Harvard Psychiatrist: THIS Food Is Causing The Mental Health Crisis! - Chris Palmer

32:55And that's what most people learning school. They're the powerhouse of the cell. But I'm here to tell you they are so, so much more than that. There are hundreds or thousands of them in most cells. They are highly dynamic. At one point, you know, the theory of multicellular life on planet Earth is that mitochondria were once independent living bacteria. And that another single cell organism engulfed that very first bacterium. And the two of those organisms lived. They stayed alive. Usually when you get engulfed by another organism, that means getting eaten and you die. For whatever reason, these two stayed alive and they became symbiotic with each other.

33:54And actually, that event is thought to maybe have only happened once on Earth. And that single organism evolved into all multicellular life that we know today. So all living organisms that we can see with our eyes, plants, all animals are evolved from that same organism. So mitochondria divide and replicate. They actually move around cells. They fuse with each other. They bud off from each other. They form patterns around the nucleus, which plays a role in which genes get expressed or don't get expressed. They do all sorts of things. When people say that we have a predisposition, a genetic predisposition to mental health disorders, and that you know, you'll have depression, if depression runs in your family, etc.

34:54Is there merit in that in your view? Is there evidence to support that? Absolutely. So we know that mental illness runs in families. Genes explain some of that, but not all of that. The environment actually can influence things called epigenetic factors, which are factors that control the expression of genes. They turn genes on or off. And those epigenetic factors are actually inheritable. You can inherit them from your parents. And so it's not all strictly genetics. Some of it is epigenetic. So first and foremost, there are no genes that are specific to specific disorders. Most people think, well, you know, bipolar disorder runs in my family.

35:49There must be a bipolar disorder gene. And in fact, there isn't a bipolar disorder gene. There are genes that increase risk for bipolar disorder, but at the same time, they also increase risk for schizophrenia and epilepsy and autism and depression and other types of mental and neurological disorders. And if you look at the unifying theme, like, is there a theme for these genes? Is there a common pathway that can help us better understand mental illness? The common pathway is that most of the genes are affecting metabolism and mitochondria. One research study that came out a couple years ago, researchers have been looking for years at a high risk gene for schizophrenia.

36:41And we know that people who have this very, very rare gene, so not almost nobody has it, but if you do have it, you're at high risk for developing schizophrenia. Along with lots of other mental illnesses, but schizophrenia is the big one. And the researchers did this deep dive into trying to understand what exactly is this gene doing? And at the end of the day, they said, it's affecting mitochondria. And that is probably how it is causing schizophrenia. Metabolism happens as a result of the work of the mitochondria. Is that accurate? So we make sure I've come clear on them before we proceed. 90 % of metabolism, at least, is occurring in mitochondria.

37:21So that definition is a scientist, I have to say, isn't 100 % accurate? Because there is a thing called glycolysis that can happen in cells where you can actually produce ATP without using mitochondria. What's that? So ATP is usually known as the energy currency of living organisms of cells. And so, and that ATP ends up making cells work. It is the energy that's flowing around cells or the molecule that's flowing around cells to make receptors work to make all of the machinery of cells work. And that becomes relevant. Maybe some of your listeners will know this. If you exercise really hard, like you're running a marathon or you're running as far as you can get with a marathon, before you absolutely are exhausted and you just have to stop.

38:19Your mitochondria will actually become maxed out. That is what's preventing you from running. Is your mitochondria max out? And they're like, you don't have enough of them or they're not healthy enough. And so they just, they can't keep you going. They can't keep your muscles going. And so you peter out. And when you peter out, you start, you turn to this process called glycolysis, which actually ends up producing lactic acid or lactate. And so, runners will get higher levels of lactate and that can create soreness and all sorts of things. But, yeah, that's some metabolism is really the process of taking food and energy, food in oxygen.

39:00I'm sorry, and turning it into energy or building blocks. And that can occur on a small scale outside of mitochondria. But as soon as the mitochondria in most of your cells are dysfunctional or dead, you die. There's no way around it. So let's use some of those examples that you gave earlier. You talked about stress and trauma and these kinds of things. I'm really keen to know how a traumatic event can have an impact on your metabolism, your mitochondria, which then manifests as a mental illness. So if we take trauma, for example, people go through early trauma in their life. I don't know if there's a, I mean, you had a very traumatic upbringing.

39:39How do you think that maybe even in your case, if you were able to see inside of your body and what was happening, that external traumatic event came into your body in some way, caused a physiological reaction, had an impact on your metabolism, which results in a mental health disorder of source. It gets a little complicated because it goes through a couple of stages. So I'll try to walk you through it in the simplest way I can. When somebody is first traumatized, everybody, if they are normal, will have symptoms. If you get traumatized, you will experience fear, you will experience hypervigilance, you will want to fight or flee or you might freeze or you might surrender, you might beg for forgiveness or mercy or whatever.

40:30Everybody is going to have those reactions. In my mind, those reactions are not disorders. They are not malfunctioning brains or malfunctioning anything. So everybody will have that. However, when that happens, it immediately changes your metabolism. Your metabolism, the easiest way to understand it is the sympathetic nervous system, gets turned on fiercely if the trauma is really bad. Because you have to defend yourself. Your life is threatened, your safety is threatened. Trauma can even be less extreme than that. You can have highly stressful events in which maybe even though your physical life isn't threatened, maybe all your money is threatened.

41:28The stock market crashes and you lose everything. And you now think, I'm worthless. I'm penniless.

41:41I'm losing my status in society. I'm going to have to live a very different life. I've just disappointed everybody who depends on me. That could be a trauma, even though by definition, because it doesn't threaten your life, it's not technically considered a trauma. So for those people that are, you know, they've been through a traumatic event, what then is going on in their body as it relates to metabolism based on that traumatic event? Trauma immediately changes metabolism. So trauma puts us into this, you know, most people know it is fight or flight mode. And again, there are other responses that one can have.

42:30You can surrender, you can freeze, you can do other things. But when people feel threatened, either physically or their reputation is threatened or their identity is threatened, immediately their nervous system and hormones are changing. And the reason they're changing is because our bodies are hardwired to protect us. And in order to protect us, it means that we need more energy and we need it now. We need more energy in order to be able to run or to fight or whatever we need to do. And that means that our heart rate goes up, our blood glucose goes up, cortisol is flowing, adrenaline is flowing through the body, inflammation is actually occurring, and epigenetic changes are occurring.

43:30Memory formation is occurring in a powerful way during a trauma. Memory, our brains are hardwiring this event so that we remember it. We remember this threatened us and you cannot forget this. This is not a trivial moment. You must remember this for the rest of your life because it's threatening your survival. And you must remember how to respond to this again? Not necessarily because our responses can be all over the map. Sometimes our responses can be quite effective and other times people can die. They don't respond effectively and they are killed. That would be the worst case scenario and then there's everything in between where you get a suboptimal outcome.

44:21You end up homeless with your psychotic mother. That's not a very effective response. What else that question I was asking is we see patterns in trauma, like a trauma pattern as a trigger, as a response. I even think about some of the small tea traumas that I had in my life that meant that I would run from romantic commitment for the rest of my life. For example, and it was like a pattern. I was going through the same loop over and over again. Trigger, Steve's responses like this causes this outcome. Trigger, so I was wondering if I learned at that very young age that cycle somewhere in my neurons in my brain.

44:56That's why I said, do we then learn the response to that trauma at that point as well? We learn the response. We remember the response that we did. As long as we've survived, that is the ingrained memory. The ingrained memory is when this happens, do this because this is what I did and I survived it. That becomes the default and then that becomes a default pattern for many people. At some point in life, it can be actually quite useful to look at that response. When I was five years old or 20 years old or whatever and that thing happened, I responded this way and I survived it. Great. But how is this working out for me now?

45:54Is that the optimal response? It's not about beating yourself up for I should have done something different back then. It's simply about recognizing and honoring. I did what I thought I was the right thing to do. I did my best back then. But I'm smarter now. I'm older now. I'm wiser now. If I could do it again, if I could go back in time as my smarter, wiser self, would I do it differently? And what would the outcome be if I did it differently? And then that becomes highly relevant to today. So when I'm in this romantic relationship now, I keep having this urge to break up because this person is disappointing me in this way.

46:48And I feel like she or he is going to threaten me or betray me or whatever. And is that the right approach? Is it true that this person is going to betray me like the person in the past did? Or am I hypersensitive to that? And again, you're wired to look for any clue that a trauma might happen again. So we're going to overinterpret things sometimes. In a in a in a ronious way. So that early trauma with that trauma I experienced made my body go into that survival mode, fight all kinds of ways and my glucose levels went out way. All of these things, all metabolism related stuff happened. How does that then cause a mental health disorder at some point down the line?

47:44If that trauma is not resolved. So for some people, they can experience a trauma. They can be quite effective at mitigating it and move on with their life. Somebody could get into a fight. Somebody could get mugged on the street. They're just walking down the street. Somebody pulls a knife on them or a gun on them and wants to rob them. If somebody manages that trauma highly effectively. Let's say you happen to have a black belt in karate and you disarm your assailant very quickly and rapidly. You may not think twice about the trauma. You may actually be involved in after that traumatic event and think I'm quite effective and skilled.

48:35Wow. Those karate classes really came in handy. And I'm quite powerful and maybe even feel a little more confident than you normally would. And that's the interpretation element, right, of the situation. So two people could be in the same situation, but have. So that person still had the same physiological reactions, a gun in your face or wherever. That person's glucose was going up. Their heart rate was going up. All of those metabolic changes were occurring. But so that's a success story. And that's probably a resilient person who moves on and never thinks twice about that trauma or rarely thinks about it and thinks about it with pride if they do think about it.

49:20In the case where it doesn't go well at all, let's leave the extreme out where the person is murdered. Let's leave something less severe than that. But the person is beaten. They are injured severely. They are terrified to go out in public. For fear that there could be another one just like that. That person. Their fighter flight system is not turning off. Their fighter flight system is now on. At least at a low level, possibly a very high level for a very prolonged period of time. They are now afraid of the world immediately after that type of horrific assault. They are now afraid of the world.

50:18They probably aren't sleeping as well. And what's happening physiologically and we know this is that those higher cortisol levels are actually causing something called hyper metabolism. There might a congear are actually working on over time. Because the body is still primed for the world is unsafe. Everything is unsafe. Maybe that person who assaulted me is going to somehow figure out where I live and come through that door any minute. So you're sleeping at night and you hear a sound or you hear a creek and you panic and you wake up and you're startled and you're terrified. Or you sleep at night and you have a nightmare and you wake up and you're reliving that experience and just you're horrified and overwhelmed again.

51:09Is this conscious because you know you speak to people with severe anxiety and they have panic attacks and they don't know why they're having panic attacks. They can't name something that they're scared of or a fear they have. No, this is not at all conscious. So at this point in the week or two after a horrific trauma like I've described. I would argue this is not a disorder. This is not the brain malfunctioning. This isn't the body malfunctioning. The brain and body are doing precisely what they are programmed to do. Protect you. Your life is in danger. Why? Because somebody just tried to take it and they were close.

51:52They came close to taking your life. They could have killed you. And so your body and brain are trying to protect you. Unfortunately, that comes at a cost. All of this energy going toward the defense system means that energy that should be going toward maintaining your cells is actually being bypassed sometimes. So we know this. So for example, there are these things called stress granules where cells that are trying to just do basic ho -hum everyday repair work create some new proteins or new receptors or do some cleanup work. The code for those which are called messenger RNAs actually gets sequestered in these little bubbles called stress granules.

52:51And what that means is that they're not getting done. The messages are starting from your DNA because the cell is saying, hey, I need some repair work over here. Send some new proteins over here to do some repair work. When your body is in fighter flight mode, those messages actually get interrupted. And that means bottom line, it means that when you feel threatened, your body is diverting metabolic resources toward your self defense system. Hyper vigilance, be ready to run at any minute, be ready to fight off the offender at any minute. You cannot feel safe, don't feel safe. When that goes on for a prolonged period of time, your cells can fall into a state of disrepair because metabolic resources are not going towards cell maintenance.

53:50If that occurs long enough or in a severe enough way, it means that some of your cells can now fall into a state of disrepair and they can begin to malfunction. When that happens, if it's happening in brain cells, that's when I would say the person has crossed the line from a normal survival reaction to trauma. If their cells in their brain begin to malfunction now because they are on a state of disrepair, they can turn into what we call a mental illness. And that means that maybe they can't remember like they used to. It means that maybe and now they can't pay attention like they used to. Now somebody might say, hey, maybe you got some ADHD going on.

54:49Or they, their anxiety pathways become what's called hyper excitable. And now their anxiety pathways are being triggered even when they shouldn't be triggered. And out of the blue, they're having panic attacks or anxiety symptoms. They can be sitting in the comfort of their own home, not thinking any scary thoughts, not having any, not watching anything on television or anything that's really disturbing. And out of the blue, they can just be overwhelmed with a panic attack. And that person, I would say if they have a panic attack for no reason, that person's brain is now malfunctioning. It is dysregulated.

55:37And I would say that that person has now crossed over into what I would call a mental disorder where their brain is in fact malfunctioning now. The great news, the hope. And we can get to more of it is that those cells can be repaired. We can fix that. We can do something about that. The person does not need to be like that forever. There's no that they now have a chemical imbalance that they were probably genetically predisposed to. And now we've got to just medicate them for the rest of their life. I don't agree with that. I'm not at all opposed to medication. If medications can be helpful to that person, 100 % let's use them.

56:28Let's help that person heal and recover. But I want to go deeper. I want to understand what is happening in that person's brain and body using this kind of information about metabolism in mitochondria. And how can we effectively help them heal and repair and recover? You know, we talk a lot about diet and food on this show. As it relates to metabolism and mental health diet. So diet is huge. And most people have no clue that diet plays any role in mental illness or mental health. 95 % of mental health clinicians think it's laughable that anybody would suggest that diet can play a role in mental illness.

57:29I think it's laughable. What do you think? I think if you do a deep dive into the science, all of the science that we have accumulated over the last 100 years and longer sometimes. If you do a deep dive into all of those neuroimaging studies that we've been doing, all of the genetic studies we've been doing, all of the neurotransmitter and hormone studies and atrama studies and adverse childhood experiences studies. If you do a deep dive into the science and you understand what is happening in the brains and bodies of people as a consequence of those things or what could be causing those things.

58:15If you put it all together, you come to this sound bite that mental disorders are metabolic in nature. And there is no questioning whatsoever. It is incontrovertible that diet plays a massive huge role in metabolism. And therefore, I believe very strongly that diet might be playing a role in the mental health epidemic that we are seeing. And it also might provide an avenue of hope and healing and recovery. And I use the word might as the scientist in me is the clinician in me. I know without certainty it can heal and recover people who have had chronic, horrible debilitating mental illnesses. And I know from my own personal story, when I was in medical school in residency, I'm still suffering from low grade depression, OCD, other symptoms.

59:32But I also developed what's called metabolic syndrome. I developed high blood pressure, high cholesterol, prediabetes. And I wasn't really overweight. I was exercising, I was following a low fat diet, mostly processed foods because they're cheaper. But that was the diet that was touted as a healthy diet. It was low in fat. And as long as it was low in fat, that was supposed to be good for us. And my metabolic syndrome just kept getting worse and worse. And so at some point, in order to treat my metabolic syndrome, I changed my diet to essentially a low carbohydrate diet. And within three months, my metabolic syndrome was completely gone.

1:00:27But the thing that just dumbfounded me was that my mental health was better than it had ever been in my entire life. And I just couldn't believe what I was experiencing. I didn't know that I could be that kind of a person. I didn't know that I could be happy and positive and energetic and confident. I had no idea. I didn't think that was in me. And by changing my diet, all of those things happened. At the level of the mitochondria, are you saying, do you believe that because you changed your diet, more sort of natural, healthier foods, at the level of the mitochondria, the mitochondria were able to function more naturally themselves in a more functional way, which meant that the chemicals they released in the processes they go through were more consistent with positive mental health.

1:01:33Is that like the simpleton's way of understanding it? And before then, you talked about man -made compounds in the foods, etc. I'm assuming you're saying that some of the modern foods that we, the ultra -process foods that have all of these random -named chemicals inside them that we see on the labels, the mitochondria don't know how to deal with that. So it's causing the same sort of dysregulation and dysfunction that they might see if we'd gone through like an extreme trauma or something else or some other adverse environmental situation. It's just this dysfunction of the mitochondria, which is causing the knock -on effects we see.

1:02:05But there's many things that can cause dysfunction in the mitochondria. We went through a bunch of them earlier. Is that like a simple way of understanding it? 100%. Okay, great. It's perfect. Super interesting. Okay, so on that point then, we have to zoom in on this thing of diet. If you wanted my mitochondria to be perfect, and maybe even give me a case that I don't know, patients you've worked with, that you've prescribed a certain diet to, what diet, what food would you tell me to eat? And what would you tell me not to eat? So I actually don't have a one -size -fits -all prescription. And so I want to say that up front.

1:02:47So I would want to know who am I working with and how is their mental and metabolic health now? Me. So you? Yeah. So I would want more details. Are you having symptoms of any mental health condition? I would say no, however, I can have moments where I feel a little bit anxious. So, you know, I've been through a lot of, I'd say like stressful events in my life because I was running a big business, we had anxious employees, pay days all the time. So I had this, at one point, I had this constant subtle stress. And so I would want to know, do you feel like you have anxiety for no good reason? Sometimes, sometimes it can feel a little bit like that.

1:03:36It's very infrequent, I'd say. But I can also have moments where I just think of something and then I get the same kind of like, it's almost like the fight or flight response is just kicked in. But you think of something adverse or stressful? Yeah, yeah, yeah. So the one thing I would say about that, and we could get into a lot more details, which we probably don't want to do now. Out of my... But my strong guess, based on just what you've said, is that that level of stress and anxiety is quote unquote normal. Okay. Because you are sensing, I have to go do something that's really scary right now.

1:04:20Or I have to go do something that's going to ruin someone's life. Or that might threaten my success. It is normal and actually healthy to have anxiety and stress in those situations. The anxiety and stress can sometimes be quite helpful and adaptive. Because it can make you pause and reflect on, is this really what I want to do? As opposed to being overly confident and just proceeding. Your own personal history almost certainly informs your level of stress response. And again, so if you go back to your own traumas, you're going to remember when I'm facing a situation like this, it's helpful to be on hyper alert.

1:05:15It's helpful to be hyper vigilant. And your body and brain will remember that helped you navigate this safely and effectively. But if I have that profile, if I have that sort of mental profile now as I sit here, and then for the next decade, I ate processed junk food. Am I going to send my mitochondria into disarray, which is going to increase the probability that I have a mental health disorder? Yes. I think yes. We've got, you know, there's no way we will ever be able to do a human randomized controlled trial to test that precise hypothesis. But we have large epidemiological studies that strongly suggest that people who eat a lot of ultra processed food have higher risk for developing depression, anxiety, and other mental disorders.

1:06:14And based on the science, the granular science, based on animal models. So we can do that to mice and rats. And in fact, that's exactly what we see in mice and rats. We feed them in a bisogenic diet, which is usually high in fat, high in carbohydrates, ultra processed foods. Some researchers have called fed rats in mice, cafeteria diets, where they feed them a lot of delicious junk food. And those mice develop higher rates of obesity, but also higher rates of diabetes and prediabetes. And oh, by the way, also higher rates of depression and anxiety. Because those are the two things that we can kind of measure in mice and rats.

1:07:09We can't necessarily measure ADHD symptoms. It's really hard to actually measure psychotic symptoms. But we can measure depression and anxiety symptoms pretty well in animals. And so in animal models, we know that that's unequivically true. And we see the same in humans though, because I was reading your book in in chapter four. You say people with ADHD are more likely to develop obesity. People are who are obese are 50 % more likely to develop bipolar and 25 % more likely to develop anxiety or depression. And weight gain around the time of puberty leads to a 400 % increase in the chance of depression by the age of 24.

1:07:45Yes. And insulin resistance at age nine increases your chances of developing a psychotic at risk mental state, which is like meaning your high risk for developing schizophrenia bipolar disorder, 500%. And Alzheimer's? All mental disorders are associated with an increased risk of Alzheimer's disease. Anywhere from the lowest is 50 % increased risk. And the highest is 2000 % increased risk. And the thread that unites all of these problems is metabolism. Metabolism. And at the end of the day, you have to talk about mitochondria in order to understand metabolism. Only 7 % of US citizens have no signs of metabolic health problems.

1:08:46Meaning 93 % or so of US residents will have at least one of the biomarkers of metabolic syndrome. Meaning they have prediabetes or abnormal lipids or high blood pressure or abdominal obesity or abdominal fat, excessive abdominal fat. So what do we offer those 93 %? So those people diet interventions would absolutely be a part of a healing strategy. A part of it, not the only strategy. I would want to know about their sleep. I would want to know about substance use. I would want to know about medications, lots of things. But for dietary interventions, I would want to meet them where they're at and just find out, or where are you at, what are you eating?

1:09:40Do you have preferences or demands for what your diet should be? Could you give me a case study then? Maybe a more extreme case study from your practice that you've seen. I could give you the simple cases where, which probably apply to the majority of human beings on the planet. But if it's okay, I'd rather give you the extreme case. Because a lot of people are skeptical. They probably hear me saying this and they think, well, you're just talking about general health and wellness. What about people with real mental illness? What about people like your mother whose lives were decimated by mental illness?

1:10:26This doesn't have anything to do with them. And what I'm here to say is, no, actually this has everything to do with them too. But yes, it applies to just common everyday people. But you know, probably it's a one story that I will just share, because it's probably one of the most powerful stories I know. It was a woman whose real name was Doris. And in the book, I called her Mildred because I changed everybody's names. But she actually gave me permission to use her real name. So in honor of her, I want to use her real name. So she was a woman who actually had a horrible abuse of childhood, lots of trauma.

1:11:15And by the time she turned 17, she started having daily hallucinations and delusions, and was diagnosed with schizophrenia. Over the ensuing decades, she tried numerous anti -psychotic mood stabilizers, antidepressants and other medicines, but none of them stopped her symptoms. She remained with all of the symptoms of schizophrenia. She ended up gaining a massive amount of weight. She ended up weighing about 330 pounds by the time she was 70. Her life was devastated by this diagnosis. She had a court appointed guardian to manage her financial affairs and other affairs. She had professionals coming into her home to help her with paying bills and grocery shopping and stuff like that, because she couldn't do it for herself, which is not at all unusual for people with schizophrenia.

1:12:15And between the ages of 68 and 70, she tried to kill herself at least six times, and was hospitalized for those suicide attempts. She hated herself and she hated her life. When she was 70 years old, her doctor told her, you're overweight and you need to go lose some weight. And she was referred to a weight loss clinic at Duke University, where they just so happened to be using the ketogenic diet as a weight loss tool. And for whatever reason, she decided to give it a try. And so she tries the ketogenic diet. And within two weeks, not only does she start losing weight, but she notices dramatic reduction in her hallucinations and delusions.

1:13:08Within months, all of her symptoms of schizophrenia were in full and complete remission. She starts tapering off her psychiatric meds. And then about six months, she was off all of her psychiatric meds. And her symptoms of schizophrenia remained in remission. Doors went on to live for another 15 years. Symptom -free, medication -free, out of psychiatric hospitals. No more suicide attempts. She stopped saying mental health professionals pretty quickly, because they were kind of worthless to their mind. They hadn't really helped all that much. She lost 150 pounds and kept it off until the day she died.

1:13:58She ended up dying at the age of 85 of COVID pneumonia. And... But her story tells us... Like we could get, if you want, we don't have to, we could get into the science of the ketogenic diet and what it's doing to metabolism in mitochondria. I love to know. But there's an entire story that helps us understand what happened to her and how exactly that resulted in her really spectacular and almost miraculous recovery. So unbeknownst to most people, most people know the ketogenic diet is a fad diet. And a lot of people are really worried about it. They've heard that it's dangerous. It'll give you a heart attack.

1:14:46You'll die. Unbeknownst to most people, the ketogenic diet was developed over 100 years ago now, by a physician for one and only one purpose. It was developed to stop seizures. And in fact, the ketogenic diet has been studied extensively for its effects on the brain over the past 100 years. And it is an evidence -based treatment for epilepsy. And the reason that is so important is because we use epilepsy treatments in psychiatry all the time. Lots of the medications that we prescribe to psychiatric patients are, in fact, epilepsy treatments. And so we know that there's a lot of overlap between epilepsy and mental illness and that treatments that help with epilepsy can also help with mental illness.

1:15:42And so we actually know more about the biology of the ketogenic diet and its effects on the brain than we do any other dietary intervention. It changes neurotransmitter systems. It decreases brain inflammation. It changes the microbiome in beneficial ways. It actually changes gene expression or epigenetics. But most important and relevant to my theory is it improves mitochondria and mitochondrial function. And if you do it long enough over a long enough period of time, you can actually repair mitochondrial dysfunction in cells, at least for some people. And then you can actually stop the diet.

1:16:31So in the epilepsy world, when neurologists use this diet to stop seizures, it's usually not a lifetime treatment. They usually only need to do the diet for anywhere from two to five years. Many people, about a third of people who have treatment -resistant seizures will become seizure -free. And another third, so two thirds total, another third will have a dramatic reduction in seizure frequency. So that leaves a third for whom it's not really working, but these are people with treatment -resistant epilepsy. And there's no treatment that's going to work for everybody because we need to look at all the other things involved.

1:17:10If say somebody has seizure cessation, they get rid of their seizures on a ketogenic diet, usually they have to do it for two to five years, somewhere in there, their clinician will help them decide how long they should do it. And then they can stop the diet. And most often, the seizures don't come back. It seems to actually heal the brain. What is that diet adding or subtracting from the body that's causing that pretty phenomenal effect to people now? The real answer is we don't entirely understand. We don't know. The ketogenic diet removes sugar, for example. It does. Pretty much entirely. I mean, I've been on that diet for about eight weeks or so just to try.

1:18:00And I could have anything with sugar in it pretty much. No sugar, no carbohydrates, very few carbohydrates. So some people will argue, well, the diet is getting rid of gluten and gluten is maybe the toxic thing. Other people will argue, oh, the diet is adding like some extra protein or meat, and maybe that's replacing a nutrient deficiency like vitamin B12 deficiency or something like that or iron deficiency. And all of those things might be true for some people. I don't think those are the primary explanation. I mean, obviously, if somebody has vitamin B12 deficiency, replacing vitamin B12 is essential.

1:18:44Somebody has iron deficiency, yes, recognizing that and replacing it. But most people don't have those deficiencies and they can still have mental symptoms or mental health problems. I believe what the diet is doing is it forces a transition in brain and body metabolism, essentially. And that transition is actually mediated through mitochondria. So the ketogenic diet forces your liver to start producing ketone bodies. So it forces your liver to break down fat. So you're losing fat from your fat stores. But that fat is being shuttled to the liver. And then the liver takes that fat and breaks it down.

1:19:30And I mean, I shouldn't say all of the fat is being shuttled to the liver. Some of the fat is going to muscles and other tissues and just being used directly. But a fair amount of the fat is actually being shuttled to the liver. And then that fat is being converted into ketone bodies. Some of it is being converted into glucose so that you maintain normal glucose levels through this. Those ketone bodies are then going up to the brain and fueling brain cells. But those ketone bodies are actually doing so much more. They're changing mitochondrial function. They're changing epigenetics. They're changing neurotransmitters and inflammation and all sorts of things.

1:20:10But at the end of the day, I'm convinced that it's really the metabolic changes and the mitochondrial changes that are so important and that are so instrumental in these dramatic improvements in things like stopping seizures or stopping hallucinations and delusions. What about fasting? There's been a lot of talk especially recently about fasting and the impact that that can have on our mental health. Do you think fasting is a positive for us as well? It depends on the person. And so the ketogenic diet actually mimics the fasting state. That's why it was produced. The ketogenic diet was actually developed by a physician, recognizing that fasting can have really powerful brain effects, including stopping seizures.

1:21:03If you're out on an island and your friend starts seizing uncontrollably, the best thing to do is to fast them. Even if the seizures stop intermittently, you would think, oh, let's feed you to keep up your sustenance and take care of you. The best thing to do for your friend, if they are seizing repetitively over days or months, the best thing to do is to fast your friend. And to tell them, let's have you go without food for a few days and that can stop the seizures. The challenge with fasting is that you could starve to death if you do it long enough. That's not a very good treatment for your friend on the island.

1:21:47And this physician who developed the ketogenic diet recognized that. And so that's why he developed the ketogenic diet was really looking to see, can we mimic the fasting state with a diet and get these longer term benefits. So back to your question, can fasting play a role? 100 %? Yes, fasting can play a role. And fasting is doing pretty much the same thing that the huge egg guy is doing. It's changing mitochondrial biology. It's improving mitochondrial function. Changing neurotransmitters, changing the gut microbiome, improving insulin signaling and insulin resistance. It's doing all sorts of beneficial things.

1:22:31There are a couple of caveats with fasting, though. One is that people who are underweight should not fast. So that includes people with eating disorders who are emaciated or underweight. But it also includes people like who have had severe depression and lost weight as a result of their severe depression or people with cancer who have lost a significant amount of weight. Fasting is not good for them. Fasting mimicking diets like ketogenic diets may in fact be very powerful for those people. But it needs to be done in a safe supervised medical way. Sugar. What impact does that have on the mitochondria?

1:23:16If I've got a super high sugar diet, is that impacting my mitochondria in some way and therefore my metabolism? It is. So low intake of sugar in people who are otherwise healthy is perfectly fine and acceptable. So lots of people can consume treats every now and then or deserts a few times a week or special holiday, they can maybe even binge on sugar over the holidays and they don't have any problems as a result of it. And that is fine. If that's the way it's working out, again, only 7 % of the population is metabolically healthy. So the majority of people, that's not the way it's working out.

1:24:10So high levels of sugar over time. We know. Can impair mitochondrial function. So there's this term called oxidative stress. An oxidative stress is primarily, it's directly related to mitochondria because mitochondria are producing the energy and then that energy production results in oxidative stress. And oxidative stress we've known for decades is bad for cells. And it is highly correlated with all of the metabolic disorders and all of the mental disorders. High levels of oxidative stress in different cells and different people with different diagnoses. High levels of oxidative stress are a unifying theme, but that is a reflection of mitochondrial dysfunction.

1:25:04So we know that if you eat, if you eat a lot of sugar over time, it can dysregulate glucose levels and then those high glucose levels can cause mitochondrial dysfunction and you can end up kind of on the downward spiral. What about caffeine and these stimulants? There's like pre -workout stimulants and you know, before you do workout, you have a big dose of this pre -workout and it kind of makes you go, you know. Do you have a view on caffeine and these sort of energy stimulants? I do. So caffeine gets complicated because we have to talk about whether it's in tea or coffee or not because tea and coffee are different stories and they have other compounds that almost certainly are beneficial to human health.

1:25:55And whether it's the caffeine itself or not is still kind of a question, an open question. Caffeine stimulates metabolism in cells. We know that. So it blocks the adenosine receptor and the adenosine receptor, the function of the adenosine receptor and adenosine on it is to slow a cell down. It's basically a feedback loop that slows cells down. It inhibits their function. So when we block adenosine, we basically stimulate the system and we stimulate our brains. And if you have low metabolic brain function, that can actually be really good. If you are feeling tired and sluggish, it can make you feel energized and clear thinking.

1:26:53The challenge is that you can overdo it. So when you stimulate it too fast, that in and of itself can end up causing oxidative stress or mitochondrial dysfunction. Maybe the easiest way to think about it is this. If you think about a car, you have an accelerator and a break. If you're going to maximize the car's function, there's a right balance for all of that. You don't want to floor the accelerator and you don't want to under do the accelerator. Likewise, you want to determine like you don't want to be pushing on the accelerator and the break at the same time. So when we think about metabolism and mitochondria, when we think about caffeine or even glucose, caffeine and glucose are stimulating the system.

1:27:51They are through different mechanisms, but they are both stimulating energy production. But when you overdo it, it would be like flooring the accelerator. And then possibly putting on the break at the same time, because you don't want to be going that fast because you're going to crash. So either you're going to floor the accelerator crash and burn or you're going to floor the accelerator and slam on the break at the same time. You're not serving your car well by doing that, by flooring the accelerator and pushing on the break. And when we use substances like caffeine or alcohol or marijuana, which are all working at the level of metabolism and mitochondria, when we use those substances, in essence, we're using accelerators or breaks for cells.

1:28:47And we can overshoot or undershoot. So it's not that I'm against the use of those things. If you use reasonable, small to moderate amounts of those on a regular basis, I'm all for it. So I drink coffee every day every morning to disclose my bias. I drink coffee every morning about two cups of coffee every morning, but that's my routine. I don't go beyond that. I don't drink coffee in the afternoon. When I do drink coffee in the afternoon, I notice it starts to interfere with my sleep and then that throws me off. I have to ask you as well. I've had so many parents message me about autism and ADHD.

1:29:31So many, you know, I've had so many concerned parents message me specifically on Instagram saying, please Steve, you know, I've had a child diagnosed with autism. They're trying to understand it. They're trying to get good information on it. You've used the word autism and ADHD as we've been speaking about metabolism. What is the link in your view? Everything. The link is everything. So the really the mitochondrial theory of autism actually was first proposed in 1985. And since then we have an explosion of research linking mitochondria and mitochondrial dysfunction to autism specifically. As I've mentioned to you, the rates of autism have gone through the roof in the United States have quadrupled in the last 20 years.

1:30:21And people think, well, what does that have to do with diet? Those kids have a need in a diet yet. Well, their parents have. And let me share a couple of statistics. So people are scratching their heads. Where's all this autism coming from? I thought autism was genetic. And if autism is genetic, it shouldn't quadruple in 20 years. Quadrupling in 20 years means something in the environment is causing it. And to provide just one piece of evidence to support what I'm saying. If a woman has obesity, she has double the risk of having an autistic child. If a woman has diabetes, she has double the risk of having an autistic child.

1:31:17If a woman has both obesity and diabetes, she has quadruple the risk of having an autistic child. If a man is obese, he has double the risk of having an autistic child. So people are scratching their heads trying to figure out where is all this autism coming from? Well, look around in the population. Are the rates of obesity going up? Are the rates of diabetes going up? The answer is unequivocally, yes. And that is a reflection. It's not about fat shaming. I don't want anybody to hear that and wag their finger at fat people and say, oh, you're causing autism because you're overeating. It's not that simple.

1:32:12That's not the way it goes. People with obesity have a metabolic or mitochondrial problem. That is why they have obesity. Now, that might be caused by the foods they're eating, but they don't know any better usually. They think it's just about calories. And what I'm here to say is no, there's more to food than just calories. It might be those chemicals in the food that you're eating or something else. Or it might be chemicals in our environment. It might be pesticides or microplastics, the forever chemicals that are becoming more and more ubiquitous. All of these things disrupt metabolism and mitochondrial function.

1:32:56And so when I talk about obesity and diabetes, increasing risk for autism, it's not about fat shaming. It's about understanding. It's about understanding that the parents have a metabolic problem already. That means that they have a problem in their cells with their mitochondria. And they then pass those on to their children. And in some cases, it may not show itself immediately as obesity or diabetes. It might show itself as a brain condition because lots of other things can play a role. And if an obese woman, for instance, also has an infection during pregnancy, that's going to increase her risk for having an autistic child.

1:33:48And even more. So she couldn't help whether she got an infection or not. Tragedically, we just had an epidemic called COVID. And the early signs are telling us that in fact neurodevelopmental disorders are going to increase as a result of that. We already had a quadrupling of the rates of autism. We are likely to see even worse statistics going forward. The hope. Is it if we understand that science? We can do something about it now today. If you understand, if you see signs of autism in your child, if you see signs of metabolic or mental health conditions in your children. If we intervene early enough, we can probably do something about it.

1:34:50How? Number one, by recognizing the problem. And then two, for some people, it could be as simple as dietary interventions or just hyper focusing on good, clean living. So that means prioritizing sleep, little less screen time, little more human contact, purpose and life, you know, family connection. No alcohol, no marijuana, no CBD. Try to avoid pills. Try to avoid pills for everything that ails you. If your child's sleeping, please try methods other than pills, including melatonin and over the counter pills. Don't just whip out a pill for your child not being able to sleep. At least try some other interventions like let's get you off the screen two hours before bed.

1:35:48Let's develop a routine in our household that we're all going to wind down. We're all going to turn off the electronics. Maybe I'm going to read you a bedtime story or we're going to play a game or we're going to do something really boring that everybody's going to say this is so boring. I'm getting sleepy. And I'm going to say great. It's so boring that you're getting sleepy. That means you're going to go to sleep because it's bedtime. Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead. And over the course of my career, I've learnt just how crucial having the right systems in places, one which has helped me across many of my investments is net suite.

1:36:29They're also a sponsor of this podcast. Net suite is the number one cloud financial system through their streamlined platform. You'll find all of your accounting financial management inventory and HR in one place. Their technology has been a real game changer, especially for my team at Flight Studio. As over the last year, we've moved out of startup mode and into scale at mode. We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and errors. Over 41 ,000 businesses have chosen to future proof their business with net suite. So if you'd like to learn how it can help your business, head to netsweet .com slash Bartlett and free download the CFO's guide to AI and machine learning.

1:37:08That's netsweet .com slash Bartlett. I have to ask you mentioned that you moved in with your mother to try and save her. When she was suffering with a multitude of sort of mental health disorders, what is that like as a child? I was trying to imagine if I moved in with my mother when she was you used to a delusional right? What is that like? I've heard people speak to me about a parent with dementia and that kind of that loss. But what is the loss like that you experienced if I was a fly on the wall in those moments? What would I have seen and if I was a fly inside of your heart, what would I have felt?

1:37:48It was actually really horrendously awful.

1:38:00When I first moved in with her, we had a little bit of money still. And so we were living in a rooming house. We were renting rooms. At some point the money ran out and the support that we were getting wasn't enough. And that's when we became homeless.

1:38:22But almost from day one, living with someone who is severely depressed and suicidal and psychotic, it's hard to not feel that yourself. It's like you're living in this just oppressive cloud of despair. And it's everywhere. It's in the air. Like when you're in the home with that person, it's in the air that you're breathing. It's hard to describe it. But that hopelessness just overwhelms. I mean, you try to cheer the person up and it's just futile. And I remember, I think the first like three or four months I lived with her, I cried myself to sleep every night, like just sobbing crying, crying into my pillow so that she wouldn't hear me because I didn't want to burden her.

1:39:38But I didn't know what to do. It was just overwhelming. And after about four months, I actually couldn't cry anymore. I just lost the ability to cry. I became numb. I just, I couldn't tolerate those emotions that just despair. I couldn't manage it. That actually persisted with me for probably like 20 years. I wasn't able to cry for like 20 years. There was a part of me that just felt like crying is weakness and crying is futile. It doesn't do anything. It doesn't solve any problems.

1:40:33It's interesting because when I was with her, I hadn't gotten to the point of suicidality myself. I was desperately wanting to stay alive to see if I could help her and keep her alive. Within about a year of that though, I started developing my own suicidality.

1:41:00And that persisted in me for years after. I tried to kill myself several times. I was injuring myself. I was doing all sorts of things. I was very, I was actually convinced. If you asked me at the time I would have said I was 100 % certain that I wouldn't be alive to the age of 20. I knew with certainty that I would be dead. And I knew that I just couldn't tolerate living. And there was no hope for me whatsoever. Chris, thank you. Your book is full of solutions and it's full of hope. And I think that's why it's such an incredibly important book. It's a book that has the bravery to illuminate another set of answers and another path forward out of the despair and the epidemic of mental health illness that we're unfortunately I agree we're heading.

1:42:02We are in and increasingly heading towards that makes sense. It's certainly increasing in prevalence. A revolutionary breakthrough and understanding mental health and improving treatment for anxiety, depression, OCD, PTSD and much more brain energy. Really, really remarkable book. And once upon a once in a while books come along that challenge the status quo in the most necessary way. And your book is certainly one of them. We have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing who they're leaving it for. And the question that's been left for you is you are known for your work.

1:42:36Chris, but what would you like to be known for as the human that you are? I think I would like people to know. Like I've shared with you today. That I was somebody who had given up on myself. Who actually thought there's no possible way. I could ever have a future. I could ever live a meaningful or even tolerable life. And that all has changed. And if it can change for me and you happen to be one of those people in a similar state right now, it can change for you too. Chris, thank you. Thank you so much. You know, there's this. There's this wonderful quote that I read earlier from the start of your book where you send that message to your mother.

1:43:38My few tell attempts to save you from the ravages of mental illness, lit a fire at me that burns to this day. I'm sorry I didn't figure this out in time to help you. May you rest in peace. But I have to point out the fact that the work you're doing, the passion you're bringing to it, the wisdom and the 28 years of study. And care you've put into all of the work that exists in your book and your wider work is saving many people's mothers. Thousands of people's of their mothers, their fathers, their daughters, their sons. And that I think is an absolutely incredible thing. So on behalf of all of those people that you're absolutely never meet, you'll meet many of them.

1:44:21Sure many of the messages you message you. But all of the ones that aren't able to or haven't yet. I just want to extend a big thank you for the work you've done in your life for those mothers, for those fathers, for those daughters and for those sons. Thank you, Steve. Do you need a podcast to listen to next? We've discovered that people who liked this episode also tend absolutely love another recent episode we've done. So I've linked that episode in the description below. I know you'll enjoy it.

1:45:00Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead. And over the course of my career, I've learnt just how crucial having the right systems in places, one which has helped me across many of my investments is NetSuite. They're also a sponsor of this podcast. NetSuite is the number one cloud financial system through their streamlined platform. You'll find all of your accounting financial management inventory and HR in one place. Their technology has been a real game changer, especially for my team at Flight Studio. As over the last year, we've moved out of startup mode and into scale at mode.

1:45:35We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and errors. Over 41 ,000 businesses have chosen to future proof their business with NetSuite. So if you'd like to learn how it can help your business, head to netsuite .com slash Bartlett. And free download the CFO's guide to AI and machine learning. That's netsuite .com slash Bartlett.