Summary of actionable brain health advice

Welcome to Zoe Science and Nutrition, where world leading scientists explain how their research can improve your health Every meal that you eat is a start of a remarkable journey through the body. The food you eat is broken down into nutrients, absorbed into the bloodstream transformed into the energy that powers every heartbeat, every movement, and every thought What if food isn't just fuel What if it's essential for how your brain operates Every meal you eat also provides nutrients to the trillions of microbes living in your gut And these tiny organisms aren't just passengers along for the ride many pharmacies They produce chemicals that send signals directly from your gut Braak Thankgs the question what you eat, shape how you feel When we think about mental health and brain health, Most of us picture medications, upbringing, or genetics We rarely think about breakfast. But what if the most powerful influence on how we feel is what we put on our plates every single day We're exploring the extraordinary connection between food and a healthy brain And joining us is someone who has helped change this conversation entirely Professor Police Jacker Professor of nutritional psychiatry and founder and director of the Food and Mood Center at Deacin University Clinical trials were the first to show that a better diet could significantly improve symptoms of major depression. helping to launch an entirely new field of science She's now overseen a large team of scientists in Australia, transforming our understanding of the relationship between diet and mental health And alongside her is Tim Spector My scientific cofounder at Zoe and professor at King's College Lond He's a world leader in microbiome science, and his personal research for the last few years has been focused on how the microbes in our gut affect our brain health Tet. We'll explore the latest evidence linking food and brain health Understand what has changed in our diet that has led to a huge surge in mental health issues. And most importantly, Felice and Tim will share simple, actionable advice Tickly improve your mood and support better brain health becausecause their research suggests you can achieve big changes perfection or restriction Pelice, thank you so much for joining me again on the show., such a pleasure Tim, thank you for joining us. oo looking forward to it So you remember, Felise, we always kick off the show with a rapid fire Q and A with very strict rules. A yes, a no, or if you have to a sentence? Yeah. Are you willing to give it a go? Yeah Can some people with depression be successfully treated by changing their diet? Can eating fermented foods lead to measurable changes in our brains? Yes Are supplements necessary to maintain brain health? No shouldhould we avoid eating all ultra processed foods? By And finally, what's the biggest myth that you hear about the links between food and mood This is up to the individual. It's their responsibility to eat well. And if they don't and they're depressed, then it's their fault That's a really big myth that's really problematic I think it's the myth that it's The mood that influences what food you eat. rather than the reality that it's the food that is the major driver of your mood. I think most people listening to this can remember a time when they've eaten something delicious and it's made them happy And before I met you, Felise, I would have thought about a piece of birthday cake. pererhaps a nice glass of wine is a thing that would make me happy But when you came on the podcast, a few years ago, you told me I should really be imagining a can of beans Yeah. Hopefully cooked in a nice way. Cooked in a nice way. And honestly when I heard that, I thought this sound of crazy, right? Like who would swap? birthday cake for like a meal of beans to actually make you happy But after a lot of personal experimentation, I've actually come to the conclusion that you're right I don't think I should be surprised that what you were telling me made sense because you've almost single handedly invented this field of nutritional psychiatry. And so it's a real pleasure to have you alongside my co founder, Tim Because over the last few years, Tim has become more and more focused on this question of the role of the microbiome on mood and brain health. So I think having the two of you here is like a powerhouse Phel, could you maybe just start by telling us how you first became interested in what seems sort of crazy that there's a link between food and mood So I came into psychiatry research pretty accidentally, sort of by the back door. I did a psychology undergrad, and then I became really interested in statistics. and so I made my way to a newly established psychiatric research unit And they had some data and they said, would you like to analyze it? So these were psychiatric data. And I bursted into tears and said, Yes, please. I was in my undergrad then So I went on and I did a number of papers using data from this really big cohort study. and I became aware that there were all these dietary data there as well as the clinical interviews to assess depressive and anxiety disorders When I came into psychiatry research, I was fascinated to realize that there just wasn't an evidence space that had linked food to mental and brain health But at that same time, so this is like the end of the nineteen nineties, early two thousands, there was an increasing focus and interest in psychoneuroimmunology. And that's basically how your immune system and your mental and brain health are linked in a bidirectional way. And of course, you know what you eat is a really powerful driver of your immune function, and I knew that. And around the same time, there were all these data coming out of animal studies, neuroscience in the states from a particular group. showing that this newly recognized area of the brain that could grow new brain cells was very important in learning and memory, but also seemed to be important in mental health be modified by healthy or unhealthy foods, manipulated So here was another piece of the puzzle. And then of course Understanding that epigenetics, you know your genes weren't just set in stone. they could be turned on and off by environmental exposures And diet was one of the exposures that switched your genes on and off. So there were all these parts of the puzzle where I knew that bits of your physiology that are firmly linked to mental and brain health were influenced by diet. So why weren't we looking at it? you know, And it was really just that whole paradigm in psychiatry where nothing that happens below the neck is of particular interest And we really hadn't started looking at the gA or any of those sorts of factors So I set out to try and understand this better and everyone thought I was a bit, you know Woooo. But luckily we had really, really good quality data. I mean, they were observational. It's not an experiment, you know, We're just collecting data from people But really importantly, we had the data that we needed to properly test the hypothesis because we didn't just have very good quality dietary data and very good quality psychiatric assessments But we also had very good data on socioeconomic status. you know, peopleeople's income and their level of education their body size, their other health behaviors, all the things that we need to take into account if we're looking at this relationship So then I was able to actually go and test this for my PhD And it ended up being a very high study And so from there, I was able to build the evidence base around how diet quality was linked to mental and brain health right across the life calls from the very start of life to the end of life. across different countries. so it doesn't matter whether they're in Brazil or Norway or Japan or where have you highigher diet quality, you know, a healthier diet that's got more of the whole foods in it tends to be associated with about a thirty to thirty five percent reduced reduction in risk. A thirty to thirty five percent reduction in what sort of co Risk for depression There was some evidence for anxiety as well, just hadn't been studied as often This was again, independent of all those other factors we talked about. Really importantly, it's not explained by body weight. People always think, this is another one of the myths That link between diet and mental health must work through body weight. You know, you eat badly or too much and you have a higher body weight, therefore you become depressed. Now, that's nothing to do with it. We see this link at every single level of body weight. So this isn't just about the fact that you're living with obesity or you're overweight and that's making you depressed. No, that's right. It seems to have nothing much to do with it at all. And then of course, we went on, we ran the Siles trial which was the first experiment to see whether we could actually alleviate even severe major depression by improving diet quality And in that study, the average body mass index was about thirty, so it was in the obese overweight category right at that point that didn't change. People didn't lose weight and the improvements we saw in their mental health, which were really large That didn't correlate with body weight change And Felise, can you explain simply what that smile study was because I know that this is viewed as a sort of rather breakthrough study up until now everything was just observational and you said I'm actually going to do like a proper randomized control trial. It was a crazy postdoc in the first year of my postdoc thinking Well, we've got the evidence now from the observational literature, from all these populations, from children up to older people across countries But we really need to know if this is a causal relationship. that means Does diet not just correlate with mental health, but does it affect mental health So I developed this protocol for a randomized controlled trial. And basically what that meant was We recruited people with moderate to severe major depression. Now many of these people have been sick for a very long time, they were very, very unwell, a lot of them Most were on other forms of treatment already that just hadn't worked And half of them were randomly assigned to get social support. The other half saw a dietitian So in the Siles trial, what we did was we measured their depression severity. That was their main outcome At the end of the trial, we saw that there was a very large difference between the two groups. So about eight percent of the people who got social support Their depression went into remission And roughly a third of those who got the dietary support Their depression went into full remission, which is really remarkable for a group who'd been sick for a long time very often. So that's a huge difference. You're saying like eight percent got the sort of the social support, but like a third of people actually came out of depression as a consequence of changing what they ate, but nothing else. That's right. The degree to which they improved their diet quality correlated really tightly with the degree to which their depression improved Tim, I'd love to hear your thoughts on this. For decades, we've been led to believe that the brain is completely separate from our body We thought low mood was just chemicals and that cognitive decline was an inevitable part of aging A roll of the dice we had no control over But at Zoey, we know the science says otherwise The truth is far more revealing There's growing evidence to suggest that our brain doesn't act alone constant partnership with our gut If you've been feeling that afternoon fog orr noticing that your memory isn't quite what it once was It might not be age. It might just be your menu Diet is actually one of the most powerful ways that you can protect your brain's lifespan and improve your energy levels So how do you use this size to get a ten year head start on a healthier brain? We put everything you need into a new guide called Eating for Better Brain Health. Inside, you'll find five strategic easy to implement tips from my Zoe co founder Professor Tim Spector along with science backed recipes designed to feed your gut and your mind. best part It's much easier than you think to make a change Longevity isn't all about luck It's a strategy and it starts with the next thing you put on your plate Most people wait until they notice a decline to start caring about their brain P longevity isn't luck It's a choice you make before you need it Don't leave your cognitive future to chance Go to Zoe d. com slash brain health right now to claim your guide. That Zoe d. com slash brain health or click the link in the show notes Police's trial was one of the reasons that, you know got me really interested in the brain again And I think what we're seeing here is how potentially important Food is as a brain medicine and this is like you know, the elephant in the room in psychiatry and psychology that Nobody is trained in metabolic health in nutrition. don't even think about it Patients with brain or mental health disorders often have the worst diets because people looking after them are not trained in any way in nutrition that only make the link. that there's any connection there at all And yet, this is one of the most powerful interventions that they can do. And The science is catching up now with with the observations. So we've had these rather crude observations We had the science that's know from my point of view The microbiome science has been there for a while. and a lot of that has been in mice. you can produce anxiety or depression in mice just by swapping around their gut microbes from one to another you know, in a way, a bit like mental health problems as being an infectious disease, which I think is kind of freaky sort of viewpoint, but that's what these mouse models show. But until you've shown it in humans, it's never really real And so linking all that stuff with the changes in the Smiles trial really to me makes it much more concrete that we have here, you know, a real the reality that we know that now food improves your gut microbiome and that And that then improves what's going on in your brain and those signals to the brain. And it's so important because you're We know that the gut is the major source of information to the brain So I think it's, you know, the most exciting area in science at the moment is this gut brain connection that we are reevaluating all the time and it's bringing in all this new neeuroscience, particularly on inflammation, which we've talked about on the show a lot, how important it is to keep inflammation levels low and we know that people with depression and mood problems have raised inflammation levels on average And all of us actually, you know in the Western world have raised inflammation levels. compared to people in other countries So this link that what's going on in our choice of food is changing to our gut microbes They're then producing these chemicals, which send signals to the brain. Brain then interprets that as being unwell And then we go into this cycle of depression behaviour, which is a protection the body. So this's the other way of thinking about you know, we know that inflammation is a protective response What's happening is inflammation in the brain is also a protective response. It's just inappropriate. It's just doing it at the wrong time But it is incredible. There's so few studies out there because this whole field Take me to the clinical. area has been cut off from the rest of medicine. You know, why do we put people in mental hospitals. Why are they separate? The worst diets are in mental hospitals And in some surveys, they've shown that long term psychotic patients, about seventy percent of them have type two diabetes And the doctors looking after them are not trained in looking after diabetes or metabolic health at all. And the whole thing is just perpetuating everyone being made worse by their environment rather than better. And we know that the drugs we've got, unfortunately, they help a few people They really failed to live up to our hopes and they haven't really changed in the last fifty years I sort of want to wind back sort of quite early where you talked about what we've discovered in mice and you sort of mentioned in passing, Tim, is mental health an infectious disease. But I think you were saying that they've done tests in mice where by changing the microbes, inside the mice They were actually changing transplanting them from one mouse to another So using this model of these sterile mice, you can implant microbbs from a stressed anxious mouse into a sort of neutral mouse with no microbes and that New mouse will then display the same anxious brain symptoms as the initial one. So being a bit joking about infectious disease, but Normally if you've got microbes from someone else and it causes a brain effect. you know, you could call it infectious in some ways, justust like we've talked about obesity potentially or type two diabetes being infectious because Microbes are responsible for it. I mean, it's not in that sense. Did you know that you can do it with humans too? So if you take poo from people with major depressive disorder, or with schizophrenia and you put them into mice compared to from healthy people You can induce what's called the behavioral phenotype. Basically, you can make a mouse behave as if it has depression or schizophrenia. you can see some of the biochemical changes. Yes You could do this with hypertension. I find it really wild that you could take poo from someone with high blood pressure and give it to a mouse and induce hypertension in the mouse. So what this is suggesting is that there's a causal effect happening here that the microbes are causing this condition or phenotype if you're talking about animals. You're saying you could take from somebody who has a mental health issue, like a serious one, like depression or schizophrenia, you can give it to mice that don't have any microbes and they basically become schizophrenic or depressed. The mouse version of it, that's exactly right. will display symptoms that were in that direction. And some of the changes in their blood as well, which is also really interesting when you think about Like we did a really large systematic literature review We looked at all of the data, all of the studies that had taken someone with major depressive disorder or bipolar disorder or schizophrenia and compared their microbes to some body without those conditions Now, as you would expect, there's differences between the microbes of people who do and don't have a serious mental illness But what I was really interested in was whether there were some commonalities, were there some common features about the microbial profiles people with serious mental disorders. And that's exactly what we saw. What we saw was consistent reductions in the microbes that produce butyrate Now Butyrate is a really powerful anti inflammatory molecule. And you'll often see that the people with some sort of an illness will have reductions in these butyrate producing bacteria But they also had increased levels of lactic acid producing bacteria Now in people with serious mental disorders, you will see increases in lactic acid in their blood and in their brain. And it's complicated There's something around the way that your body produces lactic acid, the way the bacteria does It suggests that there's something about the microbial profile that's producing too much lactic acid that's feeding in potentially to the disease profile. The third thing we saw was differences in bacteria that produce these neurotransmitters called GABA and the glutamate pathways. Now these are really dysregulated in people with serious mental disorders. So again, we don't know if it's cause or effect the fact that these bacterial differences M D too The biochemical changes that we see in people with serious mental disorders is really telling, I think. I'd add another one to that is The other consistent message you get is that you get microbial patterns that are pro inflammatory. So they're driving the immune system to produce protein markers that you might see in the blood of things that we've talked about CRP in the past that are just slightly higher, not you know, clinically really high, but just above the surface. And so this is a consistent pattern across all brain disorders is that there something going on in the guts of these people that must be sending messages you know, up to the brain to say, you know, be on alert here. You know, you got to work harder There's something going on that isn't right in addition to the changes you've suggested How could you help our listeners just to piece this together? because we started with a smile study saying that if you change what you eat, then actually you can have this profound change even on somebody with very serious mental health issues. And now we're talking about how these microbes in our gut seem to be really important We're linking the two together We now know that yah, if you improve your diet, significantly from the poor diet that most people with brain disorders are on, That will shift your gut microbes And those microbial shifts are in a certain direction that can produce these healthy chemicals like butyrate, or they're going to produce anti inflammatory compounds that are going to counteract the inflammation and These then have effects on the brain and can improve a lot of the symptoms. That's essentially what we're with sort of summarizing from kinds of different evidence, although no one study has done it all The other exciting thing is effectcise of, say a diet a healthy diet on brain symptoms. are not trivial. we're seeing effects just to put it in context that have bigger than you would get with starting an antidepressant on average. So we know that some people do well on antipressants, but many people don't. If you take the average, you' can going do better with the diet alone then an antidepressant. and obviously everything it's all personal Y study didn't directly show that because it was in addition to an antidepressant. Yeah, that's right. But there are other studies out there suggesting that these effects A really big I know that everyone listening to this is like, okay, I want to start talking about the actionable advice about what I can do. But before going to there, I'd like to talk about some of the really interesting science that both of you have been involved in, I think underpins the advice that you might give And I think what's already come through from what you're talking about is that you seem very clear about this big picture link between like the food you eat and microbes improving your mood, but like exactly how that works, is sort the challenging work that you and other scientists are doing to pin it down The team said you've done a recent study involving fermented dairy Yeahah. It's a pretty cool study. We teamed up with one of our big dairy companies in Australia and they have a product on the shelf which is a yogurt. It just has an added probiotic bacteria. It's one of the really common ones that you'll see in a lot of yogurs We wanted to do a placebo controlled trial. Now of course, if you're having yogurt It's not just got the flavor, it's got the texture, it's all sorts of things, but they made a really great placebo So what we did is we randomly assigned forty healthy women. So these weren't women with depression or anything else. They were healthy women to have either the yogurt drink or the placebo over a period of eight weeks. Now this wasn't a large amount, just a little tiny sachet, one hundred and thirty mils that you got from the supermarket And we did brain scans on them And we also measured other things like microbes and their blood and things like that. But keeping in mind, they were healthy people. So we didn't expect to see huge change in those things But what we saw at the end of the eight weeks and we worked with neuroscientists who know much more about this than we do, really, And they were kind of blown away Because if you remember me mentioning this part of the brain called the hippocampus That is really key. It's really key into learning and memory It seems to be really important in mental health. We think it's one of the main ways in which antidepressants actually work by increasing the size and the function of the hippocampus So the hippocampus is a tiny little well, it's actually two structures and it's got a bit of a shape like a seahorse and the Latin word for seahorse is ppper campy or something like that. So that's where it gets its name We used to think that your brain just lost all its brain cells, not all of them, but you know lost brain cells as you went along. And you didn't get any more new ones. And then neuroscientists started to spot this area that seemed to actually grow and shrink. So it actually would grow new neurons Particular proteins would help to grow the neurons, I think about them like manure for the brain The hippocampus is important in certain types of memory, particularly the short term memory. and it also seems to be important in mental health because when you look at the way SSRI's work, antidepressants, one of the things they seem to do is to increase the proteins to grow the new neurons. So they increase the manure for the brain It's also involved the hippocampus in sociiety, this sense that you've had enough to eat And the studies that were done previously in the healthy adolescents when they were just giing these junk foods for a week. or even just a few days and they showed that there were impairments in these cognitive tasks that are linked to the hippocampus They also showed these impairments in society. So people weren't feeling full. They wanted to keep eating And I think maybe the Hippocampus is part of that story. So it's something we really are focusing on now. We've already shown and others have now shown the same thing that People with unhealthy diets have a much smaller hippocampus. which is really key because as you get older Your hippoc campus shrinks. And because it's so important to learning in memory This, we think, is involved in part of that you know loss of cognitive ability as you get older. Now what we saw in this dairy trial was that after eight weeks of these small sachets a day, The women who got the real stuff They had an increase in the volume of their hippocampus. It actually grew, this is what we saw after eight weeks of them consuming this. We didn't see that happen in the placebo group We also saw that the there was more connectivity between the hippocampus and the frontal lobe So this is the bit of your brain that sort of guides your high order thinking and planning and this sort of thing. So It's suggesting, you know improvements in brain function And then what we saw was in the microbes, an increase in the bacterium that was the probiotic bacterium in the yogurt, which is what you would expect correlated really clearly with that increase in connectivity between the hippocampus and the frontal lobbe. And we also saw suggestions of more glutathion in the brain. Now glutathion is your brain's natural antioxidant. So it helps to protect your brain And it looked like the women who got the real yogurt compared to the placebo, had higher levels of glutathione in their brain as well. And so what is that glutathione going to be? Well it protects your brain. It's your body's own antioxidant. It protects you against inflammation and's immune irritation of it you actually could see a real difference in terms of things that are going on inside the brains of people who are eating this yogura versus this sort of fake alternative. Yeah. And that was both that this important part the one part of your brain that can like create more connections and everything the hippocampus was actually more connected, but also it was creating this chemical gluten gllution. Glution which is good helps to protect my brain. That's right. So it looked like there were Aspects of the brain that you would expect would result in better brain power. W There So larger hippoc campus, more connectivity with the frontal lobbe also more glutathion, which protects your brain from oxidative stress. So these are all good things. Now we need to do it in a much larger sample because that was a small sample and it was also women who were really healthy. So there wasn't this remarkable difference that you might see if you were looking at it in a group of women say with major depression Because we know that when people have major depression or another serious mental disorder On average, they'll have a smaller hippocampus If they are successfully treated, the hippocampus grows again. But as I said Diet really affects the size and the function of the hippocampus. So does physical activity? It could also be, you know having written a lot about fermented foods. It could be it's acting on the immune system, so we know that people who aren't used to it and suddenly get fermented foods like that We've done this big Zery trial where we had six thousand people taking fermented foods. and in the first week or two of taking it fifty percent of them who were taking three or more a day fermented food portions fififty percent showed an improvement in mood and energy Yeah in that time. and You know, this is in huge numbers of people which was the people who only managed O fermented food got less. so there was a dose response effect, which means that the more ferments you were taking every day or the more regularly you were taking them greater chance you had of having a significant improvement in mood and energy and energy is veryy much this fatigue or energy is very much a brain symptom. We now know that. We used to think it was somet to do with our muscles or It was so much to do, you know the menopause or whatever, it all comes back to the brain perception of our environment And we believe that most of these fermented foods have a major impact on the immune system through we don't understand all the mechanisms, but we do know that it reduces markers of inflammation. So it's quite possible in addition to this specific effect on this little Sahorse type is area of the brain.. It could have a general calming of information in the brain, which we now know is really important. brings in this whole other idea of anti inflammatory effects being good for things like depression The more we discover the more complex it gets. Yeah. That's definitely the story of nearly everything in science, but particularly the brain. and I think it's We may want to just go back a notch and just say, okay, A healthy brain is one that has, you know, no hardly any inflammation in it. it's getting the right signals from the rest of the body gets its main signals from the gut gut gets, you know It's healthy signals if it's eating the right foods and the microbes are converting that into the right chemicals So That, I think to me is the crucial link and I think Once we make this link between how that aects mood and we're seeing this in lots of trials, whether it's the Zoe trials, whether it' your studies U I think we're getting this this consistent message that We have to look after our guts if we're going to look after our brains and it's not just limited to depression and anxiety everything I've looked at, every mental health disorder has an element that you can link back to gut and diet or inflammation So there've been many, many, many studies now from all around the world showing very consistently and comprehensively diet during pregnancy is linked to child emotional behavioral outcomes over the first years of life It's linked to language acquisition and it's linked now to ADHD and autism Now we've worked a lot in this space and we work with colleagues all over the world. those findings are very clear What we think is going on or at least part of the story is that mothers who are eating an unhealthful diet during pregnancy They have a less diverse or a less healthful microbiome we see is linked to emotional behavioral outcomes But what we're also seeing is that those mothers have higher levels of inflammation So higher levels of something called cllye So glycA is a marker of inflammation And what we see is that mothers who have unhealthier diets during pregnancy, more Western foods, soal to processed foods, they have higher levels of glyce And that in turn is linked to slower brain development or slower language acquisition in infants You're giving this example about pregnant women and their children But listening to, I assume that's just an example, that if I am eating that diet as a fifty year old man or I'm eating that diet as a fourteen year old child, this is going to be having these effects on my microbiome and then my brain and then then my mood, is that correct? We've done many, many studies looking at, for example, adolescence. That's about the age of where really critical vulnerability in teenagers, particularly girls. And we know in young adolescents there are dose response relationships again. so more of one leading to more of the other. between the level of unhealthiness in their diets and their mental health, independent of their family backgrounds, their you family functioning Socioeconomic status, all of these things. And we see this whether it's in very early childhood, in adolescence, in adulthood, in older people, veryery, very consistent findings We're consistently seeing these links between the aspects of the gut microbiome and people's mental health across the age range, but again going to the start of life, we're seeing it involved in neurodevelopment And if you go back to the animal studies, we certainly see that that's the case So all of these signals are pointing in the same way, which is the food we eat is critical to our microbiome and all of the molecules that it produces This has a very important effect on inflammation. which is really important in virtually every chronic condition that you can think of, including mental health problems It has an impact on the brain, whether it's the blood brain barrier, the hippocampus All of these other systems, including the way your jeans are turned on and off how your mitochondria function, the little energy generators in your cells, all of these different things are affected by your microbes we We've obiously talking a lot about mental health issues. obviously police focus a lot on depression. I know that you've talked about anxiety and all these sorts of things Let's say someone's business citizen, they're not worrying about that, but they are worrying about brain health more broadly. Is that something completely different in terms of like these brain health outside of mental health or is it the same I think it's all part of the same spectrum, and I think we need to saying mental health issues there' three hundred and sixty separate symptoms and start seeing this is one organ and equally feel it for depression or dementia brain is reacting in a way that is inappropriate. Um, our age and the genes and risk factors for all these are very similar, which tells us there must be common ground and therefore In all of these studies, you see diet, poor diet uh, as Always there every single time. and the data is just as strong for avoiding dementia as it is for avoiding depression. Yeah. it's all being backed up by the science. The genetics has not shown there are separate diseases They showed at most there are two types of brain disease genetically We're susceptible to all these things, but it needs another trigger and it looks like DA is the number one thing that we can intervene on and make a huge difference. It's no surprise that You know, one of the big risk factors for dementia is type two diabetes and tyout two diabetes is totally preventable By dart say Everything is keeps coming back to the same same message that just hasn't got through to You know, the medical community. Think of a friend who starts every morning with coffee forgets to eat lunch, grabs a supermarket sandwich between meetings and then crashes on the couch at night with takeout and a glass of wine because they're too exhausted to cook Send them this episode It might explain why they haven't felt their best for a long time I promise you Could I come back to something that you've both touched on, but I feel like we've sort of not addressed head on, which is ultra processed food What are you seeing Well, ultra processed food is food that if you look at the packet, it has a very long list of ingredients It has a substrate that might have once been food, but it's been repeated and extruded and changed to be completely unrecognizable We believe, we hypothesize that there's something about the actual processing itself that might be problematic. or the level of processing that might be problematic We published this huge umbrella review a couple of years ago, in the British Medical Journal created news all over the world showing that seventy percent of the health outcomes that we studied were linked to a higher intake of ultra processed food. Sventy percent. seventy percent with particularly strong evidence for death Any cause of death? Cardiometometabolic diseases, so heart and diabetes diseases, and common mental disorders, depression and anxiety seventy percent of the health outcomes that we looked at. were linked to a higher intake of ultra processed foods. Could you help me to understand what that means? epidemiology. so it's moving from little trials to big observational studies and compilation of multiple trials. Putting them all together. So you know, our study was what's called an umbrella review So we brought together all of the metaanalysis that had already been done. So when you get small trials and you put them all together and you come up with a summary statistic, like a number that tells you something about how one thing is connected to another We took all of the meta analyses and brought them together. So we had data from more than ten million people in this large umbrella review. And in our umbrella review, we looked at a whole heap of different health outcomes And we saw that seventy percent of them were linked to higher intake of ultra processed foods. So when, for example, you looked at individual cancers You might not see that all of the cancers were linked to ultra processed food intake, but quite a number were So that's the sort of when we talk about health outcomes and the number that we looked at, seventy percent of them were linked to high processed food And the ones with really strong evidence where there were just lots and lots and lots of studies saying the same thing was around cause of death life limiting Cardiom metabolic diseases, so that's heart diseases or metabolic diseases like diabetes pressure, etca and common mental disorders, depression and anxiety Some people in the science community believe that processed foods that don't have unhealthy nutrient profiles should be demonized What they say is if the food has a healthful nutrient profile then it should be considered as food So we set out again, tiny little study to test this hypothesis Now a really good example of a nutritionally balanced ultra processed food are the meal replacements the shakes and the bars that people are often going on when they need to lose weight quite quickly Basically, these meal replacements become their food We know that they're really helpful at helping people to lose weight. But we think that as a really good model of a nutritionally balanced ult processed food, they could be used in science because they've got low levels of sugar, because they've got artificial sugars They've got added vitamins and minerals, they've got added protein, they've got added fiber They're low in fash So then nutritionally balanced is what they're called We compared them to very low calorie real food diet So legumes and vegetables primarily So we recruited nearly fifty women living with obesity. who needed to go onto these very low energy diets. And for three weeks they got either packaged, you know, pre cooked food which was primarily leg yumes, vegetables, wholeo foods, or the meule replacements, the optty fast What we saw after just three weeks was that the women who had the real food With the legumes and the vegetables, the diversity of their microbes really increased Whereas the ones who got the optopast, the microbes, there was evidence of a decrease in their microbial diversity Now critically, both groups lost weight. so it wasn't about they lost the same amount of weight. But it does suggest that even when they're nutritionally balanced, your gut microbes are interpreting them differently. If you have real vegetables and legumes, so plant foods, What you're getting as well as the vitamins and minerals and the protein and the fiber and these carbohydrates, these macro and microonutrients You're getting them in a way that nature has provided them. So you're getting them within their own food matrix, which we think is really important in the combinations that nature has intended, which we think is really important But we're also getting the photochemicals. So photochemicals are things like people have think about them as antioxidants or polyphenols. There may be as many as one hundred fifty thousand of them Now it's likely that we co evolve to have receptors to these phottochemicals in plant foods And we're not getting them at all when we're getting ultra processed foods. There's no phytochemicals in those. The food matrix is lost And we're not getting the fiber and the vitamins and the minerals in the form that nature has provided them. Yeah, because the difference is in these ready made supplements, they might have one type of artificial fiber Whereas if you're having a range of plants you're be getting hundreds or thousands of different types of fiber. So It's not giving them gut microbes the same food. It's like going to a zoo and just giving all the animals the same food Whereas in the natural way, you're giving a mix of a thousand different foods. And so bringing this back to my brain health, you're saying this experiment was a way to sort of demonstrate that The issues for my brain are not simply that I'm eating food, which has got lots of sugar in it or lots of salt. It's actually that the ultra processed food itself is worse because it's missing a whole bunch of things that like my microbes and my brain need. And so we need to start thinking not only about like improving your diet in the sense of having less Sugar directly the ultra processed food may be playing an important part of it. Am I understanding that right? That's right. And I mean, obviously it's early days. This is one small study. It's a proof of concept There's so many aspects to to process foods because apart from in this study, it was nutritionally balanced Then we're talking about what it doesn't have, but in many ult processed foods, in fact, pretty much all of them. and even in non ult processed foods actually, we're getting a huge number of things that we think are detrimental to the gut So one of them is emulsifiers And if you look on any packet nowadays, you know, emulsifiers of different sorts, sometimes I've got a number They are in everything and the animal science suggests that what they do is they impair the gut lining, which we know is really important to keep healthy People have known about cancers and obesity and that's hit the press hasn't really hit the press is how important these foods affect brain diseases. And putting it into a big context too, we've just had the latest study on mental disorders being published in the Lancet from the massive international Global Burden of Dease study So this study looks at health data from right across the world And it looks at the burden of different health conditions and as well as looking at risk factors for those health conditions and what it's concluded yet again is that mental disorders account for the leading cause of disability across the globe So it doesn't mean that they necessarily cause early death, although in some cases they do But it's that disability where people can't engage in the world in the way that they would like to in education or work or family activity, whatever. And when you look at mental disorders, by far, the majority of that burden is accounted for by depression and anxiety. I'd love to talk about like, okay somebody's listened to this, now they're really convinced that this can really make a difference to their brain health and mental health So if I was trying to reduce this but also not become terrified of everything that might be in the supermarket What should I focus on Well, for me, what I do as a shorthand is to just look at whether there are emulsifiers present in the food and I tend to avoid the ones that have got emulsifiers. Now that's a really simplistic way, but it's something that's really useful when you're rushing and you're really busy and everything else I use my Zoe app if I'm in a store to just look at the barcode and tell me what is the rating for that because nearly all food is processed to some extent and You can score into four categories and I'm many really worried about the top two categories. So low processing risk doesn't really worry me. I'm not obsessed with it And all of these foods, you could have them occasionally, it's not a big deal But if you have it regularly, as many people do as part of their diet every day for breakfast or for lunch They're getting meal deals. They're in this rut So I would tell to everybody, the first thing is get out of that rut Change your breakfast, change your sandwich., you know think about your evening meal and try and cut out ready meals Avoid anything that has a massive health claim on the front Yeah. You know look at children's yogurts or most breakfast cereals and they're full of health claims. And that is a big red flag They're trying to get you to buy this rubbish And it's going to cause inflammation, glucose spikes and mess up your brain And so we've talked about ultra processed food. Are there any other foods that you would tell somebody to focus on if they're trying to improve you know their mental health and their brain health in terms of stopping Processed meat and sugar sweetened beverages are associated with increased risk and fiber and whole grains associated with decreased risk. I would love to talk now about what you add in, let's start briefly with something that isn't food, which is supplements There's some very weak evidence for some supplements alongside other treatments in mental disorders, but they're not incredibly strong. Do you take any night supplements? I don't take any supplements. I take vitamin D in winterime in Australia because we live in the South. And Tim, what about you? I'm interested in Amega three and it has been shown that in people with low levels, it is beneficial to take Amega three supplements, but I always prefer to take the food I take sardines and anchovies and measure my blood levels Now the other thing I've started taking recently U is folic acid which we know works very well in pregnancy and protecting the baby's brain and development, so we know it has a major effect on on on the brain and this number of studies now showing that is preventive for depression and potentially other brain diseases And the third thing that I've sort of dabbled with notot quite convinced yet is Creoton And we've talked about this on the show Whereas there's some evidence there's pretty good evidence that it builds muscle Not very much, but it does build it And there's weak evidence that it might prevent against dementia So I'm looking at the evidence, but I haven't yet. jumped in to say I'm going to take this regularly You know what I did it's not a supplement, but to prevent dementia I had my shingles vaccine That's a great point Vaccines have been shown to reduce dementia. So you say what should we take Well, you should definitely take a Singles vaccine if you're offered it. And you should also take your annual flu jab because that has been shown to reduce dementia. Amazingly. no one really understands why. but it's a bit like fermented foods. Your immune system is being tickled by these vaccines. Let's move on to food and what you should add into your diet. Let's take it in inter turnance. what would be your key prescription for Lis? Well, based on the emerging evidence from the studies that we're doing, I would have said legumes before, but now I'm saying whole grains So whole grains come up again and again and again as the strongest correlate of better health outcomes, whether it's physical health or mental health. And what's a whole grain? So there' things like Oats, not the really processed ones, are very unprocessed ones, barley. Ry belelt U inoir, you know, these types of things Well, I don't like to pick out one food I don't believe in superfoods. So I would go back To our sort of mantra, let's eat the thirty plants a week and vary it and you know I'm finding I'm now getting up to nearly fifty plants on many times. So that will naturally incorporate things like whole grains,, etcetera. The more diversity, the more likely you are to get all the nutrients your brain needs and fermented foods. Fermented foods comes in a close second Yeah. and I think we should all be having some fermented foods in our diet because it works in a different way on the immune system And they're probably the two key fundamentals we should be all doing If someone is listening to this and they're saying This all sounds great, but I need really cost effective ways to be able to improve my diet. and one of the reasons that I You know, and eating lots of this ultra processed food is that it's cheap and it sort of can, you know it lasts all the rest of it What would you suggest? Food has to be accessible, it has to be easy to prepare and it has to be affordable What I do is I do on the weekend a big crock pot. I change the grains every week, but often it's things like barley in there. Legumes of different sorts. I'll put in different dried legumes. These are super cheap. Barley is super cheap. And then I can use frozen vegetables. They're really cheap and they're often frozen. really just after their pick, so they can maintain actually their nutritional density plus the whole grains, plus the legumes And I think that that's a really simple, extremely cost effective way of having super fast food available to you for the week. Great question. How do you get people on a bad diet with some mental health issues to eat better. And that's why I actually come up with a cookbook of over a hundred recipes and tips about what to keep in the larder, how to batch cook, how to use frozen foods, frozen vegetables that cann things that cost very little. And when you do that and you start thinking about it more rationally, you actually reduce what you're spending on your food. You just got to plan it right. You just got to say, I've got to change some of my habits. Let's have a new look at this So hopefully people who want more detail, you know can go and get some new ideas on how they can change what they're eating on a regular basis in ways that's really going to improve their mood and their brain We want to change people's habits for a lifetime And so it doesn't m it takes time to get there. that's not important. It's just making these permanent changes. So finish forlease If someone is listening to this, but maybe they feel a bit overwhelmed by where they are and the challenges in their life and how busy they are, what would you maybe recommend as one small change that they could sort of start with tomorrow that might really make a difference I think I'd suggest a mental change because when you think about the incredible complexity of the brain,'s the most complex thing that we know about, the incredible complexity of food, plus all the misinformation that's flying around as well as the really good information The complexity of the gut microbiome and the science there, all that complexity could just blow your brain up and you could just think, well, I'll just give up and walk away and keep eating the chips What I'd say is that's all complicated, but what you need to eat to feed your gut microbiome is super simple. So it's just lots of plant foods of different sorts I think probably throwing some fermented foods You don't have to be a vegan or even a vegetarian Just try and avoid the foods that are in packets with lots and lots and lots of different ingredients if you can and focus on the ones that are whole. and they can be frozen, they can be tinned, they can be dried They can be cheap I would like to try and do I don't even call it a summary, but maybe pick out the highlights that have rested here in my mind and maybe try and focus on particularly on the actionable advice at the end. The thing that immediately comes to mind is you can give mice something like schizophrenia and depression simply by giving them the gut microbiome of the human being with those. And I think it does really this whole idea that I grew up with that these are things that are just in your head and they're not like in your body. and it really tells you also just how important your microbiome is and therefore your food. So I think that's y. It also, I guess makes you realize that people with these mental disorders like they have a very different gut microbiome The second thing I'm really struck by is something that you said forice that mental disorders are the largest cause of disability in the world today. So this isn't just like a niche thing, that's huge, and that's before we even taught about people who are maybe high functioning but feel anxious or stressed and Then the other thing Tim that you said, which is that mental health and brain health like dementia are really the same thing The impact of food on our mental health is huge. that you can basically give people a change in diet and a third of them can stop having depression symptoms is remarkable and that works as well as you all the drugs and things we have The other thing I think that came through really strongly is ultra processed food as an issue is really real. And you said you did this massive new study and seventy percent of bad health outcomes, including mental health and cancer and heart disease are linked to an increase in eating ultra processed foods. So you just see what a big deal it is But I think the good news is, then you said there's a lot you can do. So this also isn't something that you're just stuck with On food, I think that you know the rules are the same things we talk about all the time Think about thirty plants a week particularly think about these plants that are going to really feed your microbiome, whole grains, barley, quinoa, unprocessed oats, legumes like chickpeas and beans, fermented foods but also think in this case about specific foods that you want to reduce or try and keep really low. So particularly cut out the worst ultra processed foods. know Tim says don't worry about all of them, but like the high risk and the medium risk you really want to take out. Pice says, you know, you turn it over and says Does that have an emulsifier? Okay, I'm going to try and avoid then on other things Cut out ready mails out sugary drinks Processed meat. sausages, salamis these housees is a really big deal. And Tim finally, he said, you know any food with a big health claim on it for you was a really easy way to say like I just wouldn't eat that. And then finally to finish, Pic isn't taking any supplements Both of you are trying to eat a lot of oily fish to keep your Omaga three levels up. So that's a sort of food as supplement has started taking folic acid And you both said actually just amazingly, about vaccines. Singles vaccine, flu jab, that might be the biggest thing you can do actually to like protect your mental health, which is amazing. I never would have thought about it. against dementia, specifically When you think about mental disorders, there are so many risks that we have very little control over Now the fact that something that one hundred percent of the population does several times a day actually a modifiable factor in the risk for these common mental disorders, which account for this huge global burden This is critically important So this is actually really exciting. It's something that we do have some control over, but it should not be up to the individual We need to change the system, we need to change our environment so that Less healthy foods are not the default. Just a final note, I think if everyone realizes the link between what they're eating and their mood. They would actually be really motivated to change what they're eating As you can imagine Posting this podcast, rununning Zoe. juggling family life It all keeps me pretty busy So I try as best I can to stay energized and show up well in all those parts of my life by fueling my body with the right food by exercising and by adding a scoop of daily thirty to my meals every day. If you haven't heard of Daily Thtyet It's the gut supplement designed by our Gut health scientists here at Zoe. is made of over thirty high quality hand picked plants including seaweed, fungi and different types of fiber Better yet, it contains ingredients that support gut health, digestion and energy which is ideal for pack calendars and busy lives Simply add one scoop a day. to any meal for an extra boost of fiber and plant diversity And because it tastes delicious on just about anything and add a satisfying crunch. It quite quickly slots into your life becoming a daily healthy habit you'll always have time for By the way, Whenever we talk about daily thirty as a good source of fiber We're required to say that it contains four grams of total fat per surgery Obviously, that's all amazing healthy fats from plants So What are yours today at Zoe d. com slash daily thirty. Thanks for listening and see you next time