Can you beat depression with food? with Dr. Drew Ramsey

welcome to the doctors pharmacy that is FA RM Acy, a place for important conversations and we are going to talk about something that matters today which is mental health with dr. Drew Ramsey and Drew are an extraordinary doctor, he's not your average guy, he's a farmer, he's a writer, he's a psychiatrist and he's breaking new ground by talking about things that no one really talks about, like mental health and

food

, you guys talk about that , the boys talk about me. He was one of Iowa's accidental psychiatrists, you're the intentional psychiatrist. I got little background. mood and our mental health is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and is in active clinical practice in New York City, so Columbia is not a gawky place, it is His work is quite good and he writes it in an article in New York.

Times Wall Street Journal Huffington Post Psychiatry and Lancet PR, who named him a kale evangelist, not only do they recommend kale, but they also grow kale, which we get into and has been on The Today Show, has been on the BBC and a few TEDx talks, author of three books, eats complete. The 21 Nutrients That Fuel Brain Power Boost Weight Loss and Transform Your Health Another Book Called 50 Shades of Kale Which Sounds a Little Spicy The Happiness Diet I Want to Eat and Their New E-Course Eat to Beat Depression Help every bite goes from New York City, which is kind of the epitome of urban living, to one of the most rural places in America Royale Indiana, where he lives with his wife, children and his parents on their 127-acre organic farm, which is amazing. pretty powerful now welcome draw thank you mark it's a real pleasure to be here with you so it's fun for me to be here with you when I was a little baby shrink.

I had this idea for a book and having ice, you know, God. finished residents, we don't really talk about

food

, does anyone think about this? and there was no one but you and I got that book. I remember I still read it. I remember I was on the plane. I started reading it and thank you. I'm here partly because, well, I wrote that book for consumers or people interested in their health, but actually this was also written with a subtext for doctors because there are a lot of things that I don't think every person would understand like methylation and sulfation and sophisticated biochemistry, but I felt it was important to spread it because when I started practicing functional medicine, I would take care of people's physical health and improve their intestinal function from the nutritional status of the immune system optimizer and help them. balancing your hormones and all these really simple things, simple functional medicine is not what typical doctors do and what happened was people's mental health improved, their brains improved and at first it was a little confusing for me because I was like wow, how did this happen? because there's this thing called the blood-brain barrier and what happens in your body stays in your body, it's like Las Vegas, but it doesn't turn out to be the truth anymore and that's what I jokingly call myself the accident. psychiatrist people with bipolar illness in OCD and ATD and

depression

, anxiety, all these problems get better, they don't just happen, things like Parkinson's and dementia would also get better and I thought, well, what's going on here, so I started really looking at the date and this.

It was ten years ago and there was quite a bit even then, but now I look back and it's like, wow, those are things that were actually in the embassy that no one was talking about and you start talking about this, but there aren't many psychiatrists around. . Talking about the gut flora and the mood or the immune system that is changing, I want to say that one of the interesting things that is happening now is that foods and medicines are becoming more and more or something that is adopted and understand is really critical, especially for prevention, I think you're just seeing more, you know, people talk about the microbiome.

There is a randomized clinical trial for direct clinical

depression

last fall using a probiotic. Randomized clinical trials looking at the Mediterranean-style diet to treat clinical depression, so you know what it is. It was an exciting time and no benefit in this showed a tremendous benefit, it means it shows how much benefit they have. I mean, you know that if you fail antidepressant treatment right now, you will receive one of the treatment protocols that put us on something like abilify in an atypical antipsychotic right increase. and escalation strategy, those are your evidence-based drug protocols, that's what they used to treat schizophrenia, you adapt and then it crossed over.

I like it, I like a vilify for some ego glue, I mean when you need it, abilify could be good medicine. but the interesting thing is that the number needed to treat to get it right and find the right patient for it to work is about 10 with the Mediterranean style diet with trout, the number to get it right to help one person was four and you know. . compare you treat ten people to go get nothing in one person, get one person and get better food, you treat people, food in one is better, it's much better medicine than medicine, I mean you know better, it has fewer side effects and it is what you know if you need a fire in the villa or not.

I think the part that worries me and you is that no one gets food to begin with, no one gets a lot of instructions about food when you go out, taking medications ranging from hey this. is how long are you going to be taking this or hey you know there's a little bit of weight gain let's really dial in your diet we didn't mention food and that's just Hyun Oh beyond the medications it's just a big blind spot for health. and care in general but really for mental health and that your brain consumes more food than any other organ in your body.

In all other fields of medicine you go to cardiologists. You know, we may not agree with the advice they give there, at least they talk. to patients about food gastroenterology they say they eat better yes, they see you better they say they eat better if Edie then she has to eat better eat more carbs oops it's true I mean, I clean the clinic I joke about this and you know they had cardiology there It's not okay I agree with this, but on the floor, the diet when you have a heart attack, the heart healthy diet is a low fat, high carb diet, of course, my dad has a quadruple bypass and an amazing little hospital in Southern Indiana because they really know it. how to do it right there and you look at what they bring you right after and it's like a little bit of hydrogenated soybean oil, you don't know, butter, a whip and a bun and some applesauce, yeah, pretty bad, or pancakes and your cereal, yes, just fry, nothing like that, no. what you would want for heart health No, so how did you train as a psychiatrist at one of the best institutions in the world did you somehow realize that food was relevant and that the hype we had about mental health was not the true story?

Well, I think it's me. I'm a psychiatrist, so let's start with my parents, but I grew up, my parents when I was six moved to really rural Indiana, so I grew up in Crawford County, which is something that they were a part of that return to the agrarian movement. original. I mean, they still have their original copy of Rodale on organic farming and they started talking. It's funny to remember that we are in this time where there is so much fear and anxiety politically and they were in a period like that where people wanted to get away from all their technology, yes, they wanted to get away from man and grow their own food, install panels solar and swimming naked in their pond, you know the things people did in the country, so I grew up there and very much the average farmer, how would you say?

Well you and I maybe know a few different farmers, but you know you take a farmer out on a moonlit night, you never know what happened, okay, so we were in the middle of nowhere. and we built our own house with, you know, a little help and we moved in and started growing a lot of our own food. My dad is a teacher and my mom is an educator and librarian and we settled in this community and when living on a farm like that it just gets to you it was just interesting to move to the city where I missed all this information about the mountain Just the smell of the forest at this time How is this kind of candy phone as small as leaves? decay every season has to smell oh so many smells that are just you know the way the forest just blesses you when you go out and I wrote the first time we were harvesting our honey and my friend Ian, who photographed 50 shades of kale, he He's my good friend, we grew up, he's on the farm at the end of the road and we went out, we said, let's take a break, we're going to walk in the woods, we walk in the woods and there's a huge orange stripe going down one of our little streams and We came over and it was this big bloom of chanterelles, well, and we just came back with pounds and pounds of, you know, these things, really, yeah, really gourmet mushrooms that you know out here in the middle of nowhere, just there and They cost like $30 a pound.

Yeah, and that's right, I think probably my interest in food was because my parents or my dad have always been a label reader and a very healthy guy and paid a lot of attention to what he eats. Mom and dad have done it, so you know, while I was studying medicine, I did training, it was interesting during that period of my life. I was a vegetarian, low-fat vegetarian, I heard the latest advice. Yes, healthy boy. I was in that too. Yes I say it seriously. I think all of us exercised a lot and I ate a lot of cookies and then I trained in psychiatry at Columbia and you know, I mean it's a wonderful institution.

The guy who wrote the DSM Bob Spitzer taught me the mental state. exam, yeah, it's a historic institution for mental health, so it was wonderful to be there and have one foot in that and then also have this other foot that for a long time felt separate and that this was my secret. I'm like in the middle of nowhere, a lot of people call us rednecks or country people or whatever and you can't really let that out and then it's been really nice, it's like it's changed. I don't know exactly, maybe I'm a little more confident, but I also think that as people became interested in food and started respecting farms and farmers, suddenly this wasn't an advantage and in fact it could driving a tractor and chopping firewood and, you know, growing kale and just We talk about food, but you know, we live the reality of trying to grow some of our own food.

You know, suddenly, that was something we could talk about, so that's been really nice for me. My analyst has been happy about that. That's good. Let's get into the topic of food because you've written a lot of books about it, you just published an article in the world journal Psychiatry that is an analysis of food and its impact on mental health, it was a kind of meta review of all the articles that were published. I've written about this and come to very interesting conclusions by looking at both nutrients and foods and how the impact on health and mood is something that is either learned all over psychiatry now or is just still on the fringes.

Well, I think we're learning now, so for the last five years we've had a workshop on diet and mental health at the American Psychiatric Association last year. David Boulais came and the president of our Scientific Committee, Philip, how he did all this well. I wouldn't doubt it, maybe you had something to do. Have you seen his fermentation workshop? He's a man, he's a chef, he's one of the best chefs in New York, well, I mean, it's like, I would say he's like a third chef, a third magician and a third healer because David is a Chef.

Blais is a force to be reckoned with, but he closed his main restaurant, which had been the best restaurant for decades, to start a food as medicine program, yes, and for research, he's been spending all this time in Japan researching fermentation . I think that's a good example of people who would say that we don't talk much about food and we don't know about training programs yet, and that's partly because, like in all of medicine, there is a very slow translation, we were a big problem and how do we quickly innovate, have a research finding and how do we quickly begin to adjust our clinical care model to reflect that research because that's what evidence-based medicine should be, so you would think, wow, a couple from clinical trials, a large amount of correlational data that says!

Food Matters for depression do you think that all centers interested in treating depression would have at least one nutritionist there and I think some do and we are seeing more or a lot of integration yes, I am trying, you know, I have tried to write five good ones I tried continue encouraging, but you know, yes, I am inspired by the places you know, like the Eskenazi hospital, which hasa kale farm on its roof, yes, it's a public hospital and I'm talking about food and I understand you when I see places like that where they start to follow me. and they make an intervention and they see their staff consuming 50 percent more plants and they get excited about it like it's progress, but you're right, it's not happening as much as it should and that's why we're all talking. about it but you know they actually really go oh wait we know you know what your diet is it has an impact on your mental health it's an area like if you go to a psychiatrist any psychiatry nearby but they go yeah I think there is or I think I believe it, you know, I have it, it's funny, I ran into one of my friends who is like a hardcore researcher.

Alex turns off the ski, this guy is like one of these big giant brains. PhD and I punched him in the park two or three years ago, when this grass started growing a little bit bigger and I said, you know, it's me, nod, this is like that, um, and it's backed by science and it's just you looked. He and I

drew

the idea that eating well is good for the brain. Yeah, I think we would all agree with that, so I think all psychiatrists would agree. I think some wouldn't feel as empowered as they should. To put it bluntly, some things are complicated, some things are great biochemistry, but many eat more leafy greens, eat more rainbow vegetables, the kind of things we do, and we eat whole and we eat to be depression when thinking about food categories and think.

In basics like this, it's not rocket science, this is like getting rid of refined processed foods, getting rid of junk, you know, I leave you with it all the time, eat the food that God made, don't food that man can, that's what you know and and I don't agree with his psychiatric license or his psychology license or his you know, wherever in the mental health system he is in to encourage patients, like We do it, many other lifestyle factors give them that boost, yes, elegant, yes, exactly, exercise, they say it works. better than any depressant for exercise, exercise,

beat

Zoloft at 18 months and it's one of the things that I think I love.

I prescribed Zoloft a lot and I find it to be a useful medication for some people or the right people, but you know. What we don't do is not say look, I'm also prescribing your exercise. I want a report next week, right, and that's that we're very good at psychotherapy and psychopharmacology and helping people change behavior, but it just hasn't been something that we've done enough with like, well, the most important behaviors that we actually change, you know, our exercise, food, sleep hygiene and it really makes therapy active in the way that, like, okay, I definitely want to talk about your mom really interesting I want to talk about your dreams. super interesting I want to talk about all your intimate topics interesting but I want to make sure that this week we are thinking about something that we have learned from doing a chain of that type of coaching model of having a coach in my office and I am a little jealous because our patients, You know, they get like we talked about four things here, your goals, and I was like looking at my patients thinking, man, they're going to be a little jealous, leaving my office is like some deep thoughts, but I'm actually getting triggered. and making a silly call to active cycling therapy making psychotherapy an active and engaged process, that's how just tell me more about that, right in that you feel, yeah, I mean, there's a moment. for that in a certain color I mean a good good psychotherapist, I understand what is called from the surface to the depths and the surfaces, there is time to orient yourself towards action, there is time to really support someone and the depth is when you know It's time to get into the nitty-gritty. but what caught my attention is a psychotherapist because I spend 20 hours a week at least doing psychotherapy, it is that knowledge of our deep being, we really have to help patients translate that into behavior in action and correct behavior, a knowledge . of your unconscious mind in my opinion absolutely critical to your mental health look if I trashed my house for twenty years I mean yeah I'm one that I've been it's like I started psychoanalysis when I moved to New York so I'm like a farmer and there I am in psychoanalysis, I did a little bit of psychotherapy and I was in medical school and I would say that it is actually like my secret power, I am well analyzed and when I think about and it is that journey through behavior change to ti translates into a big behavioral change actually translates into a big behavioral change in my sense of how we as men in the world should think about our behavior.

I think it's changed a lot in In terms of my I'm an only child in terms of uh, I think about what that means in terms of how I think about my peers and how I think about my siblings in a certain way, so I find that to be really supportive. powerful and full of nuances. idea, you know, knowing ourselves that way, but it has to be good, I would say it's hard, it's hard to be, you know, not being depressed if your thyroid meant working with your low vitamin DS, well, we can process it, it's Impossible not to be, I mean.

That's what I think so often that you know that's all good or you can work on your beliefs in your past history and your lineage and all that stuff really is great, but it's a lot easier if you're not. fighting these physiological problems, you can't really distance yourself. I understand that you can't get involved in your mental health if you're nutritionally depleted, if you have really terrible sleep hygiene, I mean, you can get involved, but you don't know it. you are moody and irritable or have low energy because your thyroid is off or your b12 is low.

We'll spend a lot of time talking and theorizing why this might be the case when there's really no psychological reason for it. He said your cells are thirsty and hungry and that's when we look at the rates of nutritional insufficiency in the United States. What is a critical factor for the brain? Zinc 48 percent of Americans do not eat enough vitamin E every day, probably one of the most important fat-soluble vitamins. % of Americans don't meet the recommended daily allowance, like whole grains, yeah, you know, I mean, it's like what magnesium, 40% fish oil, omega-3 is great, plus we don't even have a recommended daily amount.

The daily amount of long-chain omega-3 fats, unlike any other developed country in the world, we don't even have a nutritional deficiency rate because we don't have a standard. It's really alarming, especially when people are becoming more and more distracted. They get dragged into all kinds of strange ideas and diets about nutrition, people move away from farms. I mean, I've seen statistics like 70 to 80 percent of all food consumed will soon be prepared by someone else and I think something about you and me. The thing about doctors is we both have chef's knives like another farmer's chef, yeah, well, yeah, you know, you prescribe it, you cook it, you grow it and that's how you know it and that's how I know it, that's really my mind leading by example and so let's back up here for a moment, so if anyone's listening, they have depression, anxiety, mental health issues, what are the ways of eating that actually cause a problem and then when we'll get into what are the Ways of eating that can really solve the problem, yes.

That's a great question, let's start with the problem at the end of the fourth year before we tell you the solution and the problem in unity, its branch, many people know those words that you know, everyone knows. I'm about to say sugar, everyone knows. I'm about to say trans fats, everyone knows I'm about to say processed foods and I'm surprised that's okay, it was all diabetes, sorry, yeah, depression, that's really caught my attention as an interested psychiatrist. in behavior change and as a eater and as a parent, how can you change those concepts from concepts to behavioral and action-oriented elements in your own life?

So what is causing the problem is simply not not getting enough of the right nutrients and I would argue many are missing a set of nutrients Americans are not Americans are not getting phytonutrients these are not eating plants Americans are not eating seafood because they eat 14 pounds per year and they are fish sticks, they are not seafood that they would like them to eat. Don't you know this isn't wild salmon and shrimp ceviche? Yes, and there is also a problem that is not just about the choice of food, but about the missing spirituality of the food and what people have.

We have lost our soul to food and when you tell people to eat well, there is this notion that it costs too much or takes too much time or I don't know how to do it and I write that those are our lost lies, yes. and I think it's just I mean my mom taught me how to cook and she taught me that recipes start with olive oil or butter, garlic and onion, and then you add some vegetables into that and and you're good, right, you put a little bit of meat and the hat, you're good, so a much higher menu, yeah, I mean, I think that's what surprises me with things like when we make our lentil soup in AU. make lentils, carrots, celery and that's it, we put it in a crock pot and I love serving that spread.

Wow, what's here? It's lentils, yeah, a carrot, celery, a little pinch of sea salt, so anyway, that's what's at the end of the fork that's causing the problem is people not eating it in the first place. with the right fork, people don't take a deep breath and activate their digestive system and people in no way offer gratitude or thanks for that, most people. You all are out there doing that, but the number of times we did it when we had that wonderful dinner with really good and we sat there and I'm sitting next to Gabby in the first action and I'm thinking like I've been to the Midwest like you don't eat until you give thanks and I said let's have a moment and everyone is ready to give thanks and their other heads for a moment she said such a wonderful grace for food for us so that kind of thing is not It's just that that garbage is in the, you know, it's not even your fork, it's in the package that you are eating or that is in the way, it's just that we have lost track of where it comes from and in valuing that and honoring it and we are doing a better job, you know, honoring the farmers who grow it, you know who they are, you know, these silent heroes, you know, they talk about a health care crisis, I mean talk about doctor suicide, I mean the biggest threat to farmers right now is farmer suicide.

I mean, they're just losing dozens of farmers a day. It's the number that actually came up. There was a little confusion about who is the group most at risk for suicide. The farmers or the doctors and I think. You know, either way, it's horrible. Is there scientific data showing that sugar and processed foods cause mental illness? Well, let's talk about the data set, there is the big data set and there is controversy about this data set, it is correlational data and the controversy is that it really confused us with a lot of nutrition policy, you know, smart people who look at that.

I really like the writings of Gary Taubes and Peter Attea, who look at the science behind correlational studies and have some serious questions, yes, but if we're going to think about the data being useful, the data being very clear when you eat more processed foods, which means simple sugars and trans fats and a lot of simple carbohydrates in all those ways that you know you're not just Ritter people, it's like you know you know fructose. syrup and well I love corn syrup solids right now they change the name high fructose corn right it was like it sounds like corn like corn syrup or it's all made like maple syrup yeah and those are the things that I certainly don't want people to avoid and what does the data say?

If you eat highly processed foods, you have a 50 to 100 percent increased risk of clinical depression. Oh, if you eat high glycemic index foods, there's a great desk that if you came. from a colleague at Columbia who looks at high glycemic index foods, so they are foods that further raise blood sugar, have a significantly higher risk, people have a higher risk of depression, the Health Initiative Women is such a large study of women 45 and older, etc. there is correlational data and it is consistent when you look at the meta-analyses, it is consistent that the foods that we have created in the last hundred years lead to an increased risk or increased risk in that population of depression, the same data for ADHD, yes, no.

So much data on anxiety disorders, which is interesting but certainly seems clinically true to me, then we went onto randomized controlled trials and the reason it's interesting is on the molecular side, like in the mouse models, you know this and this I mean. you know, not having enough nutrients and putting in a lot of fuel, yes, I mean those responsible, I mean, it's very clear what the press might look like: you put them in little cages and they're still trying and then you put them in swimming is a forced swimming test and when mice are depressed they don't fight to get out they just stop swimming they can drown we don't let them drown but they would drown if you didn't catch them where are the non depressed mice? they're fighting their way out, yeah, that's what a depressed mess looks like, so the randomized controlled trials that have come out recently are exciting because we can say it makes common sense, we can say that on a molecular level it makes a ton of sense, we can say.

Let's say it makes sense in the correlational data, but you and I know that the labeled drugs won't change until we have randomized clinical trials and that's where people like Felice Jaca and Michael Burke and the food and mood center in Australia are really , I would say, the Natalie paar Letta is not part of that group either, but she is part of the leaders in this and they are now doing numerous randomized trials and creating resources for patients with mental health problems like depression, yes, to make sure that is part of the equation and that his data seems quite solid and when I love this is when the data comes out, it is curious that one of the great leaders in psychiatry does not do it. mention it by name but you have been very critical it becomes really crib igg great post on how and some know one of these health drug review websites do you know how bad the trial was or how small it was or is like fighting, everyone always criticizes each other about the study and I was like, "we don't have data," you say there's no data and then when people do a really good test you want to separate them, yeah, and there's a sense of which is almost as if it were you.

I know people really have people unlike paradigm shifts, well I mean how bad has it gotten? It marks that we are in a paradigm shift. We're suggesting that our patients, our neighbors, our families, be okay for things like when they think about their brain. and your mood and your risk of dementia and depression like we've gotten so far down the rabbit hole of medicine that that's a paradigm shift, yeah, so it's not at all and you're right, there's so much data out there. you know, you might be aware of Headlands' job, which was to totally show Captain Joe Joe, he's the latex leader, he calls himself, he's the servant, he's the Surgeon General as a soldier in the Surgeon General's Army. , there you have it and him. he did his incredible studies looking at increasing omega-3, I mean increasing omega-6 fats, refined oils and decreasing omega-3 fats led to violence, homicide, suicide and that changed behavior and I remember that once I came back from you.

I know somewhere and I had a letter on my desk in my office and it was from a prisoner who wrote me a letter, read my book Cultural Metabolism a long time ago and said, "You know, I was a violent criminal in my life and I I realized and understood it." When I changed my diet after reading this book in prison, I don't know how he did it, he realized that he was a very different person. They did studies in prison where prisoners have healthy diets and ultimately reduce crime by 56 percent of the human population. multivitamins reduce crime by 80 percent, well you can do it in prisons, yes, you can see it's the notion that we know we don't approach that correctly, what is criminal activity violence?

So, some of their things we don't understand, some of them certainly horrible character pathology, but some of that when we think that this is a population that in general does not have good nutrition or in general does not learn a lot of mental health skills, you know that There is a way that some of what is happening is certainly just a result of a broken system of mental health care and I would say a broken system of our culture. I've been really inspired this month by Benjamin, the biography of Benjamin Rush, and the reason is because I didn't know anything about Benjamin Rush and Benjamin Rush is one of our youngest founding fathers, he's the second youngest signer of the Declaration of Independence and the only, I think, I think the only signing doctor, yes, and he is our original American doctor that they called.

He was the American Hippocrates back in the day and he's also our original psychiatrist and he founded the first psychiatric hospital and he helped us found this country on a very, very simple principle: when we think about mental illness we can't put people in asylums and they say that they don't have spirituality or that they are sinners or that they are bad people, that we, as doctors, are not going to treat them like patients and we are going to take care of them, and that inspired me to really think. about what's happening in our country and how bad our mental health is and how we all know it and we're finally starting to talk about it, but we were founded as a place where we should be free to talk about it.

I'll get you a cup of Benjamin Rush yeah I think you should read it so draw you wrote that this article was published at 10:00 merit 2018 in the Psychiatric Journal and was actually quite detailed in terms of its analysis of the types of foods and nutrients, so help us bring this home, what are the things that you will learn from there, what are the most important nutrients that we need and one of the most important foods to help us get those nutrients and generally , to help us first. Indeed, disease and so simple that articles called antidepressants, foods and people can look at it and it's an open source article and I do it with my colleague Dr.

Laura LaChance and it's just arithmetic, it's counting beans and we go through all the literature looking at all the core nutrients, vitamins and minerals, and we did a literature search to say which of them have significant evidence that they can help prevent. depression and that they can be used to treat depression and there are 12 that we have found and I bet you could name which 12 are on the market since they are the 12 that we would expect omega-3 fats and zinc and vitamin E b12 magnesium Okay, iron, so we just looked at what a nutrient profiling system is, you just try, it's just a system to look at which foods have the most of those nutrients per calorie and then what makes a good nutrient profiling system. doctor, the possibility that I really wanted to create a good one because interestingly, I think there have been 27 nutrient profiling systems created in the world, some people have seen some like the Andy or the new Val, you know how many have been on health mental and so what we do as a good nutrient journey system looks at food categories, so we're not saying kale, kale, kale, kale, people say well, I don't like kale, hey, I need too much, yes, exactly, oh no, it's toxic now that he has a toxic job, but what we do.

Let's say they're leafy greens and then what we did was we scored, we looked at all the top foods for these nutrients, we scored them and then we created a list of the top plant and animal foods, and so they are, you know. First of all, it's the foods at the top of the list that I think are interesting, like oysters, clams and mussels that are in the top 5 for animals and the reason we choose animal foods is because No nutrient profile system usually has meat or animals in it because everything is usually based on calories and plants always have less calories, but most people eat meat or seafood, so we wanted to give people a list of Which ones have more nutrients, why would these seafood be the best? think about Easter, why are they at the top of the list?

You get 10 to 15 calories per oyster, so let's say six oysters have 60 calories and for those sixty calories you get seven hundred and sixty-eight milligrams of release and omega-3 fats. "You're getting three hundred and forty percent of your vitamin B12, you're getting at least a third of your eye and you're getting five hundred percent of your daily need for zinc, you're getting it and it goes on and on and on." We're getting some vitamin C and oysters, let's go get some oysters, yeah, exactly all of that for sixty calories and that's just, and on the other hand, looking at plants, things like watercress top the list and why only the Watercress has many nutrients, there are no calories, they are very few. calories, and that's a great example of nutrient density, those foods and therefore the food categories that people should look for things like leafy greens, rainbow vegetables, more seafood, and if you eat meat and red meat, look for more wild red meat or red meat fed, so this is fascinating, so the diet that prevents cancer, heart disease, dementia, depression and solves most chronic diseases is the same , it's really should, well, it's where we stay in medicine, we kind of separate mental health and brain health. of the red like you were saying something like somehow the blood and brain barrier was like you don't go through like we don't think that for sure the same all the same activities that we think about in terms of our general health and the foods that we want that people eat and the things that we want people to do move their bodies connect be part of your community yeah that's key to your brain health in your mental health yeah and the problem with you know our food supply is that it is often depleted even if you are eating the best foods you know you have an organic farm soil really matters in food yes and if you are farming and depleting soils most of our soils are more like dust and the dirt, well, they're just like the chemicals and the chemicals out, I mean, it's really, you know if you grow a life, you know if you live off the food that you grow, you don't know, you don't do it that way. manner.

A lot of food is grown and even you know even organic foods are fun to look at if you drive through the production spell and I encourage people to do this and you look and you know you're going to see organic things out there, yes, but no. they like. It doesn't look like a healthy farm, somehow it has a lot of food but it doesn't smell good. The people who work there don't seem happy in a way, it's because of their large organic monoculture, yes. yeah, there's a big monoculture, you know, you watch a video, the soil, if you had orders, great soil, there's a ton of tillage, there's a ton of spent diesel, there's a ton of compaction, yeah, and it's real.

I think it's a challenge right now if the industry Organic is with Michael Pollan, he calls it and in many ways you know it's been a big win because we have a conversation about organic. It's better than I know. Organic was only trying to reduce cancer by 25% of the people who got it. study it well if you do so you know there's something there so it's a step in the right direction but when you think about where I'm from and you drive around our soil is pretty hard in Crawford County but boy do you want to.

I would say that many places mark where we live. If you take a lot of Americans, they wouldn't know they were in the United States because it's just that core notion, the Central American notion of a small farm and what that looks like. and how does that work a few cows a couple of pigs not a monoculture a nice garden for all your food and to share with your neighbors that is diet in a way and I think when Barry calls it the disturbing thing about America, yeah, and I think that well you know maybe dead isn't that, he's on life support and maybe we're seeing a change now.

It seems to come like other smaller farms, I hope so. I mean, it's definitely coming back. You see it, you see it on the coasts. You see it. around the urban centers, but there are still a lot of places that you don't know where it's not happening and that kind of combination of you know, I would say agricultural tourism and interest in food, but also interest in farms, but I'm hopeful, so my question was going along the lines of "Okay, so even organic isn't the best it could be if the food has been grown in a way that creates more starch, many of the phytochemicals have been extracted from the nutrients." Is there no such thing as soil, even if it is the best organic form and, by the way, Dan Barber and Walter Rob, former CEO of Whole Foods, or created a seed company to reinvent new seeds and grow them so that they taste and have La nutrient density in their rich phytochemicals is a very different idea than breeding them for yield there, pest resistance or water for cooking a drought, but they are doing all that too, but they are doing both, so the question is whether that is right, so do we need? supplements and you use nutritional supplements and yourpractice for treating mood disorders, so I believe that even with the foods we have today you can still get all the nutrients you need.

It's actually a challenge if you look at the recommended daily amount and think about what you need. I would need to eat to accomplish that, yes, it's a bit challenging, it requires a bit of thinking about it. Oh my gosh, yeah, I tell people don't just eat nutrient dense foods, you'll be fine, but if you start scratching your head and add enough, you can be tough, yeah, that's the stop. I once had a patient who was like, I don't think anything is like that, so I literally looked at the red food and said, "Okay, selenium, it's in Brazil, so I have Brazil nuts a day like them." it had 17 names of pumpkins, you know, two cups of, you know, broccoli, whatever, okay, if you want to do that, go ahead, let's take a good look at your nutrient levels.

I have this problem where I don't like the idea of ​​flipping a food. into a mathematical equation and yeah, I have myself, you know, I'm 44 years old and I stopped taking all supplements probably about 10 or 15 years ago. I guess that's not entirely true. I'll take I'll take some omega-3 sometimes and certainly in my practice for people who don't eat seafood or for people who just ate seafood from time to time, especially for people who don't want to try medicine, you know, and never have. fact, not even for the people who do. put 1 to 2 grams milligrams of fish oil on them.

I mean the trials that, you know, fish oils are very grounded in science and the kind of studies on depression is one of those things that has statistical significance, but you can't prove it. clinical significance in the meta-analysis that is obtained on a point reduction on a Hamilton D depression rating scale that said you can't take fish oil and eat as a process, yes, exactly put this place on being positive so that know that you know. and you wonder design, well, you wonder, do they control that? You know, now we have all this trimming and lengthening in terms of how we process mega 3 fats or genetic variation, yeah, I mean, there is some.

You also know if you have someone who is a seafood eve or not, but the bottom line It's just that I think there are certain supplements that should be tried, especially when people are struggling with a traditional antidepressant response like many people. Look, they're living on a medication that works like sleep happiness, but they're not eating well and for some reason they're not going to start eating well, so that's a really good example of someone taking a multivitamin or something with zinc. or magnesium certainly anyone has low levels, I mean I didn't feel like you were low, I definitely test your patience, yes, yes, I just don't, is it extreme or not at a given current, maybe it's exhaustive, but I certainly test everyone, I mean.

Do you believe what you are saying before? I think any mental health doctor who fails, I mean, it's negligence if they miss a thyroid problem, a vitamin B12 deficiency, yeah, syphilis. I mean, there are a lot of biological causes of depression and I think you and I see that you get them. sometimes you get lost where it is like that there is not even functional medicine this is just basic medicine everything is good man yes it is good medicine. I mean, you know my practice. I see common deficiencies in your tests or vitamin D, magnesium, omega-3 fats, sometimes iron. yeah, and the B vitamins, particularly around homocysteine ​​and methylation issues, which is this b12 and b6 folate cycle, so I find that giving people a fish oil and vitamin D and maybe a level low magnesium generally has a huge impact and well, do you think if that If you're going to have them change their food right away, there are some that you know require a little bit of time to change the food.

I felt like we were so exhausted that yeah, well, it's hard and it's also really hard when you're depressed, yeah, you know, so I think it's also something that people can do, yeah, because that's how it is. I mean depression causes a lot of carbohydrate cravings and many of you know that we eat, we call it comfort food because the reasoning is that we eat it. when we want to be comforted, right, I mean, I know when I'm in that bad place, man, I am. I'm a macaroni and cheese guy, yes I use some. Sarah told me not to talk to you about carbs, I need to eat my food, but it's um, I think that's something too, the other one that I think is exciting is L methylfolate, it's just exciting the idea that we're actually a prescription drug. for depression, well, it's a deadline, but yes, it's a B vitamin. true, yes sir, but I can't say that it's a B vitamin that big pharma usurps, that's one way I think about it, and that is that yes, you have L methylfolate, which is folate with a methyl group added to it and instead of that it's five dollars, it's 200 dollars, yes, but you can get it for five dollars, you can, you can get it, but the idea is that We are now because this will be the next border mark, as you know, what is the one we are going to do. start to really get into precision psychiatry and that's my new favorite center in Columbia is the Center for Precision Psychiatry there's a center for precision psychiatry there's a center for practical innovation there's a center for women's mental health I want say, we're going to be and there's a new center for media and mental health that's online and precision psychiatry is just that, which there isn't, I mean, one of the things that I think is interesting is that there isn't There is no one, there is no one more critical of psychiatry than our blackboard than ourselves, yes, there is no one. sit with failure see failure well, no one sits with that, you know, until you sit with the wrong prescription for an antidepressant and then you make it right and you know that someone has suffered because you didn't make the right decision when you sit which you want to do well with more than anyone else because that's your job and so it's an exciting time between the new knowledge of the microbiome and psychiatric genetics, which isn't there yet, but man, it's getting close to where I hope watch the tide turn in our methyl mental health epidemic we'll watch the tide turn and then we'll let the epidemic turn yes we won't rest until it's resolved oh no we can't no it's I mean it's the food it's stupid , as you know, paraphrasing a former president, but it's like people don't understand how powerful it is and the impact on how quickly it works.

How do you get people to see it? Because I feel like when we tell people, "Hey, eat well, feel good," they understand when we say you. You know, if you know what I do, I just think you know that often incremental ISM doesn't work because people don't see a change, so people eat shit, you guys just stop drinking soda, but you're eating like shit, right? ? I'm going to feel better, so I usually put people on like ten days, you can do anything, so I put them on basically an elimination diet. I call it the ten day detox diet and you can experience without me telling you the changes that happened in your body and your brain and your mood or energy your sleep and it's fast so generally people can do anything for ten days and then they say oh okay, they have to have it, man, thanks, any good behavior change, again, we can't.

I'm telling you you can't read about it, the studies won't help, the science bit, you have to experience it working and as soon as you experience that extra energy, that's better, what I find is better sleep quality, yeah, ya You know. I'm waiting to hear more mood, more energy, people like you, doctor, I'm really sleeping better, yeah, in all those ways that you know it's different, that makes nothing affect the mood. I would say it's like sleeping, so yeah, it's amazing, well, yes. We were able to change psychiatry and you had some kind of autocratic wand that you could wave and I became the Emperor of psychiatry.

I thought in dsm-5 you would say that every psychiatrist needs to train in functional medicine, nutrition and well, don't do it. I do a few things, one is that America really knows about psychiatry because I think very often when they think of psychiatrists, they think of Freud, they think of an old white guy with a beard and they don't think of our current one. president Alice Stewart, the first African American woman president of the American Psychiatric Association or don't think about my colleague Christina man Gurion, who was like one of those Estella, she's my medical student now she's vice president of health equity and diversity at UCSF and these are women who lead psychiatry and we are diverse and we are desperate to find well, we are desperate for some things well, we are desperate to get better we have many solutions that we have, for example, just you know The number one way to treat schizophrenia or To keep people with schizophrenia really well is not an antipsychotic that helps many of them with the symptoms, but it is a job, which is why there is a program headed by the mental health office at Lloyd Cetera in New York and in the Columbia Center for Practical Innovation looking at that and now making sure that there are 7,000 families in New York that are receiving job support.

Well, yes, I have communications about such basic and simple things that are basic healthcare. things that are happening outside the hospital, yeah, I don't want to, I would like to see more shows like that. I think there certainly needs to be training, I would say not just in nutrition, but also in lifestyle and lifestyle modification. I think that is done. we're dumb in medicine in general and we don't know how to do it and I think a lot of times doctors don't think they should do it and maybe that's true, maybe it's not, but what we need is easy, yeah. and even writing a recipe for food and exercising some systems, that's all they'll do, but developing that ability, I'd like us to do that.

I guess then you want to hear that my number wouldn't change. I guess I came across this. This week, while I've been thinking a lot about mental health innovation, the number one change I want to see is that I want us to stop meeting with patients when they have a mental illness. I want us to start meeting with patients and helping them stay mentally well. The most powerful tool a psychiatrist has is the power of prevention and no one comes to talk to me or thinks about talking to me or fights the stigma of talking to me until they're late and that's great.

I'm going to get better wherever you find me, I'm going to help you get better, but I'm going to help you get better, that's actually the way of saying it, but I hope that what changes and what's changing is we get started. having a language to talk about our mental health and recognizing that we all have this mm that I think people think about people like you and me. One of the things I love about you is that you talk about being depressed and people think you're brilliant. successful doctor you are an innovator II like you don't have depression and it's like no, you know you have it and you have it and that's what I hope changes in terms of the field in the DSM, the diagnosis Simon there are guys smarter than me thinking about that, I think it's just yeah, we're going to have a calculation that the way we've been doing it has been necessary without the DSM, that's a way of labeling people based on symptoms, yeah. meaning they almost have it doesn't tell you why it doesn't tell you why it's a symptom-based approach to diagnosis because we know it's hard, we don't know why, what I love is that Dow just put a lot of effort into them. others.

The idea in psychiatry is not a great idea, even in the new identification, you know, inflammation has a lot to do with depression, yeah, that's been an idea and functional medicine and wellness for 15 years, so yeah is changing and I think we will see more of an integrative model here, the other thing is I just hope that we come out of the shadows a little bit and that we are collaborating and integrating more and more, especially with wellness, yes I agree, I think rethink mental health and then change our meaning. we attach a lot of that that is not always necessarily psychological often is, but it is not always and how do we combine it with a psychological approach that is the original, you know, the original psychiatry, the model that they teach us is the biopsychosocial model and except that they usually talk about the biography, well, you know, the biography is if they leave out some of the violet serotonin, right, that is given in any gift, which is like the worst impression of anything that has ever happened in psychiatry, why What is one of you that knows about hundreds of molecules in the brain?

No one really knows anything about BT and half as BNF is a hormone that mix grows in the brain, that's when we worry, that's what food and exercise is like with therapy, everyone has comments hanging on serotonin, well , dr. Ramsey, it has been a pleasure having all of you at the doctor's pharmacy, you have been listening to dr. Drew Ramsey on the doctor's pharmacy, a place for conversationsimportant and if you love this podcast, sign up to listen to it wherever you find your podcasts, share it with your friends and family on social media and leave a review we'd love to hear. from you and if you want to know more about dr.

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