Vital Choice founder Randy Hartnell discussed brain food with TED-talk star Drew Ramsey, M.D. 12/21/2017
Unfortunately, many Americans aren’t eating right for brain health, and that was the focus of Vital Choice founder Randy Hartnell’s interview with psychiatrist Drew Ramsey, M.D.
Dr. Ramsey is a new voice in the emerging field of “nutritional psychiatry”, which rests in part on findings from Vital Choice advisors like brain expert Michael Crawford, Ph.D., and NIH psychiatrist Joe Hibbeln, M.D.
People’s mental acuity and mood face daunting challenges from today’s toxic combination of multitasking, poor diets, excessive sitting, and sleep deprivation.
We've covered some of the research in this field ... you'll find more on that at the end of Randy's interview with Dr. Ramsey.
The following is an edited transcript of Randy’s interview with Dr. Ramsey.
Dr. Ramsey, thank you for making time. Please introduce yourself and talk about your affiliations.
I am a psychiatrist and physician based in New York City. I attended Columbia University Medical School — where I never had one class about nutrition — and I am currently a faculty member at the University.
For the past 10 years, I’ve worked with patients who suffer from depression, anxiety, and bipolar disorder. I am currently spearheading a nutritional psychiatry movement to help clinicians incorporate food into their practice.
I am also the author of several books, including The Happiness Diet, Fifty Shades of Kale, and most recently, Eat Complete, the first nutritional psychiatry cookbook. It is specifically designed around a core set of foods that have the most of the 21 nutrients that are most highly correlated with brain health.
In 2015, I gave a widely acclaimed TEDx talk on nutrition and brain health entitled "The Brain Intervention at the End of Our Forks".
Can you tell us a bit about your concept of “brain food”?
Your brain is made of food. People who are missing certain nutrients are more prone to mental illnesses and psychiatric illnesses and brain-based disorders.
Your brain is your most important asset, so it's been very exciting to see this nutritional psychiatry movement take hold, especially with the first-ever randomized clinical trial — the SMILES study [see reference below*] led by Dr. Felice Jacka — demonstrating that dietary interventions can work for depression. And it comes on top of a tremendous amount of data linking how you eat to your risk of things like depression.
This is very exciting, especially with how we think about disability. The largest driver of disability is brain-based disorders, specifically depression and suicide. You tend get these illnesses when you're young, unlike heart disease, cancer, etc. which you generally get much later in life.
Depression and anxiety disorders really can derail a young person, and it hits when you're 15 or 16, in those very vulnerable years. The hope is that food is a piece of the equation. That's what basic biochemistry and common sense tells us. And now we have the evidence. But we have to translate that evidence into very active interventions with patients.
You discuss living in an era of “food fear”. Can you explain what you mean?
We totally live in an era of food fear. Sugar is toxic, and this food is horrible, etc.
Our hope is to help people restore a sense of ownership, and food joyfulness and confidence around food, and then to spread that.
It’s not just you eating a great meal of wild salmon, kale, and quinoa. It's the sharing of that. It's the difference between going to the supermarket, and going to the farmer's market, and what that emotional experience is like for you.
To that end, we've created an e-course "Eat to Beat Depression" with the notion that there is a core set of foods that we really want to emphasize.
I wonder if you could talk about an "A-ha," moment you had.
The first "A-ha" moment I had was very hard for me. I was a very young psychiatrist working in New York City, and I was running one of Columbia University's large day programs for individuals who have severe mental illness.
The class of medications that had come out were the so-called “atypical” antipsychotics, which caused a lot of weight gain. I wasn’t feeling good about what I was doing because although my patients’ mood would get regulated and their voices would go away, they'd gain 30 pounds and their blood sugar would go up. That did not feel like I was adhering to my credo of "Do no harm."
I remember clearly sitting with a man and telling him, "You should stop eating so much fat. You should stop eating cholesterol." Basically, very unhelpful advice. I remember he left the room, and I decided that it was time to change something.
A few days later, I was in my private practice and I was speaking with a woman who had been in psychotherapy with me. She was describing what she was eating, and it was very focused on weight loss and no cholesterol.
I had this idea pop into my head. I tried meds and they'd help some, but what would be the happiness diet?
I realized I didn't know, so I went on a quest to figure that out of what the literature says. What does biochemistry and common sense say? That has led to the last several years of collaboration on food and brain health that we've presented at the American Psychiatric Association Conference for the last five years.
Some other "A-ha" moments that stick out include the first time I wrote out my first prescription. It was on a little three by five card.
I just wrote some foods that this young man liked that he wasn't eating, things like lentils, avocado, and basic brain foods. It was the first time I told somebody, "You should eat this."
Another "A-ha" moment came recently with a woman who had a really severe, resistant depression, and is on a number of medications that are very helpful to her. But she wanted another layer of help, in terms of her mood and her resilience.
She’d never cooked before, was scared of food, and had a cook who cooked most things for her. Over the last month, she’s transformed her health. We have a health coach and chef who works in our clinic — Samantha Elkrief — who went into the woman’s home and did an assessment. The woman didn’t know how to chop vegetables! That’s critical because it's really easy to tell people to eat more vegetables, but if they don’t know exactly what to do with them, it's very hard for a patient.
She was nervous about going to the farmer's market. But now she's chopping vegetables like a champion. So is her child. And they're engaging around food. They're eating together. She's cooking for her family. She feels empowered.
It's those “A-ha” moments, when people reach out to me via our website or online, and share some story of how food helped them through a tough time.
There’s so much focus on how ill we are that I feel like we forget to emphasize the health inside each of us. I think our job in medicine is shifting to helping people seek that and find it, not just to take care of symptoms and illness.
I find myself in conversations with a patient about how food plays a role in their life, and suddenly we're joking about recipes. We're joking about how do you massage kale. We're talking about could you get a little more zinc in that smoothie, and have you heard about the benefits of pumpkin seed. It's this kind of collaborative creative work that kind of squishes the hierarchy.
No longer am I the doctor and you're the patient, because I never liked that. That never felt good to me. But we're both eaters, using food as a vehicle to do that in a wonderfully, resilience-building way.
Hippocrates, who said “Let thy food be thy medicine and thy medicine be thy food” would be proud. And farming's cool now. There's even one in North Brooklyn, called the Brooklyn Grange, that overlooks the Manhattan skyline. It doesn’t get any better than that.
How do you build a better brain and when should you start?
You build a better brain by understanding the direct impact of food, nutrition, lifestyle, exercise, and mindfulness in your health.
When we guide people through our eat/defeat depression course, we start with assessment, what I call low-hanging fruit. It's where can we make some changes. Can you switch out that sugary snack for some nuts? Even if it's nuts and dark chocolate, that's better.
You build a better brain through an idea of nutrient density, so you get more nutrients per calorie.
A good example of nutrient density is to compare a 12-ounce soda (140 calories) that has no nutrients for your brain with a kale salad (also 140 calories) that has three cups of kale and a little olive oil.
But with those 140 calories, you're gonna get 1,500 percent of your daily vitamin K, 600 percent of your daily vitamin A, and 390 percent of your daily vitamin C, plus fiber, a little protein, and all these interesting phytonutrients like sulforaphane and folate. You get more absorbable calcium than you get in a carton of milk, and on and on.
Our brains get fed far fewer “empty” calories and that transforms our health, so we work on helping people translate single nutrients into foods.
For example, folate is very important to brain health, but most doctors and patients ask, "what foods are top in folate? They don't say lentils but they are a staple, in part because they're so nutrient dense.
Also, wild salmon fits the bill because its long-chain omega-3 fats are key to brain health.
I have a 6-year-old and a 3½-year-old, and we know, based on the research of scientists like professor Michael Crawford and Dr. Joe Hibbeln, that the most critical time, in terms of outcome, is when people are thinking of conceiving or when women are pregnant. Kind of like a farmer, you have to prepare the soil for optimal growth.
I also like to emphasize that you can transform your health at any age.
I’m not talking about blind hopefulness. I sit with people and I see them on the brink of taking their own life, tearful, unable to think, unable to sleep. And then I see them a month later, with a small vibrancy, without symptoms, as a full-functioning wonderful human. You see this contrast and it’s amazing.
It's very clear for me that incorporating food has made me a better clinician. It's made my patients healthier, and it's made my professional work richer.
If you help someone shift their dietary patterns as you provide them some of the information, as you give them a core set of foods like we do in Eat Complete, and some recipes to get started, that that really leads to a lifelong dietary pattern of nutrient-dense brain food.
As Dr. Mark Hyman likes to say, eat the food that God made, not the food that man made.
Back to that question of how do you build a better brain. We focus on food categories and we see that people are missing seafood, leafy greens, and what we call rainbow vegetables.
One way to know whether it's a brain-food plate is look at your plate. Does it have a lot of natural colors on it, and does it have a lot of plants? And ideally crunchy plants. People should also eat more nuts and certainly beans and legumes.
I was speaking with Dr. Amudana Sanchez Viegas, and I asked her, “What should Americans do?” And she said, "You know, beans and legumes. Lentils and beans are just missing in Americans diets."
Fermented foods are something we also emphasize, helping people understand the importance of what we call the good bugs in Eat Complete. Those are the main food categories that we tend to front load into our interventions.
The final common pathway for building a better brain is a brain-derived neurotrophic factor (BDNF), which is a growth hormone for the brain.
There are a number of nutrients that directly induce BDNF, especially omega-3 fats from seafood and the antioxidants in plant foods. One of the reasons plants are so healthy is that these antioxidant nutrients are telling the brain to grow, connect.
You're obviously very passionate about this. Why is that?
I'm a farm boy at heart. My parents, in the late 1960s and early 70s, were part of the "back-to-the-land" movement. We were living on Long Island, and they bought 127 acres in rural Indiana and wanted to live off the grid. So, I grew up in the woods, and grew up farming. I still smell my mom's tomato sauce, or even just think about it, and I start to salivate. It's like a Pavlovian response.
I went into medical school, and I was a low-fat vegetarian and I really cared about my health. I was an athlete in college. I pole vaulted and played basketball, and really didn't incorporate that into my professional work. I was worried people would think I wasn’t a serious doctor.
I think I got passionate about it when I finally merged those personal and professional lives and understood that everybody cares about food, along with the fact that I believe in it and I think it works.
My engagement with food has enriched my life in so many ways, and talking with patients about food has taught me so much, and getting involved in nutritional psychiatry has helped me create a network of professional colleagues who I just adore and learn from.
It's really been a pleasure to talk to you.
Thank you so much.
NOTE to our readers: We urge you to visit Dr. Ramsey's website.
*Jacka FN et al. A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial). BMC Med. 2017 Jan 30;15(1):23. doi: 10.1186/s12916-017-0791-y.
As promised, here are links to some of our past reporting on research into the effects of diet and lifestyle on brain health and mood.
Lifestyle & diet: Can Dementia be Defeated Naturally?
- Junk Sleep Hurts You as Much as Junk Food
- Need More Sleep? You're Not Alone!
- Suffering a Lack of Sleep? Try Seven Secrets
Foods and diets:
- Miracle-Gro” for Your Brain
- Food for Your Mood
- Women's Depression Tied to Junky Diets
- Top Psych Panel Says Omega-3s Deter Depression, Bipolar Disorder
- Live Cultures May Lift Mood
- Turmeric (Curcumin) Targets Stubborn Depression
- Omega-3s Show New Benefit for Mood Health
- Omega-3s Enhance Mood and Brain Speed in Clinical Trial
- Omega-3s vs. Depression: Do they Really Help?
- Chocolate Sparks a Key Brain Protector
Multitasking: Does Media Multi-Tasking Fray Your Brain?