Welcome to a new episode of the evolution radio show Nutrition and our mental health have a connection but this is not mainstream yet. That is why I am delighted to have psychologist Dr. Georgie Ede as my guest. She got her education at the Harvard Cambridge Hospital where she was educated as general adult psychiatrist and worked until 2013 in psychopharmacology She left 2013 for Smith College, North Hampton Back then she was the first and only that gave students and faculty nutritional coaching as alternative to medication. Her speciality is the ketogenic diet, paleo diet as well as food intolerance and she coaches students and faculty for better mental health Her focus is on the effect of foods on the brain chemistry, hormones and metabolism She writes for psychology today and her website diagnosisdiet.com We talk about the influence of food on mental health Why does it make sense to think about nutrition when you have a mental illness, like depression bipolar disorder, ADHD, psychosis or fear We also talk about anti-nutrients in plants and why animal foods are so important for brain health. Enjoy the episode and I am looking forward to your comments. [INTRO] Georgia, a very warm welcome to the Evolution Radio Show. Thank you very much for inviting me, Julia. Thank you for coming and for you taking the time to share your knowledge. And so we just met a few weeks ago in Switzerland at the Keto Live Conference. Very interesting and a wonderful and great event. But you are a psychiatrist and you are interested in nutrition. And you’re working with nutrition and helping your patients with nutrition. But before we get into the nutritional aspects, I would really like you to tell my listeners a little bit about your background and especially what got you interested in nutrition and since psychiatry and nutrition, that is not a logical connection. So when I was in medical school here in the United States, four years of medical school, the way it works here is four years of medical school. And we had maybe two or three hours of nutrition education in four years of medical school and then four years of psychiatry residency training. We didn’t talk about nutrition at all. Not once. So when I finished my training, I didn’t think about nutrition and psychiatry. I didn’t think about the connection at all. And then I practiced for a number of years. Different settings, mostly university settings, Harvard University, where I trained, and Smith College and private practice and general clinics and hospitals, many different places, but never used nutrition until I had my own health problems in my early 40s. And I went to all of my very smart Harvard doctors and they could not help me. So I had fatigue and digestion problems and migraine headaches and sleep problems and all kinds of things and chronic pain. And I had, I was exercising every day and I was eating the way I was told to eat low fat, low cholesterol, high fiber diet and lots of fruits and vegetables. And I still was not feeling well. So the doctor said nothing is wrong. All of the different doctors, I had many, many tests. And so I I just decided that I would try to experiment with my diet to see if I could help the digestion problems. And so I experimented with the diet over about six months. I just kept right. I wrote everything down that I ate and all the symptoms that I was having. And I just experimented. And after about six months, all of everything, all of the problems were gone. I felt fantastic. And the diet that I ended up with was mostly meat and very low plants. And, you know, no dairy products, no soy products. It was fair. No grains, no beans. All of these things I used to eat and I felt wonderful. And but the interesting thing as a psychiatrist was I felt better emotionally and I felt clearer. I could think better. I was not anxious. I didn’t I used to get depressed in the winter time. I that did not happen anymore. My sleep was good. My energy was good, my concentration. So I became very curious about why this diet would be good for the brain. And if I could use this diet to help my patients, which ever since that was two thousand seven or two thousand eight. So more than ten years ago, I’ve been using nutrition, studying nutrition and writing about nutrition and using nutrition with my patients. Ever since then. That’s super interesting because especially if you think about it, the dogma is: the brain needs glucose. You know. And then you’re changing your diet to a more or less carnivorous kind of diet, very low in plant, very low in carbohydrates and you function better. And you see all those improvements. You know now I eat almost no plants now at all. But ketogenic diet – extremely low carbohydrate, almost no carbohydrates, most days zero, and it’s even better. So I use the ketogenic diet with my patients very, very often. Yeah. We will dig into that a little bit later, but at the at the conference, you talked about the connection between food and the brain, kind of you defined your work as nutritional psychiatry. Yes. People might probably never heard about that term ever. But there is that. Are you kind of, you know, the first one working or defining that field that there is something like nutritional psychiatry? Do you feel like you’re a kind of a front? You know, you’re out there. That’s the frontier. I think I’m part part of a very small, very, very small group. There’s maybe about half a dozen, maybe five or six that I am aware of in the world who are using metabolic psychiatry, looking at brain metabolism, particularly low carbohydrate diets. There are very, very few of us, maybe even less than six. I would have to count in my head. But yes, this is a brand new field and we need many more psychiatrists to become interested, which is why I like to go and speak at conferences, try to get the information out because it’s so helpful with patients. Much more helpful than most medications. Often. From what we or you now know, what’s your hypothesis or your thinking, why would Ketogenic or very low carb or low plant based diet work in mental health or in psychiatric conditions? What’s your hypothesis? Yeah. So my hypothesis is particularly about the low carbohydrate diets. Most people don’t need to remove most of the plants. That’s if you have a lot of food sensitivities that can be helpful to remove a lot of the plants. But for most people, simply removing most of the carbohydrate will be extremely helpful. And the reason for that, there are three – many, many reasons – but there are three big ones. And one is that when you when you stabilize your blood sugar levels, your blood glucose, that takes your brain off the roller coaster. And so the blood sugar and insulin levels that are going up and down all day. If you eat a regular diet, you’ll get big spikes of glucose and then crashes in glucose all day long. And insulin too. Insulin is a hormone. It’s a master hormone that controls many, many other hormones in the body, including the stress hormones, for example. And so many people, when they’re eating this way, will have their mood will change throughout the day, their appetite will change throughout the day, their energy level, their concentration. And it’s very disruptive. And sometimes people will think, oh, I must have bipolar disorder, I must have a mood disorder when or their sleep will be if you eat this way, you may have a big spike and a big crash even in the middle of the night. This can happen. It can wake people up and they feel panic, anxiety. So just stabilizing the blood sugar is half of the of the benefit. And then the other two reasons are that when you have a lot of you have too much blood sugar or too much insulin, you have inflammation and oxidation in the brain. And these are just it’s the biochemistry of the brain. It will cause a lot of internal damage to microscopic damage that is at the root of most psychiatric problems is inflammation and oxidation. And a lot of that comes from processed food, sugars and vegetable oils like soybean oil. And then the third reason is this insulin resistance, which I’m sure you talk a lot about, is that the more sugar you eat and the more insulin you have in your blood, the brain can become resistant to insulin. And that means that the insulin can’t cross the brain. So the sugar goes in, no problem. But the insulin can’t get in as easily. So the brain cannot use the glucose without the insulin. So you have high blood, high brain glucose, but low brain insulin. And this is a huge problem because then the brain is starving for energy. It cannot turn the glucose into energy. And this can over time lead to very serious problems like Alzheimer’s disease, dementia, Parkinson’s disease, risk increases. And most of our psychiatric diseases, we are slowly learning are related to this problem with the brain processing glucose. Just to sum it up, so there is the energy component on one side and the stable, the stabilizing of the blood sugar and stabilizing of insulin levels and not having those spikes and those. Yeah. That blood sugar rollercoaster. That’s about that’s one part. And the other part is regulating inflammation and the part with the insulin resistance. Exactly. And you just you mentioned it briefly that the insulin resistance in the brain is a little bit different than insulin resistance in the rest of the body. Can you explain a little bit deeper? What’s the problem with or where are the differences? Yes. So in the body, a lot of people are familiar with type 2 diabetes. What happens in the body with insulin resistance is that normally if you eat food, especially food that contains carbohydrates, you will get your body will release insulin into the bloodstream and that insulin helps the glucose axe, when you eat, you’ll get a glucose spike from the carbohydrates. The insulin is released to tell the body what to do with that glucose. And in the body, for example, will tell the fat cells or the muscle cells to unlock and let the glucose in so that you can burn it for energy or you can store it as fat, or you can use it to build new pieces of the cell. So the insulin unlocks the cells and lets the glucose in the glucose cannot get in easily without the insulin. So in the body, what happens slowly is that the cells have a harder and harder time using the glucose and the glucose will, they won’t let the glucose in and the glucose will pile up in the bloodstream. The brain does not need insulin to let the glucose in. The glucose walks in. No questions asked because the brain needs a lot of energy and some of that energy must come from glucose. So the brain has no barrier. It says, please, glucose come in. We do not need any insulin. Just please come in. So if your blood sugar is very high, your brain sugar will be very high. It’s always proportional, always directly. You have high blood sugar, you will have high brain sugar. But if you have high blood insulin, it’s the insulin that has a hard time getting into the brain. So because the receptors that let the insulin into the brain become resistant, they become damaged or smaller numbers of them. And so the insulin, the glucose comes in, no problem. And that high glucose, every time you get a blood glucose spike, you get a brain glucose spike and that’s causing inflammation and oxidation inside the brain. And then to make it worse, you have not enough insulin to process all that glucose and turn it into energy. So you have a brain which is surrounded, swimming in glucose, starving because insulin. So this is the big difference from between the body and the brain. I am very happy that you’re clear, that you explained that because there’s a lot of misinformation and/or half-knowledge about the whole insulin resistance in the brain. And that’s something a lot of people get, you know, kind of pushback. If they say that the brain is going to be or it becomes into insulin resistance, then that will be, you know, the brain does not need insulin to get the glucose in. Yes, but for different things. Exactly right. Misinformation is the right word. So many of my patients will say, well, I need to eat sugar because I have to feed my brain sugar. Well, as you know, we don’t have to eat sugar to make blood sugar. We can make blood sugar out of fat and protein. Yes. So that’s easy. A lot of people also think, well, if I can’t think clearly, I can’t concentrate, I should eat more sugar. But the more sugar you eat over time, the less you’re bought, the less your brain can use it. So it actually works against you to eat more sugar. And a lot of people. It’s the opposite. So this is a big problem in changing the education. [ADVERTISEMENT in German for brain-effect.com] In your work with patients are you using, is it necessary to go to use a ketogenic diet and are you going for that? And so my follow-up question would be how low would you recommend usually to go with the carbs and what kind of? And the whole plant food issue, would you recommend going full blown carnivore or would your just try to slowly decrease, blend food and see where you are? Or just the other way round? Go full carnivore and increase slowly in some kind of plant food like in the elimination diet. What’s your take on it? Most people are in two categories. There’s this category of they want to do 100 percent. They want to do all at once. Let me take everything out and then gradually put things back in to see which things are bothering them. So some people who consult with me, they want to do a carnivore diet as an experiment and then they can put back one plant food at a time to see how that goes. Other people are one at a time people and they want to start here and take one thing away at a time. But I recommend for everybody, I sort of have these five different levels. So I recommend for everybody. Take out all the processed foods, everybody. I don’t care who you are. Nobody should eat those. They are poisonous. Sugar flour,, fruit juice, cereal – take it all out and adjust. That’s food deficiency. Exactly! It’s very, very important. Even if you make no other change, even if you don’t want to do low-carb, just take the processed food out. And when you do that, you have sort of what they like to call kind of a Mediterranean diet or similar to Mediterranean diet, which is really a lot of people think, oh, Mediterranean is olive oil and nuts and wine. Well, it’s really also almost no processed foods in the Mediterranean. It’s very low in processed foods. And I think that’s why it looks a little bit healthier in the States. But so that’s where everybody should start. Well, the next level down is a paleo style where you take out all the modern agricultural foods, so the grains and the beans and the dairy products and take those out because that’s a much more nutritious and a safer diet for the body and for the brain, because we are very well adapted, evolutionary from an evolutionary perspective to digesting and using those foods. When you have a lot of grains and beans, they are working against your nutrition. They make it hard for the brain to get nutrients. So they’re very low in nutrients themselves. They’re terrible sources of most nutrients. So they remove those. That makes a big, big difference for a lot of people. So the first step is no processed. The second is try the paleo. The third is low-carb. Now, if you have insulin resistance, I think you should go directly to low-carb. But not everybody has insulin resistance. Some people may not need to be low-carb. It’s safe for everyone with very, very few exceptions. Very few exceptions, safe for everyone. But not everybody wants to do this and not everybody may need to do this. But this is really important. If you have damaged carbohydrate metabolism, even as paleo diet is going to have too much natural sugar in it from fruits and from root vegetables. So if you have insulin resistance, this is it, low-carb is good. And then and then below that you have the more carnivore, low plant or carnivore diet. So if you do this low carb paleo diet and you still don’t feel right, then you might have some sensitivities to plant foods like nightshade, which are things like tomatoes and peppers and eggplant, or you might have the sensitivity to other kinds of plant foods. And so. for some people it’s very important to experiment with low plants or even no plants for a little while to see if that makes even more difference. So some people do this like this and some people do this like this. Would you say that if you have depression or ADHD or bipolar disorder, would you go straight to Keto or? This is an excellent question. It really does depend on the disorder and the severity of the disorder and whether or not the person has insulin resistance or other problems they have. But generally speaking, if you have a serious mental illness, that is maybe you’ve been in the hospital, maybe you are unable to work because of serious depression, suicidal thinking, or if you have a psychosis, symptoms from schizophrenia or similar psychosis symptoms. If you are really struggling, then I think a ketogenic diet is really worth trying because serious mental illness in most cases suggests that the brain metabolism is very damaged and not in every case, but in many cases. And so the bipolar disorder, for example, true bipolar disorder they used to call manic depression, very extreme moods is very similar to epilepsy. And we know that ketogenic diets are really very, very powerful treatment for epilepsy, so bipolar disorder… I think a ketogenic diet is a very good place to start for psychotic disorders. I think it’s a very good place to start. But these other sort of mild depression, mild anxiety, ADHD… Sometimes those are just food sensitivities and sometimes they are just a lot of junk and a lot of processed foods and too much sugar. It is just getting rid of the, you know, just cleaning up the diet can make a big difference. Some excellent studies in Europe, many years, maybe 20, 30 years ago, many of these ADHD in children… If you could clean the diet and just eat simpler foods, Whole Foods, then a lot of these kids, two thirds to three quarters of children know very, very significant improvement in ADHD or sometimes even completely disappear after a couple of weeks. So the milder conditions sometimes. And then there are cases of psychosis, schizophrenia, where all you do is take the gluten out, just take out the wheat and it disappears. So there are these exceptions. But I think there is, by the way, for your listeners, there’s on the dietdoctor website I have a guide, four different episodes. If you are taking a psychiatric medication and you are trying a ketogenic diet, please read that first. It’s free. Yeah, I will link to it in the show notes. Good. Because if you take medications, the Keto diet is important to pay attention. As you mentioned that would you recommend that someone who is really is on medication should consult with his psychiatrist, just let him know or her know that he or she is trying something different? Absolutely. The medications … and this isn’t a problem with the diet, it’s a problem with the medications. And so if you’re not taking a medication, it’s very safe to try ketogenic diet. But if you have a serious mental health problem and you’re seeing a therapist or a psychiatrist or a nurse, you should tell them and talk to them first, because there is this transition. The first few weeks can be very… It’s a very powerful intervention and it can change your brain chemistry very quickly and your body chemistry. So the first couple of weeks can feel difficult. People they can become more anxious or more depressed while they’re changing their diet. You want extra support and have somebody help and work with you to make sure if you’re taking a medication, the diet can change the level of the medication, the amount of the medication in the blood very quickly, because it’s such a powerful intervention. And so for some medications, this can cause temporary problem. And whoever is prescribing your medication can adjust the medication so that you don’t have any problems with them. That’s really important to mention that if someone takes medication, it’s very important to talk to the doctor about it. One thought I had about a ADHD. Exactly. I think sometimes it’s like, you know, the children are getting all those sugars and really they sit, they’re forced to sit, I don’t know, six-eight hours a day. It’s totally not evolutionary. We’re not made for that. They are forced to sit at a very young age and then they are just bombarded with sugar and with all those, you know, with all of those, you know, social media and TV and everything. And I think it just adds up. And then my mom, at least that’s my hypothesis that it’s just a manifestation of children not living in an evolutionary setting. And just they are just fed the sugar and it’s like, you know, it’s like an energy drink. It’s like I’m giving the children a lot of lot of energy and not letting them, yes, spend it. You’re exactly right that, you know, we’re not designed to be sitting down all day. I mean, kids get restless and they want to go outside and play and they say “No, sit in your seat and listen”. And then you and then we think of these food. We think of processed foods as foods for children. Yeah, it’s crazy. We use boxes and cereals and yogurt with sugar and everything with bright colors. And we think of cereals. We think of these things as for children. This is not good food for children. This is poison literally within the brain. And even worse, they’re very addictive. You are you were then teaching your child to have an addiction to sugar at a very young age. That then becomes very difficult to stop. Oh. Everybody who knows how hard it is to stop eating sugar. The first few days are really terrible. So this is just an addiction. And the younger it starts, the harder it is to undo. I hope that someday it will be banned to really market these kind of foods specifically to children, you know, like the cereal boxes with the funny cartoon characters and everything. So when I was a child, we had gum cigarets or, you know, chewing gum cigarets and cigarets made out of chocolate. That’s crazy. And of course, that was banned for some 7 years ago. But I think all the baby cookies, which are just shaped like animals or as I mentioned, that the cereal boxes with the cartoon characters. I think that that has to stop. That’s an excellent, excellent point. And the I listened to a lecture recently by Dr. Joan Ifland, it’s available free on YouTube for people to watch. And she studies the marketing of food to children, marketing of processed food to children and how so much of it is controlled. The tobacco companies bought a lot of the food companies and they use their same marketing techniques to target children. It’s terrifying. The last point on that, the last topic I really want to go into is and you mentioned it several times, is the risk of plant based diets and why we do really need animal food, especially for our brain and for mental health maybe. I’m sure there is. There are a lot of hour long talks about that top Bacon. I found them on YouTube and I will link to all of them in the show notes. But if you could give us that, yeah, just a synopsis of all your thinking. Absolutely, so I am worried about plant based diet, particularly because most people do not realize how important it is to supplement plant based diet, not just with vitamin B12, but there are many nutrients which are difficult, very difficult to get from plants. If you eat only plants without any supplements, that is that you will not be able to survive. Plants are missing many essential nutrients and are very, very low in quite a few nutrients. Vitamin K2, the essential fatty acids, the omega 3 fatty acids, even certain omega 6 fatty acids. And there it’s harder to get iron from a plant based diet. It’s harder to get minerals like zinc from a plant based diet. And it’s even can be harder to get to get vitamin A from a plant based diet depending on what you’re eating. So many plants are low in nutrients and they’re high in what are called anti-nutrients. So they contain naturally substances which block or interfere with our ability to extract certain nutrients from food like iron and zinc, for example. So for all of those reasons, if you remove all the animal foods from the diet and you don’t put in all the supplements you need, you are very high risk for nutrient deficiencies. And nutrient deficiencies are very common in the general population, but they’re also even more common in people who have mental health disorders. So it’s very, very important to understand that the studies that tell us that plant based diets are healthier than a diet that includes meat. All of those studies do not just remove animal foods. They remove almost all the processed foods. They remove all of the sugar, all the flour and all the fried foods and the packaged foods. There are Whole Foods diets that are plant based. So we don’t know if you simply remove the animal foods from your diet. We have no idea if that’s healthier. So it’s really important to understand the science does not support removing animal foods from the diet. So if you choose a plant based diet, that’s OK. That’s your choice. But please supplement very, very carefully and learn everything you can and make sure that it’s a Whole Foods diet. And because you can eat junk food all day long and still have a vegan diet, very, very dangerous. That’s the worst of the combination of all the processed foods and not enough nutritious animal foods. The animal foods contain everything you need in the right form, easy to digest and easy to access nutrients. A good plädoyer for our to finish up this wonderful, wonderful interview. Thank you very much for your time. I’m linking to all your videos and of course, to the diet doctor article and to your website diagnosisdiet.com. So everyone who wants to connect with you and get maybe your insights on Keto diet in the context of mental disorders or psychiatric disorders can contact you via the website, is that correct? Yes. So I do also have a consult service that you can access through my website if you want to talk with me directly about if you are a clinician or if you’re a patient who wants some advice. I’m happy to talk with you and Julia, thank you very, very much for everything you are doing to get this information out there. And it was just so wonderful to meet you in person at Keto Live. Are you coming next year to Keto Live? I’m not sure yet, but I am planning to. Are you going? Yes. Yes. So next next year I’ll be giving presentations about brain development. Nutrients for baby and child, infant brain development and all that and how you build the best possible brain. A very important topic since I think, you know, it starts already during development, the fetal development, if there aren’t the right nutrients there, how should the brain develop? And I think a lot of problems we are seeing now are probably already you know, it starts already in the development that the mothers are nutrient deficient and not really good. Yeah, there are not enough omega 3s and all the important fatty acids to build a healthy brain. Exactly right. So the conference will begin with brain development and it’s going to finish with, at the last day will be Dr. Steven Koonin. He is great. Alzheimer’s and Ketones. Just amazing. World class researcher finishing the conference will start with baby brain and will end with aging brain. Aging brain. Wonderful. That’s. Yeah. Thank you very much for the wonderful interview. Yeah. See you again. Thank you very much. Thanks everybody for listening.