In this episode, I am speaking with research scientist Dr. Bonnie Kaplan, Ph.D. She’s a professor emeritus in the Cumming School of Medicine at the University of Calgary in Canada and published widely on the biological basis of developmental disorders and mental health, particularly the contribution of nutrition to mental health problems, poor nutrition to mental health problems, and good nutrition to resolving mental health problems. She’s also the co-author of the book, The Better Brain.
Table of Contents
In this podcast, Dr. Kaplan and I discuss:
- Why we can’t rely on studies on single vitamins and minerals
- The prevalence of mental disorders in the general population
- How nutrition can be used to treat symptoms of ADHD, Anxiety, Autism, and depression
- How the foods you eat influence your brain health (can it really fix mental health issues?)
Listen or download on iTunes
Listen outside iTunes
Transcript
Ari: Hey, this is Ari. Welcome back to the show. I am very excited to introduce you to today’s guest. Her name is Dr. Bonnie Kaplan and she is a research scientist. She’s a PhD. She’s a professor emeritus in the Cumming School of Medicine at the University of Calgary in Canada. She has published widely on the biological basis of developmental disorders and mental health, particularly the contribution of nutrition to mental health problems, poor nutrition to mental health problems, and good nutrition to resolving mental health problems. She’s also the author with her co-author Professor Julia Rucklidge of the book, The Better Brain, which I highly recommend.
That’s going to be what we’re talking about in this episode. This is a wonderful episode, great, very, very important content, and for a very important topic that is affecting so many hundreds of millions of people, particularly in the Western world. It really is an epidemic as far as how poor nutrition is creating brain health and psychological health, mental health problems. I’m really grateful for her work and shedding light in this area. She’s also just a lovely, brilliant person. I hope you enjoy this episode and get a lot of value from it. Welcome to the show, Dr. Kaplan, such a pleasure to have you on.
Dr. Bonnie Kaplan: Thank you. It’s my pleasure to be here.
Ari: Let’s talk big picture first. I read your book. I’m a big fan of your book. I really loved it. It’s an area I’m also particularly passionate about and I feel doesn’t get the attention it deserves. I spent two years in medical school with the idea that I would eventually become a psychiatrist and then got very disillusioned with that. I left medical school. I went to a PhD program in clinical psychology. I completed all three years of my coursework for that PhD program. Then, also became largely disillusioned with that. There’s an interesting thing that goes on in psychiatry and psychology. Psychiatry tends to reduce everything about mental illness down to a chemical imbalance that we can address with a drug.
Then, in psychology, everything is thought of as purely psychological, purely cognitive, and the problems are psychological and they need to be addressed with psychological, psychotherapeutic talk therapy type solutions. One thing that was glaringly obvious to me as someone who had studied nutrition for a very long time and health science more broadly and exercise science and lifestyle medicine, holistic health, is there’s this entire body of evidence around things like nutrition and supplementation and sleep and exercise that we have research linking to mental health and even in the treatment of some of these conditions.
What was remarkable to me is that body of scientific evidence just wasn’t being integrated into either psychiatry or psychology. I’m wondering if you just have any thoughts, like big picture thoughts on that whole landscape.
Dr. Kaplan: Did you see the Dilbert cartoon today?
Ari: No, I didn’t.
The problem with studies on vitamins and minerals
Dr. Kaplan: [laughs] I don’t have it in this room, unfortunately. It speaks to where the money is. I didn’t know that about your background, Ari. It’s people like you who I would love to entice you to become interested in this field because if you really read the whole book, you saw that there is a vast amount of research, vast amount of research, not just linking nutrition and mental health, but proving with longitudinal prospective studies that you can predict risk for the emergence of mental health problems based on what people are consuming. There’s also all the studies that have been done showing that if you forget looking for– I know this is not exactly what you asked me, but I think it’s a relevant point.
We’ve lost so many years by people looking for magic bullets. People thinking there’s a silver bullet out there, “Oh, it must be vitamin D. Let’s give people vitamin D and everything will just be fine,” or then it was omega-3s and everything will be fine, and all the big funding agencies throw millions and millions of dollars at these individual nutrients. I published an article you’re probably familiar with psych bulletin. I can send it to you if you want. It’s 2007. We reviewed all the studies from the 1920s up to the year 2000. They were all magic bullet studies and each one said, a few people got a little better. Gee, there’s a hint here.
Then, along came the people who didn’t have built into them this idea that you can only change one variable at a time. Instead said, let’s give the brain everything it needs, which is the full complement of roughly 30 minerals and vitamins, plus of course omega-3 fatty acids, but even they can’t. None of us can figure out what phytonutrients to give yet because there are thousands and thousands of them and we don’t know what they do, but anyway, forget the magic bullet approach. Now we have a body of literature of over 40 studies, all peer-reviewed, every manner of symptom. There was a theme which I’ll come back to if you want me to, and we’ve shown that you can actually treat mental health disorders.
It’s still not magic. There’s no study that has found 100% response rate, so there’s no magic out there, but it is a powerful tool that should be in the toolbox. Now coming back to what you really asked me, why isn’t it? It’ll come back to money. Big Pharma has money and there’s no money to be had from minerals and vitamins. You can’t make money. You can’t patent them. You can, but there’s no point, and it’s very easy to violate a patent. It’s a sad commentary on humanity if you want to get really big.
Ari: Yes. I’ve actually been studying health science since I was a little kid since I was 12, 13 years old, so over 26 years now, and I remember hearing things of that nature a long time ago, two decades ago of people saying, oh, you know, it’s where the money is, but I didn’t really get that until these last couple of years. I didn’t really get the importance of what that really means. I also want to comment on what you said about the one thing. This is something that I’ve talked about over the years. In general, not just in this field, but across the board there is this human psychological tendency to try to look for the one thing that is the “cause” of this particular condition. Also, the one thing that’s the cure.
It’s amazing how poor the track record is of that kind of thinking and yet everybody [laughs] continues to do it as though it has a really good track record. The other thing that you said is they do all these studies, these magic pill, magic bullet sorts of studies on vitamin D or omega-3s, or is it vitamin C or whatever, and most of those studies, as you said, show minimal results.
Dr. Kaplan: There’s always a little.
Ari: Right. Not only in this field though, but across the board in every aspect of health. Let’s say you do a study on vitamin C and cardiovascular disease. Does vitamin C reverse atherosclerosis? Does it reverse neurological disease? Does it cure cancer? You will find that it does not. [chuckles] It does not perform particularly well in any of those particular things when studied in that way as a solo intervention, and the consequence, this is something you didn’t mention though I’m sure you agree with, the consequence of that is that then the people within conventional medicine get to point to each one of those individual studies and say, “You see, it doesn’t work.”
You see that those studies on vitamin C didn’t do anything, and the studies on vitamin D didn’t cure depression, and the omega-3s didn’t cure atherosclerosis. Therefore none of those things work, it’s all quackery. Right?
Dr. Kaplan: I know. It’s very frustrating. You mentioned track record. Actually, the track record issue is an interesting one because it has been an obstacle in mental health because when vitamins were first being defined and then as 18th, 19th [inaudible 00:09:49] that’s when they were finding magic bullets. If you want to get rid of scurvy or prevent scurvy, a very small amount of vitamin C every day is what you need. I think that we inherited that mentality with vitamins and minerals in particular, that there would be just a single nutrient, and it’s really led us astray.
Now, you also touched on when you were speaking there, you’re right, we’re very much on the same page.
You touched on something that I’ve been thinking a lot about lately. I’ve been saying it to some very large audiences, just the other day, actually, to over 600 people, and I saw a lot of heads nodding. It was an actual in-person event, [laughs] the largest one I’ve had since the beginning of the pandemic. I said, “I’ve been thinking about what happens to us when we need help with, say, a broken bone, or we go to our doctor because our chronic asthma is acting up, or we have a chronic problem with arthritis.”
When we go to get medical care in the Western world with any of those kinds of problems, we go in with the assumption, and [inaudible 00:11:03] perfectly valid assumption that the treatment that’s recommended will be based upon the whole evidence base, and that the people who are treating us will know all the different ins and outs, even if it’s cancer, saying, “This is what we think you should be treated with based on our view of everything.” That is not true for brain health. When we go in for help with mental health or dementia, we can be damn sure that the recommendations will be based only on pharmaceutical products. We should be rather outraged at that.
I had a father email me. Actually, I turned this into a slide [inaudible 00:11:46] one day, email me about three weeks ago about his daughter who– I don’t even remember the results. It doesn’t matter, but he asked me some questions. He was concerned about her and I said, “Well, you should look into the nutrition thing. Here is where you can look into [inaudible 00:12:01] clinician [inaudible 00:12:02] do that online or offline.” He read our book and he emailed me back outraged. He said, “I have every right to expect that the medical personnel that I go to see about my daughter would be educating me about this and they didn’t.” I thought, “I had never thought of it from that point of view before.”
What MDs don’t know about nutrition and the impact their lack of knowledge has
Ari: I have a bit of an insider’s perspective here because of what I mentioned at the beginning of this podcast. I did the first two years of medical school, which is, the first two years is medical school curriculum, it’s where they take their courses. The second two years is rounds of different specialties in the hospital. Then, I was in a PhD program in clinical psychology. I can tell you, medical doctors learn basically zero. They learn virtually nothing about nutrition. They learn virtually nothing about lifestyle, exercise, or circadian rhythm, sleep, and stress. Almost nothing.
Dr. Kaplan: Nothing, I know.
Ari: We’re talking the equivalent of a few hours. I knew more about nutrition when I was 14 years old than most MDs know about nutrition because they don’t receive any education in it. In clinical psychology, they similarly don’t receive any education on nutrition or lifestyle. We know these things are hugely related to mental health. That’s okay, not everybody needs to be educated in everything, but the problem is that we have a general public that looks to those people and assumes they do have knowledge of that field of evidence. It’s so far from reality, it’s absurd. Then, it’s further amplified by the fact that many MDs don’t even know there is knowledge outside of their domain of what they’re educated in.
They assume that they’re educated in everything that there is to know, so they have then a default assumption that if there’s somebody saying something that they weren’t uneducated in, “Oh, it must be pseudoscience because I didn’t learn about that.”
Dr. Kaplan: Yes, the assumption is that it’s [inaudible 00:14:33]. Actually, I want to tell you a story by me. It’s in a book, but we published this one. It’s about a boy named Andrew, or we called him Andrew, that’s not his real name. He was an amazing case because he was in a tertiary care pediatric hospital with childhood psychosis at the age of 10. That’s pretty serious. He went through all kinds of clinical trials for six months, and the best psychiatrists could not figure out how to get him well. They sent him home. I could be more dramatic and tell you about his hallucinations, delusions, et cetera, they were quite remarkable. They sent him home, his mother had to quit her job to be taking care of him.
He was quite psychotic. The family had heard, this was in the very early days of when some of the broad spectrum formulas were being developed, but they had heard about one of them, and they wanted to try him on it. Well, they were now in an outpatient clinic and they were scared that the outpatient psychiatrists would consider them flaky, so they called me. They knew I had published in this area, and asked if I would go with them to the psychiatrist’s appointment. [inaudible 00:15:52] what happened at the psychiatrist, this boy [inaudible 00:15:56] well with no hallucinations or delusions over the course of taking the micronutrients.
Here’s the interesting part that I want to say to you given what we’re talking about. Well, he was such a dramatic case. He was known in that hospital as being the sickest child they’d ever seen on inpatients’ unit, and so the psychiatrist and I went and presented him at Grand Rounds for developmental psychiatry. There was a real, “Oh, wow,” reaction. Everybody knew who this was. Even though we didn’t name him, they recognized him, they knew how sick he’d been, they were very impressed. The psychiatrist who was a fairly junior psychiatrist because the department never has time to go to rounds had introduced us, was walking me out of the room at the end of the Q&A.
I said, “Doctor so and so, you have other children on your unit. Would you like to explore the use of this?” and he said “No.” Do you know why?
Ari: Why?
Dr. Kaplan: He said no because it’s not part of clinical practice guidelines. One of the things we do is we educate people in our book about clinical practice guidelines and how they are infiltrated by pharmaceutical money. The former head of the DSM-IV has published on this also, and so nutrition will never be in clinical practice guidelines. That’s how money influences how our children are treated. That’s very upsetting.
The prevalence of mental disorders
Ari: Yes, it’s very heavy. One thing you wrote in your book was how in Western countries mood and anxiety disorders have increased dramatically over the last few decades. What popped into my head to ask you in relationship to that is Steven Pinker’s work, I don’t know if you’re familiar with it at all, but one of the things that he argues is that it’s a very optimistic take. It’s like everything is better right now than at any point in human history. Things are better than ever. I’m wondering if you could explain that apparent paradox of how somebody could argue things are better than ever yet how we could have more happiness and mood disorders, more depression and anxiety than ever before.
Dr. Kaplan: I don’t recall. He mostly focuses on things like war and stuff like that. His wife is a psychologist, so [laughs] I’m going to have to look into that, whether he has written on mental health. The answer is why things are worse. For a long time, I heard things like, “Well, life is tougher now.” Well, my ancestors had World War II, World War I, in between the depression, they had the Holocaust, they had the stock market crash, they had the [inaudible 00:19:07], they had a lot of problems, but they were eating real food and they had better resilience.
A very simple answer to your question, and you can already tell that I can go on and on and give you a lot of details, but the simple answer to your question is I think our resilience is what is very, very feeble. All you need to do is look at the– Do you want some of the prevalence numbers? Do you want your audience to know this?
Ari: Yes, please.
Dr. Kaplan: When I was a kid, which is ancient times now, like in the 1950s and ’60s, the rate of mental disorders was 1% or less. Now it’s 20%, according to the World Health Organization. Now, for a long time, I would say until 10 years ago, as the prevalence rate was zooming up, in spite of this was the period of the psycho-pharmacology revolution. Some people would say it’s partly caused by that, but I’m not going to go there, but why was it zooming up? There were essays written in every psychiatry journal I think saying, “Well, it’s just because more people are speaking up and saying they need [inaudible 00:20:18]. Of course, we want people to feel comfortable coming forward.
They were also saying things like, they’re just more educated, [clears throat] excuse me, about this not being the best way to live, that there might be a better way to live, so they’re coming forward. I don’t see those essays anymore. I read a lot of psychiatry journal abstracts anyway often, I don’t see anybody saying that anymore. I think everyone is pretty convinced that the increase in prevalence is real. Now I’m going to end this with the worst number of all.
That 20% sounds high, especially in just one lifetime, but it’s only a point in time. It’s called point prevalence. If you look at lifetime prevalence and ask, well, what’s the probability for any given individual that sometime in their lifetime they will be diagnosed with a mental disorder, it is 50%. That’s also the World Health Organization numbers. That number is like a sucker punch. You know something is wrong. That can’t be normal that half of us are mentally ill. That’s a lack of resilience. Everybody knows that nutrition is the foundation of our mental and physical resilience. That’s why we have the World Food Programme and kitchens and everything helping people who are in need. They have to have food.
We know it and we somehow let our kids and ourselves eat ultra-processed chemicals without any food in them.
Nutrition and mental health issues
Ari: Do you think that nutrition is responsible for would you say the majority of mental health issues that we have today, or how would you rank the magnitude of that as a contributor to the mental health epidemic? Then, what would you say are some of the other maybe top two, top three, top five things?
Dr. Kaplan: You can guess, Ari, that I get asked that question a lot, and you may not like the way I’m going to answer it because it’s a non-answer, and yet I think it’s a more informed way to look at it. Nutrition [inaudible 00:22:36] foundation, it is the fundamental way that we build and maintain ourselves. Everything else comes on top of that. I’ll even illustrate it with an anecdote that I hear this a lot from people, people who say I was taught cognitive behavior therapy or this or that, or whatever, but not until I fixed my diet could I utilize the information I had been given. In a situation like that, would I say that nutrition’s more important than CBT?
No, I have enormous respect for all of meditation, psychotherapy, all the kinds of exercise, all the lifestyle issues, but if you’re not first optimizing your brain function, you’re cheating yourself. Does that make sense?
Ari: Yes, absolutely. When you said resilience a minute ago, do you conceptualize that largely as the result of good nutrition, or is resilience the result of other things as well?
Dr. Kaplan: Well, you don’t ask me to rank things anymore. You now know I’m [inaudible 00:23:49] do it. [chuckles] I will simply acknowledge, good grief, you can have all the best nutrition in the world, but if you have drug addiction, abuse, family violence, you’ve got a lot to be resilient to. My husband sometimes says I’m not a real psychologist and I’m not. I always say I’ve never helped people. I just study. I’m fortunate to study something that helps. Anyway, I acknowledge the importance of psychosocial factors. I know how important they are, but again, you can’t utilize those things unless you’re able to sleep well, which we know is affected by our nutrient intake.
If you can’t self-regulate your emotions, which is the primary most thematic change we see in people who improve their nutrition, that self-regulation. Think of it as the foundation, okay?
Ari: Yes. You said in the book that the right nutritional approach could cut society’s mental healthcare budget by 90%, so is it accurate to say that most of these mental health issues are coming from poor nutrition if that’s the case?
Dr. Kaplan: No. I think there’s a little leap in your logic there. The [inaudible 00:25:25] percent is based on some cases that we studied and we brought health economists in to evaluate the cost of their mental health treatment. Well, one was that boy I was telling you about Andrew, a health economist pulled the cost of treating him as an inpatient for six months, and then the cost of treating him as an outpatient with micronutrients in the immediate following six months, even though it took longer than six months for his hallucinations to go away completely, he had improved a great deal. That was 97% savings of our healthcare budget.
We published another woman who had lived in three different provinces, and we had another 10 years, and again, it was over 90% savings. We don’t have enough of that information yet. We also know, though from one of the Australian studies, people who changed the way they eat actually can save like 20% food budget by [inaudible 00:26:27] instead of ultra-processed chemicals. Everyone’s shocked that, well, I eat from the vending machine because it’s cheaper than eating real food. No. I’m not even going to count the costs to your health, but it’s only cheaper in that moment.
You’re only putting in like a buck and a half or something and you can’t spend that in a grocery store, but if you add up what you’re spending for a week, you will save money if you learn to cook with whole foods. Sorry, that was a little beyond what you were asking in terms of healthcare costs, but it’s a cost, it’s very relevant.
Why conventional approaches to neurological conditions may not be beneficial
Ari: Yes. It’s a great answer. To play devil’s advocate, let’s say someone has anxiety disorder, depression, ADHD, schizophrenia, something like that, well, maybe not, we’ll leave schizophrenia out of this for now, but why not just use conventional approaches? Why not just put them on some meds and send them to psychotherapy? What is the big difference between someone doing that versus doing what you’re advocating?
Dr. Kaplan: We have a wonderful quote early on in the book from Autumn Stringham. I don’t know if you noticed that. She had a postpartum psychosis and was on five psychiatric medications and getting the best psychiatry care that we had in our province. She said, “On psychiatric meds, I got better, but on nutrients I got normal.” We hear that a lot. Of course, there are no side effects.
We’ve been studying side effects for 25 years, published all kinds of data on everything from serum levels and serum markers and heart rate and blood pressure and stomach aches and headaches, and every single study has always found that vitamins and minerals don’t cause the adverse effects that psychiatric meds do in most people. Now, having said that, I know a couple of people who report having no adverse effects from a psych medication, and they feel it helps them. I say, don’t rock the boat. Take it. What’s wrong with that? Did that answer your question?
Ari: It did, yes. There was a study that came out maybe a week or two ago that I remember seeing. I’m sure you must have seen it. It was talking about how antidepressants were shown not to improve long-term measures of quality of life. Did you see that study?
Dr. Kaplan: I’ve actually seen more than one. There are a lot of negative studies coming out on psych meds now. I don’t feel that it’s necessary to be negative about psych meds in order to get people excited about looking at their nutrition. I worry about people feeling guilty about having put their kids on psych meds because they didn’t know what else to do or people who’ve been on psych meds for a long time. I don’t want anyone to feel guilty about that. There may be a better way for you or maybe not. You shouldn’t feel guilty. Yes, quality of life, you should read some of [inaudible 00:29:54] if you want to read and it is R-E-A-D. He has documented so clearly the adverse events from psychiatric medication across all ages. One of the things that we’ve never talked about is the number of young men who become [inaudible 00:30:13], and it’s irreversible, even when they go off of their psych meds. These are very powerful medications and they’re not understood.
The physiological mechanisms that link nutrition to mental health and brain health
Ari: Yes. Okay, so let’s talk about some of the mechanisms, the physiological mechanisms that link nutrition to mental health and brain health. What’s going on here? I know that there’s obviously a gut-brain access, some of these nutrients serve as precursors for neurotransmitters, but how would you go about explaining all of the many different mechanisms going on there?
Dr. Kaplan: Sure. I’m going to give you a quiz list. You took biochemistry somewhere along the way, right?
Ari: Sure.
Dr. Kaplan: Did you learn what a cofactor was?
Ari: Yes.
Dr. Kaplan: Do you remember?
Ari: Oh, a nutrient that is necessary in adequate amounts for a certain enzymatic process to take place.
Dr. Kaplan: Exactly, and the speed of that enzymatic process is measured by Michaelis constant. You might remember that. We didn’t even put that in a book. You don’t need to know that level of difficulty. If I had [crosstalk]–
Ari: I’m glad I got the quiz right because now I don’t have to edit this part out. You didn’t embarrass me.
[laughter]
Dr. Kaplan: I would never intentionally embarrass you but you can see why, given what you just said though, Ari, you can see why I would like the concept of cofactors to be taught starting in about sixth grade because kids can understand it and then they understand the first and the most direct [inaudible 00:31:53], which nutrients are important for them, which is their brains don’t work without them because what is going on in your brain? It’s metabolism, which is a fancy word just to mean transformation of one chemical to another. The way those things happen in human physiology is enzymes, and enzymes don’t work at an optimal speed unless they have a sufficient number of co-factors present.
When I was taught as a child, “Oh, you must eat a–” We used to call it a balanced diet. God knows what it was back then. Anyway, a balanced diet in order to have strong muscles and bones, that’s all they said, and I have nothing against muscles and bones, but I didn’t know that the brain that sucks up disproportionately way more of the cofactors than any other body part. When we’re eating, I want children to learn that every bite of food that goes [inaudible 00:32:51] is either feeding their brain metabolism because of the role of cofactors or not.
Now it doesn’t stop there though, and you very rightfully pointed out that it’s a broadway in which micronutrients, meaning minerals and vitamins, in this case, are important for us. Omega-3 fatty acids are so critical to our [inaudible 00:33:15]. We are fatheads. Two-thirds of our brain is fat and if you’re not [inaudible 00:33:22], then you’re going to be filling in your cell walls with a whole lot of omega-6s. That’s what you get in those terribly overprocessed packages of chemicals that you buy in the grocery store or any convenience store, so you need to change that balance and get more omega-3s to have very efficient and competent cell walls in your neurons. It doesn’t stop there.
I’ll list two more things, okay? One more thing is kids do learn what mitochondria are, that they’re the little energy factories [inaudible 00:33:57] and they are in every cell in your brain and your body and every single cell has at least one, some cells have dozens, and they have one job and that is give us the energy that we need for everything that we’re doing and for all of our organs. The way they do that is by producing ATP, which is our energy molecule. What do you need for the metabolic steps to produce ATP? You need minerals and vitamins, so every cell in your body and your energy level and the efficiency of every one of your organs is dependent upon nutrients coming in all the time.
The last one you mentioned, and that has to do with our society just loves these trendy things, right? Functional medicine people have been talking about leaky gut and the gut microbiome for over two decades, probably three decades, but it’s caught on now and it’s going to be, this is how you have to relate everything to the microbiome. Well, I don’t really disagree with that. The reality is that our microbiome is absolutely critical. I like to say it’s smarter than us because we humans cannot produce, synthesize any vitamins or minerals, and the microbiome can’t synthesize minerals either, we have to get those from healthy soil.
That’s another story if you read that chapter on the soil microbiome, but if you have a [inaudible 00:35:33] gut, some of those good gut bugs are going to be producing small amounts of some B vitamins, but you and I don’t know how to do it. Our guts know how to do it, so if your gut is working well and you’re absorbing the nutrients from a healthy diet, then that helps get those nutrients up to the brain and it all works together. Better stop. I can go on and on on mechanisms but those are the ones that I think are the most important to know about.
Treating ADHD, Anxiety, Autism, and Depression with Nutrition
Ari: Okay. As far as nutrition and supplementation approach for specific psychological health problems, like let’s say a distinction between ADHD versus anxiety versus depression versus autism, do you have big differences in how you would approach those things nutritionally or in terms of supplementation?
Dr. Kaplan: Keeping in mind that I am not a clinician, I never was, I’ll answer your question in terms of the research. Remember early on, I said that there is a theme. I always say that God didn’t create our brains with the DSM in hand, if God has a hand, okay, and so we don’t have a little box for depression and a little box somewhere else for anxiety, et cetera. We notice in our studies, if we recruit people with, say, ADHD, parents come back and report improvements in all kinds of other things. The child is sleeping better. The child is feeling better. There’s more energy. They’re less constipated. Any number of different things.
That’s what you would expect with nutrition is that you get across the board healthy brain. What have the studies shown? Our book came out before the latest ADHD clinical trial, which is a really important one, the MADDY trial, Micronutrients in ADHD Youth. I’m including that in my answer, even though it’s not in our book. Excuse me. In all of those studies, it is mood regulation that is the most amenable treatment and the easiest [inaudible 00:37:56] broad-spectrum micronutrient formula. Where do you get irritability? Well, you get irritability with ADHD, you get it with depression, you get it with anxiety, you get it with, what have I left out, spectrum disorders, [inaudible 00:38:13] it’s transdiagnostic.
Many of these symptoms are transdiagnostic. That’s why people end up with [inaudible 00:38:20] diagnoses in their lifetimes. They don’t fit into a neat little box, so it’s basically if you have concerns about your brain health, in general, it just makes sense to feed your brain an array of micronutrients and omega-3 fatty acids.
Neurotransmitters and mental health
Ari: Can you talk to me a bit about neurotransmitters and what are some of the biggest issues with neurotransmitters that you see as relating to this mental health story, and then secondary to that, can you talk a bit about how nutrition relates to neurotransmitter optimization?
Dr. Kaplan: Sure. In a way that I have, but I didn’t use the words that would enable you to know that I had, so some of this is a little bit redundant. In chapter two of our book, we convinced our editors that even though this is for the general public, we really could have one little diagram showing some brain metabolism. A tiny little piece of the tryptophan to serotonin metabolism. Tryptophan is an amino acid, which is a precursor to serotonin. Now, everybody knows that serotonin is a good neurotransmitter to have. It is believed that that’s why some medications called SSRI, selective serotonin reuptake inhibitors, are helpful because it leaves more serotonin in the [inaudible 00:39:54].
Well, what the micronutrients do is much more fundamental. It enables your brain to do what it’s supposed to do, which is to synthesize more serotonin. How does it do it? Because if you’re giving your brain a whole bunch of micronutrients at all times, and actually, I want to say something about time, then there will be plenty of cofactors on board, and you will be optimizing your production of serotonin. In that tiny little diagram that we have in chapter two, I forgot now, but I think there were about 12 micronutrients to make that happen. Your next-door neighbor may say, “Oh, I think you should take vitamin B6, I hear it’s really good for the brain.” I agree it’s really good, but why would you take just one?
We have evolved to need them all and in balance. I made a note here to say something about times. I want to give you a factoid that a lot of people find is something that they remember and can grab on to. I mentioned that our brain is the greediest organ. One way to look at this is that there is roughly five or six liters of blood going through in us at any given time as adults now. Our brain is only 2% of our body weight, and so, you would think that 2% of the blood would be up in our brain at any given time, but you would be wrong. It’s at least 10 times that amount.
Ari: Wow.
Dr. Kaplan: Our brain vasculature is incredibly, incredibly complex, and so it is sucking up way more of the micronutrients than any other organ. Every minute of your entire life it is absorbing 20 to 40% of the nutrients that you are feeding it. That’s why it’s so important to think every time you take a bite of food, what am I feeding my brain?
The best nutrients for brain health
Ari: Okay. On a practical level, we know that you recommend supplementing with broad-spectrum vitamins and minerals. Will any over-the-counter multivitamin product work for that, or do you have more specific recommendations in that regard?
Dr. Kaplan: I do, and I wish I could give you a list of 10 or 20 or 30. Even the manufacturers wish there were 10 or 20 or 30. It’s hard to get other companies interested in going into this. People often ask me the question, Ari, a little differently, and I just want to mention, they’ll say, “If I buy one of these one-a-day type of vitamins,” which, with every passing year, they’re adding more and more minerals to them, we still call them one-a-day vitamins, “Is that a bad thing?” I always say, “No, it’s not bad. Any amount of additional nutrients you can get is probably a good thing, but you have to look at how they differ from the ones that have been shown to be therapeutically beneficial.”
There has never even been an anecdote that I’m aware of of anybody improving their depression or anxiety by taking the over-the-counter formulas. When I tell you the two ways they’re different, it’ll make perfect sense. One is the dose. The over-the-counter ones are typically about 20% of the [inaudible 00:43:33] and the Recommended Dietary Allowance. The Recommended Dietary Allowance is based on– Do you know what it’s based on? Have you ever heard the story? I’m quizzing you again, so you can edit it out. [laughs]
Ari: I don’t. [laughs] No, actually, I don’t. I don’t think I know where you’re going with that.
Dr. Kaplan: Okay. It was based on what it was believed to take to keep the World War II soldiers able to march, basically, and fight. It’s based on healthy young individuals who did not have a mental disorder, and who they were only concerned about physical health, and they were eating well, in addition. It has nothing to do with treating a mental health problem. Not surprisingly, RDA is a very, very low bar. Now, that doesn’t mean that any of the broad-spectrum formulas that have been studied are mega doses, they are not, but there is this broad area between the RDA, which is quite low, and the tolerable upper level at which there has occasionally been a report of a toxicity.
All of the broad-spectrum formulas fall in that range. They are a higher dose. They’re also in balance. They also have a broader spectrum. The main thing is the dose and the spectrum. I mentioned that the one-a-day type, and I don’t mean to be referring to one-a-day as a brand, the one-a-day type of vitamins and minerals have increased the number of their minerals, but they’re still very few. The reason is, I think, is that they know they’d have to start telling people to take more than one pill a day because it’s hard with minerals to get them into a single pill. I always say think of the Rocky Mountain [inaudible 00:45:30] minerals are bulky.
Anyway, and the broad-spectrum formulas are simply based on what is known about brain function, and so there are roughly 50 vitamins and 15 minerals, and a few antioxidants too, in very small amounts.
Ari: I know quite a bit about this kind of problem because I have my own supplement brand.
Dr. Kaplan: I just remembered that, yes.
Ari: Basically, almost all my formulas are not in capsules, actually, for this reason because one of the things that I do differently from pretty much almost every other brand out there is I’m using real dosages of these ingredients that I’m putting in my formula, whereas most other supplement companies are putting in 1/10 or 1/20 of the effective dose. There is a physical mass problem that you encounter when you are doing what I’m doing, which is, if you want to put in, let’s say, to a brain formula, you want to put in 15 different ingredients all at real clinically-effective, the studied doses that have been shown in research to be effective, all of a sudden, you’ve got four grams of powder.
It doesn’t fit into one capsule, or two capsules, or three capsules. I have that problem with all my supplements, including my multivitamin and mineral formula for the exact reason that you said. Most of them end up being powders, or they end up being at least five capsules or so, per serving. In general, if somebody’s saying, “Hey, take this multivitamin, multi-mineral supplement, and it’s easy to take, it’s only one pill a day,” that’s pretty much a dead giveaway that it doesn’t have adequate amounts of everything that you need if they crammed it into one capsule. I find that many people don’t understand this. They don’t understand that there is a physical mass.
You can’t just condense all the stuff into one capsule. You have to deal with the laws of physics in that regard. [chuckles]
Dr. Kaplan: Yes. Does anybody ever report improved mental health on any of the formulas you make?
Ari: For sure. Oh, yes.
Dr. Kaplan: When are you going to do a study, Ari? Because [crosstalk]–
Ari: I know. Actually, believe it or not, I was hoping to pick your brain a bit on that after we record this podcast. I’ve been speaking with a few researcher friends of mine about how I can start to do some studies, hopefully in a way that doesn’t cost millions of dollars to conduct. I would love to pick your brain in that regard.
Dr. Kaplan: Excellent. Okay.
The best food for brain health
Ari: Beyond supplements, beyond multivitamin, multi-mineral supplements, what about food? What about nutrition? What are your recommendations there as far as optimizing mental health? Is there a particular dietary pattern that you’re recommending to follow, and what are the core principles of how one should eat to optimize their brain health and mental health?
Dr. Kaplan: The latest research from the US government, it’s only a few months old, shows that only one-third of the caloric intake of American children has any micronutrients in it. I’m not sure I got the verb right. Let me say it a different way. 67% of the caloric intake of children under the age of 19 comes from ultra-processed chemical packages. We have an entire generation or two of children who are feeding their brains at about one-third of what our ancestors were eating because they’re not eating real food. By the way, if you look at the American data, this is US, this is the [inaudible 00:49:32] survey data, I can send you the references if you want from the US government.
If you look at the adults, it’s a little better, it’s 57% instead of 67%, but it’s still pretty terrible. The results, the data from the UK are about 65%, and the Canadian data, it’s a little outdated, but it’s over 60%. It’s a Western world problem. Just like the pharmaceutical companies control what goes into our treatments, the food companies control the non-food products which we are eating. They have influenced whole multiple generations of people that it’s okay not to eat real food. The number one thing to do is what Michael Pollan says, “Eat real food.”
He also said not too much and mostly plants, but for the topic we’re discussing, eat real food, or with Andy Wile, Dr. Andrew Wile used to call even before Michael was on the scene, he said true food. You have to eat true food. Just doing that, you’ll be feeding your brain much better.
Why the Mediterranean diet is best for brain health
Ari: I know in the book you talk quite a bit about the Mediterranean diet as a good base dietary template to follow. Why not something more trendy like the keto diet?
Dr. Kaplan: I’m glad you asked that. First of all, if you go back and look, I think every time we said Mediterranean, we put Mediterranean style diet because nobody really knows anymore what’s the Mediterranean diet. Does it require sit-down dinners with family and friends? Some people would say yes, red wine, et cetera. The point is that if you look at the graph of the Mediterranean style diet food, it’s real food, it’s fruits and vegetables and nuts and seeds. Depending on if you’re a pescatarian or a vegetarian or whatever, you get your protein from different sources, it’s whole grains and it’s olive oil. It’s learning how to cook with lentils, beans and legumes are where you will save your money and enrich your diet.
That’s why it’s the first step toward getting what your brain needs. As you increase that, you will not have room for those ultra-processed chemicals that some people call ultra-processed foods, but I refuse to call foods, they’re ultra-processed non-foods. You said it yourself, trendy. There are all kinds of trendy diets that come and go. Ketogenic is fascinating to me because I used to work in an epilepsy unit for a while when I was more in the neurosciences, this was 50 years ago, ketogenic diet was all the rage, and I know it’s had tremendous effects for some people, but let’s step back and remember that we’re talking about mental health.
If you’re talking about mental health, you’re dealing with people who probably aren’t feeling very good about themselves, even if they’re not outright depressed, the last thing they need is a failure experience. Some of these diets, we don’t call them trendy diets. I think in the book, we call them restrictive diets. They’re hard to follow. Even a gluten-free diet is hard to follow, and some people don’t need a gluten-free diet, so we don’t say you shouldn’t do any of those, but we’re just saying don’t make it your first step, first eat real food. See how much better you can get on that. If you decide maybe you really do think you might be gluten sensitive, go on a gluten-free diet.
If you think you really want to try intermittent fasting, try it, but first, get rid of the rubbish. That’s my philosophy.
Ari: Are there any specific foods or supplements beyond broad-spectrum nutrient supplementation, things that you would put in the category of superfood, super herbs, super supplements of various kinds, anything that has jumped out to you that has really impressed you as far as its ability to improve brain health and mental health?
Dr. Kaplan: Actually, the simple answer is no. Certainly, omega-3 fatty acids are important for building and maintaining our cell walls, and that’s true throughout our brain and body. There are herbs like turmeric that are very well supported for our arthritis kinds of pains, inflammatory things, but I don’t think there’s any evidence of it being particularly relevant for brain health. For brain health, if we just stick to mental health, I would just say eat real food and get rid of the rubbish. Don’t try a restrictive diet first because you might find it too hard and you’ll feel like a failure and this is not the way to go. You want to feel good about yourself.
Do all the other things, exercise, meditation, family support, et cetera, and I know people transform their lives doing that, even without any kind of supplementation.
Dr. Kaplan’s top three tips for optimizing brain health
Ari: Dr. Kaplan, I’ve really enjoyed this. If you were going to leave people with your top two or top three big takeaways, or key insights from all of your work, what would those two or three things be?
Dr. Kaplan: Okay. So hard to boil your whole life down this way, Ari. Eat real food and get rid of the rubbish. That’s number one. Pay attention to learn how nutrients work in your brain so that you know why. We get asked a lot, why did we write a book on nutrition, there’s so many nutrition books out there, and there are even fewer mental health or brain health, and I call them to shake their finger in your face books because they say, eat this, eat that. I don’t think that changes anybody’s behavior. Learn why what you put in your mouth matters, and that’s why we wrote our book was to explain that we teach the triage theory, which I don’t have time to go into here. We teach about the brain pathways.
Learn why and be good to yourself. Don’t become a fanatic. I always say life is not worth living if I can’t have an occasional chocolate chip cookie.
Ari: [laughs] Thank you so much, Dr. Kaplan, I’ve really, really enjoyed this. Thank you for coming on the show and sharing your wisdom with my audience. To everybody listening, I want to strongly recommend you go to Amazon or Barnes & Noble or wherever you buy books and get Dr. Kaplan’s book Better Brain. Dr. Kaplan, is there anywhere that you’d like to direct people to to follow your work or get in touch with you or anything like that?
Dr. Kaplan: I appreciate your asking that, Ari. You can find everything including the picture of the purple cauliflower so that you get the correct book on my own website. The only thing you have to know is my middle initial, which is J, so it’s bonniejkaplan.com. You can contact me there. All the emails come directly to me, or my co-author Julia Rucklidge, and there are a lot of videos and there’s a link to Julia’s TEDx talk, which has been seen several million times. A lot of good resources there.
Ari: Wonderful.
Show Notes
The problem with studies on vitamins and minerals (03:38)
What MDs don’t know about nutrition and the impact their lack of knowledge has (12:35)
The prevalence of mental disorders (17:41)
Nutrition and mental health issues (22:00)
Why conventional approaches to neurological conditions may not be beneficial (27:22)
The physiological mechanisms that link nutrition to mental health and brain health (30:34)
Treating ADHD, Anxiety, Autism, and Depression with Nutrition (36:11)
Neurotransmitters and mental health (38:44)
The best nutrients for brain health (42:14)
The best food for brain health (48:25)
Why the Mediterranean diet is best for brain health (50:50)
Dr. Kaplan’s top three tips for optimizing brain health (54:30)
Links
Recommended Podcasts
