikes act on our dopamine 22:02 one pathways, similar to street drugs like cocaine. 22:05 So those cravings are very real when they develop 22:08 and we create more of the food once you start eating it. 22:12 I offered us asking my patients, you know, if you've ever done 22:14 through that drive through and you've upsized or supersized 22:18 one of your items like fries, don't you probably feel 22:21 like you did feel like having more dinner or the next day 22:24 because you've set up that craving system in your body. 22:27 And so I think it's important to pay attention to that and understand 22:31 that one of the ways to help yourself is to take a step back and say, 22:35 what can I be set here? 22:37 Instead of ordering 22:38 that take out every single day for lunch and dinner, can I, you know, think of 22:42 going through to a healthier takeout, get a fresh salad with fresh ingredients, 22:46 go to the supermarket if they have a salad bar. 22:49 You know some of them do, even if you don't want to put it together. 22:52 Can you go to a place that you put that together? 22:56 But it's actual food, and the more times we can actually we can eat real food, 23:00 the better it is. 23:01 So the classic examples eat the apple, skip the straw board, apple juice. 23:05 Same thing 23:06 with an orange because those lacked the fiber and often have added sugars. 23:10 But the fruit itself will give you the fiber, 23:12 the vitamins and minerals that your butter that your body needs. 23:16 Yeah, and I think, you know, meal prep is absolutely underrated. 23:20 Like this weekend. 23:21 You know, okay, me being bad is 23:24 get ordering a vegan pizza on ancient green crust 23:29 and eating that for three days in a row because that's me being bad. 23:35 So not fast food or anything like that. 23:36 But then on Sunday, I at home. 23:41 Sunday I did my meal prep. 23:42 So I've got my four wedge salads ready to go with the rainbow on them. 23:46 Right. 23:47 So we've got the cucumber, we got the radishes, we've got purple cabbage, 23:51 we've got sprouts, we've got is on there carrots. 23:56 I was chopping up something else. 23:58 There's a few other things on there. 24:00 And then having it with my protein, my tofu and white beans. 24:03 Right. So that's meal prep. 24:05 And then the second meal prep I was deciding what to do 24:07 with this, this bunch of cilantro I have because I'm heading out of town. 24:11 So I'm like, I don't want it to go bad. 24:13 I was either going to make a salad dressing with it 24:15 because I pulled out the lemons, but then I'm like, 24:18 you know what, I'd rather make juice shots. 24:20 So I made orange, lemon and cilantro juice. 24:25 So they came so good. 24:28 That combination. 24:30 Yeah, yeah. Polyphenol fix for the morning. 24:33 So it's also a matter of let's 24:35 get a little creative and think about food in a different way. 24:39 So since we're talking about food I want to move to the next question 24:43 which is your anti-anxiety shopping list. 24:46 Right. 24:46 So specific foods with specific mechanisms to calm 24:50 the nervous system through the gut. 24:52 So walk us through the ones that have the strongest evidence. 24:57 Tell us why behind each one. 24:59 Not just what to eat, but what is it going to do to our brain? 25:02 Correct. 25:03 So, you know, I love those Christopher's vegetables. 25:06 They often really at the top of my list. 25:08 And these are things like cabbage, cauliflower, 25:12 broccoli, Brussels sprouts and also things like a ruler. 25:15 So ruler is a Christopher's vegetable. 25:17 So they left, for example, has a slightly bitter taste, which ends 25:21 up being better for our gut microbiome then rich in sulforaphane. 25:25 And there's a trick about when you prepping them 25:28 to allow for that development of the sulforaphane. 25:31 You can chop them and leave them for 20 minutes 25:34 or chop them in the morning, 25:35 leave it in the fridge and eat it in the evening 25:37 for your steamed broccoli or roasted broccoli, whatever you're making. 25:40 So the sulforaphane is very powerful. Now. 25:42 They also contain other ingredients rich in fiber, vitamins, and minerals. 25:47 But this is this is one that really does help fend off inflammation 25:51 in the gut and help lower your symptoms of anxiety over time. 25:56 That's a staple of your diet. 25:57 They also very low calorie. 25:59 So in mental health, one of the things we have to pay attention to 26:02 is sometimes people have developed side effects of medications already. 26:06 They've made, 26:07 may have gained weight from it, or are kind of being depressed or anxious. 26:11 The appetite is kind of really often they choosing not 26:14 they not choosing the healthiest foods. 26:16 So they so having options that are not as calorie dense
Anti-Anxiety Foods and Nutritional Psychiatry 26:22 low calorie but high nutrition value is important. 26:25 And cruciferous vegetables. 26:28 If you spice them up the right way, you know, whether it's fresh herbs 26:31 or other ingredients like spices, that makes it, you know, 26:35 extremely nutritious for you to be eating, then you move on. 26:40 Are you saying that 26:42 any cruciferous vegetables we should chop up and wait 20 minutes? 26:45 What does that do to the sulfurous pain? 26:48 So the louse, the greater development of the sulforaphane. 26:52 So mostly when I do that, I really pay attention 26:55 to cauliflower, broccoli and Brussels sprouts that way, and sometimes cabbage. 26:59 But the study is mostly done on broccoli. 27:01 So it's just a you know, it's something I talk about in my book. 27:04 And it's a neat thing if you think about it. 27:07 So the meal prep really helps with that because now you're chopping. 27:11 And by the time you actually get to 27:12 eating, which already activated it, you've been back to it. 27:15 Exactly. 27:16 So the other sort of group that I'd like to pay attention to is the healthy fats. 27:20 So the avocados, olive oil, make sure that maybe 27:25 you have sliced avocado with your breakfast or lunch on your salad, 27:29 or you have an avocado oil dressing on extra virgin olive oil dressing. 27:34 These are good ways to bring in some healthy fats. 27:37 Then I like to think about the fats like 27:40 the mega threes from chia seeds or walnuts. 27:44 These are great to add into your diet as well. 27:47 And other sources. 27:48 And then, you know, making sure that you have probiotics. 27:52 Maybe you have a coconut yogurt or you have a milk yogurt. 27:56 There are ways to bring these into your diet that are really important. 28:00 So there are three biotic fibers and probiotic fibers and prebiotic 28:04 can get from the alien family, like garlic leaks and onions. 28:08 The fibers are going to nourish and feed your gut microbes. 28:12 So all those favorite gut probes that we love, like I mentioned, 28:15 others are going to be fed by these prebiotic. 28:19 And then you get your probiotics from. 28:23 And fermented foods are also really key, like kimchi. 28:27 Every culture has a fermented food. 28:29 Yeah. 28:29 So, you know, tapping into something that you really used to eating. 28:33 That fermentation process 28:35 also brings in really important anti-inflammatory properties. 28:39 A study done at Stanford University towards the end of Covid 28:43 actually found that eating and adding invented 28:47 foods to your diet will help lower inflammation in your gut. 28:51 So these are just simple things that you can start to get used to. 28:55 Find one that you like, and then add a little bit to meals every day. 28:58 The only caveat I have, which I call nutritional psychiatry 29:02 nuances, is just loading on five of mentioned foods. 29:05 For someone who has a gut health condition 29:08 can be problematic because if you have IB s IBC, 29:12 also 29:13 colitis or Crohn's and other conditions, you you know, 29:16 you should be talking to a specialist like Doctor Monisha because you can't 29:21 just load on these foods, which can then cause you more discounted. 29:25 So you might have to have a more specialized plan. 29:28 It's not that they unhealthy, it's more that what can your gut tolerate and when. 29:32 So those are just important things to remember that 29:34 not everyone can do the same thing, but these are foods 29:37 that have positive effects. 29:40 And then remember when you're leaning into the plant plant 29:44 rich foods, you are just getting a natural source 29:48 of plant polyphenols, which is why we say eat the colors of the rainbow. 29:52 It's actually referring to these different plant polyphenols that are so powerful. 29:56 Yeah. 29:57 And I would say to the audience that's listening, start slow. 30:00 Right. 30:02 So when you're increasing your fiber, you also want to increase your hydration. 30:05 But start start slow and you know, you'll hear me talk a lot 30:10 about 30 different plant foods in a week, or for me, maybe in a meal. 30:14 But the variety is what matters, not necessarily quantity, right? 30:18 Because we want all of these. 30:20 The fermented foods that Doctor Mumma mentioned are beneficial 30:24 for the Gaba producing strains like Lactobacillus, the dark leafy greens. 30:29 There's so many to choose from for magnesium. 30:31 Then you have the omegas that she mentioned 30:33 for that neuroinflammation, right. 30:35 So there's so many. 30:37 We've got the alien family for the prebiotics. 30:40 Is there one food on your anti-anxiety food list that consistently surprises 30:45 people, something they would never expect to find on the list. 30:49 So it's actually a purple version of it is on the cover of my book. 30:53 It's a purple sprouting broccoli, which is seasonal, 30:56 so you can't always get it, but it, you know, a form of people. 31:00 I like to say, Malaysia, that when people you know 31:03 are craving something, they're not reaching out for broccoli. 31:06 But the surprising thing is that it's very powerful. 31:10 And if you can find a way to love it and embrace it and 31:14 but it's roasted or make it made into a salad, 31:17 whatever it is you do with it, you know, people even make, 31:20 I think, shots from broccoli sprouts, you know, things like that. 31:23 These can be highly nutrition. 31:26 But why is it surprising? 31:28 Because it's low calorie, is high in fiber, rich in sulforaphane. 31:32 It's giving you so many nutrients. 31:34 But I think that people struggle with well, it's usually when I'm on my plate. 31:38 So this is how you think about it when you go out for dinner. 31:41 Think about getting that as one of your side dishes. 31:43 Think about adding it into your rotation. 31:45 If you're having, you know, if you're having a chopped salad, 31:48 think about using your roasted broccoli from the night before 31:51 and adding it into your salad, because it's it's just an option 31:55 that can be super delicious if you if you embrace it. 31:58 Okay. 31:59 You just convinced me I am not a broccoli person. 32:01 I will eat an entire head of purple cabbage. 32:04 I do broccoli sprouts. 32:05 I am going to make the strong effort to start adding in some broccoli. 32:10 You know I'll still do my sprouts and my other cruciferous, 32:13 but I will make a strong effort. 32:14 Now, the broccoli usually sits in the freezer, 32:17 so I forget about it, but I'm gonna do a soup with it. 32:20 You know, you could do a suit people 32:21 to throw some broccoli because it's a strong effort since Doctor Uma said so. 32:25 So let's talk about this. 32:27 Are you a field called culinary psychiatry, where you actually 32:31 teach mental health professionals to cook as part of their clinical training? 32:35 And I'm also trained in culinary medicine. 32:37 So I, you know, I do this with my patients. 32:39 We do cooking classes and they're like, it's like they're in my kitchen with me 32:43 where I'm like pulling stuff out and I'm showing them how to do stuff. 32:46 But what is the act of cooking a like why actually is the act 32:50 of cooking a clinical intervention? 32:52 And what does a psychiatrist learn when they're putting that apron on that 32:57 they can't learn from a textbook or a prescription pad? 33:01 A few different things. 33:02 You know, we launched some congregation classes at the American 33:09 Psychiatric Association national and International meeting in 2025. 33:14 So for the first time, together with the president 33:17 and someone who really leads lifestyle psychiatry doctor, 33:22 we were able to coordinate and conduct classes for mental health 33:27 clinicians who attended the conference and who wanted to do this extra training, 33:31 and we used the Los Angeles training kitchen at their country school. 33:36 So they were actually in an environment that was a real culinary school. 33:40 It was a lot of fun. 33:42 But how the direction that I've been using and taking this area is 33:46 how do you interpret a simple recipe to a patient? 33:50 How do you teach them? 33:51 Like you and I talked about broccoli, you know, what can you do with broccoli 33:55 to make it interesting? 33:56 You can use a frozen steam it and zest, fresh lemon zest and a squeeze of lemon. 34:01 And it'll be with salt, a little bit of pepper. 34:04 It can be super delicious. 34:06 There's not much you have to do to something. 34:08 And sometimes I had a very interesting client 34:11 who I would not never have guessed militia, 34:15 who was a business executive, and said to me, 34:17 everyone tells me to have a car and I don't know what to do with it, right? 34:21 And it never hurt me. 34:22 She just didn't like to cook or didn't. 34:24 It wasn't something she enjoyed. 34:26 So she was trying to figure out, well, what do I do if I get it? 34:29 You know, so simple things of, well, have you ever tasted guacamole? 34:33 Well, you can do that at home. 34:35 Or look at how easy it is to make this happen. 34:37 Or you can slice it and make your own avocado toast.
Cooking as Clinical Training 34:41 So it's interpreting that in the moment with healthy ingredients 34:44 and teaching people how to make healthy swaps, 34:47 I devised a method called the Soul method SAW, 34:51 which is swap and walk, and this is a way for someone 34:55 to find a jumping off point for themselves to start making healthy changes. 35:00 So it's often overwhelming to get that list of 20 vegetables or 20 foods to eat. 35:05 But you can start with the anti-anxiety shopping list. 35:08 You can choose what you'd like 35:09 and then decide, what's that one thing I want to swap? 35:13 Maybe it's, you know, from Covid giving up certain vegetables that you couldn't 35:17 get fresh, or adding in ice cream to your meals every night. 35:21 And you and I still doing that, you know, several years later. 35:25 While you can make a delicious ice cream from bananas and you can 35:30 even make a chocolate flavored. 35:31 So there are ways to rethink what you're doing. 35:34 And that's what culinary psychiatry does in the moment. 35:37 It really helps the client, but also the clinician, 35:40 to be able to learn this method to teach as part of their clinical practice. 35:45 Yeah. 35:45 You know, I often I talk to patients and I see that many, you know, 35:50 if you've grown up as a latchkey kid where there was just frozen meals 35:54 and you're just, you know, 35:55 you're not sitting down and you're you're not in a family that's cooking. 35:58 When you grow up as an adult, you also do not know how to cook. 36:02 So I run into many patients who they're like, I don't like it. 36:06 And I'm like, well, why don't you like it? 36:07 And they're like, well, 36:08 because they were trained because their parents weren't doing it right. 36:12 So this is why I love doing these cooking classes with my patients, 36:15 because their eyes go, oh, I didn't know that that was so simple and possible. 36:19 Right. 36:20 And, you know, so it's always good to see that, 36:23 you know, we can learn something at literally any age. 36:27 Now, if you were sitting in a room full of psychiatrist today, what is the one 36:31 cooking technique you would insist that they master and why? 36:37 That's a great question. 36:39 What are we getting our psychiatrist? 36:41 Probably. 36:41 Probably learning to work with any vegetable. 36:45 Like how do you think about a vegetable? 36:47 What do you do with it? How do you wash it? How do you prep it? 36:49 How do you cut it? Pepper. 36:50 You know, simple things that can actually make life easier 36:54 because you can make a salad with that. 36:55 You can add that to a stir fry. 36:57 You can make it into a soup. 36:58 And how do you trim as part of this, you know, so maybe a whole bowl 37:02 of fresh veggies and from the from, say, 37:05 romaine lettuce to asparagus, what do you do with these 37:10 and what are some things that you can then cook with them? 37:12 Can you steam them? 37:13 Can you make a roasted vegetable tray with them. 37:16 And you can, you know, split half that train. 37:18 You can bake your tofu on the same sheet pan with the similar spices. 37:23 You know, they're easy ways to do this, I think prepping things, 37:27 learning how to do that, and then understanding 37:30 that you can use things like frozen broccoli, frozen cauliflower as well, 37:34 you know, there's a sauce package. Just ignore that. 37:37 Use the actual whole food because frozen foods 37:40 are flash frozen in the United States, so they frozen at their peak. 37:43 So they actually healthy options for us. 37:45 And things like frozen base are cost effective options. 37:48 So there are lots of things you can do that just make life easier. 37:52 And to your point, when people realize how easy it is to steam broccoli, 37:57 they think to that, you know, 37:59 they sort of the eyes open and they're like, wow, I can do that. 38:02 You know, this is not this is not rocket science. 38:04 What do you do with the water after the steamed broccoli that night? 38:10 Like nice green. Green what? 38:12 I'll tell you what I do, but you tell me what you do. 38:14 So I usually say. 38:16 But either for a smoothie or shocked with. 38:19 Sometimes the flavor is not that delicious, right? 38:21 It's not that tasty, but it's rich in polyphenols. 38:25 And I will use the cool it and use it for smoothie the next day. 38:28 Or use it for juice shop where there's a little bit of fresh 38:31 injury time that overpowers that taste, but I'm not getting the nutrition from it. 38:36 Soups, soups. That's the other thing. 38:37 Yeah, I don't know if this is the right thing to do, but I feed my plants 38:42 like I will go water my plants with that for you, right? 38:45 That's a good idea. Yeah, it's nutrient dense. 38:48 Yeah. 38:49 So, like, I have a window sill with all my herbs and fresh herbs. 38:52 So I'm like, okay, you guys are getting a little getting used to. 38:56 Yeah. That's great. I love it. Okay. 38:59 So you have worked with a number of patients for who food 39:03 genuinely changed the trajectory of their mental health. 39:06 Can you share, without any identifying details, a case where the gut 39:11 brain connection was the real turning point in what happened to that person? 39:16 You know, I had a woman who appeared. 39:19 This was before Covid appeared in my office for the first time, 39:23 an initial evaluation. 39:25 And she came to me saying, young 39:28 executive in her office down the road from the hospital. 39:31 And she came in saying, I need Zoloft. 39:35 I read about it. 39:36 I think it's going to help me because I'm so anxious. 39:38 I just can't manage. 39:41 So, you know, written about her in one of my books, and part of 39:44 it was because it was such an eye opening moment. 39:46 So, you know, I still prescribed medications if and when needed. 39:49 But I said to, would you be open to conversation during the evaluation, 39:52 realized that she was this upwardly mobile executive in our office who was single 39:56 and lived in local area, walked to work, you know, exercised, 40:01 maybe had a dinner out with friends on the weekend 40:04 and a cinema, glass of wine, maybe 1 or 2 glasses of wine, but perhaps, 40:07 you know, took the lunch to work and had generally a healthy lifestyle, 40:11 which had gotten promoted about three months prior. 40:15 And all of a sudden six out of seven days she was traveling. 40:18 So she was not home. 40:20 She was keeping up with exercise, but she was eating completely differently. 40:25 So no, she wasn't able to carry lunch on the plane as she wasn't able to meal 40:29 prep. And she was eating in airports. 40:32 She was eating at, you know, when she arrived at a hotel late at night, 40:35 she would catch a snack with, you know, something to drink, or she'd be eating
A Patient Case and Practical Gut-Health Changes 40:40 out of the fridge in her room, which would have unhealthy snacks in it. 40:44 So there was this, this big, big change. 40:46 And then she was socializing more because of networking for work. 40:50 So almost every evening she was out, she was at a very fancy dinner, 40:54 and everyone is having 2 or 3 glasses of wine. 40:57 So to keep up, she wanted to socialize and, you know, be part of the milieu. 41:02 And she was now drinking maybe two glasses of wine and night. 41:05 What it happened is she gained weight because she'd kept up with exercise, 41:11 but she had developed as bios in her governmental bar and been thrown off. 41:16 And I said to her, well, given what you're telling me, this is what I think 41:20 has happened, would you be open to trying this through 41:24 a nutritional lens and starting this first while we work on your anxiety? 41:29 So we did, you know, trot and breathwork exercises 41:32 and in a couple of classes and sort of mindfulness 41:35 exercises to help manage the anxiety but also changed her died. 41:39 So we gave a whole plan of how she could manage travel, 41:43 carry healthy snacks, stop at a supermarket and buy fresh food. 41:47 You know, skip every single boss of wine, have one for the evening. 41:52 Or to maybe, but really drink lots of water. 41:55 That looked like a little bit of a cocktail, but it's actually sparkling 41:58 water. 41:58 Gave her tip several lifestyle tips that helped her still be popular 42:02 with her networking clients, but really were helping 42:06 reduce inflammation and had got and help her eating healthier foods, even for, 42:11 you know, taught her 42:12 how to read restaurant menus ahead of time and choose the healthy choices. 42:16 So when she sat down with everyone, she wasn't just getting the stake in potatoes, 42:20 she was actually getting a, you know, plant based build up as well 42:24 balanced, healthy, but rich in those plant polyphenols and healthy fats. 42:28 So it took time, and she was very willing to try this and not take the medication. 42:34 And it was so great to see us working to help 42:38 clear the information in a gas microbiome so that reducing eventually 42:43 she didn't need a medication, but that was highly unusual 42:46 because she was very motivated. 42:48 And sometimes you would have to stop the medication 42:52 to help the anxiety and help and do the nutrition plan alongside that. 42:56 Yeah, absolutely. 42:57 I feel like I have met many similar patients and I'm like, 43:00 you're going to stay on the medication until I know your gut is strong enough, 43:04 and then we'll talk about tapering and that. 43:07 But, you know, it takes the body time to kind of build up 43:12 all these biochemicals, neurotransmitters to start functioning against. 43:17 It's not overnight. And they've got to be patient. 43:19 And and I think that's the key here is to just it's possible but be patient 43:25 with the process and just, you know, with the right guidance there is a way. 43:30 Right. 43:30 So last question I want to make this as concrete as possible for our audience. 43:35 Is someone that's listening right now that's managing anxiety, 43:39 low mood or brain fog and has never once connected the that to their gut. 43:44 What are the three most important changes besides broccoli 43:49 that they can make to what they eat this week? 43:52 Like, let's make it realistic. 43:53 And when might they first notice something? 43:57 If they start making some changes? 43:59 This week of year three recommended changes. 44:02 So I'll go back to what I teach people in the first session, 44:06 which is the swap at work. 44:07 I'd like them to swap one unhealthy habit with its ice cream. 44:11 Not enough vegetables, drinking a soda, drinking and energy drink 44:16 doctrine, enough water that can, you know, all add to swap. 44:20 Swap that out for one healthy habit and easiest thing to do is add 44:24 in more beans and legumes for your plant based protein or more vegetables. 44:28 Plant you know, fiber, nutrients, minerals, helping feed those gut microbes. 44:33 So adding in veggies is very easy and many of us 44:37 just don't need enough eat enough servings of vegetables. 44:41 So that's often the add. 44:42 But sometimes some people 44:43 are want to bring up hydration again, because when you're dehydrated, 44:47 you can feel more anxious. 44:48 So just drinking and sipping enough water is important. 44:51 And the W for work can be a mindfulness practice. 44:54 It could be a breathwork exercise. 44:56 It could be doing 20 more minutes on the treadmill to help 45:00 help you with that feeling of angst. 45:02 I've had patients say to me, when I feel that panic attack coming 45:06 on, I will get on to elliptical machine, distract myself for 20 minutes, 45:10 listen to music and that helps. 45:12 So you can take either any one of those three and start 45:17 with the one that bothers you the most in one of those categories 45:20 to make it easy for you, and definitely doesn't have to be rocky 45:24 if that's what you're you're into. 45:25 But that creates a framework for people to get started, 45:29 and sometimes it's as simple as adding in several glasses of water to your day 45:34 because people, especially where it's been this hot this summer, it's 45:37 just hydrating is so, so important to amazing. 45:42 All right. So we're gonna swap. 45:43 We're going to add the fiber and we are going to stay hydrated. 45:47 So thank you doctor uma. 45:49 This has been genuinely one of my favorite conversations 45:52 because you have given people not just information but permission. 45:57 Permission to understand 45:58 what they feel in their mind might also be a message from their gut. 46:03 And that single trip to the grocery store can be the first step 46:07 towards really feeling better. 46:09 So thank you so much. 46:10 Now doctor Uma Naidoo can be found at her website. 46:14 You umanaidoomd.com and I also encourage you to check out her books, particularly 46:20 This is Your Brain on Food and Calm your Mind with food. 46:24 Now here's my key takeaway for you guys on this episode. 46:28 Your gut is not just digesting your food, it's writing your mood, 46:33 and every bite you take is either sending a love letter 46:36 or sending a warning signal to your brain. 46:40 So stay tuned because coming up next, we've got another great speaker. 46:45 So thank you very much. Thank you.
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