EPI 244: Harvard Trained Psychiatrist On Foods & Habits That Fight Depression & Anxiety Without Medication. With Dr. Uma Naidoo

Welcome back to another episode of the Peak Performance Life podcast. Today, I am very excited to have a very special guest. Her name is Dr. Uma Nidu. She is a nutritional psychiatrist and serves as the director of nutritional and lifestyle psychiatry at Massachusetts General Hospital. And she's also on the faculty at Harvard Medical School. And she is the author of some amazing books. One of them is called This Is Your Brain on Food. And the most recent one is, remind me again, this is Calm Your Mind with Food. Calm Your Mind with Food. That's right. Calm Your Mind with Food is the most recent one. Two very hot topics, two very important topics that I think are often very, very much overlooked in terms of how we feel on a day-to-day basis, which a lot of times determines what actions we take, how much motivation we have, how much happiness we have in our lives. So thank you so much for joining us. I'm so excited to jump into this. Thank you for inviting me. I'm excited to be here. Yes. Well, let's start with a little bit of a background. How did you get interested in the work that you're doing today? I think it stems largely from my childhood culturally. Food was very important. I grew up in an extended family system. And eating healthy whole food was just part of how we lived. I like to tell people, Taylor, the first time I met a pop-top was when I moved to immigrate to the US. It's sort of funny because I kind of wasn't used to food like that. But that being said, you do get used to it very fast. But that informed me when I really noticed the gap in mental health, that we were prescribing heavy-hitting medications, which definitely can be life-saving for some people. And no one was talking about the side effects. Like, how do you handle the weight gain? What happens when you're not really improving on a medication? What else can you do? And this gap led me to ask more questions and do more research. And really, the emerging science of the gut microbiome is happening around the same time. And I had the opportunity to start studying this more deeply and realized that there was so much growing evidence behind nutrition, nutritional neuroscience, and how the brain is impacted by food, nutrients, vitamins, minerals, that there was more to say on the topic. And that's what led to my first book. And seeing patients and helping people use this method is really what even led me to be able to write a book. Amazing. Amazing. I love when we combine the fields of psychiatry and health instead of looking at them separately. I think it's such a big thing. People miss. People think of mental health as an above the net concept. And it's really, for quite some time, has not been that. It's an integrated part of our lives. And the rest of the body cannot function without the brain. But the brain has to interact with the gut. So it's really all systems that are interacting. And people can no longer just assume that food is related to weight loss or our waistline. Its food is really important for our mental well-being, the functioning of our brain, the functioning of our gut, and more. Yeah. Yeah. And I can attest to it. Because since I started eating healthier myself, I just started feeling better. And now people ask me, oh, don't you, you don't want to have a drink? You don't want to eat this dessert or something? And I said, no, I feel so good. I don't want to. You start to change what you actually desire. Because when you start to feel so good, people, I think, many times don't realize that. Especially when you look at teenagers, for example, many times, they eat an awful diet. They're maybe not even going outside. Maybe they're playing video games 12 hours a day while eating fast food. And then you wonder, what's going on here? It's more true. It's so true. It's so true. And I think that's the whole reason to be on great podcasts like this one, to spread the message. And so more people understand that there are different ways we can handle this. Outdoor time is so important, not just for vitamin D, but to help us to carry rhythm and sleep. And not being in front of a device constantly is also very important to any one of us. Yes, absolutely. Well, let's get into some of the things that you've learned over the years. Some of the things that people are doing wrong that can be hurting their mental health, or maybe there are situations where people were not in great mental health, but they changed their diet or some lifestyle and got a lot better. Right. I think one of the things I always love to share is someone whom I worked with early on in my clinical years, a young woman in Boston who was very highly successful in her career and hadn't necessarily been seeing anyone in mental health, not even a counselor, and came to my office asking, pleading for a medication called Zoloft. And I said, well, let's assess this. Let's talk and have a discussion. And as we spoke about her life, it turned out that she'd been promoted at work. Was a young executive living on her own with her dog and amongst her friends in the area right close to Mass General, which is Beacon Hill and is really beautiful. So she spent a lot of time outdoors. She would walk to work and things like that. But she'd come with this great promotion. But this promotion had upended all her healthy lifestyle habits. So she was on planes about five to five or six days of the week, almost never home, not eating at home, eating out, going to networking dinners, eating on the run in airports, snacks, having more wine than she'd like to because of the networking events, having unhealthy, fancy dinners. And she had exercised throughout this time. So she didn't necessarily show any change in weight. She kept up with her yoga practice, which she was able to do in hotel rooms. But her eating, her food, had died change significantly. And not really out of choice, but because she didn't really know how to navigate that. So over several months, her gut microbiome had developed dysbiosis because she was eating fast food on the go, snacks in airport lounges. Like I said, while I'm on that, she was used to consuming usually just an evening on the weekend with her friends. And all of that had resulted in a lot of gut inflammation or dysbiosis, which over time had led to neuroinflammation. And she had this massive surge of anxiety. So when we spoke about it and we kind of unpacked it a little bit, she recognized what I was saying. And her first question was then, well, maybe I don't need the medication. Can I work with you on changing back to how I'd been eating? I said, absolutely. And we really worked on a slow and steady, kind of innovative plan because she continued to travel. And how could she pack healthy snacks? What could she think of in planning when she got to a new city in terms of what she ate? How could she handle those dinners? And over about two months, she really started to feel better. She ended up not needing a medication. But what I thought was also so powerful is how food can just throw the microbiome off and therefore throw our mood off so significantly. And the fact that it was hopeful, it can be reversed with dedication, some discipline, and just wanting to feel better. Yeah, that's a great story. And everything you mentioned, too, is so common. Like, I was just in a conference this past week for three days. And so I ate out at restaurants on the Las Vegas strip, two days in a row. And I feel it. I start to feel it in my stomach. Why does my stomach not feel so good? And the same thing, traveling. I learned this years ago as well. I bring my own food when I know I'm traveling, because I know I'm not going to eat airport food. Right, and you're not going to get much on the plane. So it's tough, but actually, if you think about it, and you're traveling domestically, it's pretty easy to carry food or smoothie mix that you blend wherever you are, or your own nuts and other healthy snacks. So you're right. It just takes a bit of planning. It takes you have to really think ahead and plan ahead. And that's what I try to tell people, because so many people are like, oh, I don't have anything now. It's like, come on, we've got to plan ahead here if you're really serious about this. It's kind of like a mom who's traveling with her toddlers, right? She's not going to leave the house without diapers, a change of clothing, and food for them. She's just not going to be able to travel. In a similar way, we have to tend to the part about food related to ourselves. That and water, having a sustainable water bottle, because now you can fill it in any airport or airport lounge. And that type of stuff is so important when we travel. Yeah, absolutely. What do you think are some of the foods? Why does eating out a lot wreck our gut? What is it about some of these foods, and what kind of foods do you think are the worst for our mental health, I guess? Sure. So some of it falls into the foods that we eat at restaurants, but not all of them. Mostly, I think the issue with restaurants, some large database studies looked at when we eat at home and prepare our food at home. People, over time, consume fewer calories and end up either losing weight, but most significantly, they don't gain weight. What that really informs us of, and our understanding of the research, is that restaurants can use less healthy oils. They can add sugar for flavor. Because as a chef, one of the things I know is we add fat, salt, and sugar for flavor. And the truth is, those are not necessarily all the healthiest ingredients. So the restaurants may tweak a recipe so that it tastes so good, but it might have more sugar or sodium than your body really needs. They might cook in a way that is less healthy, like frying, or adding a lot of extra calories that you don't need, or an extra portion of something. And a lot of those things really don't help us. So eating out once in a while and enjoying it, absolutely. But if that's your go-to every day, then understand you are facing those issues. In addition to that, it's the ultra-processed, processed, fast foods, junk foods, packaged foods, artificial sweeteners, sodas, diet sodas, and really the fried foods and then the types of fats that are more trans fats and hydrogenated oils are a problem. So I think that if we could just carve out cutting back on those and adding in really more healthy whole foods wherever we can, and I like to say eat real food. Just eat food. It's eat the orange or the clementine or the apple. Skip the apple juice or the orange juice, which has no fiber remaining. And a lot of it's often added sugar as well. Yeah, you mentioned trans fats, and I know that's a big one. What are some of the most common foods that are high in trans fats that a lot of people are eating? Right. So it's often we were supposed to have most of it removed from our food system. But I can share with you that trans fats and hydrogenated oils are things like the types of fats in shelf-stable bakery goods or things that really last a long time. So they're there to really create not only flavor, but make those foods last and give them the fact that they require. But they're not freshly made or freshly baked. It doesn't mean that they're bad, but they are engineered to last longer. So always read the label. Just read the label to see what's on and whether it's something you want to be eating. Use AI or some way to look up an ingredient that you don't recognize. Usually, I like to say to people, if it's not something you recognize, it probably isn't found in nature, like an apple or an orange. So if it's carboxymethylsolulose, which is a food thickener, which actually in animal studies has been shown to really wreck the microbiome, that's probably not good for you. So that's usually a great rule of thumb. If it's a long label with words you don't identify, it probably isn't the healthiest. Yeah, and that's a good point. I didn't even think about that. Like packaged cookies, for example, or packaged things that are sitting in your cabinet for two years, meant to be shelf-stable for so long. That's right. Yeah, even that could be different than a homemade, freshly baked something, right? Exactly. I mean, if you made something from scratch, it's always going to be a different product, because A, it's freshly made. And B, it may take a few steps longer, but you know what goes into the cookie that you're making. Yeah, yeah. And let's talk a little bit more about what are some of the, OK, so what are some of the good foods that are good for your gut, good for your mental health? Sure, so I can actually use an acronym that I created for my book, Calm Your Mind with Food, because anxiety was found to increase by 25% worldwide during COVID. So the fact that some of us are not feeling well, not sleeping well, many of us don't realize that there's underlying anxiety. And one of the things we can easily do is tweak our diet. So I created an acronym called CALMS. And the C is for coli, which is found in eggs or legumes, also other foods, but I'll just list a few. Vitamin C, so citrus fruit, and extra dark natural chocolate. People love it when they say that. The A is for ashwagandha, which is an Ayurvedic herb, so it's very bitter tasting. So if you speak to your doctor about a supplement, there are many available, and it actually does help anxiety. The other A is for antioxidants. So when we talk about the colors of the rainbow, we're really referring to the colors of nature, but they also represent different anthocyanins from blueberries, for example, and that's a powerful antioxidant. The A is for liquids, and liquids represent both water, always dehydrating, because when you are dehydrated, you can feel more anxious, and that's important for people to know. But also tea, healing, calming teas, chamomile, green tea, passion flower tea, these are ginger tea, mint. All of these are really calming and soothing to the body and the mind. The M is for more omega-3s. Omega-3s are the really healthy types of fats that our brain and body needs, and you get that from salmon, or chia seeds, and then magnesium. Turns out many Americans are low in magnesium, so it's worth speaking to your doctor about the appropriate blood test, and seeing if you need some magnesium. Supplements are an option, which you can also get magnesium from food, and the S in calms is for spices and herbs, because they are virtually no calories if it's a pure spice. They flavor up food, but they're also very rich and powerful in antioxidant and anti-inflammatory effects, but also certain spices have additional effects, so you really can't go wrong with spices and herbs. That's amazing. Yeah, and for my daughters, I actually think the two biggest supplements I try to get them to take the most is magnesium and fish oil. For the omega-3 and the magnesium. And then I think they learned about ashwagandha from TikTok because they say, guys, can I have some ashwagandha? And I said, yeah, this thing's really going viral on TikTok these days, but yeah, that's a good one. Great acronym there, great acronym there. So what about lifestyle? What, we mentioned about going outdoors, things like that. Let's talk a little bit about that. That's such a critical question, because in my book, I also speak about the blue zones and the pollen nine, because I think it's a great way to talk about an integrated model of care, including other lifestyle factors, because I've always done that type of work in my clinic. So I say to people, if you're not feeling great or feeling super anxious, get on a treadmill for 10 minutes, take it out for a walk, walk to buy the newspaper or a cup of coffee, just get yourself moving, because there's a way in which it almost burns off some anxiety and some angst that you may be feeling. So talk about, it doesn't have to be a structured exercise. If you're not feeling great mentally, at least start with something that's a kicking off point from which you can build. Spend time outdoors because exposure to the direct sunlight without a window actually allows for your skin to work on vitamin D, and you need vitamin D to both help you mood, but also anxiety. And then there's mindfulness practices. Maybe you meditate or maybe you journal, maybe you do a breathwork exercise. All of these really become extremely important. Hydration remains a lifestyle factor. Nutrition is a very big pillar of lifestyle, but also sleep, paying attention to resting well, paying attention to cutting back on toxic substances. So manage the caffeine is actually very good for your body in moderation. So things like that, be mindful of when you have coffee, if you are a coffee drinker, and what you put into it. So these things become a part of a broader lifestyle, lifestyle way that we can lead our lives, and it's so important for that balance in feeling better. Yeah, yeah, absolutely. I can relate 100%. If I don't move for a couple of days, I can, I just, I don't feel good. I don't, my mental health is just not as good. I don't feel like even, I often tell people, because people are like, how do you even have the time to go to the gym, you know, five days a week or whatever you do, or, you know, and I say, well, actually the days when I don't go to the gym, I feel less productive, even though I may have 90 minutes less of work that day. So, you know, you can really feel it. You can just, when you don't move for a couple of days, you just feel it. And the other thing is sunlight. I'm always trying to tell people, obviously we're not saying to get sunburned, but I like to get morning sunlight before 10 a.m. And I feel such a big difference. It helps my sleep later on at night. And there's something, I know vitamin D is there, but I feel like there's with both movement and sunlight, there's something else that I don't know if we can even fully explain, but just from how many millions of years we've existed out in the open in sunlight and moving around, there's something there that just makes you feel better. That makes you feel better. So, you know, a few comments on what you said, I'm great, that's a great habit to have, I encourage more people to do it. You know, the fact that you're there before 10 a.m., your sunlight is, you know, kind of reaching you through your eyes. It's regulating your sleep and circadian rhythm, which is your natural body clock. But also, my guidance around being in the sun without sunblock or sunscreen is about 10 minutes so that you get some vitamin D in your system, you're spending time, and then just apply sunblock or sunscreen wherever, you know, your body's exposed, and you can still be outside for longer. But I think that those just become key ways that we can make swell tweaks to feel better. These do not cost us anything to go outdoors, and they can help us feel a lot better. Yes, absolutely. And you mentioned drinking, and we talked a little about water and being hydrated, but there's something I notice a lot of, and that's people like, oh, I wanna, it's all about weight loss a lot of times. So they're like, I wanna lose weight, so I'm gonna drink, you know, I'm gonna, it's okay if I drink three Coke zeros a day or three Diet Cokes a day, because they have zero calories, and I'm just concerned about losing weight, but I think there's more to it, right? These things are not good for your gut, even if it's diet. Exactly, if it's labeled diet on low sugar, they often have artificial sweetness, and artificial sweeteners are non-nurative sweeteners, meaning they're providing nutrition. They are there to replace that sweet taste that we want. Now, if you have the occasional cup of tea or coffee and you want a sweetener in it a couple of times a day, and that's what you do, that's fine, but if you're having six cups of tea or coffee, plus diet soda, this is a very large amount of artificial sweetener that's entering your body. They should be used in moderation, and for example, if there are now baking mixes with artificial sweeteners, these are just not something one should be doing, because a cup of baking mix that contains whatever the artificial sweetener is, is really not gonna be good for your gut. That's why I limited to or guide people to the newer artificial sweeteners. If you need a little bit of sweet in your coffee, that's okay, but just don't also drink tons of diet soda, and so-called no-sugar drinks, because they contain something to sweeten them, and that's very disruptive to gut microbiome, and over time can cause dysbiosis and that disruption in your gut. Yeah, I remember I had a friend who didn't know, he got some really bad inflammatory thing in his body, and he went to his doctor, and his doctor just gave him some medication without asking him anything about what he's putting in his body, and I said to him, and he's like, hold on a second, I gotta go grab another Diet Coke, and I said, I'm curious, hey, how many Diet Cokes are you drinking a day? And he said about eight, like eight Diet Cokes a day he was drinking, and I said, by any chance did your doctor ask you what you're putting in your body or drink? He said, no, no, he just wrote me the prescription he gave me the medication. I said, I'm not a doctor, but you may wanna try to lower that- Explain that, and lower that, and explain it's true. And he did it, and as soon as he did it, he literally got better very, very quickly. He said, I had no idea. Yeah. So yeah, there's definitely something there. Now with regards to sweeteners, are there any sweeteners that you think are better than others? I find that, for example, monk fruit and stevia, especially if it's organic monk fruit and organic stevia, unless I'm consuming really large amounts, I seem to be okay, my stomach seems to feel okay with those compared to like erythritol, for example, which is a sugar alcohol, that one, if I take in more than five grams of erythritol at a time, man, I can feel it in my gut almost immediately. Well, so I think that the ones you mentioned are perfectly fine and moderation, allulose is a newer one, so far the data is looking promising. So a little bit of, and some people do use a little bit of erythritol, it responds to different people differently, but a little bit of monk fruit, like I said, my guidance on this is, don't be leaning into diet soda or diet drinks or everything that's labeled sugar-free, and don't sort of replace them in bulk in something you're baking or making, because that's not those levels about official sweeteners, just too much for your body and your gut to handle, without having a direct impact on you and your body is sensitive, so just over a teaspoon of the erythritol disrupts it, so that's super important to pay attention to, not only for you, but for all of us. Yes, absolutely. And when you were working with a client, for example, or a patient, is there something, like are there specific gut tests that you're, are you doing any time, or I guess are you doing any kind of gut testing or anything like that, or is there any kind of, what would you do if someone was coming in, they said, hey, I don't feel too great, what kind of intake would you do there? So, you know, a lot of it is asking a ton of questions about their dietary history, their lifestyle, a full mental health history and all of that, and it really depends on my, I usually collaborate with the primary care doctor, or other doctors on the care team to decide what they need, do they need a metabolic health panel, do they need gut microbiome testing? Now a lot of hospitals don't offer gut microbiome testing, so do they need to get that done privately and send us the results? So it's all become, I would say, much more personalized now. So whereas I might, 10 years ago, have said, oh, this is a list of tests now, we have a list, but then we check out what is needed for that individual. I'm a big fan of checking vitamin D levels. If someone is vegetarian or vegan, a vitamin B12 level, I'm also a fan of checking magnesium because many people don't even realize that they deficient, so things like that, I do consider part of my screening as well. Excellent, excellent, very good there. And I guess, there's a lot of controversy, I have a lot of, we have a lot of holistic health doctors, we have a lot of medical doctors, we have different people that come on this podcast. There are some that are sort of against SSRIs, antidepressants, things like that, obviously there are situations, this is not, we're not making general statements here, obviously there are certain situations when it's very necessary. But overall, I'm curious, what are your thoughts? And then there are, one guy, I was reading his blog about how when you're on SSRIs for too long and your body becomes dependent, and then when you get off of them, there's a problem, and things like that. So I'm just curious for those with all the noise around SSRIs and antidepressants, what are your thoughts on them? So I think that having worked in the traditional field of mental health psychiatry for more than two decades, they definitely serve a purpose for individuals who really need them. The severity of illness can sometimes require a medication, but then the doctor still has to manage the side effects. So I think that is with that caveat, the fact that I'm describing it doesn't mean I'm not checking multiple things to make sure and offering them lifestyle methods to feel better as well alongside that. So if it's necessary, they can be life-saving, however. I think what tends to happen is that we have this all in one effect in the US. It's either take these medications and then take higher doses, et cetera, et cetera. I think it is very individual who can benefit from a lifestyle change, a dietary change, who is motivated and disciplined to do that. That's also important because you can give a person a list of foods and a list of lifestyle changes and maybe too much for them and they feel overwhelmed, they don't want to do it or they can't do it. So I think it's always a balancing act. Also, there are now newer companies and organizations doing safe, deep prescribing for medications. There's a company called Outro Health that is based out of the United Kingdom, but it also has a presence and patients can engage in the United States. So Outro Health will help you safely, deep prescribed from a medication under the care of a physician in collaboration with your care team. So their physicians are trained to safely help you come off the medication because we're absolutely right. Someone comes off the medication, they can have devastating side effects, but if you do it in a certain way under the guidance of an arbor doctor who's trained to do it, it can actually over time help you because you might be able to find other solutions. I think that those really work well alongside nutrition and lifestyle measures. And I think that it's always a careful consideration if a person has to take a medication. And if they are not suicidal, not manic, haven't lost touch with reality, there's an opportunity for them to be assessed, look, can we work on some lifestyle measures? Can you be safe as we do this? And if we fail after a couple of months when you're still feeling terrible, yes, we can consider a trial of medication. I think it's really important to have that discussion about just jumping first to the virtual prescription pen. Yeah, wow, that is so great. I'm so happy we brought this up. So Outro Health, I had never heard of that before. Of all the podcasts we've done here. And I always was, you know, because it's interesting, I could have some, a lot, you know, quite a bit of friends who are on some sort of prescription and they're saying like, well, you know, I'm on it now. I don't know how I'm gonna get off it without side effects or something. So under a doctor's supervision, you know, doctors that are trained in how to people get off the prescription, because you don't really, if you don't have to, you don't wanna take it forever if you don't have to. If you don't have to, and sometimes these medications are not effective for everyone. And a lot of patients experience being taking one medication, then their doctor adds on a second medication and more, and they're on a bunch of medications and they're really not feeling good. As part of this model, there's also coaching involved, nutrition and lifestyle measures. So the doctor has the knowledge of how to tweak that for you and some nurse practitioners as well. But I think that if you do it carefully with people who are trained, I think that's the message you wanna get out there, that it is possible, don't try it on your own. And if your doctor's open to this kind of idea, then maybe open up that conversation with them. Yeah, yeah, really, really good advice. Any other advice for people that just want to feel better every day? One of the things I've done is I've designed a protocol called, for this exact reason called the SOAP protocol, it's SAW. It's a protocol that's designed to help you. And it's really so there's a jumping off point for any person listening to this kind of new information, because nutrition and food are the missing, kind of the missing conversation in mental health. People do all sorts of things, including medications, but they don't really think about how they're eating. So S is for SWAP, and SWAP is one unhealthy habit. Like your friend, your colleague, or maybe it's that you gave up the gym during COVID and you didn't go back, or maybe it's that you're just eating something you really shouldn't be and you know that it's not good for you. So SWAP, that one thing with the healthy version of it, or healthy choice, that makes it flexible. You decide, the ball is in your court and it gives you autonomy. A is for ADD. So can you add in, are you not drinking enough water? Can you hydrate more? Can you add in some extra sides of vegetables every day? Because vegetables are pretty low in calorie if they're prepared healthily, and they're giving you great antioxidants and anti-inflammatory properties, and they say shade. So you may not crave dessert if you're actually full after your meal. So adding something in is pretty easy, and it doesn't make people feel deprived because they're adding more to their food or what they're drinking that day than having to take away or avoid foods. And the W is a broad category. It's really walk, but it's also mindfulness or meditation or journaling. What else can you do that could help you feel better? And the SAW, you can start at any point that works for you. You can exercise more, or you can maybe take up resistance training because you've heard that muscle health is so important and building up your muscles is key. So try that, or you can add something, or you can just start with swapping something that you're concerned about. Yeah, yeah, that's really, really good stuff. Is there anything else that we didn't cover here today that maybe we should have? And I'm curious as well, actually, one other thing, on the topic of so many people trying to lose weight, and so they're like, oh, I remember one time, I had a friend and we were out to eat, and he said, no olive oil, no oil. And he told them, he said, send it back. I don't want the extra calories from the olive oil, this kind of thing. And it's kind of like your body is going to eat and need a certain amount of calories. If you just try to cut, cut, cut, and do 1,000 calories a day or something, it's not going to be a great result. Olive oil is very healthy, in many ways. So maybe there's, yes, there's some more calories to olive oil, but it's not something that I necessarily would want to cut out of my diet. It's going to actually, in many cases, make me more satiated, I feel like, and then I'll be less hungry later. More satiated, but also brings healthy fats to your brain, your body, your gut. So I think people don't realize that olive oil is healthy, but it is calorie dense. So no one's saying, put half a cup of olive oil into everything, we're saying sprinkle it on some roasted vegetables. Have it in some salad dressing, but don't exclude it because it's a healthy fat that is helping your brain and body immensely. And just do it in moderation. So I'm not a big fan of avoiding or omitting things completely unless they are, you have a food allergy and intolerance, or literally for whatever reason, your body cannot tolerate it. But I prefer people to adjust, to moderate, to swap, to add something in and see what they can do rather than exclude something completely because sometimes they exclude something healthy like olive oil. So that would not be on my list of foods to avoid. Just limit the amount or think about the type of preparation you order in a restaurant and don't overuse it at home, but to make sure it's part of your pantry. Yeah, yeah, absolutely. I'm curious if you have any thoughts on, I've actually read there was a book like The End of Alzheimer's or something like that, and you talked about using the keto diet. A lot of people are talking about using ketosis and a very low carb, you know, healthy, if you're doing it the right way, it's healthy fats and protein, but you know, pretty extremely low carb. And I'm not saying everyone should go extreme low carb, but I'm curious what your thoughts are about that, you know, are we eating too many carbs and is that contributing to issues or as long as it's the right carbs, are you okay with it? I'm curious where your thoughts are. So the bottom line, I'll comment on keto as well. The bottom line is our body needs carbohydrates, just like it needs sugar, but it's the source of where those come from that are important. Carbs from cauliflower, very different from multiple sizes of bread and a massive ball of pasta. Sugar's from a quarter cup of berries is very different. The salt sugar is very different from soda or piece of cake. So I think where we get those from is important. With the ketogenic diet, it is very rigid. And I will say that some individuals who use a ketogenic diet lean into less healthy fats, right? So not just fat, high fat and protein, it's also things like a ton of bacon. And a piece of bacon down again is fine, but don't exist on that. I think it kind of gets a little warped. The reality in mental health is that it does work. And in my first book, this is your brain on food, I covered, actually both my books and covered the ketogenic diet, but that book we talked about in relation to schizophrenia and bipolar disorder, certainly has been shown to be helpful, but individuals, if they're using it, really need a lot of structure and help around them. And sometimes those individuals with severe illness may not have that available to them. So I think it's a very careful discussion to be held with a clinical care provider. On the other hand, they do work in the right settings and nutritional ketosis instead of developing things like the keto flu when people can actually feel quite sick is very different. So definitely a place for it has to be carefully monitored. And it's just to fit the right individual using it who can tolerate it and manage the restriction. So yeah, and so do you think overall, most people are eating too many carbs and could benefit by going a little bit lower carb and replacing it with either protein or healthy fats? Yes, I think as Americans, we tend to be a carb loving nation. And I think that often that's because people hear these messages and they think they have to give up an entire food group. No, eat more vegetables, have a seeded cracker or a seeded loaf that has sprouted grains in it. That's a slightly healthier version than just sliced bread, which is shelf stable and is less healthy for us because it's really becomes a simple carb at that point. So go for more complex carbs, quinoa, that's also happens to be gluten free, barley, things like that that are also satiating. So you don't need a ton of it. Cut back on the amount of pasta you're eating, eat a different serving, lighten it up, mix your, I have great recipe for noodles made from spaghetti squash. Now a lot of supermarkets that are selling the noodles made from zucchini. And if you use half the amount of pasta and you put in some zucchini noodles, you still have the feeling that you're eating pasta, but you're not eating, you're eating half the amount of carbs because you're eating a vegetable that is very low carb. So there are ways to think about it. There are also noodles made from congee root, which are very low calorie. And if people use them, the right way to flavor them up, they can actually be really delicious. So I think there's lots of, so the answer is yes, we do. We do eat many more carbs than we should and a lot more sugar, which adds to that. So. Yeah, and I agree. I think if you can switch to gluten free carbs, that's probably a good step. That's one step, yeah. Yeah, I don't know too many people who eat a lot of gluten and say, I feel great when I eat gluten, right? It's not something you traditionally feel very good at. It doesn't seem to be good for your gut. So, I think the issue becomes a lot of people may have either, not, well, celiac disease is not as common, but people might have realistic celiac disease, but they also might have non-celiac gluten intolerance. So I think that's important to understand. And I think that, I would much rather have people find healthy ways to eat what they like. For example, a product that's gluten free doesn't mean that it's healthy, because it may actually have unhealthy flowers in the product, whether it's a cookie or a bread roll. So it's just a balance of what, cut back on your carbs, get them from healthier sources. If you're ready to cut them out completely, then make sure you have someone helping you guide the process. And definitely just do it with awareness, because I think we all love the bread roll when we go out for dinner, and it's set up that way, and so it's the first thing you see. Yes, I know. I wish they would change that though. I feel like, especially the restaurants are doing themselves a disservice. People would eat more if you didn't bring out this big bowl of bread in the beginning, they could make more money off people. Exactly, it's tough to know the goal of it, but I think there's so many different theories around it. And so I just think that it's really hard when you arrive hungry and ready to eat, you get this great aroma of freshly baked bread, and it's tempting, and I think it leads us down a path. Yes, well, Dr. Uma, this has been amazing. I want people to learn where they can follow you, find you, buy your book if they want to learn more. Thank you. So you can find me on my website, you'll find a lot of resources there, umanidumd.com, follow me on all social media at drumaidoo.com. But most importantly, subscribe to my free newsletter, because you get free information every single week, and you'll find that by going to my website, and you can sign up for the newsletter right there, and that's a good way to stay in touch, know what I'm up to, and my books, This Is Your Brain on Food, and Calm Your Mind with Food, which you'll also find available either at your local bookstore, online, or on my website. Amazing, amazing. This has been really great stuff. I'm so glad we're shining a light on the fact that mental health has so much to do with what you put in your body, what lifestyle choices you make, and it's not just so cut and dry, people are throwing around the world depression and mental health more than ever before, and for some reason, not a lot of people are talking about how nutrition and food and lifestyle can be oftentimes, in my opinion, more effective than prescription drugs. Yes, I agree. I definitely agree, I've seen it, I've seen it in my practice, I've lived it, so I think that it's very important for us to consider. But thank you for having me. Yes, thank you for shining a light on this. This is really important work that you're doing, and I hope we can do it again sometime. I look forward to it. Thank you. Thank you for listening. If you enjoyed this episode, it would really mean a lot to me if you would forward this episode along to any friends, family members, anyone that you think that would get value out of it and learn something important. The mission at Peak Performance is to help people prioritize and transform their health, and so if you think someone will get value, please, please, please do forward this episode along to them. Also, if you could please rate and review and subscribe on whatever podcast player you are listening to this on, we would greatly appreciate that as well, it means a lot. And I want to tell you about a couple of new products that we just released. You can get 20% off your first order at buypeakperformance.com, that's B-U-Y, peakperformance.com. We just released a brand new grass-fed beef protein isolate. 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