Patient Education

Nutrition and Mental Health

“What if you discovered that the best place to begin your personal pursuit of happiness is at the end of your fork? Emerging research from the fields of neuroscience and nutrition shows that by changing what you eat, you can improve your mental and emotional well-being. You can stabilize your moods. You can improve your focus. You can even make your brain grow.” – Tyler G. Graham, Drew Ramsey M.D. from The Happiness Diet.

Food is the fuel for our bodies and, most importantlyforour mental health, our brains. While the brain accounts for about 2 percent of the body’s weight, it consumes about 20 percent of the body’s fuel.So thetype of fuel we feed ourselves is critically important for the smooth functioningof our brain and bodies. Imagine putting diesel fuel or kerosene in a car that is designed for regular unleaded gasoline. Think there might be a problem with how that car runs? Same with what we eat. Our nutrition is a critical factor in how well our brain functions, and thus, our mental health.

“Our dietary choices are among many lifestyle habits that can lead to either wellness or chronic disease. Chronic disease accounts for 70 percent of American deaths: half of Americans are suffering from at least one chronic illness, including diabetes, heart disease, cancer, and Alzheimer’s disease…But what you may not realize is that the food you eat and the beverages you drink change your emotions, your thoughts, and the way you perceive the world. Just as important, your mood and perceptions also directly and powerfully influence your dietary choices.” – David Perlmutter, M.D. and Austin Perlmutter, M.D. from Brain Wash

Unfortunately, nutritional science can be controversial and confusing. From Atkins to Weight Watchers, Jenny Craig to Nutrisystem, Whole 30,ketogenic, low-carb, low-fat, high-protein, etc. etc., the options are endless and often contradictory.There are,however, some general principles that emerging nutritional research seems to point to as general guidance. The first is that a calorie is NOT just a calorie. The old belief that “the calories in needs to be less than the calories out” to lose weight and be healthy is clearly outdated.Just because the energy contained in the diesel fuel and the unleaded gasoline are similar, it does not mean the car engine will run as well.

“Science definitively proves that all calories are not the same: Sugar and starch calories act completely differently than calories from fat when you eat them. In a 2018 Harvard study, researchers fed two groups identical numbers of calories, but one group ate 60 percent of calories from fat with less than 20 percent from carbs while the other group had 60 percent from carbs and 10 percent from fat. In the most overweight of the participants, the low-carb, high-fat group burned 400 more calories a day without any more exercise, and while eating the exact same number of calories. Sugar slows your metabolism. Fat speeds it up.

Calories are information, instructions that affect hormones, brain chemistry, the immune system, the microbiome, gene expression, and metabolism. The energy-balance hypothesis is dead—except in the minds of those in the fast-food industry because they have a stake in pushing the idea that weight is all about calories in and calories out. But any third grader could tell you that 1,000 calories of soda and 1,000 calories of broccoli have profoundly different effects on the body.” Mark Hyman, M.D.from The Food Fix

“In the year 1800, Americans ate about 5 pounds of sugar per person a year. 100 years later, our sugar consumption was at 70 pounds per year. Today, the average American consumes around 150 pounds of sugar and sweeteners per year, according to the USDA. We are eating as much sugar every week as we used to eat annually. Studies show that countries with the highest per capita intake of sugar are the countries with the highest rates of depression.” –Tyler G. Graham, Drew Ramsey M.D. from The Happiness Diet.

So generally, limiting sugar and starchy processed carbohydrates, such as bread, pasta, rice, crackers, etc. (that are quickly converted to sugar once they are ingested), appears to allow for optimal brain functioning. And PLEASE, don’t drink your sugar whether in soda pop or in fruit juices.

The second principle that is generally emerging and agreed-upon is the unhealthy nature of ultra-processed food, or what some refer to as “edible food-like substances”. These are generally foods that come in packages or wrappers, often with ingredient lists that are difficult if not impossible to pronounce.

“Depression has long been associated with a poor diet, but the direction of causality has remained a question mark. Being depressed can cause us to seek comfort with our favorite junk foods, but can those foods actually be fueling the fire that’s making us seek them out to begin with?

One of the most encouraging studies was published in 2017 from Deakin University. The study found that, for patients with major depression, cutting out junk foods and focusing instead on fresh vegetables, fruits, raw unsalted nuts, eggs, olive oil, fish, and grass-fed beef improved symptoms by an average of about eleven points on a sixty-point depression scale. By the end of the trial, 32 percent of patients had scores so low that they no longer met the criteria for depression! Meanwhile, people in the group with no dietary modification improved by only about four points and only 8 percent achieved remission.

Since that trial, a 2019 meta-analysis of the small but growing body of literature has confirmed that for even nonclinically depressed people, a nutrient-rich diet (especially one that encourages healthy weight) can have a meaningful mood-boosting effect.” – Max Lugaverefrom The Genius Life

“Eat real food, or if you have packaged food, make sure every ingredient is something you recognize or would have in your kitchen and use in cooking. No one has azodicarbonamide, mono- or diglycerides, BHT, or carrageenan in their cupboards. An egg or an almond or avocado doesn’t have an ingredient list or nutrition facts label” – Mark Hyman in The Food Fix

So eat real food, not something ultra-processed and made in a factory. Eat something your great-great-great grandmother may have eaten.

The third and final emerging principle for optimizing the brain’s functioning is the importance of healthy fats. The human brain is nearly sixty percent fat. We’ve learned in recent years that fatty acids are among the most crucial molecules that determine your brain’s integrity and ability to perform.

“It is true that the fat on our bodies is making us sick and causing us to die too soon. But the seemingly logical leap that the fat we eat creates the fat on our bodies and clogs our arteries is wrong. … The whole idea, which we have bought wholesale, is scientifically untrue. In fact, the science shows the exact opposite. When you look closely at the data, it supports the idea that if you eat fat, you get thin (and reverse heart disease and type 2 diabetes, while preventing dementia, cancer, and other disease processes). The reality is that the more fat you eat, the more fat you lose and the better your body functions.” Mark Hyman M.D. from Eat Fat, Get Thin

First, let’s highlight the one thing EVERYONE agrees on: trans fats are evil. DO NOT EAT ANYTHING with “partially hydrogenated oil” in it.

Now let’s take a quick look at the good fats (then more on the bad):

• Extra virgin olive oil. <— “Liquid gold” is what Hyman calls it. Fun fact: Did you know oil is extracted from olives in multiple pressings? Yep, apparently the first squeeze is the best, hence you want “extra virgin” oil. Other things to consider: organic, cold pressed is best and store it somewhere dark and cool
• Extra virgin coconut oil. Coconut oil, Avocado oil(and MCT oil) are super healthy. Great for cooking and Dr. Hyman calls MCT oil “superfuel for your cells.”
• Fats from whole foods like avocados, nuts and seeds.Also from wild-caught salmon and other fatty fish, grass-fed beef and butter, and pasture raised pork.

The bad fats? Vegetable oils. Corn oil, soybean oil, canola oil, safflower oil, sunflower oil, peanut oil…

Vegetable oils were almost unknown in the food supply at the turn of the 20th century.

Now? Did you know America consumes 18 BILLION pounds of soybean oil per year? Yep. A whopping 20% of our calories come from soybean oil (TWENTY PERCENT!!). Soybean oil is in almost everything and it is 50% linoleic acid which is an inflammatory omega-6 fat.

It’s important to know that our overconsumption of vegetable oils which are high in omega-6 (and are in basically ALL processed foods) contributes to an imbalance in our omega-3 to omega-6 ratio which contributes to inflammation which is the root cause of a ton of problems. Addressing this is super important. Eliminating veggie oils and replacing them with the good fats is a wise step for healthy brain functioning. Emerging research shows that these oils may even be toxic to our mitochondria, the energy producing parts of our cells.

Now, any nutritional advice must always come with the caveat that different styles of eating works differently for different bodies and body chemistry.So you need to find what works for you and be willing to experiment within these broad principles. And certainly, if you are being treated for diabetes, renal disease, or any other medical conditions that nutrition and diet may affect, you need to work with your physician to monitor things closely as you embark on any lifestyle change. Many of the books in the recommended reading section have meal plans to start your journey, including healthy and delicious recipes to explore.

And finally, and most importantly, be easy on yourself. Making small but consistent changes is the key to any long-term lifestyle change. All of the research shows that going on some crash diet with a fast dramatic weight loss and with eating patterns that you will not be able to sustain in the long run, will just cause frustration and likely will result in you reverting back to the unhealthy eating patterns you were trying to change in the first place.

References and recommended reading

The Happiness Diet, A Nutritional Prescription for a Sharp Brain, Balanced Mood, and a Lean, Energized Body. Tyler G Graham and Drew Ramsey MD

Food Fix, How to Save Our Health, Our Economy, Our Communities, and Our Planet–One Bite at a Time. Mark Hyman MD

It Starts with Food, Discover the Whole 30 and Change Your Life in Unexpected Ways. Dallas Hartwig and Melissa Hartwig

The Genius Life, Heal Your Mind, Strengthen Your Body, and Become Extraordinary. Max Lugavere

Eat Fat, Get Thin, Why the Fat We Eat is the Key to Sustained Weight Loss and Vibrant Health. Mark Hyman MD

Fat Chance, Beating the Odds Against Sugar, Processed Food, Obesity, and Disease. Robert Lustig MD

The Case Against Sugar. Gary Taubes

Bright Line Eating, The science of Living Happy, Thin and Free. Susan Pierce Thompson, PhD.

The Fatburn Fix. Boost Energy, End Hunger, and Lose Weight by Using Body Fat for Fuel. Catherine Shanahan MD

Brain Wash, Detox Your Mind for Clearer Thinking, Deeper Relationships, and Lasting Happiness. David Perlmutter, MD and Austin Perlmutter, MD Grain Brain, The Surprising Truth About Wheat, Carbs, and Sugar—Your Brain’s Silent Killers. David Perlmutter, MD