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How to Eat Your Way to Mental Clarity, with Nutritional Psychiatrist Drew Ramsey
Most of the foods we consume are created for the supermarket shelf, not for our health, says psychiatrist Drew Ramsey. But you can boost your brain function and overall well-being with this one very low-tech, analogue tool: your grocery list.
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: A lot of people like to talk about multivitamins and how they're an insurance policy. And it's always confused me as a doctor. Do you really think there's an insurance policy for not eating well or not exercising or moving your body or not living in a compassionate and peaceful way? There's no insurance policy for that. When you don't eat well you get sick. And that's one of the reasons that I really promote a food first philosophy that certainly if people have a deficiency, for example, if you have an illness like pernicious anemia where your body doesn't allow you to absorb B12, of course you have to take a B12 supplement. Or if you're severely iron deficient, take an iron supplement. But over the long term what we really want to see is that people are getting their nutrients from food.
So some of the reasons for this aren't about nutrition, they're about community, that when you're engaged when your food and your food supply, when, for example, you go to a farmers market or if you have kids if you take them to a farm and teach them about where our food comes from that really creates a different philosophy or a different mindset about nutrition and about how we nourish ourselves. Certainly you can live on a multivitamin and sipping on some coconut oil, but that to me doesn't create a great meal. And that's really where I think about my favorite healthy delivery system, it's the dinner table where as people sit around there's a lot more going on than just the food. My family we're talking and we're processing the day and we're trying something new. Even just engaging with your food the creative process of cooking, you take some of these wonderful food I just sort of picked up at the deli and I thought well we can just whip up a little quick salad, add in lots of fats and proteins with these nuts and seeds, s little leafy green with the watercress. I've never made a salad that has those ingredients but it's a creative and fun process in a way to engage.
I think that's a big difference the idea of starting your day taking a set of pills that someone has prescribed for you or that we have thought about as that's what makes you healthy as opposed to really seeking out the top food sources. And food is really the foundation of your health. There's also some differences in terms of absorption. There's some molecules, for example, that just aren't in multivitamins or aren't in as good of a form I would say.
Things like a vitamin E. In the natural world there are eight forms of vitamin E, in supplements there's one form. In all these foods that I love to talk about the leafy greens and lemons and red peppers there are a host of what's called phyto nutrients or plant-based nutrients. And these are really the miracle molecules of why plant-based diet are just so incredibly good for our health because they're signaling molecules. They literally travel from the end of our fork into our DNA and change how our genes get expressed and they turn on genes that keep us healthy. So that's another way that supplements and real food differ as you get these phyto nutrients. I like the idea that food becomes a way of nourishing the self in a way that a supplement really can't. There are a lot of beliefs in supplements but really you can get all of the nutrients that you find in supplements in whole good nourishing organic foods.
Another important perspective when we think about brain health is it allows us to look at certain food trends in certain ways that you can take something that people think of as healthy like juicing or a smoothie. If you look at a smoothie for a lot of people it's often a lot of tropical fruits and maybe some low-fat milk or yogurt and really it's a lot of simple sugars. And we want people to have a more robust meal with her smoothie. So all the smoothies in Eat Complete have seeds or nuts in them because I'm trying to increase the fat content in a smoothie and increase of the protein content. Now fat has been a bad word for way too long. I hope that everyone now is considering fat as something that's really healthy. One reason is your brain is mainly made of fat and your brain is amazing. Human brains are amazing so fats are very, very important to brain function. And also it's important in terms of staying full that when we eat fats and proteins and complex carbohydrates our bodies just stay full longer so you're eating fewer calories and that helps move you towards an optimal weight.
So really eating for brain health helps you look at something like a smoothie and say I want to get as much of the whole food as possible. It's why the smoothies in our house I don't usually juice ever in our house, we just throw the whole food in there whether it's kale, blueberries, some kaffir, a little fermented dairy product, some almonds, for example, and blend it up where I'm really, again, trying to deliver a lot of nutrition in a small dose. The other thing I like about smoothies is often times I'm working with patients who are depressed and they don't have a lot of appetite so it's a little bit of a paradox, we know they need to eat much better in terms of really to restore their full health. So they don't have a big appetite so something like a smoothie with, again, lots of nuts and seeds and some healthy fats really can help them because it goes down easy and it's in a small, small amount.
There are a number of myths that I think are also really important to dispel about eating for your health. One is the myth that it costs too much. I grew up in a food desert in Crawford County Indiana, very rural Indiana and a food desert is a place that there isn't fresh food and there aren't grocery stores. And what's very interesting about where I grew up is there are a lot of farms. So you'd wonder how is there a food desert? And we see what's happening really over the last ten years in America is a change in how we get our food. Increasingly we're having food delivered to us. Increasingly we're having farms, like right here in New York City one of my favorite farms is on a rooftop across the river, huge farm; feeds hundreds of families called Brooklyn Grange Farm.
So in terms of access we really see things shifting where there are great policies in the many states now where food stamps are two for one in a farmers market. So there's this redistribution of how we think about food and food dollars, but access can be a huge issue so how do you find access? There are lots of great resources to help you find local farms in your area. A CSA or community supported agriculture is a way that for a few hundred dollars you can get a big box of produce every single week. And so there's all kinds of little tips and hacks in terms of how you can get this food into your diet without spending a lot of money. Eat Complete is a plant-based book. Plants cost less money than things like meat and even a lot of processed foods. So when I think about how to describe what is a healthy food to people I talk about the rule of kale. That kale has been a phenomenon and even there's a little bit of kale backlash now, but really the point is that kale teaches us a lesson. There's three lessons. The rules of kale are we want to look for foods that are nutrient dense, more nutrients per calorie. The difference between a kale salad is a bevy of nutrition and good feeling and something like a soda or a marshmallow, just sugar no nutrients for your brain. We want everybody to be nutrient dense food.
The second rule kale is about culinary versatility, that you can do a lot with it. I mean you might not think so. Back in the day kale was just in the salad bar at Pizza Hut. It's like the third circle of hell for kale, but culinary versatility is that you can use kale in a lot of different things. You can drop it in your smoothie; you've just increased the nutrient density of that smoothie. You can make a kale pesto or a kale soup or a kale salad and put a nice piece of salmon or wild shrimp on top of it. You can make a kalejito even. You can use it and all kinds of ways creatively. And then the third is accessibility. Kale grows everywhere. It's $2 to $3 dollars for a big bunch of organic kale. You can make a giant batch of kale chips. You can feed a family of four for probably a week on a few dollars of kale.
And so that's really I think where the accessibility issue hits home for me is that we forget to teach people about proper nutrition and about our relationship with the food supply and we don't learn these basic culinary skills. I'm not a great chef. I have a chef's knife and my cutting board and some olive oil and that's the base of almost all of my dishes and a cast-iron skillet. Simply combining good wholesome foods together it ends up being just absolutely delicious and incredibly nutritious. And that's the goal and I think we have to really understand that for a lot of people the barrier is money and time. And one of my favorite little tips is around dried beans and lentils. So dried beans here in Manhattan $2.29 a pound for the small red bean. The small red bean has more phyto nutrients or antioxidants per gram that any other food, even more than blueberries. So an example of really, really low cost point very, very nutritious food. And then time. And part of my focus in Eat Complete was trying to find very, very simple quick recipes for people to employ in their every day life. Because as a clinician I really am on the front line of seeing the difference of sort of telling people what to eat and helping them really change their behavior.
I meet with a lot of eaters where it's very clear to me they know exactly what they should be eating, but how you actualize that, how you manifest that in your every day life is the challenge. And that's where dispelling these myths like it takes forever. I cooked breakfast for my kids and my wife this morning in five or ten minutes. It's simple, oatmeal with some almond butter scooped on top of it. If I want to get fancy maybe I'll put a little lemon zest on there, a little cinnamon, maybe drop in some fruit; simple, simple whole foods. A real easy test of your food is look at your plate and everything should have one ingredient. You're looking at brussels sprouts maybe with a little bacon in there or you're looking at wild salmon with a garlic scape pesto, all things that you recognize and know as opposed to reading ingredients on the back of a package where those foods are generally created for the shelf; they're not really created for your health.
If you have an appointment with psychiatrist Drew Ramsey, there’s no guarantee that you’re going to walk out of there with a bottle full of pills. Sometimes you’ll emerge with a recipe for a blueberry-avocado-kefir-nut smoothie. Or a shopping list for how to make kale pesto. Ramsey is leading the charge in a relatively new branch known as nutritional psychiatry. Physically, we can see the difference between someone with a good diet versus a poor diet, the external symptoms of nutritional deficiency are obvious, and so you don’t have to stretch the imagination too far to imagine the difference it might make internally, particularly to your cognitive abilities and your mental health.
Vitamin supplements are necessary for those of us with specific deficiencies, but according to Dr. Ramsey for comprehensive health in all spheres, a thoughtful and nutrient dense diet is much more effective than a multi-vitamin, for many reasons, not least of which is that supplements don’t deliver all forms of nutrients – as he points out, in the supplement bottle there is one form of vitamin E, whereas in the natural world there are eight varieties. These nutrient molecules are vital because they signal instructions to our system. "They literally travel from the end of our fork into our DNA and change how our genes get expressed and they turn on genes that keep us healthy."
Ramsey brings to attention the versatility of food, and breaks down the myth that providing good food for yourself or your family has to cost the world. In a move that salutes the character of Bubba from Forrest Gump, and his multi-scene soliloquy on the various ways one can cook shrimp, Ramsey does the same in this video for kale, and all the ways you can turn it into nutrient-dense brain food for just a few dollars – everything from kale soup to a kalejito.
From tips on how to improve your smoothie game, and waving farewell to outdated schools of thought that demonize fat, to ideas about food as a communal ritual, and accessing quality produce on a small budget, in this video Ramsey explains the molecular power within foods that can keep our brains and bodies running optimally. Research shows that eating a diet with plenty of plant-based whole foods, good fats, and some seafood (and reducing processed foods), can decrease your risk of an illness like depression by as much as 50 per cent.
Drew Ramsey's book is Eat Complete.
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Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."
The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
A new study looks at what would happen to human language on a long journey to other star systems.
- A new study proposes that language could change dramatically on long space voyages.
- Spacefaring people might lose the ability to understand the people of Earth.
- This scenario is of particular concern for potential "generation ships".