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The Key to Mental and Cognitive Health Is Diet — This Diet
It's official - it's a food intervention. Psychiatrist Drew Ramsey is going to be supportive, but he's also going to tell you to clean up your diet, and eat right for brain health.
Dr. Drew Ramsey is a psychiatrist, author, and farmer. He is one of psychiatry’s leading proponents of using dietary change to help balance moods, sharpen brain function and improve mental health. He is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and in active clinical practice in New York City where his work focuses on the clinical treatment of depression and anxiety. Using the latest brain science and nutritional research, modern treatments, and an array of delicious food he aims to help people live to their happiest, healthiest lives.
He is the co-creator of The Brain Food Scale, co-founder of National Kale Day 501(c)3, and a member of the medical review team at Dr. Oz’s webportal ShareCare. He frequently speaks and conducts workshops nationally, including two recent TEDx talks BrainFork and Brain Farmacy on food and brain health. His work and writing have been featured by The New York Times, The Wall Street Journal, The Huffington Post, Atlantic.com, Prevention, Lancet Psychiatry, and NPR, which named him a “kale evangelist.” His recent bestseller 50 Shades of Kale has made this superfood accessible to thousands. His first book, The Happiness Diet: A Nutritional Prescription for a Sharp Brain, Balanced Mood and Lean, Energized Body explored the impact of modern diets on brain health.
Dr. Ramsey teaches and supervises Psychiatric Evaluation and in the Columbia University Adult Psychiatry Residency Program. He serves as a thesis mentor for graduate students at the Columbia University Institute of Human Nutrition where is also lectures on nutrition and the brain. From 2005 to 2008, he directed the Audubon Continuing Day Treatment Program, a bilingual service for the severely mentally ill located in the Washington Heights. He is a faculty member at the Center for Mind-Body Medicine. Dr. Ramsey is a diplomate of the American Board of Psychiatry and Neurology. He completed his specialty training in adult psychiatry at Columbia University and the New York State Psychiatric Institute, received an M.D. from Indiana University School of Medicine and is a Phi Beta Kappa graduate of Earlham College.
Drew Ramsey: We know that brain health depends on proper nutrition. And so when we see people who have nutritional deficiencies, maybe, for example, having not enough vitamin B12 or missing certain fats like the omega-3 fats in their diet, we see that there's a vastly increased risk of illnesses like depression and anxiety. We also know that in clinical trials we can use those nutrients to actually treat brain illnesses like depression and dementia.
So every good psychiatric evaluation involves some lab testing just to make sure that the basic physiology, things like your thyroid, your B vitamin levels, the amount of potassium and sodium in your body that those are normal. And for a lot of people they are but for some people they aren't. And those are instantly reversible deficiencies. For example, if you have an iron deficiency you're going to be sluggish; you're going to have a brain fog. You're not going to feel well. It's interesting that we sort of start with evaluation in labs when really part of my work has been how do we get food into the conversation. And so I can assess you with a lab test, but, for example, if you never eat wild salmon or mussels or any good fatty fish that are a good source of those long chained omega-3 fats, we know that your levels are going to be low. So really we can learn a lot about someone's nutritional status just by asking them simple questions. It doesn't require expensive testings. In our clinic we simply ask people what they eat for breakfast lunch and dinner.
And that's really the goal of my book. Eat Complete is helping people - walking them through a nutritional assessment; it's called a Simple Food Assessment just because it's simple. And thinking about what are your challenges at every meal and what are the nutrients in the foods, most importantly the foods that are missing? We know that there are these very important nutrient-dense foods, the foods that have more nutrients for your brain per calorie. And we want those nutrients because you use them to make everything in your brain. If you think about it, every molecule in your brain starts at the end of your fork. And so really what I love about food in clinical practice - I'm a psychiatrist - is that it gives us an intervention that really you can focus on and employ every day and it's a way that we can help patients and people in general take care of themselves, really employee self-care with every bite. So that's the idea behind nutritional psychiatry, as it's being called.
So, a lot of times we focus on super foods or singular foods. I focused a lot of my work on kale. But really how we want to think is in food categories. And what I see in clinical practice over and over again is these same food categories are missing in people's diets. When we look at the eater landscape in America what we see is that people are really missing some of these key nutrients. They're eating very - I call it the beige diet or the 12-year-old boy diet, like lots of highly processed foods, not a lot of colors. We want to get people having more of those rainbows on their plate. So the food categories that I really love to see people put back into their diet when it comes to eating for brain health, we love to see the leafy greens. So things like kale, I've got some watercress right here that I particularly like; very, very dense green.
And nutrient dense, that's a very important concept, it's much more important than calories. Calories really only help us calculate nutrient density. And nutrient density is the bang for your buck. Something like this watercress it's going to be under 30 calories for a whole cup. And with this or any other leafy green you're going to get so much vitamin K, vitamin C, vitamin A. You're going to get fiber and you're going to get these phytonutrients. Those are molecules in plants that we understand - they're much more powerful than just antioxidants. So leafy greens and crunchy vegetables, or we call them the rainbow vegetables; you want to look at your plate and see colors. You want to see greens and reds and oranges because each of those colors represent a different phytonutrient, a different pallet of medicine, as it were. A lot of those powerful phytonutrients, they're what color a plant. And so we know everything with red like that red pepper has lycopene just like a tomato and watermelon. So colorful fruits and vegetables and leafy greens.
And then the category that so many people are missing is seafood. So we want to get more wild fish and particularly small fish like anchovies and sardines and there's all kinds of really fun creative ways to do this. I love to prescribe ceviche because it's a no-cook way of doing food. Something like a scallop or shrimp just in lime juice. So in terms of the nutrients, what are we trying to get into people's diets when we get to eat more of these leafy greens and seafood? And we're getting much more of these long-chained omega-3 fats. Those are very critical for brain health. The longest DHA is actually what brain cells are made of. And then others EPA, for example, is a very interesting fat that helps kind of thin the blood. Imagine that your blood is kind of silky smooth and that's obviously very important in terms of delivering oxygen to the brain and also preventing vascular disease as you age.
Other nutrients that we want to see a lot of in people's diets, we want to see more fiber, more plants because as we understand the connection between the gut and the brain you can't have a healthy brain without a healthy gut. I mean everybody just knows that I think a little intuitively, when you don't feel well down here you don't feel well up here. We also understand there's a lot of cross talk between the brain and the gut, just literally hundreds of thousands of neurons, nerve cells that communicate back and forth between the brain and the gut. And we know the gut has certain bacteria living in it, the bacteria that really get fostered and are promoted to grow when you eat more plants, more crunchy plants and more fermented foods.
That's one of the key nutrients that often gets left out of the conversation - fiber, because gut health is so key. So omega-3 fats, the B vitamins, vitamin B12 - which the food category for that are going to be mussels, clams and oysters - just find very high concentrations of both B12 and other minerals that are important for the brain, like zinc is one of my favorites. And so the idea behind nutritional psychiatry and behind Eat Complete is how do we look at what nutrients are missing and then translate that into food? So instead of telling people: 'Hey, you should eat more iron', we say 'Hey, you know what a surprising food is that's full of iron? Clams'. Or another great source of iron are these cashews, they're one of my favorites. Because along with leafy greens and seafood you want to get a lot of nuts, so almonds, cashews - here's a nice almond for vitamin E. And then these are some of my favorite medicines in my clinic, these are pumpkin seeds. And pumpkin seeds are pepitas, are great for three nutrients: zinc, magnesium and then tryptophan. Tryptophan is the amino acid that we use to make serotonin and dopamine. These are very, very important mood-regulating and learning-regulating neurotransmitters or chemicals in the brain. And so the idea is to give people a core set of foods. You know, again, with every bite you're getting all the nutrients that your brain needs.
Like the rest of the human body, our brain depends on good nutrition. In fact, it’s where everything starts and from where everything flows. Lack of certain vitamins can lead to drops of mood, cognitive ability and physical functionality. For these reasons, when getting a psychiatric evaluation it makes sense to call a nutrition intervention to make sure slumps in vitamin and nutrition levels aren’t the cause of common mental diagnoses such as depression and anxiety.
Drew Ramsey, MD and author of Eat Complete and co-author of 50 Shades of Kale, wants to make sure people know about the links between wellbeing and nutrition. A well-balanced diet is firmly linked to a person’s wellbeing. Without enough iron, as he points out, a person will feel sluggish, cloudy, and at the bottom of their game.
Most of us don’t consider every vitamin when we think up our meals. We may know that fish is a good source of protein, but we’ll stick to what we know, choosing to get our protein from steak or poultry of tofu. What a person might overlook is that fish such as salmon and tuna, and especially the smaller, oilier, and more sustainable fish like sardines and anchovies, are not just good sources of protein, but also a major haul of omega-3 fatty acids that are a critical brain booster. Omega-3 are long-chained acids, and a type called DHA is actually what brain cells are made of. So raise a sardine on toast in the air and say cheers to a more robust brain.
In Drew Ramsey’s clinical practice, checking to make sure people are getting all the vitamins and nutrients they need doesn’t necessarily require expensive and expansive testing – sometimes it just requires a few questions, such as do you eat fish, mussels, clams? How about cashews?
That’s what Ramsey considered while he was writing his book Eat Complete, and designing the assessment practice in it. Ramsay is on a mission to translate nutrients that are hard to quantify into more practical food categories, to help people know what they’re missing and how they can fill in their nutritional gaps. Eat Complete looks at phytonutrients, and how to recognize them. As Ramsey describes, phytonutrients are often leafy greens and colorful fruits and vegetables with nutritional benefits beyond their widely known antioxidants. Ramsey reminds us what we should instinctively know: when looking down at a plate, if you see a wide variety of colors (natural ones, not M&Ms;), you’re doing it right. From red tomatoes to green kale and orange carrots to purple cabbage, each color literally represents a nutrient content that is shared in other vegetables of its color. So mix it up to reach far and wide across the nutrient spectrum.
Armed with more workable knowledge of which foods will do what, your wellbeing could improve across all facets. You’ll feel more energetic, have more cognitive clarity, your blood quality will be smoother (yes smoother, it prevents vascular disease and helps oxygen get delivered efficiently around the body), and your gut health, which is being increasingly linked to mental health, will also rocket upwards. Interestingly, self-congratulatory pats on the back have also been known to increase.
Drew Ramsey's book is Eat Complete.
Andy Samberg and Cristin Milioti get stuck in an infinite wedding time loop.
- Two wedding guests discover they're trapped in an infinite time loop, waking up in Palm Springs over and over and over.
- As the reality of their situation sets in, Nyles and Sarah decide to enjoy the repetitive awakenings.
- The film is perfectly timed for a world sheltering at home during a pandemic.
The multifaceted cerebellum is large — it's just tightly folded.
- A powerful MRI combined with modeling software results in a totally new view of the human cerebellum.
- The so-called 'little brain' is nearly 80% the size of the cerebral cortex when it's unfolded.
- This part of the brain is associated with a lot of things, and a new virtual map is suitably chaotic and complex.
Just under our brain's cortex and close to our brain stem sits the cerebellum, also known as the "little brain." It's an organ many animals have, and we're still learning what it does in humans. It's long been thought to be involved in sensory input and motor control, but recent studies suggests it also plays a role in a lot of other things, including emotion, thought, and pain. After all, about half of the brain's neurons reside there. But it's so small. Except it's not, according to a new study from San Diego State University (SDSU) published in PNAS (Proceedings of the National Academy of Sciences).
A neural crêpe
A new imaging study led by psychology professor and cognitive neuroscientist Martin Sereno of the SDSU MRI Imaging Center reveals that the cerebellum is actually an intricately folded organ that has a surface area equal in size to 78 percent of the cerebral cortex. Sereno, a pioneer in MRI brain imaging, collaborated with other experts from the U.K., Canada, and the Netherlands.
So what does it look like? Unfolded, the cerebellum is reminiscent of a crêpe, according to Sereno, about four inches wide and three feet long.
The team didn't physically unfold a cerebellum in their research. Instead, they worked with brain scans from a 9.4 Tesla MRI machine, and virtually unfolded and mapped the organ. Custom software was developed for the project, based on the open-source FreeSurfer app developed by Sereno and others. Their model allowed the scientists to unpack the virtual cerebellum down to each individual fold, or "folia."
Study's cross-sections of a folded cerebellum
Image source: Sereno, et al.
A complicated map
Sereno tells SDSU NewsCenter that "Until now we only had crude models of what it looked like. We now have a complete map or surface representation of the cerebellum, much like cities, counties, and states."
That map is a bit surprising, too, in that regions associated with different functions are scattered across the organ in peculiar ways, unlike the cortex where it's all pretty orderly. "You get a little chunk of the lip, next to a chunk of the shoulder or face, like jumbled puzzle pieces," says Sereno. This may have to do with the fact that when the cerebellum is folded, its elements line up differently than they do when the organ is unfolded.
It seems the folded structure of the cerebellum is a configuration that facilitates access to information coming from places all over the body. Sereno says, "Now that we have the first high resolution base map of the human cerebellum, there are many possibilities for researchers to start filling in what is certain to be a complex quilt of inputs, from many different parts of the cerebral cortex in more detail than ever before."
This makes sense if the cerebellum is involved in highly complex, advanced cognitive functions, such as handling language or performing abstract reasoning as scientists suspect. "When you think of the cognition required to write a scientific paper or explain a concept," says Sereno, "you have to pull in information from many different sources. And that's just how the cerebellum is set up."
Bigger and bigger
The study also suggests that the large size of their virtual human cerebellum is likely to be related to the sheer number of tasks with which the organ is involved in the complex human brain. The macaque cerebellum that the team analyzed, for example, amounts to just 30 percent the size of the animal's cortex.
"The fact that [the cerebellum] has such a large surface area speaks to the evolution of distinctively human behaviors and cognition," says Sereno. "It has expanded so much that the folding patterns are very complex."
As the study says, "Rather than coordinating sensory signals to execute expert physical movements, parts of the cerebellum may have been extended in humans to help coordinate fictive 'conceptual movements,' such as rapidly mentally rearranging a movement plan — or, in the fullness of time, perhaps even a mathematical equation."
Sereno concludes, "The 'little brain' is quite the jack of all trades. Mapping the cerebellum will be an interesting new frontier for the next decade."
What happens if we consider welfare programs as investments?
- A recently published study suggests that some welfare programs more than pay for themselves.
- It is one of the first major reviews of welfare programs to measure so many by a single metric.
- The findings will likely inform future welfare reform and encourage debate on how to grade success.
Welfare as an investment<p>The <a href="https://scholar.harvard.edu/files/hendren/files/welfare_vnber.pdf" target="_blank">study</a>, carried out by Nathaniel Hendren and Ben Sprung-Keyser of Harvard University, reviews 133 welfare programs through a single lens. The authors measured these programs' "Marginal Value of Public Funds" (MVPF), which is defined as the ratio of the recipients' willingness to pay for a program over its cost.</p><p>A program with an MVPF of one provides precisely as much in net benefits as it costs to deliver those benefits. For an illustration, imagine a program that hands someone a dollar. If getting that dollar doesn't alter their behavior, then the MVPF of that program is one. If it discourages them from working, then the program's cost goes up, as the program causes government tax revenues to fall in addition to costing money upfront. The MVPF goes below one in this case. <br> <br> Lastly, it is possible that getting the dollar causes the recipient to further their education and get a job that pays more taxes in the future, lowering the cost of the program in the long run and raising the MVPF. The value ratio can even hit infinity when a program fully "pays for itself."</p><p> While these are only a few examples, many others exist, and they do work to show you that a high MVPF means that a program "pays for itself," a value of one indicates a program "breaks even," and a value below one shows a program costs more money than the direct cost of the benefits would suggest.</p> After determining the programs' costs using existing literature and the willingness to pay through statistical analysis, 133 programs focusing on social insurance, education and job training, tax and cash transfers, and in-kind transfers were analyzed. The results show that some programs turn a "profit" for the government, mainly when they are focused on children:
This figure shows the MVPF for a variety of polices alongside the typical age of the beneficiaries. Clearly, programs targeted at children have a higher payoff.
Nathaniel Hendren and Ben Sprung-Keyser<p>Programs like child health services and K-12 education spending have infinite MVPF values. The authors argue this is because the programs allow children to live healthier, more productive lives and earn more money, which enables them to pay more taxes later. Programs like the preschool initiatives examined don't manage to do this as well and have a lower "profit" rate despite having decent MVPF ratios.</p><p>On the other hand, things like tuition deductions for older adults don't make back the money they cost. This is likely for several reasons, not the least of which is that there is less time for the benefactor to pay the government back in taxes. Disability insurance was likewise "unprofitable," as those collecting it have a reduced need to work and pay less back in taxes. </p>
What are the implications of all this?<div class="rm-shortcode" data-media_id="ceXv4XLv" data-player_id="FvQKszTI" data-rm-shortcode-id="3b407f5aa043eeb84f2b7ff82f97dc35"> <div id="botr_ceXv4XLv_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/ceXv4XLv-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/ceXv4XLv-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/ceXv4XLv-FvQKszTI.js"></script> </div> <p>Firstly, it shows that direct investments in children in a variety of areas generate very high MVPFs. Likewise, the above chart shows that a large number of the programs considered pay for themselves, particularly ones that "invest in human capital" by promoting education, health, or similar things. While programs that focus on adults tend to have lower MVPF values, this isn't a hard and fast rule.</p><p>It also shows us that very many programs don't "pay for themselves" or even go below an MVPF of one. However, this study and its authors do not suggest that we abolish programs like disability payments just because they don't turn a profit.</p><p>Different motivations exist behind various programs, and just because something doesn't pay for itself isn't a definitive reason to abolish it. The returns on investment for a welfare program are diverse and often challenging to reckon in terms of money gained or lost. The point of this study was merely to provide a comprehensive review of a wide range of programs from a single perspective, one of dollars and cents. </p><p>The authors suggest that this study can be used as a starting point for further analysis of other programs not necessarily related to welfare. </p><p>It can be difficult to measure the success or failure of a government program with how many metrics you have to choose from and how many different stakeholders there are fighting for their metric to be used. This study provides us a comprehensive look through one possible lens at how some of our largest welfare programs are doing. </p><p>As America debates whether we should expand or contract our welfare state, the findings of this study offer an essential insight into how much we spend and how much we gain from these programs. </p>
Richard Feynman once asked a silly question. Two MIT students just answered it.
Here's a fun experiment to try. Go to your pantry and see if you have a box of spaghetti. If you do, take out a noodle. Grab both ends of it and bend it until it breaks in half. How many pieces did it break into? If you got two large pieces and at least one small piece you're not alone.
But science loves a good challenge<p>The mystery remained unsolved until 2005, when French scientists <a href="http://www.lmm.jussieu.fr/~audoly/" target="_blank">Basile Audoly</a> and <a href="http://www.lmm.jussieu.fr/~neukirch/" target="_blank">Sebastien Neukirch </a>won an <a href="https://www.improbable.com/ig/" target="_blank">Ig Nobel Prize</a>, an award given to scientists for real work which is of a less serious nature than the discoveries that win Nobel prizes, for finally determining why this happens. <a href="http://www.lmm.jussieu.fr/spaghetti/audoly_neukirch_fragmentation.pdf" target="_blank">Their paper describing the effect is wonderfully funny to read</a>, as it takes such a banal issue so seriously. </p><p>They demonstrated that when a rod is bent past a certain point, such as when spaghetti is snapped in half by bending it at the ends, a "snapback effect" is created. This causes energy to reverberate from the initial break to other parts of the rod, often leading to a second break elsewhere.</p><p>While this settled the issue of <em>why </em>spaghetti noodles break into three or more pieces, it didn't establish if they always had to break this way. The question of if the snapback could be regulated remained unsettled.</p>
Physicists, being themselves, immediately wanted to try and break pasta into two pieces using this info<p><a href="https://roheiss.wordpress.com/fun/" target="_blank">Ronald Heisser</a> and <a href="https://math.mit.edu/directory/profile.php?pid=1787" target="_blank">Vishal Patil</a>, two graduate students currently at Cornell and MIT respectively, read about Feynman's night of noodle snapping in class and were inspired to try and find what could be done to make sure the pasta always broke in two.</p><p><a href="http://news.mit.edu/2018/mit-mathematicians-solve-age-old-spaghetti-mystery-0813" target="_blank">By placing the noodles in a special machine</a> built for the task and recording the bending with a high-powered camera, the young scientists were able to observe in extreme detail exactly what each change in their snapping method did to the pasta. After breaking more than 500 noodles, they found the solution.</p>
The apparatus the MIT researchers built specifically for the task of snapping hundreds of spaghetti sticks.
(Courtesy of the researchers)
What possible application could this have?<p>The snapback effect is not limited to uncooked pasta noodles and can be applied to rods of all sorts. The discovery of how to cleanly break them in two could be applied to future engineering projects.</p><p>Likewise, knowing how things fragment and fail is always handy to know when you're trying to build things. Carbon Nanotubes, <a href="https://bigthink.com/ideafeed/carbon-nanotube-space-elevator" target="_self">super strong cylinders often hailed as the building material of the future</a>, are also rods which can be better understood thanks to this odd experiment.</p><p>Sometimes big discoveries can be inspired by silly questions. If it hadn't been for Richard Feynman bending noodles seventy years ago, we wouldn't know what we know now about how energy is dispersed through rods and how to control their fracturing. While not all silly questions will lead to such a significant discovery, they can all help us learn.</p>
Finding a balance between job satisfaction, money, and lifestyle is not easy.
- When most of your life is spent doing one thing, it matters if that thing is unfulfilling or if it makes you unhappy. According to research, most people are not thrilled with their jobs. However, there are ways to find purpose in your work and to reduce the negative impact that the daily grind has on your mental health.
- "The evidence is that about 70 percent of people are not engaged in what they do all day long, and about 18 percent of people are repulsed," London Business School professor Dan Cable says, calling the current state of work unhappiness an epidemic. In this video, he and other big thinkers consider what it means to find meaning in your work, discuss the parts of the brain that fuel creativity, and share strategies for reassessing your relationship to your job.
- Author James Citrin offers a career triangle model that sees work as a balance of three forces: job satisfaction, money, and lifestyle. While it is possible to have all three, Citrin says that they are not always possible at the same time, especially not early on in your career.