← The Neuro Experience
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- [00:00]
A
We really do need to change this because people are being given the wrong information. Medications can change brain chemistry, but they can't get at the deeper causes of brain malfunction. Let's zoom out for just a moment.
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Dr. Georgia Eade, a Harvard trained psychiatrist and best selling author of Change youe Diet, Change youe Mind.
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The cornerstone of my work is the ketogenic diet.
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B
We are diving deep into the fascinating and crucial interplay between nutrition and mental health. With over 1 billion people, people worldwide affected by some form of mental illness ranging from depression and anxiety to bipolar disorder and dementia. All mental health issues are mood disorders, but not all mood disorders are mental health disorders. Can you explain what you mean by that?
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Well, all mood disorders are mental health disorders.
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B
There's so many things to unpack there.
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A
People have so much more control over their mental health than they realize.
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B
Let's talk about adhd because it's a mystery to me what ADHD is and how nutrition plays a role in this.
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A
Great. So ADHD is.
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B
Dr. Georgia Eid, thank you so much for coming to the Neuro Experience podcast. I love discussing how the relationship between food affects mental health outcomes. The whole world of psychiatry very much interests me and is a bit of a question mark for me. So I know going to get into so many things you, we're going to especially touch on your book Change your diet, change your mind. Before we get into it, I want to ask you probably the burning question that I actually get asked almost every day. And that is what really is the top foods for brain health?
- [01:49]
A
Yeah. So there, I think if you asked most people about food and the brain, you would hear answers that have to do with superfoods and foods that have antioxidant superpowers and anti inflammatory superpowers and you know, special kinds of superfoods. Blueberries, flax seeds, chia walnuts, curcumin, you know, turmeric. You would hear a long list of superfoods that people put their faith in and hope that if they just kind of sprinkle more superfoods on top of their diet, that that is going to protect and improve their brain health. And unfortunately that is not the case. Those strategies do not work. And if we're really talking what we really need to understand instead of, you know, if you really are serious about improving and protecting your brain health, which is your mental health, your neurological health, your, your stamina, your mood, your, your ability to concentrate your memory in the future, if you really are ser. Improving your brain health and protecting your brain health, you can't just sprinkle superfoods on top of your unhealthy diet. You have to fundamentally restructure your diet from the ground up in ways that make biological sense. And if you do that, you will see noticeable improvements in your mental health, in most cases in days to weeks. So these are very powerful strategies. And it's not about focusing on any one particular food. I mean, there are foods you need to include that nourish the brain, but there are also foods you need to exclude. That's where the real power lies. The real power lies in removing foods from the diet that are damaging the brain, that are causing all of that inflammation and oxidative stress and insulin resistance in the first place, rather than trying to fight them with special superfoods. So this is, this is upside down from how most people think about brain food, but this is the, the, this is the most empower and most effective strategy you have, is figuring out which foods are the most nutritious. And I help people sort that out, figuring out which foods are causing damage, removing those, and then getting your glucose and insulin levels under control so that you energize the brain safely for the rest of your life, protect your brain metabolism. So these new brain food rules, these are the ones that people need to learn if they're really serious about, about their brain health.
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B
There's so many things to unpack there. Because first of all, what I was going to state to everybody is there is a common misconception when it comes to neuroscience, and that's where people really separate the brain from the mind. I've noticed your book is change your diet, change your mind, but it's not change your diet, change your brain. Are you saying, as a, as a psychiatrist, are you saying that behavior, let's just call it the mind, really dictates brain health outcome? And when I talk about the brain, and this is for everybody listening, I'm talking mainly structural parts of the brain. We're talking brain volume, size, maybe arterial health. Are you talking about that as well? And can nutrition play in both our mind, mainly neurotransmitters, how we think, how we act, anxiety, et cetera. But he also talking about how nutrition can also change the brain, the structural parts of it.
- [05:29]
A
Yes, exactly. So the, the brain, the most powerful way to change brain chemistry and change brain anatomy is through food, because that's where the brain chemicals and the brain components come from in the first place. And so if you're trying to change your brain with food, which you can, you need to change your Mind about food. Because the strategies that work best, many of them, fly in the face of some of the beliefs, the widespread beliefs about what a healthy diet needs to look like. And so if you really want to get at the root causes of mental illnesses of all kinds, whether they're major, minor, whether they're attention problems, mood problems, stamina problems, concentration problems, memory problems, if you want to get to the root of those things, there are many things you need to change your mind about when it comes to what a healthy diet needs to look like. So that's why the title change your diet, change your mind. Because to change your mind with diet, you have to change your mind about diet. So so many of the things we've been led to believe, we've heard them so often we assume they're true. Things like whole grains are good for you, red meat is bad for you, cholesterol is bad for you. Plant based diets are healthier. Must have a rainbow of fruits and vegetables. That's the best way to protect your brain from damage. So all of those are myths, all of those are, are false. And so if you really want to improve your brain health in ways you will notice, most people, if they change their diet in the right ways, will notice meaningful improvements to their mental health. As you were saying, their behavior, their mood, their, their energy levels, how resilient they are throughout the day, how even they feel, how positive they feel, how well they sleep, how well they concentrate, how much they get done. If you, if you want that kind of result, you need to change your diet in very specific ways that respect brain biology.
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B
Yes.
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A
Rather than nutrition ideology. It, no. In, in four years of medical school and four years of psychiatry residency, we didn't talk about food in the brain once. And so it honestly never crossed my mind that the brain cared what we ate. I, like, I think many women thought of food as a way to control my weight and maybe my cholesterol levels. And that was pretty much it. And, and the very little that we did learn about nutrition in medical school, we had maybe two or three hours worth of nutrition, nutrition lectures in a full four years of medical school. Most of what we were taught was not correct. So I had no idea.
- [09:25]
B
That's scary. That's very scary.
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A
It's scary and it needs to change. Because how many people listening to us talking right now go to their, their doctor or their nurse practitioner, whoever it is, they see for primary care, for nutrition advice? How many of them are listening to advice from their doctor, the nurse practitioner about what to eat really Honestly, unless you take it upon yourself to learn about nutrition science as a medical professional, you will not learn it from medical school or professional training. You won't and it's just not part of the curriculum. And so this is, we really do need to change this because people are being given the wrong information. And, and, and the, the, the sort of, the blessing and a curse is that if you have the right information, you can turn things around very quickly. In a lot of cases, even, even in very serious situations of serious chronic, so called treatment resistant mental il have the right information about what the brain needs to eat to function properly, then you can in many cases reduce or even eliminate the need for psychiatric medication. And you can even in some cases, I've published a study on this and others have as well, you can reverse, you can put even very serious mental illnesses into remission if you have the right dietary information. So this is really powerful information that all practitioners need to learn. I teach a CME accredited course in ketogenic diets for mental health. One of the most powerful strategies people can use to improve their mental health is a ketogenic diet. But that's not the only option. So in the book I know keto is non starter for a lot of people. There are many changes you can make to your diet without going to a ketogenic diet that can help you feel better, perform better and think better and sleep better and so forth. So there's so much, people have so much more control over their mental health than they realize.
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B
Yeah, so you've mentioned before, and I quote, all mental health issues are mood disorders, but not all mood disorders are mental health disorders. Can you explain what you mean by that?
- [12:06]
A
Well, all mood disorders are mental health disorders. So if you have, if your mood is not stable, if your mood is unpredictable, if your mood is, if you go to extremes easily, if you feel irritable, you lose your patience easily. You're naturally pessimistic, you worry all the time. You know you don't have a positive outlook on life. Or you may even feel so depressed that you, that you can't get out of bed or can't get anything done. You may even want to hurt yourself, harm yourself, may even want to give up or die or disappear. Something is wrong with your brain. And, and the brain is an organ like any other organ. It can malfunction just like any other organ can. This is not about character weakness. This is not about your mother. This is not about, you know, this is, this is not about some myster chemical imbalance that we don't have a way to test you for and we don't, and we don't have good treatments to correct. This is a brain malfunction that we can, that we can address by understanding better how to help the brain function, what the brain needs to function properly. All of us have been given the wrong information about nutrition for generations. So we have been feeding our brains improperly our entire lives. Of course it's not going to function properly. Most of us are walking around with suboptimal mental health. Even if we don't have a diagnosed mental health condition, most of us are not functioning at our best. And that's, that's both the, that's both a, a tragedy and a great hope. Yeah, because you have the right information, you can change how you feel in many cases, as I said, in days to weeks, if you have the right information.
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B
I think I really want to touch on what you mean when you say, you know, if you're feeling irritable, if you're feeling anxious. Because when it comes to things such as cognitive decline and Alzheimer's disease, for example, we know that the earliest symptoms are. We forget our keys, we forget our treatment aims, we. But it's very important to differentiate between what is just normal life under stress and what is, you know, pathophysiology. And so I can, you know, I'm a, I'm a mid 30 year old menstruating female, so I can be the first to say that sometimes I feel irritable and I'm anxious and I'm all over the place depending on my moods. But that doesn't mean I have a direct mental health disorder. Is it something where, I mean, maybe it is, maybe you can tell me, but is it something. First of all, is this in line with the DSM and is this something where you have to experience these symptoms ongoing for maybe 10 days or three weeks?
- [15:02]
A
Yeah, so you're bringing up an excellent point. There's a lot of confusion about where the line should be between normal variation in mood, for example, to take mood as one example, memory is another example. But there's a lot of confusion about where the line needs to be between normal and abnormal, between kind of everyday issues that people might, you know, struggle to remember, why did I come into this room? Or getting depressed after, after something difficult happens in your life, or being worried about a very real stress in your life versus a mental health disorder. And, and the reason why there's confusion about that is the line is. Actually, there is no line there. The line is Very fuzzy. It's a spectrum. So mental health and mental wellness exist on a spectrum of excellent to very poor. And all of us live somewhere on that spectrum. And there is no solid black and white line. It's a matter of degree how well or unwell you are. So the, the, the so called DSM 5, the Diagnostic and Statistical Manual of Mental Disorders which psychiatrists use to assign diagnoses to people. That book lists the number of symptoms you have to have and how long you have to have them and how much they have to interfere with your function for you to qualify to have a diagnosable mental health condition. So, and these are fairly arbitrary, but in any case you have to draw the line somewhere if you're trying to make a diagnosis that an insurance company will reimburse you for. But, but really in real life, what, what matters is how well are you functioning? Are you able to get the things done that you want to do? How do you feel throughout the day? Do you feel positive? Do you feel energetic? Do you feel resilient? Do you feel capable? Are you sleeping well? Do you have enough energy to get through the day all you know? How, how are you managing your relationships, your work responsibilities and are you able to experience joy? All of these things are, are a matter of degree. And there's room for most of us to improve where we are now. Especially if you're eating a sort of typical diet, there is a lot of room for improvement. So I think it's less important to un, you know, to sort of, for each person to compare themselves to the spectrum and for everybody to optimize their mental health. Get as far over to this side of the spectrum. Flourishing, Mental flourishing. True. Well, being as you possibly can. And for that's going to be a little bit different for everybody. But we've, I mean I've had people in my practice since I've been working this way, I've been working this way for about 15 years who say, you know, I've never felt this good in my entire life. Life. That's very different than prescribing a medication and somebody coming back and saying, well, you know, my depression's a little bit better, my symptoms are not as bad. And that's what you will usually hear if you prescribe medications for a living. The medications can, in some cases they have their place and I still use them in my practice. They're not, they can be useful. They fail most people, but they can be partially useful. In some people, these medicines, what they're trying to do is they're trying to suppress symptoms, but they can't get at the root of the problem and they can't heal. They can't heal the brain. They can't nourish or protect or energize the brain in a way that a really well constructed, healthy brain, healthy diet can. This is why I love to say, because it's true, that the most powerful way to change your brain chemistry is with food. Medications can change brain chemistry, but they can't get at the deeper causes, the drivers of brain malfunction. We don't just want to know is there a chemical imbalance and which medicine might try to correct that imbalance. We want to know what's causing those chemical imbalances in the first place. And that's an empowering question.
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B
So what you're saying is we, these mental health disorders and I talk, you know, we can say depression, anxiety, and the malfunction is not a result of how we are born. It's a result of the external environment.
- [19:45]
A
It is both like everything in human biology, it's a combination of our environment, the, our, what's called nature and nurture. Right? So the nature, so what the genes we were born with and the, and you know how, you know how, for example, our brains developed in the womb. These are, this is a very, very important factor which also comes down to good nutrition in large part. So some of, some of what we, what we've inherited, some of what we've been exposed to before we were old enough to make our own decisions, those and some of the traumas that we've experienced or injuries, head injuries, psychological trauma, nutrient deficiencies, genetic, genetic vulnerabilities, all of those things are kind of the cards we were dealt. And then on top of that, so that varies from person to person. But then on top of that, we have the choices that we make, the lifestyle choices that we make. So nature, nurture. And so, and some of this is luck, Some of this is luck. So you know, you can't choose your parents, you can't choose your genesis. So some of this is set in stone. But what most people don't realize is that those influences pale in comparison to the lifestyle choices that you make in terms of setting really laying a good foundation for the metabolic and nutritional status of your brain. How, what is it composed of and how well is it energized? And you have tremendous control over those things. So I like to say your DNA is not your destiny. In most cases, your genetic vulnerabilities are going to be contributing only to a Very small extent, your total mental wellness, most of that is within your power to control.
- [21:36]
B
I'd love to just hone in on some of the disorders that are really affecting society right now. And you can probably see. Speak more about this than me, but what I'm seeing is a number of cases of adhd, adult ADHD being diagnosed. I want to know more about that. And then we'll move into two others. And then what I'm really, really super interested in is the, the overall pathophysiology. Like what, what are we talking about? We're talking about the food having an effect on the mitochondria. Are we saying downregulation of inflammatory biomarkers? And then there's this whole question around the ketogenic diet and increasing LDL cholesterol, of course, and apob and how that might have an effect on cardiovascular disease risk. So I have so many questions, but let's talk about adhd because I gotta tell you, it's a mystery to me. I don't have it and I can't understand. You know, I have a very, very, very close girlfriend who just. She. And she hasn't. She's been diagnosed and she's actually on Vyvanse, I believe. And I just see, you know, sometimes her attention span, even when I'm talking to her, maybe she'll just switch. And I, I wish to God that we can help her. So help me to understand what, what ADHD is and how nutrition plays a role in this.
- [23:04]
A
Great. So ADHD is, is very common and in children as well as in adults. And really? I think so. So ADHD stands for Attention Deficit Hyperactivity Disorder. Some people just have the inattentive symptoms. They, they. Their attention, their attention is not properly regulated. Some people have hyperactivity symptoms. Those are, those are the kids and adults who can't sit still, restless, that sort of thing. Feel like they're being driven by a motor. Lots of phrases people use to describe this. And some people have a combination of the two. Inattentive symptoms and hyperactivity symptoms. And so this is according to the DSM 5 that we're talking about before the Diagnostic and Statistical Manual. I really don't like the term Attention Deficit Disorder because even though that's the correct term, because it really isn't a deficit in attention. I mean, I worked in an ADHD specialty clinic for several years, the Hallowell center outside Boston. I worked in college mental health at Harvard University and later at Smith College for a total 12, 13 years, working with many students who had attention issues. It's not that these people cannot pay attention, it's that they cannot direct the attention where it needs to go, when it needs to go there, for as long as it needs to be there. So we all know people with ADHD who can focus for hours on something that doesn't matter, something that they don't have to get done that day, or something that intensely interests them. We all, I mean, it's not that they can't pay attention, they can't control where the attention is going, when it needs to be there. And for, for the long, a long enough period of time. So they've, they do not, they cannot be effective in their lives. They can't, they. And ADHD can be actually a very disabling disorder in some cases. It can really interfere with people's ability to hold down a job, to hold down a relationship, to get credentialed in whatever the field is that they wish to, they wish to succeed in if they're following sort of a more academic or vocational path. So people can't get things done that, that matter. And, and this is really frustrating because it has nothing to do with intelligence. So you can be a very, very intelligent person and fail over and over again in your life. And this mismatch between, between potential and actual capability is very frustrating for people because they know that they could do it if they could just concentrate and, and not procrastinate.
- [26:00]
B
Is this a problem of dopamine?
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A
Dopamine is one of the chemicals that's implicated. So dopamine malfunction, but also norepinephrine malfunction, but also brain energy deficits, meaning energy dysregulation in the brain. And this, I mean, this really is one of the foundations of, of many mental health disorders is that the brain isn't getting not enough energy for long enough in a stable enough way. So the brain needs to be receiving a constant supply of high quality, smoothly delivered, clean energy to function properly. And there, there, there are two different ways to energize your brain. So you can energize the brain the wrong way, which means that you're going to get peaks and valleys in energy delivery to the brain. You're sometimes you're going to have too much energy in the brain, you're going to be in overdrive. Other times you're not going to have enough, so you're not going to be able to get anything done. So the regulation of energies, the energy needs to be smooth and constant and reliable and clean. So one way you can energize your brain because this is what concentration is all about. You know, your brain needs to have enough energy to get things done that you need to do right. So in any case, there are two ways to energize your brain. One is a very clean way, which is this, you're not going to bombard it with too much sugar and vegetable oil and ultra processed ingredients that will actually cause a lot of inflammation and oxidative stress in the brain. That's quite damaging and that can, can cause the brain to malfunction or you can, or you can deliver energy safely with whole foods in a way that keep your glucose and insulin levels under good control so that your brain will have the right amount of energy at all times. 24, 7 and it's properly regulated. So attention regulation can be a problem in people who, who don't. Whose energy, brain energy is not properly regulated. So I have patients in my practice who've had ADHD for years and years, often decades. Because many adults ADHD can persist into adulthood. It can also develop in adulthood, even in people who didn't have it when they were children. Right. So it's not always a childhood onset disorder. I have people in my practice who, when they are following a ketogenic diet, for example, which energizes the brain very differently than a high carbohydrate diet does, they don't need to take their Adderall on days when they're in ketosis. They can skip their stimulant medication or they can reduce the dose. And so you can see in clinical practice what a difference this makes. And I'm involved in a study that's about to be launching at Oxford University led by Ali Houston, that's going to be looking at ketogenic diets for ADHD in adults. There's another study that we're hoping will be funded in the very near future that we hope to start in 2025 at the University of Michigan with Dr. Laura Saslow, where we're going to be looking specifically at ketogenic diets for ADHD in adults. We believe that this intervention has tremendous promise for people who are struggling with attention regulation issues.
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B
It's. I want to talk about other diseases, but I think I just want to stay on really understanding the ketogenic diet and, and how it's having this effect. Would exogenous ketones as well help with these symptoms?
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A
They can in some cases. But the problem with so exogenous ketones for, for listeners who don't know what those Are. Well, let me back up a little bit. So a ketogenic, what a ketogenic diet does is you, it, it lowers your insulin levels to the point where your body can start to burn fat for energy, more fat for energy. So if you're eating a high carbohydrate diet, you'll most of the time be running your cells on glucose, blood sugar, much more glucose than fat, you'll be burning more glucose than fats. You're more, burning more carbohydrate than fat, essentially. Right? So you're, you're in sugar burning mode, for lack of a better way to say it. So if you're eating a high carbohydrate diet, you're mostly running on glucose. When you're eating a ketogenic diet, you're lowering your glucose levels by lowering your carbohydrate intake. You're lowering your insulin levels by, by not just lowering your carbohydrate intake, but also being careful not to overeat protein. You're getting your insulin, your glucose and your insulin levels down. And when your insulin levels come down to this, to a certain point, fat burning will switch on. And when fat burning switches on, some of that fat will be broken down into tiny fragments called ketones. It's really just kind of pre, it's kind of ready to use fat fragments that the brain can burn for energy. They cross the blood brain barrier very easily and they bridge any energy gaps that might be there. A lot of people, the majority of Americans and a growing number of people around the world have something called insulin resistance, which means the brain isn't getting enough insulin. And if the brain doesn't have enough insulin, it can't burn glucose to full capacity for energy. So the brain slowly loses its ability to burn glucose for energy at full capacity. So you start to get some energy deficits. And so to bridge that energy gap, that glucose burning gap, the, you need a supplemental fuel source and that can be key. Ketones can cross the blood brain barrier and bridge that energy gap and bring those sputtering cells back to full, fully energized again. If they haven't already died, which is we could get, get into neurodegenerative diseases later, Alzheimer's disease. But if the, if the cells are still alive, but they're just sputtering, trying to do their best, even though they, they, they don't burn glucose very well anymore, then ketones are a godsend because they, glucose and ketones can work together to fully energize those cells again. So this is the beauty of a ketogenic diet, is that the majority, 93% of Americans have some degree of insulin resistance, which means 93% of Americans, their brains aren't functioning at full capacity and need some energy support. So this is a beautiful way to solve that problem. So that's a ketogenic diet. Now the other way you can do this is you can take exogenous ketones, you can swallow ketones from a bottle, beta hydroxybutyrate molecules. And so you'll, you'll get that spike of ketones in your bloodstream and those ketones will cross the blood brain barrier and bridge energy gap. But a couple of problems with that strategy. One is it's much more expensive because ketone supplements are expensive. Another is they only last 90 minutes, maybe two hours tops in the bloodstream. So you'd need to take them multiple times per day. Not everybody tolerates them well, although most people do. But the, really the big problem with ketone supplements is that they don't lower your glucose and insulin levels into the normal healthy range. And that's the pro, that's what's causing all the damage in the first place. So you'll get the ketones bridging the energy gap. But underneath all that, you're still damaging the brain, you're still damaging the brain's ability to turn glucose into energy. You're still damaging the brain's architecture, you're still creating in waves of inflammation, ways of oxidative stress, and you're worsening insulin resistance over time. So underneath those ketones are, would be. Those exogenous ketones are really just like a band aid because underneath there's still the disease process, whatever it is, whether it's attention issues, memory issues, mood issues are, are marching on. So things are getting worse underneath and you're just really delaying the inevitable with exogenous ketones.
- [34:26]
B
It's very hard though to get into a, a ketogenic state. I do believe. Don't you have to completely. Because I've tried it once. I think I was actually measuring, I was using the. Is it the keto meter? I don't know. The, the.
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A
Yeah.
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B
To, to actually test my ketone levels via a pin prick test. You can just do a simple blood test, keto meter, maybe it was called to be in complete ketosis. What would that have to measure if you were using this machine?
- [34:57]
A
Yeah. So what, what I really want this, I'm glad you're asking this question because what I really want people to understand is that that some People do need to be in ketosis long term to be well, but many people don't. Many people just need to be able to access that ketogenic state on a regular basis. They need to get their insulin levels down at least overnight when they're sleeping, which is not happening for most people. Most people are eating in a way that their insulin levels are staying high all day long between meals and even well into the night, sometimes even all the way until the next morning. And if your insulin, if you're living your life in a high insulin state, I mean, that's the root cause of most of the chronic diseases we face. Mental illnesses as well as physical illnesses, cardiovascular disease, obesity, fatty liver disease, many cancers, most brain illnesses, neurodegenerative disorders, Alzheimer's disease, for example, depression, bipolar disorder. So whatever disease you're worried about, chances are insulin resistance, this high insulin levels that will lead to insulin resistance are, are underneath, are our major driver. I've got a chapter in the book that lists all the diseases that high insulin levels will lead to. But what you're saying is so important because that low insulin state, that ketogenic. So when your insulin levels are nice and low, low enough that fat burning switches on. It's not just that you're burning fat for energy, which is a great thing to do, but that low insulin state is when all of the healing pathways turn on so your, your brain and body can't recover or do maintenance or recycling work or, you know, do the. All the work of cleaning up after a very busy stretch of food processing. They. It's. It's as if you were running an automobile factory and you never, you never let. You never shut the factory down so you could do maintenance and repair. So we are designed to function optimally by spending, ideally overnight, at least, letting our insulin levels come down into that healing mode. And it's not just about burning fat. And it's not just about, you know, it's not about weight. It's not about. It's not even about treating mental illness. It's about care and maintenance of ourselves. We need to enter that state on a regular basis, even if not all the time.
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B
I'm so, you know, this just brought up something. So right now, for some reason, there's. In my workspace, there is this insulin thing happening right now. We just interviewed Dr. Ben Bickman.
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A
Yes.
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B
You know, and he was. And this was last week, and he just really drove home that this hormone insulin is at the seat of really good health, but also at the seat of metabolic dysfunction. And I just read A1. It's so fascinating what you're saying. Just read a wonderful New England Journal of Medicine study that was done on Tirzepatide. So it's the GLP one plus the GIP medication that is now, you know, it's meant to be used for insulin resistance. But other than helping with type 2 diabetes, this drug now has also been shown to have an effect on the inflammatory state. So they did this as a measure of C reactive protein. So what they found was that individuals who were on Tirzepatide for, I think it was six to eight months had noticeable differences in their crp, some going from four to less than one as a byproduct of, I'm guessing, maybe not triggering insulin, which is probably because you're. When you have this drug, it satiates you. You don't feel like eating, therefore you don't get this insulin spikes throughout the day. But I thought that was really fascinating, the fact that, okay, yes, you're losing, you're losing fat, we hope, or you're losing weight, let's just say. But you're also having an effect on your entire inflammatory levels and probably cortisol as well, which then they're showing outcomes in many things, mental health and mood, but also pregnancy outcomes. I think they even did trials on IVF outcomes as well. And we know that PCOS is just insulin resistance. So all of it is just doing this full circle. For me right now, it really is.
- [39:44]
A
Coming back to Dr. Ben Bickman. He is one of my favorite teachers and researchers in this field. And I've met him many times and always enjoy being with him at conferences and listening to him speak and talking with him. And I always often tell people that if I could have one implant in my brain, it would be a doctor Ben Beckman implant it.
- [40:07]
B
Yeah, he's wonderful.
- [40:09]
A
He's really. There's so much to learn from him. But so, and he's absolutely right about insulin being the, the. If you're going to pick one thing to focus on and understand in your life for, for optimal health, it is how to control your insulin levels. And it's very easy to do. So you can do it with a GLP1. GLP1s are going. I, I have no doubt GLP1s are going to be found to help with almost, with just about literally any disease you can imagine. Because the way they work is they reduce appetite, they reduce glucose levels, they reduce appetite, they reduce food intake, and they reduce glue. So all of those different. So they make you feel full sooner, for longer because they delay the gastric emptying so the stomach stays full for longer. Food stays in the stomach longer so you don't feel like eating. They also turn down the liver's production of new glucose molecules that are being poured into the bloodstream. So glucose levels come down. And, and just by eating less, your glucose levels will come down too because you're not eating as much. That's going to raise your glucose level and your insulin levels are going to come down. So your glucose and insulin levels are going to come down. And that's the very same thing that a ketogenic diet does without side effects. Co pays injections. It, it's, it's the very same mechanism underneath. So now I, I read just the other day that more than 50% of Americans qualify to be prescribed a GLP1. I mean, think of that, that, that, that is the degree of metabolic dysfunction in our country. And those are just people who meet this high bar for, for this expensive medication. Most of us have some degree of, of metabolic dysfunction. So the beautiful thing about this is, you know, some people say, well, your GLP1s are great, they work really well, but the problem with them is on.
- [42:06]
B
Top of the cost.
- [42:07]
A
Yeah, on top of the cost and the same and all that sort of, there, there is the, the, well, you can, if you stop them, all of your problems are going to come back. Right. So they don't, they don't solve the problem. They just put a band aid on the problem. Right. But there's this wonderful study by Virta Health that came out last year where they, they took people who, with people with type 2 diabetes and obesity who had benefited from GLP1 medications and then they transitioned them to a ketogenic diet and then they took them off the GLP1s and those people were able to maintain the benefits, all the, the lower glucose levels and the weight loss off of the GLP1s by, by transitioning on to, to a low carbohydrate diet. So one of the things I think GLP1s can be. You were just saying how hard it is to get into ketosis. It's not. And there, there are lots of tips and tricks for getting people into ketosis and I've put a lot of them in the book. But for people who do struggle, especially people who have a long history of severe obesity or food addiction and really struggle to get their appetite and their food intake under control so that they can get into ketosis, a GLP one can be a wonderful Bridge because it brings the appetite down and allows you to follow that ketogenic diet. Get into ketosis without all those cravings and then you can take the GLP one away. Once you, once you're solidly, once you're in ketosis, after you've been there for a few weeks, it becomes very easy to stay there because your appetite is so well regulated, your insulin glucose levels are down, your cravings go away. All of these things are beautifully managed once you get to the other side. But it's getting there, it's that transition that can be so hard for people. So I do see a role for GLP1s for helping people get onto a ketogenic diet if they're not able to do it on their own. But, but I, but I'm not a big fan of GLP1s long term. For most people I think there will be exceptions, but for most people, I mean really, we can't medicate our way out of this problem. We have to face the fact that we are eating the wrong way, we're eating ourselves to death, and it is about eating less and exercising more. But we need the right rules. We need to understand what is it that is okay to eat, what are the right foods that won't get, that won't feed our cravings and, and cause our insulin levels to stay up and keep us hungry and fat. And I think this is, I mean this is really what it's all about. People have the right rules, they can succeed, but they're being given the wrong information about how to eat to maintain a healthy weight and to maintain good physical and mental health in general.
- [45:15]
B
All right, so let's play devil advocate right now, right? I, I am in the area of Alzheimer's disease. I, it's what I see every day. Apart from working in neuro oncology. What I find is that there is a very, there's, there's two bands here. Okay, You've got the, the carnivoresque diet, we'll call that over here. Who is saying this is the best diet for your brain? And I think that, that, that is very much you. This is the best brain as it relates to, as it relates to all cause, mortality, mental health disorders and neurodegeneration. So you've got carnivore over here, but then you've got the plant based diet. Now what we do see in a lot of the studies, and by the way, I'm, I'm around 70, 30. So I, I'm, I'm an omnivore I eat everything. I do eat a lot of meat, but I also substitute with a lot of plants as well. We do see a lot of the studies for Alzheimer's disease are this, they're advocating for this Mediterranean diet. And when you look at this Mediterranean mind diet, it is predominantly fish and plants. So how do you fight back against that and fight back against the norm and advocate for the carnivore diet as it relates to neurodegenerative diseases such as Alzheimer's disease?
- [46:40]
A
So much to say here. So one is that the mind diet, which is a modified version of a Mediterranean diet that's supposed to be even better for the brain than a standard Mediterranean diet, failed in a three year randomized controlled trial.
- [46:56]
B
Yes.
- [46:56]
A
Of people, in people with cognitive decline, it made no difference whether they followed the mind diet or the comparison diet. And so that diet, there's no evidence that the mind diet is better for the brain. But I am definitely not here to say that people worried about Alzheimer's need to follow a carnivore diet. I'm not even here to say that people can't eat a plant based diet and improve their metabolic health. The beautiful thing about metabolic health is it's not about plants and animals, it's about insulin. So you can lower your insulin levels into the healthy range, even into the ketogenic range. If you need to do that on a vegan diet, a vegetarian diet, an omnivorous diet, a low fat diet, a low calorie diet with intermittent fasting, or with a carnivore diet. If you have the, if you know how to construct your diet, if you know what raises and lowers insulin, you can design just about any diet to get your insulin levels down and protect your brain metabolism. This is really important because one of the reasons I wrote the book is I really wanted to build bridges between these communities and the nutrition science is so polarizing. We're not, there's so much blame going around and meat is better and plants are better. And I mean, if we look, the book looks at the biology and if you want to understand the biology, the biological differences between plant and animal foods, all of that science is there. And I am convinced based on the biology of food and the biology of the brain and human cells that that ideally the optimal human diet would include meat or, or meat or fish or seafood or poultry, eggs and animal foods. But that doesn't mean that you can't construct a diet if you have the right information that is going to, going to be safe for your glucose and insulin levels and and nourish your brain properly. Especially if you're without animal foods. You will need to supplement very carefully because you'll be missing some nutrients, but that can be done. I'm really, I really like to say I'm nutritionally pro choice and I want to help everybody, regardless of their dietary preferences, have access to a better brain health. And I think if we, I really want to take the heat out of that conversation because as soon as, as we say, well, this diet is the best, or this diet is the best, first of all, we don't know which diet is the best diet for the brain. We don't have clinical trials that can, that can prove to us beyond a shadow, there are lots of different diets that can improve metabolic health. Many, many different diets have been shown to be healthy, healthier than the standard American diet. I have a slide in one of my presentations where I show people all the different types of diets that have outperformed the standard American diet in clinical trials. But what are they being compared to? They're being compared to the lousy standard American diet. So any diet beats the standard American diet. But how are we supposed to know which diet is best for the brain? And we're not going to have a clinical trial, a randomized controlled trial where we compare eight different diets to each other to figure out which one's best. What we need is a set of rules, a yardstick against which we can compare any diet that comes along. So what we need to know is what does a brain healthy diet need to accomplish? And if you understand that it needs to nourish, protect and energize the brain, three simple things. It needs to nourish the brain by providing all essential nutrients. It needs to protect the brain by excluding damaging ingredients. It needs to energize the brains by keeping glucose and insulin levels in a healthy range. If you can do all three of those things, it doesn't matter what foods are in the diet. You can do this, as I said, with a vegan pattern, a vegetarian pattern, a low fat pattern, a low calorie pattern, a carnivore pattern, omnivorous pattern, a Mediterranean pattern. You'd have to get rid of the grains and legumes. So there are lots of different ways to approach it. And what I love about that is that that means that these strategies are accessible and acceptable to everyone. So insulin is not about plants and animals. Ketones are not about plants and animals. It's about getting those insulin levels down to where they need to be. As Dr. Ben Bickman says, you know, you had focus on that insulin. That is the, that's, that's the, that's the most powerful lever you can pull.
- [51:48]
B
Yeah. Do you think that there is a place for an N of one discussion here? What I see is that you've got, okay, you've got, when you look at a patient and you're working with a patient and, but then you can also see a randomized control trial being done. You should know firsthand that just because a study has been done and it's well constructed, it doesn't mean it might fit this patient because everybody is different. The way I approach everything in practice really is an N of one rather than a one size fits all approach. Do you take this into consideration as well when you look at your patients?
- [52:24]
A
Yes, and I've written the book that way too. They've given people lots of different options, different ways that they can personalize the diet to their own preferences and tolerances, enter their metabolic health and their goals. So, for example, so this is how I work in my clinical practice. Everything's personalized, but in the book, I did as much as I, I could to help people personalize their own diets, helping them understand what they need to, what their choices are and, and, and, and, and giving, giving them different options. So, for example, the book has three fundamental dietary patterns in it. It has a moderate carbohydrate, kind of 90 grams of carbohydrate per day paleo diet. So this includes fruits and starchy vegetables. It's not a ketogenic diet, allows people to have a serving of fruit or starchy vegetable at each meal. So it's not a low carbohydrate diet or ketogenic diet, but it's a whole foods diet focused on the right whole foods because not all whole foods are actually good for us. So it doesn't have grains, it doesn't have legumes, that sort of thing. So there's a, there's a 90 gram per day of carbohydrate paleo diet. There's a ketogenic diet based on paleo principles, and there's a carnivore diet for people who want to explore that option or use it as a temporary elimination strategy and a discovery strategy. So, and then, and then there's also a list of single steps people can take if they just want to make one change to their, they're not really ready for an overhaul of their whole diet. It, There are single steps people can take. You know, you could remove alcohol, you could Remove sugar, you could remove flour, you could remove grains, you could, you know, you could remove dairy. There are different things you can experiment with as you. To move closer and closer to, to a healthier, to a brain, healthy diet. Everything's personalized. Some of us have food sensitivities. I've. One of the reasons I got into this business was I, I had a lot of food sensitivities I wasn't aware of. And so it got me really curious about food and how food interacts with the body. And so some people, some people don't tolerate eggs. That's not a great breakfast for everybody. Some people don't, don't tolerate seafood. Some people don't, don't tolerate cruciferous vegetables. I mean, everybody's a little bit different, right? So this is where the personalization comes in. But if you understand how food works, if you understand what's in there, is it easy to digest? Is it hard to digest? Does it have all the right nutrients in it? What are the chemicals that it contains that I might need to be aware of? A lot of all plant foods protect themselves with chemical weapons, but we've evolved alongside a lot of those chemical weapons. And if we have good, robust defense strategies, if we haven't damaged them too much over time through our toxic environment, we should be able to tolerate a wide variety of plant foods. And. But many of us have lost that ability. So that's another layer of personalization. What if you're really sensitive to things that you should be able to tolerate, but you can't? So even if it might be a food that's healthy for you, so there's all these layers, and that's the book, kind of walks people through in a way that I think will, will help them construct the diet that, that will work best for them.
- [56:03]
B
Let's now talk about lipids and lipid profile. So we've got the standardized cholesterol panel that you can get from your physician within that would contain your total cholesterol, your triglycerides. You'll see something called ldl. You'll see something called hdl. And if you've got a really great practitioner, you may see something called apob. Now we know that having. Well, actually, I don't know. I see so many things, but it's. I, it's. I'm under the impression that we want to kind of, kind of keep a low LDL and APOB profile just to avoid cardiovascular disease. That plaque buildup that may cause atherogenic plaques, you know, or even cause Maybe a stroke from occurring. I know that the, the. I know that the Journal of Neurology released an article, I think it was like a research study around two years ago, stating that LDL now in midlife for women is a risk factor for Alzheimer's disease or high ldl. So when we think about the ketogenic diet, it, when I think about it, I think, okay, well, what are we doing to our cholesterol if we increase our saturated fat intake? Because a lot of saturated fat is found. Well, a lot of meat products, I would say, like red meat, contain saturated fat. Right.
- [57:35]
A
Well, let's zoom out for just a moment. So in the book, I talk a lot about cholesterol, explain to people what LDL is, what HDL is, what cholesterol is, why cholesterol is important, why fat is important. And essentially, LDL and hdl, they are, they are the transport system. They are the vehicles that carry fat and cholesterol molecules around the body. Fat and cholesterol can't travel in the blood without a vehicle like a pod that they, that they can sit in and be transported through the blood. They don't dissolve in the blood, so they have to be. Be transported in pods. And so LDL and hdl, these are basically just transport pods that carry fat. Fat is energy to cells and cholesterol molecules back and forth between cells. And cholesterol is a vital, a vital component of all animal cells, including all human cells. All cells need cholesterol. All cells are made from cholesterol. Cholesterol is a vital nutrient, without which we, we would not be sitting here having this conversation. So ldl, so when you. So cholesterol is good, it's there for a reason. Fat is good. It's there for a reason. So what is this lipid panel telling us? When a person goes to their clinician, their primary care, and they get this lipid panel. Most people have had this done multiple times, typically at least once a year, you'll have a lipid panel. This is one of the ways that your doctor is evaluating you for future cardiovascular risk, like how. What is your risk for a future heart attack or stroke. And so one of the ways they do this is this lipid panel. So the lipid panel, as you said, it has the ldl, has the hdl, has triglycerides. That's the simple cholesterol panel, will have total cholesterol and ldl. They're similar. The, the, the h. Let me back up here just a minute. It'll have the total cholesterol which is kind of way to estimate everything together. But the, the numbers that, the numbers that people will really remember are their ldl, their hdl, and their triglycerides. So most clinicians will focus like a laser beam on the ldl. And if they see it above a certain number, say above 100 milligrams per deciliter, for example, in the United States, they'll start to think, oh, this is risky. Do, do we need to do something about this? High LDL is a risk factor for, for cardiovascular disease. How do we get the LDL down? Should I maybe prescribe a statin medication to get this LDL down? Now? It's not that LDL doesn't matter. It's that it's the least helpful number on the panel. The LDL tells you almost nothing about your future cardiovascular risk. You can have a heart attack with very high ldl. You can have a heart attack with very low ldl. It's almost as good or bad as a coin toss. It's very, very weakly. It's a very, very, very weak predictor of future cardiovascular risk. Risk. That's not so with HDL or triglycerides. Hdl. Triglycerides are really good predictors of good markers of metabolic health and good predictors of future risk. If your triglycerides are above 100 milligrams per deciliter, that is a red flag. If your HDL is below 50 and you're a woman and below 40 if you're a man, that's a risk. That, that, that's a red flag. Those need to be addressed. We don't have medications for those. And that's why doctors focus on the ldl. Because you can lower your LDL with a statin medication, but a statin medication is not going to help you with your hdl. Your triglycerides, the only thing that's going to help you with your triglycerides. Triglycerides are fat in the blood. Too much fat in the blood is, is reducing the amount of carbohydrate in your diet. It. Because triglycerides are simply excess carbohydrate that the body has to turn into fat. So if you're eating more carbohydrate than you need, then you can burn or store right away. We can't store much. We just have small, small storage tanks for, for starch and carbohydrate in our bodies. We have unlimited potential to store fat, of course, but we, we, we, we can store less than a day's worth of carbohydrate in our bodies for energy. If you can't use it or store it right away, if you can't burn it off or use or store it right away, all the rest of that carbohydrate, even if you're eating a zero fat diet, gets turned into saturated fat on purpose by the liver to be stored in your body. And that is on purpose because it's energy. You don't want to waste that energy. You can't store it as starch, you can't burn it because you, you've eaten more than you need. What are you going to do with it? The body has to turn it into fat and it turns it into saturated fat because saturated fat is the best, lightest, most compact, most efficient way to store energy. Saturated fat is not a bad thing. It is simply, it is simply a way to store energy, way animals store energy for future use. So now a ketogenic diet in some cases will cause LDL to go up. And that scares a lot of people because they've been trained to think LDL causes heart disease. There is no scientific evidence that LDL causes heart disease. So that's thing number one. Thing number two is, yes, sometimes LDL goes up on a ketogenic diet, sometimes it doesn't, sometimes it stays the same, sometimes it goes down, sometimes it goes up by 10%, sometimes it goes up a lot. There's a, there's a subset of people where the LDL on a ketogenic diet goes through the roof. It goes up by hundreds of points. That has been really scary to a lot of people because again, we're taught, think of ldl, high LDL as bad. And this tends to happen most often in lean individuals, younger individuals, athletic individuals. And there's been some wonderful research just published by Dave Feldman and his colleagues studying this group of people where they have very high LDL reactions to a ketogenic diet. These people were on a ketogenic diet for five years and they, and they have very high LDL levels. And they compared, they looked directly at the arteries of the heart using coronary angiography and to see, to see if they had any plaque. And they compared that to people who were not eating a ketogenic diet for five years and had much lower LDL levels. There was no, no difference in the amount of plaque in the arteries. If anything, there was even a trend towards less plaque in the people who had had high ld. Very, very high LDL levels for five years on a ketogenic diet. So we're starting to see, we're starting to see this hypothesis about LDL causing heart disease and ketogenic diets, raising LDL being a bad thing. We're starting to see. The science coming in is very reassuring. So when I see a patient with a high ldl, whether they're on a ketogenic diet or not, it's not that I ignore the ldl. I just, I just, I just bypass it. Just don't stop thinking I can. Okay, why is the LDL high?
- [65:37]
B
Yeah.
- [65:38]
A
And what else is going on? So let's look deeper. Let's look at, let's get a coronary artery calcium scan or, or let's get an apob. Or let's do deeper fractionation of the lipids to look at. Okay, the LDL is high. Is it good LDL or is it bad ldl? Because there are different types. So we have to evaluate the LDL in context. It's not, not to ignore it, but to say, okay, let's look deeper and understand, is the LDL high for a good reason or a bad reason? Because the, the, a very healthy reason why an LDL could go up a lot on a ketogenic diet is that your cells are burning more fat for energy, so they need more fat to be delivered, and therefore they need more LDL pods to carry that cholesterol, that cholesterol and fat to those cells. So LDL carries cholesterol and fat to cells that need it. If you're burning fat, which, who doesn't want to burn more fat, if you're burning fat vigorously, you're going to need more LDL pods. So of course your LDL will go up. So there can be good or bad reasons for LDL to be high.
- [66:44]
B
When I teach blood work and blood chemistry, I'm always talking about trends and ratios. And with ldl, I'm talking about the ratio between LDL and hdl. And if you've got enough hdl, which is pretty much, I describe it as the janitor who comes in and cleans up the LDL particles that are just spread all over the place. You could essentially have a high LDL if you've got enough hdl, that can come in and clean it up. But I do believe I am with you on always doing further investigations, always doing a, a CAC scan. You can, you can even look at LP to see if you need to really counteract that as well from a genetic standpoint. But it really shines a light on how much misinformation there is around this ketogenic. Lifestyle. Do you know I've had him on the podcast before. Carnivore, Maryland.
- [67:44]
A
Yes, I do.
- [67:45]
B
Yes. Sorry, his name slipped my mind. And that's not an Alzheimer's disease symptom, by the way. Guys, I just got so much happening right now, but Paul Saladino. There we go. So I've had him on the podcast and he gets a lot of. I think he's. I don't know his stance anymore, but I know he went from a carnivore diet. Maybe he's a bit of an omni of all right now, but he. Or he's. He's said many times that having a high LDL is not problematic, but I think, again, n of 1, right, I know we're going a bit over time, but I do have a question. When you're talking about burning fat, what about for the people who are like, okay, but I want to be lean. And we know that the. We know that your muscles, right, can. If you're in a. Let's just say you're in a calorie restricted state. How does the body choose to burn fat first as a fuel rather than eating into the muscle tissue if it doesn't have any carbohydrates to burn?
- [68:46]
A
Yeah. And that's about being fat adapted. So if you're eating a high carbohydrate diet, but it's a low calorie, high carbohydrate diet, you'll be basically switching back and forth between burning carbohydrates for energy and then. But you're not eating quite enough calories, right, because you're trying to lose weight. So you're eating a low calorie, high carbohydrate diet, which is what a lot of people do to try to lose weight. I did that for years when I was younger.
- [69:11]
B
I think every woman has done that.
- [69:14]
A
My gosh, I've been on every diet. Right. So a low calorie, high carbohydrate diet. And what you're doing in that case is you're burning carbohydrate when you're. After you're, after you've eaten, you're in carbohydrate burning mode. And then you run out of carbohydrates to burn. And your body tries to burn fat to try to make more glucose molecules for your bloodstream. And it's not very good at doing that. So it can. Because it. You haven't taught it to do that. You haven't spent enough time in that mode for it to really have the machinery all ready to go to burn fat smooth, to switch back and forth easily between burning carbohydrate and burning fat. That. So it can, under certain circumstances, reach into the muscle to get those amino acids to turn those into glucose. But if you're eating properly and you've got good meta, what's called metabolic flexibility, you've got good metabolic health. You can, you could, if you've got, if you're starting off with good metabolic health, which you probably aren't if you're trying to lose weight, if you're trying to lose weight, if you're overweight, there's a 90% chance that you have poor metabolic health and that you've got insulin resistance. And therefore it's going to be a little harder for you to switch smoothly and comfortably back and forth between burning mostly glucose and burning mostly fat. So that could put a stress on your muscle system. You could lose more muscle under those circumstances. But if you've trained your body to burn fat for energy and you're eating in a healthy way, that's not going to give you extreme spikes in glucose and insulin because you're eating whole foods, for example, and you're not overdoing it on the carbohydrate. Or if you're eating a, a ketogenic diet, which will train your cells to burn fat beautifully 24 7, which is what people who are trying to lose weight would love to achieve. They'd love to be burning fat around the clock right then. Then you're not going to go to the muscle because you can. You've gotten really good at turning fat from your body into energy and protein from your food into energy going to the muscle. You've got to have enough protein in your diet to be able to spare your muscles that. It's really important.
- [71:32]
B
That's what I see with the whole tirzepatide and ozempic problems. I would say it's not having at least 100 grams of protein per day. I say 100 grams. It's really dependent on how much you weigh really in kilograms. But, you know, a good measure is 1.6 grams per kilogram of body weight. And that's just like more so maintaining. Right. So on average, I always recommend a hundred, if you can, 110. But look, you get that if you're having the ketogenic diet in the, in the meat, I guess you could.
- [72:10]
A
And it doesn't even have to come from meat. It can come from tofu or plant sources as well, whatever people prefer. But Tofu is the only plant source that has, you know, a good amino acid profile, a complete protein compared to animal foods. All other plant proteins are somewhat less, depending on which one we're talking about, are somewhat less, are less complete or less, less optimal for meeting your amino acid requirements. So, yeah, it doesn't have to be meat, but any diet, ketogenic diet or otherwise, has to have, as you rightly say, the right amount of protein for that individual. And you know, this again, varies depending on, it varies depending on gender and height and, and body habitus and your exercise and, and illness and pregnancy and age and all kinds of other things. But it, it, and I spell this out in the book as well, help people. There's a formula they can plug in to figure out how much protein is likely going to be a good starting point for you as an individual. And it usually is somewhere between 90 and 150 grams per day, depending on the person, somewhere between 1.2 and 1.7 grams per kilogram, and in some cases maybe even a little higher. So your 1.6 is a beautiful number because that's, I mean, we don't want people to be under eating protein. That is the, that is definitely a recipe for failure and poor health. If you're trying to lose weight, you don't want to skimp on the protein. You want to, you want to get your insulin levels down without skimping on the protein.
- [73:53]
B
Yeah. Georgia, you've, you've really excited me through this conversation. I, I'm, I, I think everybody should be reading your book, especially if you are a medical student and maybe thinking about going into psychiatry. But change your diet, change your mind. Georgia, what's the, I guess your overall mission moving over the next five, ten years with all of the clinical studies that you're doing?
- [74:21]
A
Yes. I mean, really, if I had to summarize all the different types of work that I'm doing, like, why do I do. What I do is because I really want to see these interventions in the hands of everyday people and clinicians around the world so that we can start not just treating mental health conditions better, but preventing them as well. Because if we have the right information, I believe that a lot of these conditions are actually preventable to a large degree. If you feed the brain properly from birth, actually from before birth, from the time of conception, then we lay a wonderful foundation for brain health. So interventions and preventions and really empowering clinicians and patients around the world to take control of mental health and turn our global mental health crisis around. Give people. Hope. I say hope is on the menu.
- [75:25]
B
Hope is on the menu. I love that. And you've got the same mission as me to an extent. So, Georgia, thank you so much for coming onto the Neuro Experience podcast. I think we need to do around two, because we didn't even get into all of the other psychiatric disorders that I wanted to discuss. So and they're just in my mind still. So we're going to have to do a part two on that.
- [75:49]
A
I'm happy to come back, Louisa. And it's really great to talk with, you know, somebody who's so knowledgeable about neurology and and I love that you're interviewing people about metabolic health, in particular, connection between metabolic health and brain health. It's just a really powerful and important connection. So thank you for the work that you're doing.
- [76:07]
B
Thank you.