Currently, our healthcare system is broken. Somewhere along the way it morphed from “healthcare” into “sickcare”. We go to the doctor when something is ailing us and they treat the signs and symptoms we present with. Physicians do a remarkable job at what they’re trained to do: treating sick patients.
I have a deep admiration for their work, but their education, focus, and attention is skewed towards states of disease rather than health. I want to emphasize that I’m not faulting physicians for this; they’re just operating within the strict confines of the current system. They’re not incentivized to keep you healthy, but rather to treat you when you’re sick. As such, very little time is spent studying the finer details of nutrition and the tools it provides to optimize our health.
For better or worse, that leaves your health in your hands. While your doctor is still responsible for (and capable of) healing you in times of sickness, you have the potential to maximize your state of health and prevent disease. In order to do so, you’ll need to be armed with know-how to implement these lifestyle changes. Luckily, you’ve got resources like this to help you get there.
Now, I’ll be the first to admit that much of what you’ll read online isn’t always true. This is especially true when it comes to nutrition/weight loss. Everyone seems to be competing for the most alarming headline or intriguing new fad. Here, I’m not going for clicks. I’m not even going to promise you weight loss. While I think you will lose weight by following my recommendations, this will be a byproduct of becoming a healthier you…weight loss is not the end goal. This is an important distinction that partially explains my aversion to the word “diet” and the negative connotations our society has attached to it.
People hear “diet” and automatically assume weight loss is the ultimate goal. This is why so many “diets” fail. They may help you lose a couple quick pounds, but if it leaves you in a mental fog with little energy it likely isn’t very sustainable. This connotation also explains why a fit person often receives eye rolls when they mention they’re trying a new “diet” -- the eye-rollers think (and often say aloud), why do you need to diet? I could go on and on here, but altering what we eat is much more powerful than changing numbers on the scale. As such, we will make sustainable nutritional changes aimed at optimizing mood, energy levels, immune function, and metabolic efficiency. Do this, the weight will take care of itself.
Given my professional and personal experiences (see About Me), my interests are admittedly skewed towards optimizing brain health and retaining a healthy brain as we age. However, as a medical researcher with expertise in neurodegenerative diseases, it's becoming increasingly understood that the brain should not be treated as a separate entity; our cardiovascular, metabolic, and immune health all profoundly impact the health and function of the brain. Therefore, much of my principles for optimizing brain health are rooted boosting the health of these other bodily systems.
Given this interconnectedness, it’s no surprise that lifestyles can meaningfully influence our risk of developing diseases like Alzheimer's, Parkinson's, Amyotrophic Lateral Sclerosis (ALS), and Chronic Traumatic Encephalopathy (CTE).
While I've been excited about the rapid advancements we've made in understanding and treating these diseases, I have also become frustrated by the lack of resources and general effort by the medical community to prevent them in the first place. While the industry works feverishly to find a "cure", I believe the most effective cure for the foreseeable future will be proper prevention.
“a gram of prevention is worth an ounce of cure”
...some 300 years later this quote still rings true. Its truth extends well beyond the scope of neurodegenerative diseases, but it is spot on when it comes to these debilitating conditions.
We all inherit some level of risk for these conditions at birth based on our family history and specific genes. Certain lifetime events (e.g., head injuries, chemical exposures, substance abuse, etc.) and unhealthy lifestyles will exacerbate this inherited risk. Conversely, it is possible to mitigate this risk - both inherited and gained (ie, head injuries) – with healthy lifestyle decisions.
Exercise will always remain an important piece of the puzzle, but recent research points to the profound influence that our gut has on the pathogenesis of these diseases. By gut, I mean primarily two things:
1) The trillions of bacteria inhabiting our gut (more specifically, our colons).
2) The nutrients we consume both to fuel both ourselves and these commensal species
“All disease begins in the gut”
Some 2,000 years later and we're starting to realize the truth in Hippocrates' statement. You would be hard pressed to find a field moving faster than that of the human microbiome. The trillions of species inhabiting our gut have made it abundantly clear that they can no longer be ignored as we now understand they are capable of profoundly modulating our own physiology. Put another way, we need to start treating the human body as an ecosystem, which can be referred to as the human biome. Likewise, nutritional psychiatry is a burgeoning field as physicians and researchers alike are beginning to realize the therapeutic potential of food as medicine.
Indeed, both aspects have evolutionary undertones as there are countless “evolutionary mismatches” negatively influencing the health of our gut on both accounts. To name a few, the composition and diversity of the microbiome has been adversely affected by antibiotic exposure (which, at times, can be quite excessive), limited exposure to soil, Cesarean sections, deficiencies in the dietary fiber these commensal species rely upon for fuel, and excessive cleanliness. So what does this have to do with the brain?
As an example – Remarkably, the bacteria in our gut are responsible for producing ~80-90% of our body’s serotonin. As you may be aware, serotonin is a neurotransmitter that our brain relies upon to function properly. In fact, the most commonly prescribed class of drugs for patients with depression/anxiety is “serotonin uptake inhibitor” (aka SSRIs). SSRIs work because there is a shortage of serotonin available in the brain. These drugs attempt to fix this problem by preventing the “uptake” of serotonin, thus leaving more freely floating neurochemicals for the neurons to use. This has proven to be an effective strategy (at least in most cases), but, in my humble opinion, it is only masking the symptoms. It never addresses the root cause of the problem as there is still likely a shortage in the production of serotonin in the body. Given that the vast majority of these neurochemicals are produced in the gut, it is likely that the more effective long term strategy would be to fix this imbalance at its source by healing the gut.
Similarly, the foods the average American consumes on a daily basis bears little resemblance to what evolution prepared us for. This is true for the quantity, quality, frequency, and type of foods we eat.
· Quantity: caloric surplus
· Quality: modern day processed foods lack the good stuff (nutrients) and typically have high amounts of unfavorable additives like simple sugars
· Frequency: it is highly unlikely that we evolved consuming multiple meals a day, everyday of the year. Instead, there were irregular periods of fasting.
· Type: the typical Western Diet has an abnormal ratio of calories that is high in fats AND carbohydrates
On some level, most people are aware that the poor quality and high quantity of foods we consume contribute to poor health outcomes. What is less commonly understood, however, is that the frequency in which we eat and the types of foods that we consume add a layer of complexity by manipulating our hormones that regulate our metabolism. So what does this have to do with the brain?
As an example – Typically, Americans on a standard Western Diet consume high levels of carbohydrates. Carbs are everywhere; in your orange juice and cereal to start the day, your sandwich at lunch, and pasta at dinner. Each time you eat carbohydrates, your body breaks it down into molecules that can be used for energy (glucose). This causes a spike in blood glucose (aka blood sugar), which triggers the release of the hormone insulin. Simply put, insulin is a storage molecule – it tells your body to store energy. It does so by facilitating the transfer of glucose out of the blood and into our body’s cells to be used as energy or stored in a dense form of energy for later use….fat! Yes, most of the fat on your body is not from dietary fat, but instead an excess of carbs that our livers convert into fats for our body to use as energy at a later date. This frequent exposure to carbs, high blood glucose, and insulin is leading to skyrocketing rates of insulin resistance and metabolic syndrome. In addition to making us fat, this poor metabolic control is significantly increasing the risk for neurodegeneration. Think about it – our brains need energy, lots of energy. When the brain’s cells become resistant to insulin, insulin is unable to facilitate the transfer glucose out of the blood and into the brain. As a result, the brain does not get the energy it requires and it can “short-circuit”. This “short-circuit” involves complex biochemical mechanisms, but, taken together, they contribute to the pathogenesis of neurodegeneration. So much so that researchers at Brown University began calling Alzheimer’s Disease Type III Diabetes, or "Diabetes of the Brain", because one of the first signs of neurodegeneration is insulin resistance in neuronal cells.
The example above is just one of many examples to highlight the importance of understanding how the foods we consume will influence our body’s hormones. I will teach you how to make your body metabolically flexible again, which serves to increase insulin sensitivity of your body’s cells.
My nutritional philosophy provides a unique combination of guidelines to follow for optimal health of the microbiome coupled with principles learned from the ketogenic diet. Admittedly, this combination is unlike anything you’ll see recommended by old nutrition textbooks or government organizations. But then again, these are the same authoritative organizations that spent the last several decades pushing simple carbs at the bottom of the food pyramid. Perhaps it’s time for a fresh look based on the science, as opposed to conventional wisdom.
My views may certainly be construed as unconventional, but they are grounded in science. I have guidelines to follow that will work for most people, but no single dietary plan will work for everybody. As such, I will work with you personally to tweak our plan to find out what works best for you.
