Speaker 1: Doctor Matt Bernstein, Welcome to the podcast.
Speaker 2: Thanks for having me, glad to be here.
Speaker 1: So, Matt, you have been a practicing psychiatrist for over
Speaker 1: twenty years and you're the CEO of A Chord, and
Speaker 1: a Chord has really caught my eye because you provide
Speaker 1: metabolic based mental health programs and like, when I saw that,
Speaker 1: I'm like, hallelujah, hallelujah, somebody actually approaching mental health from
Speaker 1: a different and probably more effective angle. Before we dive
Speaker 1: into this, do you just walk through the training required
Speaker 1: to be a psychiatrist and maybe give us a couple
Speaker 1: of career highlights or career lows or what sort of
Speaker 1: drove you to this spiece?
Speaker 3: Absolutely, so it's like being a psychiatrist is a medical doctor.
Speaker 3: So first we do four years of undergraduate education. I
Speaker 3: was actually an English literature major at Columbia University. Then
Speaker 3: I had a little time in between that and medical school,
Speaker 3: which is four years. And then beyond those four years,
Speaker 3: we do four years of psychiatry training, one year in
Speaker 3: internal medicine, and then three years of straight psychiatry.
Speaker 1: So you're twelve years in all.
Speaker 2: In all, post high school, twelve years of training, that's right, yeah.
Speaker 1: This is crazy, so kind of thirty years old by
Speaker 1: the time if you don't take any breaks by the
Speaker 1: time you pop out of the training sass. Right, okay,
Speaker 1: and then let's so you organized the first metabolic psychiatry
Speaker 1: conference in twenty twenty three. We had a very very
Speaker 1: brief chat before you came on. I've had a metabolic
Speaker 1: neurologist on who you're familiar with, doctor Matthew Phillips. And
Speaker 1: now we've got a metabolic psychiatrist, which is really cool.
Speaker 1: Now I've got a little insight into this area, mainly
Speaker 1: through reading doctor Chris Palmer's book, which I'm sure you'll
Speaker 1: be familiar with Brian Energy. But tell our listeners what
Speaker 1: is metabolic psychiatry overall?
Speaker 3: Sure, So it's really approaching mental health through the lens
Speaker 3: of metabolic health, with the recognition that the brain is
Speaker 3: the most energy intensive organ in the body by far,
Speaker 3: weighing about two percent of our overall body weight, but
Speaker 3: using usually more than twenty percent of our overall energy.
Speaker 3: So the brain requires lots of energy. When the body
Speaker 3: isn't producing energy efficiently and effectively, it affects brain health first,
Speaker 3: and we can intervene on brain health through that metabolic
Speaker 3: these metabolic interventions, and we've known this for I mean
Speaker 3: really actually millennia. In the time of Hippocrates, they used
Speaker 3: fasting to treat seizures fifth century BC, and then this
Speaker 3: was picked up again in the nineteenth century. There were
Speaker 3: fasting clinics all over the place, and a very clever
Speaker 3: doctor at the Mayo Clinic in nineteen twenty one used
Speaker 3: the ketogenic diet to treat pediatric epilepsy.
Speaker 1: I remember that, yeah, and it was very effective. Yeah,
Speaker 1: and then we just sort of forgot about it for
Speaker 1: a quite.
Speaker 3: A wele well, the neurologists never fully forgot about it.
Speaker 3: They were studying this all along and using it in
Speaker 3: treatment refractory kids. So for the first thirty forty years
Speaker 3: after that, it was used extensively in epilepsy. But then
Speaker 3: the medications came along, and everyone's enamored with the drugs.
Speaker 3: Right there, we can pop a pill, you know, you
Speaker 3: take of medication. It's much easier, you don't have to
Speaker 3: completely change your diet, and so that's what neurologists gravitated
Speaker 3: towards to treat epilepsy. But there was always a recognition
Speaker 3: that with certain kids, the diet worked much better than
Speaker 3: the drugs. And there were kids who would be on
Speaker 3: two or three anti seizure medications at a time, still
Speaker 3: having seizures all throughout the week, and they would switch
Speaker 3: them to a ketogenic diet. They would see control over
Speaker 3: the seizures. They could taper them off of all of
Speaker 3: those medications and still get control over the seizures with
Speaker 3: the diet. And then what was even more amazing is
Speaker 3: many of those kids could come off of the diet
Speaker 3: after two or three four years and still retain control
Speaker 3: over the seizures.
Speaker 1: So that period of because they kind of fixed in
Speaker 1: inverted commas, the dysfunctional metabolism in certain parts of the breed.
Speaker 3: I think we don't really know scientifically exactly why some
Speaker 3: of those kids can come off the diet and some
Speaker 3: of them can't, but that was certainly an intriguing thing.
Speaker 3: You know, there's very few brain disorders where there's any
Speaker 3: treatment that fixes the problems such that you don't need
Speaker 3: the treatment anymore. Yeah, so that's really fascinating and intriguing
Speaker 3: and led to lots of neuroscience research about how are
Speaker 3: thesees doing what they're doing in the brain. And so
Speaker 3: now we've had decades of neuroscientists delving into, you know,
Speaker 3: what is going on with ketogenic diets and brain health,
Speaker 3: and there's now lots of studies about that, and lots
Speaker 3: of theories and many mechanisms now that have been identified
Speaker 3: about how these ketogenic diets improve brain health.
Speaker 1: Yeah. I remember going through my nutrition master's degree and
Speaker 1: you know, the whole talk about the brain was the
Speaker 1: brion needs glucose, and it just runs off glucose. But
Speaker 1: but then we have seen that the brion actually functions
Speaker 1: really well in the absence of glucose and actually in
Speaker 1: some cases seems to prefer ketones.
Speaker 3: Yes, well, just to clarify, actually it never stops using glucose.
Speaker 1: Yeah, correct.
Speaker 3: So, no matter how deep of a ketosis someone's in
Speaker 3: and how helpful that is for their brain, there are
Speaker 3: certain parts of the brain that always going to be
Speaker 3: using some glucose. And so what we do is we're
Speaker 3: really providing this additional source of fuel, not not a
Speaker 3: complete alternative source of fuel. But in addition, we're getting
Speaker 3: a signaling from the keytones to tell these neurons and
Speaker 3: other brain cells to change in certain ways. And we
Speaker 3: think that maybe you know, in it, you know, we
Speaker 3: don't know which is more important, but that's also very important,
Speaker 3: that signaling that the ketones are giving to the brain.
Speaker 1: And I think it's important to know when people are
Speaker 1: on a ketogenic diet that the body still makes enough
Speaker 1: glucose that's right right through gluconeogenesis, So it has this
Speaker 1: whole process that's evolutionarily conserved that it can make as
Speaker 1: much glucose as it needs in the absence of a
Speaker 1: dietary source of glucose, like, for instance, if our ancestors
Speaker 1: were were not deliberately practicing fasting, but if they went
Speaker 1: for periods with our food and I see, I want
Speaker 1: to just take a couple of steps back and your
Speaker 1: description about the brilling. You know, two to three percent
Speaker 1: of our wee about twenty plus percent, and particularly in
Speaker 1: times of chronic stress, you know, or high cognitive demands,
Speaker 1: you know, up to thirty percent of our energy. But
Speaker 1: and then when you look at it like that and
Speaker 1: then realize that that compromised energy supply can really affect it.
Speaker 1: But like, like when you thought of that, was it
Speaker 1: like a duh moment For years as a psychiatrist where
Speaker 1: you going, oh my god, this is so bloody obvious.
Speaker 1: Not that I've seen it. I can't unsee.
Speaker 3: Yes, absolutely, yeah, I mean, of course this was not
Speaker 3: part of my training at all. We didn't learn nutrition
Speaker 3: in all of those twelve years, you know, college, medical school,
Speaker 3: residency training. I got almost no training in nutrition, which
Speaker 3: is very common in the States, It's.
Speaker 1: Very it's very common over here in Australia, it's very
Speaker 1: common around the world. I mean, most medical degrees would
Speaker 1: have a maximum of two weeks of nutritional training. But
Speaker 1: for me that they in psychiatry in particular, has got
Speaker 1: no nutritional training. I mean that's kind of dark a
Speaker 1: just stuff, really, isn't it. When we know what we
Speaker 1: know today, it's true.
Speaker 3: Yeah, I mean I think and there's a lot of
Speaker 3: resistance in the psychiatric world about this alternative way of
Speaker 3: seeing brain health and mental health.
Speaker 2: As you might imagine.
Speaker 3: Yeah, this message that we can have such a profound
Speaker 3: effect on the brain through non pharmacologic, non psychotherapeutic options,
Speaker 3: and it's not to throw those away. They can be
Speaker 3: incredibly powerful and life saving. I've seen medications and other
Speaker 3: biological standard psychiatric treatments save lives many times. I used
Speaker 3: to work on an inpatient unit with people who were
Speaker 3: acutely ill. The medications literally would save lives. We used
Speaker 3: ect It would save lives, I have no doubt, but
Speaker 3: those treatments are not very good at continuing to make
Speaker 3: people well after the acute crisis is over.
Speaker 1: Yeah, yeah, you know that's it's an interesting observation, Matt.
Speaker 1: I'm just today five weeks out from open heartshot. Wow,
Speaker 1: because I'm very very lucky. Boy. I am discovered because
Speaker 1: I'd play soccer with a cardiologist and asked them, if
Speaker 1: you do some checks. I was born with a bicusp
Speaker 1: of diotic vale, right, So I'm very lucky because it
Speaker 1: probably would have killed me if I hadn't picked it up,
Speaker 1: or certainly caused heart failure. But what I observed going
Speaker 1: through that whole hospital system is that we have a
Speaker 1: very very effective sick curse system, but not a very
Speaker 1: effective health slash willness system. Right. It's really all about
Speaker 1: just treating the disease or the condition and really not
Speaker 1: very much, if anything, about then returning to optimal health
Speaker 1: and wellness and quality of life and all those sorts
Speaker 1: of things.
Speaker 2: That's exactly right.
Speaker 3: Yeah, that's exactly how I see things. And as you
Speaker 3: said before, once you sort of see this this way,
Speaker 3: you can't unsee it. Once you see the importance of
Speaker 3: the underlying metabolic health to the function of all the
Speaker 3: cells in the body, not just the cells in the brain,
Speaker 3: but all over, you can unsee how important that is.
Speaker 3: And once you also feel it and experience it, when
Speaker 3: you achieve some better metabolic health. Wow, I mean, you know,
Speaker 3: the sky's part for most people when that happens, And
Speaker 3: it does take a lot of work. I mean, of
Speaker 3: course you know, and I know that this isn't something
Speaker 3: you do by you know, hanging out on the couch
Speaker 3: and getting up and you know, doing a few laps
Speaker 3: on a treadmill once or twice a week like this
Speaker 3: is serious work.
Speaker 1: And coming back to your point earlier, lots of people
Speaker 1: will in a human nature, we default to the easier option.
Speaker 1: It's easier to pop uphill, and that's what people tend
Speaker 1: tend to go towards. And it's harder to change your lifestyle.
Speaker 1: And it's really freaking hard to change that, yes, particularly
Speaker 1: if you've been eating a certain way, and certainly ultra
Speaker 1: processed foods, which we're now seeing are quite addictive. I'm
Speaker 1: not sure if you saw the recent umbrella review on
Speaker 1: ultra processed foods so a review of reviews of meta
Speaker 1: analysis and find convincing class one evidence that increasing ultra
Speaker 1: processed foods in the de it increased risk of anxiety
Speaker 1: by I think it was forty eight percent off the
Speaker 1: top of my head, and common mental health disorder by
Speaker 1: fifty three percent. Like class one evidence. Yeah, you don't
Speaker 1: say that shit in nutrition, right, I mean, this should
Speaker 1: just be alarm bailed for psychiatrists on people all around
Speaker 1: the bloody country.
Speaker 2: Shit it shit, absolutely, Yeah.
Speaker 3: The more we actually study it, the more we see
Speaker 3: how powerful food is. It's really the most powerful thing
Speaker 3: to control our epigenetics. You know, we're all born with
Speaker 3: certain genes, but that's really only ten to twenty percent
Speaker 3: of the story of health. The other eighty to ninety
Speaker 3: percent is what's going to turn the genes on and off,
Speaker 3: which is epigenetics. And of course many things control epigenetics,
Speaker 3: but food is the one that we have the most
Speaker 3: powerful control over. You know, it's so powerful and we
Speaker 3: can control it, and here we are instead, you know,
Speaker 3: eating diets that really you know, do the worst to us.
Speaker 1: And absolutely absolutely, and I think Hippocrates let food be
Speaker 1: thy medicine and medicine be thy food, right, absolutely, the
Speaker 1: intur Greeksikia. So now I know there was a bit
Speaker 1: of a pivotal moment for you in your journey, and
Speaker 1: it was around your son's mental health journey. Could you
Speaker 1: tell us a little bit about that?
Speaker 3: Sure? So you know, here we are, we have three boys,
Speaker 3: and we're talking about eight years ago now almost. We
Speaker 3: have twins at the time who were fourteen and another
Speaker 3: one who was twelve. They were very happy, well adjusted kids,
Speaker 3: going to school and playing sports and music and friends
Speaker 3: and all these things. And you know, I'm a psychiatrist,
Speaker 3: my wife's a psychologist. You know, some people might say,
Speaker 3: our poor kids, they've got double shrink parents, you know,
Speaker 3: of course, but but they were doing great. And then
Speaker 3: all of a sudden, two of my boys, one of
Speaker 3: the ones the twins, who was fourteen and the other
Speaker 3: one who was twelve, got very very sick, all both
Speaker 3: at the same time, which was very unusual, and it
Speaker 3: looked very psychiatric mental health. In the beginning, they got
Speaker 3: a cute depression, severe anxiety, but when we started really
Speaker 3: looking closer, they had a lot of physical symptoms and
Speaker 3: really severe cognitive symptoms. Which one would not expect from
Speaker 3: just you know, depression and anxiety and kids. They could
Speaker 3: not even go to school. I mean they really just
Speaker 3: had to drop out of life. It was that severe,
Speaker 3: and it really almost happened overnight, and so two at
Speaker 3: the same time, you know, we were wondering, you know,
Speaker 3: what happened?
Speaker 2: What, you know, did we do something?
Speaker 3: But it really pointed to you know, potentially something environmental
Speaker 3: or infectious that you know, would cluster together like that.
Speaker 3: Well it took quite a while to figure out, but
Speaker 3: eventually we learned that they had a form of autoimmune encephalitis,
Speaker 3: which is essentially the immune system attacking parts of the
Speaker 3: brain that were causing these mental health symptoms. We got
Speaker 3: no help from traditional medicine. I mean literally none. And
Speaker 3: here I am, we have great resources, I know a
Speaker 3: lot of people, I'm a doctor myself in Boston. We
Speaker 3: could get no help from traditional medical care at all,
Speaker 3: and eventually sort of went into this medical odyssey working
Speaker 3: with functional medicine providers and environmental medicine providers and eventually
Speaker 3: got them well through very intensive treatments of infections and
Speaker 3: their immune systems that traditional medicine didn't provide. One of
Speaker 3: my sons is still unfortunately sort of had a relapse
Speaker 3: during COVID and so he's not all the way well yet,
Speaker 3: but at one point he was almost all the way
Speaker 3: well from those treatments. And really what it taught me
Speaker 3: was that we don't know everything, and in fact, we
Speaker 3: don't know a lot about the body and biology and
Speaker 3: the brain. And you know, it really made me rethink
Speaker 3: how many of my own patients have something physical going on.
Speaker 3: I mean, as you probably know, you know, psychiatric diagnosis,
Speaker 3: mental health diagnosis is.
Speaker 2: Not based on valid biology. We sort of gave it.
Speaker 3: We sort of gave up validity and psychiatric diagnosis with
Speaker 3: ds M three.
Speaker 1: Yeah, I have talked about this quite a few times
Speaker 1: that there's I think DSM five and you correct me
Speaker 1: if I'm wrong. Maybe is one hundred and six identified
Speaker 1: conditions and not one of them has a consistent biological signal. Correct.
Speaker 2: Correct.
Speaker 3: So we don't use biological markers in psychiatric diagnosis at all.
Speaker 3: We try to rule out a few things. You know,
Speaker 3: if someone goes to an er, they'll get a chemistry
Speaker 3: panel and a complete blood count, and you know they
Speaker 3: may get an EKG or if in very rare circumstances.
Speaker 3: They might get a CT scan of their head if
Speaker 3: they're a first episode of psychosis, but that's kind of
Speaker 3: the end of the medical workup most of the time.
Speaker 3: And I just start thinking to myself, you know, my
Speaker 3: kids had a condition. If I, if we didn't dig deeper,
Speaker 3: my wife and I, they would have been lost to
Speaker 3: their a mental health condition that no one can treat,
Speaker 3: no one can help. And how many of my own
Speaker 3: patients have we sort of done the same thing to
Speaker 3: have we abandoned they have a you know, this is
Speaker 3: a there's a physical basis to what's going on in
Speaker 3: their brains, and yet we just put them in this
Speaker 3: diagnostic category, give them some medications that were essentially fiddling
Speaker 3: with neurotransmitters, which may be somewhat effective, as I said,
Speaker 3: sometimes life saving in the acute setting, but very or
Speaker 3: almost never does a psychiatric medication get someone all the
Speaker 3: way back to wellness, true true wellness, where they're back
Speaker 3: to their functioning, they're back to their normal social roles.
Speaker 3: The medications just don't do that almost ever. And the
Speaker 3: sometimes with psychotherapy we can get almost all the way there,
Speaker 3: but we're missing something in my field clearly, and So
Speaker 3: then I was sitting in a Grand Rounds lecture at
Speaker 3: McLean Hospital part of Harvard, and my colleague who I
Speaker 3: knew from way back when I was a resident during
Speaker 3: my training, doctor Christopher Palmer, who you mentioned his book,
Speaker 3: is giving a lecture on ketogenic diets and psychosis and
Speaker 3: showing data about how ketogenic diets can help the brain,
Speaker 3: and then showing some case reports of some people with
Speaker 3: chronic psychotic disorders who were on the strongest medication and
Speaker 3: still having psychotic symptoms and having those symptoms completely reversed
Speaker 3: by a ketogenic diet.
Speaker 1: Wow.
Speaker 3: And I'm sitting there and my jaw hits the floor,
Speaker 3: and literally, I think most of the people in the
Speaker 3: room didn't quite believe him, but I knew him, and
Speaker 3: I knew he was telling the truth. And I had
Speaker 3: already had my own experience with my kids at that point,
Speaker 3: and I knew that, you know, there's more to the story,
Speaker 3: And here he is, you know, telling me what more
Speaker 3: of the story there was. And I was sort of
Speaker 3: off to the races learning more about that at that point,
Speaker 3: and then trying to figure out how am I going
Speaker 3: to apply this to my patience, which is a big challenge,
Speaker 3: which we can get into.
Speaker 1: Yes, just before we move on, I just wanted to
Speaker 1: say that that as a fellow dad, I really think
Speaker 1: for you, you with your your your your kid's journey
Speaker 1: and having had a my little guy went through cushions,
Speaker 1: which is pretty horrible and has pretty horrible mental health
Speaker 1: effects that nobody even bloody looked at. And yes, when
Speaker 1: like medicine was fabulous to the point of getting the
Speaker 1: tumor rut, but then absolutely useless in terms of his recovery,
Speaker 1: and we had to go and work with a functional
Speaker 1: medicine doctor and do all sorts of different things slightly
Speaker 1: alternative to get him back to wellness. So yeah, look,
Speaker 1: I just want to say I feel your pain, and
Speaker 1: I know how motivated can it can also be, and
Speaker 1: to go and try and find something that's actually going
Speaker 1: to work. Now, now that's getting back to this whole
Speaker 1: idea of metabolism and mental illness. How much of mental
Speaker 1: illness do you think has a strong metabolic component.
Speaker 3: It's a great question, and I don't pretend to know
Speaker 3: the answer to that. We're still so early in the
Speaker 3: science of really understanding how powerful these metabolical treatments may
Speaker 3: or may not be in mental health disorders. But what
Speaker 3: I can say is that for the people who respond
Speaker 3: it can be really incredible. And then the people who
Speaker 3: even have a lesser than incredible response, there's still profound
Speaker 3: and powerful, important changes that are going on that we see.
Speaker 3: So at the minimum, I tell people, if you're going
Speaker 3: to do this, it's a lot of work, but I
Speaker 3: can guarantee you that you're going to feel more energy,
Speaker 3: You're going to have better sleep, you're going to have
Speaker 3: a better concentration and focus. Those things are almost universal
Speaker 3: for anyone who's done a program of improving their metabolism
Speaker 3: and really improves their metabolism. We may also get, you know,
Speaker 3: bonus things like, you know, stabilizing your mood if you
Speaker 3: have bipolar disorder, or reducing your psychosis if you have
Speaker 3: a schizophrenia or schizoeffective disorder, or reducing your obsessions if
Speaker 3: you've got OCD. I've seen all of those things happen
Speaker 3: in people. And at this point, again the science is
Speaker 3: so early, it's hard to predict how much of a
Speaker 3: symptomatic benefit people are going to get, or maybe how
Speaker 3: long it might take. I mean, that's the other part
Speaker 3: is that for some of these people, it may be
Speaker 3: that this is a treatment that could give them some
Speaker 3: immediate benefit. As soon as they're into keytosis, some people
Speaker 3: start feeling the benefits, and for other people it may
Speaker 3: take quite a few months or even many months for
Speaker 3: them to get all of those benefits. But the benefits
Speaker 3: accrue over time as the metabolism continues to improve, as
Speaker 3: the mitochondrial health continues to improve from that ketone signal,
Speaker 3: the benefits keep accruing.
Speaker 1: Now, and look, we'll dive into the role of the
Speaker 1: mitochondria in a minute, and really into the kedogenic diet,
Speaker 1: but just really if we take a step back and
Speaker 1: look at first principles here kind of like you know,
Speaker 1: the observation earlier on that the bring you know, it's
Speaker 1: only two to three percent of the way but uses
Speaker 1: twenty percent plus of energy. I like to think of
Speaker 1: these things from the perspective of the human genome. And
Speaker 1: I remember as a legendary exercise physiologist Professor Frank Booth,
Speaker 1: who in a research paper in twenty twelve said the
Speaker 1: human genome hasn't changed in over forty five thousand years.
Speaker 1: They said the current human genome requires and expects us
Speaker 1: to be highly physically active for normal functioning. But then
Speaker 1: you add on a couple of things to that. And
Speaker 1: if you just look at our species, the evolution of
Speaker 1: our species, we've always moved as shitload, shitload more.
Speaker 2: Than we had to just survive, right, we had.
Speaker 1: To absolutely, And now the research around the role of
Speaker 1: milo kinds, these signaling molecules from contracting muscle and how
Speaker 1: they impact every friggin organ including the brain. You know
Speaker 1: this is in your face, right, But then you know nutrition,
Speaker 1: we have always as a species eaten natural foods, and
Speaker 1: the enzymes in some of those foods they work as
Speaker 1: cofactors for our metabolism. And it just for me is
Speaker 1: pretty friggin obvious that with then you take this genome
Speaker 1: and you stop it moving or reduce its movement. You
Speaker 1: then do two things in nutrition. You reduce the amount
Speaker 1: of good nutrition that it's it's it's really depended on
Speaker 1: and depends on metabolically, and you replace that with a
Speaker 1: whole heap of ultra processed ship which we know is
Speaker 1: doing damage. And then if you throw in lack of
Speaker 1: sleep as well, which you know was a psychiatrist can
Speaker 1: cause mood disorders in and of a tone and a
Speaker 1: whole heap of overstimulation, like good luck with your mental health.
Speaker 2: It's so true. It's so true.
Speaker 3: The modern world is an absolute setup for poor mental health.
Speaker 3: It's not individual people's fault. I mean, I think that's
Speaker 3: really important to say, is that the system is set
Speaker 3: up for people to have poor mental health.
Speaker 2: Everything you described is one hundred percent true.
Speaker 3: And I would add in were we evolved to have
Speaker 3: light as a nutrient as well, the right amount of
Speaker 3: blue light in the morning and no blue light in
Speaker 3: the evening and throughout the night, and that was such
Speaker 3: a powerful way to control our circadian rhythms, and our
Speaker 3: whole biology is controlled by those rhythms. And we've also
Speaker 3: messed that all up by being indoors all the time
Speaker 3: and having blue light at the wrong times at night,
Speaker 3: which is the most powerful signal for us, Katie and clock.
Speaker 3: But absolutely the exercise thing, you know, you make me
Speaker 3: think of this book I read by an anthropologist Dan Lieberman.
Speaker 2: He's at Harvard.
Speaker 3: Yeah, yeah, well he wrote Exercised also, which is an
Speaker 3: interesting one. It's all about how we are not. We
Speaker 3: did not evolve to choose to exercise ever. In fact,
Speaker 3: we evolved to conserve our energy because throughout our evolutionary
Speaker 3: history we were barely surviving. You know, food acquisition was
Speaker 3: the biggest challenge for survival and predators of course, but
Speaker 3: food acquisition was really the main thing. So that means
Speaker 3: we were going through periods of time where there was
Speaker 3: no food or no carbohydrates, in and out of ketosis
Speaker 3: all the time. So we certainly evolved to have ketones.
Speaker 3: Keytones were part of our survival mechanism, which I want
Speaker 3: to go into as well. But you know, we had
Speaker 3: to move so much to survive. Whenever there was a
Speaker 3: chance to rest our, brains of course were evolved to
Speaker 3: choose to rest. And here we are, we have no
Speaker 3: survival need to move anymore, correct, And so of course
Speaker 3: no one wants to go. It's not in our brains
Speaker 3: to want to go and exercise. I mean, of course,
Speaker 3: those of us who do, we've taught ourselves that this
Speaker 3: is good for us and that will feel good, and
Speaker 3: that there's really good reasons to do it, and and
Speaker 3: then it becomes a habit, and of course you know,
Speaker 3: we feel all the benefits of it, but most people
Speaker 3: don't do it because we didn't evolve to, you know,
Speaker 3: wake up and decide I'm going to go run for
Speaker 3: no reason. And in in you know, in persistence cultures,
Speaker 3: subsistence cultures, now, you know, in you know, traditional cultures,
Speaker 3: people look at the idea of exercises the craziest thing
Speaker 3: they've ever heard, you know, because he goes and talks
Speaker 3: to these people, and you know, in the remote parts
Speaker 3: of Africa, and yeah, the hads they don't exercise for
Speaker 3: exercise sake.
Speaker 2: Ever.
Speaker 3: They sit around if they can, and of course they
Speaker 3: still because their survival needs will get you know, a
Speaker 3: good ten twelve miles a day, but they will never
Speaker 3: choose to do it if they don't have to.
Speaker 1: Yeah, absolutely, Like we are absolutely aligned on this. I
Speaker 1: wrote a book called death by Comfort while modern life
Speaker 1: is killing Us and what we need to do about it,
Speaker 1: And it was that whole idea that we am default
Speaker 1: towards comfort and relaxation because of exactly all the stuff
Speaker 1: that you just said. Yeah, now, let's let's not then
Speaker 1: talk about the role of the ketogenic So you've mentioned
Speaker 1: a number of times the ketogenic diet, and let's use
Speaker 1: that as a segue into metabolic treatment versus medication treatment.
Speaker 1: So obviously you're an expert in both camps right now,
Speaker 1: So just give us the overview on that and as
Speaker 1: dive as deep as you want into high a ketogenic
Speaker 1: tyte and ketones in particular or play a role here.
Speaker 2: Yeah. Well, yeah, there's so many ways I can go
Speaker 2: with this.
Speaker 3: But the one thing I want to say at first
Speaker 3: is that, and I know you know this, is that
Speaker 3: we don't have a lot of deep knowledge about how
Speaker 3: psychiatric medications help with mental health disorders, and in fact,
Speaker 3: the prevailing theories, for example, the serotonergic hypothesis of depression
Speaker 3: has been challenged and I think very much.
Speaker 1: I've had one of the authors of the seminal research
Speaker 1: paper on this podcast.
Speaker 3: I know exactly what you're talking about, the umbrella research
Speaker 3: article from the group in London.
Speaker 2: Yeah.
Speaker 3: Yes, so you know, all we know is that we
Speaker 3: can fiddle with these neurotransmitters and we can get some
Speaker 3: percentage of people of reduction and symptoms, not a huge
Speaker 3: percent them and certainly not all the way to wellness
Speaker 3: and with a lot of side effects. Meanwhile, on the
Speaker 3: other side of the ledger, with this metabolic approach, the
Speaker 3: ketogenic diet, as I alluded to, the neuroscientists have been
Speaker 3: studying this intensively because they've known the ketogenic diet works
Speaker 3: in epilepsy and they're trying to figure out, well, how
Speaker 3: does it work? Of course, I think the main motivation
Speaker 3: for a lot of them is how are we going
Speaker 3: to find a drug that mimics what this diet does,
Speaker 3: because it's hard to get people to do the diet.
Speaker 3: But we now know that there's at least seven main
Speaker 3: mechanisms of how this diet works, and I can go
Speaker 3: through I can go through them. We've already alluded to
Speaker 3: some of them, but one is this alternative source of fuel,
Speaker 3: and that one's important. I'll go into a little detail
Speaker 3: about that. The brain becomes insulin resistant just like the
Speaker 3: rest of the body does. In mental health disorders. It
Speaker 3: may be that the brain is insulin resistant well before
Speaker 3: the rest of the body. Different organs get insulin resistant
Speaker 3: at different rates, and so when the brain is insulin resistant,
Speaker 3: it can literally be bathed in glucose but not be
Speaker 3: able to get that glucose into the cell to burn
Speaker 3: for energy.
Speaker 1: And the keytones type three diabetes type three.
Speaker 3: Exactly, So that same mechanism may be at play with
Speaker 3: mental health disorders, or at least some of them. Or
Speaker 3: some of the people that have them, and we bypass
Speaker 3: that blockade essentially by getting ketones into those neurons, and
Speaker 3: it doesn't need insulin to get in. And so in
Speaker 3: that case, some people will get that immediate effect from keytones.
Speaker 3: Even exogenous keytones will give them a huge mental health boost,
Speaker 3: or even something like MCT oil which makes has deliver
Speaker 3: make keytones out of it.
Speaker 1: That's a really important point that I just want to
Speaker 1: double click on mot that that and again those first principles.
Speaker 1: If your neurons are not getting the energy, they don't work,
Speaker 1: they stop working, and then you are going to have
Speaker 1: compromise Brian function, which can manifest in a range of
Speaker 1: different psychiatric conditions. Absolutely, and you restore the energy, then
Speaker 1: neurone start working again, that Brian starts working again. I
Speaker 1: think that's really important for people to understand. I just
Speaker 1: wanted to really emphasize that.
Speaker 2: Thank you.
Speaker 3: Yeah, I agree, that's important to double click on for sure.
Speaker 3: So that's the first mechanism. Second one I would say
Speaker 3: is this improvement in mitochondrial health. So the keytones are
Speaker 3: a signal for mitochondria biogenesis, but also for mitophagy, essentially
Speaker 3: the recycling of the old damage, non working mitochondria, you know,
Speaker 3: breaking them down for parts and making new, good, well
Speaker 3: functioning mitochondria. And people might remember from their high school
Speaker 3: biology that mitochondria are the energy factories in the cell,
Speaker 3: which they certainly are, but they do many many other things, right.
Speaker 1: Shit, look right, more than just producing energy. We've actually
Speaker 1: had a whole podcast on the mitochondria with doctor Cristo
Speaker 1: bill Yow. So anybody who wants to dive into that
Speaker 1: can can go and look at that. But yeah, uh,
Speaker 1: I mean, I'm all over this like a spider monkey,
Speaker 1: that that that mitochondry. But isn't it amazing just as
Speaker 1: a little aside high the sale and even in the
Speaker 1: mitochondria high it recycles and these these but this this
Speaker 1: mital autophogy that hi just high freaking clever and and
Speaker 1: and how there's no wasted resource within the sales r.
Speaker 1: It's constantly recycling stuff to to recreate. Ny.
Speaker 3: Well, it's amazing. The whole process of autophagy is absolutely incredible.
Speaker 3: We recycle everything.
Speaker 2: All of our.
Speaker 3: Cells get recycled, not just the mitochondria, but our cells
Speaker 3: and our tissues recycle. In fact, you know, if you
Speaker 3: look at like one of your muscles. You know, your biceps.
Speaker 3: Let's say you know that bias is not going to
Speaker 3: be there's not going to be a single cell that's
Speaker 3: the same a year from now.
Speaker 2: That's there.
Speaker 3: Now, Yes, it's just incredible. We keep recycling ourselves. We're
Speaker 3: not the same cells now. There are some cells that
Speaker 3: stick around and don't recycle, neurons in particular, but muscle cells,
Speaker 3: they'll just recycle, turnover. We got a whole new set
Speaker 3: of them, whole new muscle, you.
Speaker 1: Know, in a year. Absolutely incredible, that's right, and that
Speaker 1: most people have good no idea about that, right Like that,
Speaker 1: I talk about change and cellular change. The only reason
Speaker 1: we're still alive is that we're constantly recycling.
Speaker 2: So we need to take care of our recycling.
Speaker 3: And one of the ways we get ourselves to recycle
Speaker 3: is having some periods of time when we're not eating.
Speaker 2: That helps with autophogy. Exercise for sure.
Speaker 3: Ketogenic diets are very powerful signal for autophogy and especially mytophagy.
Speaker 3: So that's our second mechanism. The third one is less
Speaker 3: oxidative stress. So when we burn fat for fuel, it's
Speaker 3: much cleaner than burning glucose for fuel, and so we
Speaker 3: are producing less oxidative stress. People are so interested in
Speaker 3: taking antioxidants, which I'm all for as well, but even
Speaker 3: more powerful is just let's produce less oxidative stress in
Speaker 3: the first place. And if we can reduce some of
Speaker 3: the simple carbohydrates, get our bodies to be burning more
Speaker 3: fats and ketones in the brain versus you know, glucose,
Speaker 3: we're going to create less oxidative stress in the first place,
Speaker 3: create less of that damage.
Speaker 2: Less energy is.
Speaker 3: Needed to squelch the oxidation oxidative stress.
Speaker 1: Absolutely, and I think most people don't realize. I mean,
Speaker 1: most of the ultraprocessed foods are simple carbohydrate bias because
Speaker 1: it's very very cheap to produce it highly profitable, and
Speaker 1: most people don't realize about age GLYCATIONI antestors that we
Speaker 1: get from the die congestion of these simple carbohydrates, and
Speaker 1: that causes oxidative stress and inflammation at a cellular level,
Speaker 1: which just wreaks havoc on your metabolism.
Speaker 3: Yes, it does, absolutely and and just you know how
Speaker 3: much resources need to be put into fixing all the damage.
Speaker 1: That's a good point, actually, Yeah, the antioxy and defense
Speaker 1: systems and stuff like that expensive to runness stuff is.
Speaker 3: So you already mentioned the fourth mechanism, which is inflammation.
Speaker 3: So the ketogenic diet reduces neuroinflammation. We now know that
Speaker 3: inflammation is a huge component for most of the mental
Speaker 3: health disorders. It's been most studied in depression. They're actually
Speaker 3: studies that show that people who are depressed, who have
Speaker 3: elevated C reactive protein, their depression responds to anti inflammatory
Speaker 3: drugs and so you know, and that's been replicated a
Speaker 3: number of times.
Speaker 1: Actually, Yeah, and I've seen studies actually on tumoric and
Speaker 1: calcumen being pretty effective as an antidepressdent. And actually out
Speaker 1: of iran on looking at saffron, yes, which is anti inflammatory,
Speaker 1: good anxiety really effect.
Speaker 3: Safron's good for anxiety actually, but of course those are
Speaker 3: not nearly as powerful as the reduction in inflammation we
Speaker 3: get from a ketogenic diet.
Speaker 2: Yeah, So that's the fourth.
Speaker 3: Fifth one I'll talk about is neurotransmitter based. So we
Speaker 3: ketogenic diet produces an increase in GABBA, which is our
Speaker 3: calming neurotransmitter, the one that people are looking for when
Speaker 3: they're taking a drink of alcohol or taking a medication
Speaker 3: like a benzodazepine like laraise a PAM or diazepam clinasea PAM. Yeah,
Speaker 3: the brand name would be Valuum or adavan xanax. Those
Speaker 3: there's the brand names. And it reduces the kegenic diet
Speaker 3: also reduces glutamate, which is this excitatory neurotransmitter that we
Speaker 3: certainly need, but too much of it causes lots of problems.
Speaker 3: And in fact, a study just came out today I
Speaker 3: think in the British Journal of Psychiatry. A group in
Speaker 3: University of Edinburgh did a pilot study on ketogenic diet
Speaker 3: and bipolar disorder and they didn't have a control group.
Speaker 3: There are controlled studies going on now, but most of
Speaker 3: the ones published so far don't have control groups. But
Speaker 3: they saw a really nice response to bipolar with the
Speaker 3: ketogenic diet dose response as well, so that the higher
Speaker 3: the keytones, better response. But what they also did is
Speaker 3: magnetic resonance spectroscopy of the brains and what they saw
Speaker 3: is it very significant reduction in glutamate in these people
Speaker 3: whose bipolar got better from a ketogenic diet. And this
Speaker 3: is really cool because the other things that reduce glutamate
Speaker 3: are anti epileptic drugs. And also when people with bipolar
Speaker 3: recover from any mechanism, they get a reduction in glutamate.
Speaker 3: But this was the biggest reduction in glutamate that's been
Speaker 3: seen from any intervention was the ketogenic diet. So that's
Speaker 3: really exciting because we're now seeing some really good hard
Speaker 3: science associated with the clinical outcomes in that study, which
Speaker 3: is very cool.
Speaker 1: That is that is very cool actually, and and the
Speaker 1: dose response that's a telling thing as well, isn't it
Speaker 1: when you see that dose response for people, I think
Speaker 1: we are a gluten baturgic society. We really because we're
Speaker 1: just always all right, and this is what a lot
Speaker 1: of people don't realize. And glue to me. It's been
Speaker 1: highly implicated in depression as well. And then because glue
Speaker 1: to me, I think it's important for people to understand
Speaker 1: that that excital toxicity that can happen with too much
Speaker 1: glue to me, basically the nerve celle can fire itself
Speaker 1: to death. And and actually my main professor, Grant Scofield,
Speaker 1: showed me research that when a a sale and neuron
Speaker 1: dies from excited toxicity, it actually spills out glue to
Speaker 1: me and inflammatory compounds that then infect and have a
Speaker 1: negative effect on surrounding neurons, and there can be like
Speaker 1: this negative domino effect.
Speaker 2: It's very interesting.
Speaker 1: Yeah, and that's so that's in the intro. I didn't
Speaker 1: realize that included. Sorry, A kindogenic diet increases GABA, which
Speaker 1: is the balance. I mean, everybody hears about serotonin and
Speaker 1: dopamine and all of these things, but there are dominant neurotransmitters,
Speaker 1: aren't it, glued to meine in gabba and if they're
Speaker 1: not in balance, good luck.
Speaker 2: They're all over the brain.
Speaker 3: So right, there are systems that use serotonin, there's some
Speaker 3: systems that use neuroper nephrins, some that use dopamine, but
Speaker 3: the whole brain is running on GABBA and glutamate. I mean,
Speaker 3: it's the brakes and the gas. It's like the basic
Speaker 3: fundamental neurotransmitter systems in our brain and they've got to
Speaker 3: be in balance. And as you're right, modern world, as
Speaker 3: we talked about, is very pro glutamine and very short
Speaker 3: on gabba.
Speaker 1: Yes, yeah, absolutely, yeah.
Speaker 3: So what we got two more more one The one
Speaker 3: is really an overlap with exercise, but the ketogenic diet
Speaker 3: on its own increases bdn F brain drive neurotropic factor.
Speaker 4: Ah, that's interesting, okay, Because I knew that that a
Speaker 4: mega three fatty acids can increase BDNF, I did not
Speaker 4: know that that a ketogenic diet produces BDNF.
Speaker 1: My listeners will be very familiar with BDNF. I'm buying
Speaker 1: on about it all the time. I think somebody once
Speaker 1: described it as miracle growth. I think you guys used
Speaker 1: to have miracle growing.
Speaker 3: Yeah. Yeah, So the way I describe it is, all
Speaker 3: these neurons have these fine little branches and they connect
Speaker 3: to not just a few other neurons, to hundreds and
Speaker 3: sometimes even thousands of other neurons that process these They
Speaker 3: call them dendrites, and they call they almost look like
Speaker 3: the branches of a tree, so they call that arborization.
Speaker 3: And what B D and F tells these neurons to
Speaker 3: do is make more branches, you know, arborize more connect
Speaker 3: to more neurons, and the more connections the better. So
Speaker 3: we really need this stuff for our brains to function optimally.
Speaker 3: It's one of the things that exercise is very good
Speaker 3: at producing more bdn F. But ketogenic diet also does
Speaker 3: that on its own, and so you're doing both.
Speaker 2: You get that, you know, double effect essentially.
Speaker 1: Yeah, I wanted to ask you about because I remember
Speaker 1: years ago, and I don't know where I saw the paper,
Speaker 1: but it was suggesting that some of the antidepressant medication
Speaker 1: and you know, it was like, well, if it was
Speaker 1: about serotonin, these antidepressants can impact on serotonin because they
Speaker 1: inhibit the reuptick pumps as as you will though, right,
Speaker 1: but that that happens instantly, but people generally don't see
Speaker 1: an effect for weeks. And I remember reading a research
Speaker 1: paper that was suggesting that some of those drugs could
Speaker 1: increase b dn F, and they thought that it was
Speaker 1: the increase and the bdn F, not the change in
Speaker 1: serotonin that could have an impact on some people. I've
Speaker 1: read those any thoughts.
Speaker 3: I've read those studies too, and I think there is
Speaker 3: something to that. But you know, again, like most of
Speaker 3: the research with antidifferent.
Speaker 2: You know, there's just not that much there.
Speaker 3: Maybe it's b D and F, but here we have
Speaker 3: much more science in with the ketogenic diet about raising
Speaker 3: BD and F.
Speaker 2: It's a solid mechanism, you know, we know that it
Speaker 2: does it. Yeah, it's not and.
Speaker 1: It doesn't come with a ridiculous list of side of correct.
Speaker 3: Correct, And so the last one is the microbiome gut
Speaker 3: brain axis. So we know that the ketogenic diet yeah,
Speaker 3: changes the microbiome and there and we know how powerful
Speaker 3: the microbiome is as a mediator between this gut brain axis,
Speaker 3: which is a really powerful impact on brain health and
Speaker 3: gut health. It's this bi directional communication, incredibly powerful signals
Speaker 3: through neurons, through chemicals, through hormones that are going back
Speaker 3: and forth all the time. I like to say, you know,
Speaker 3: if someone comes in to see me, if they've got
Speaker 3: a significant depression anxiety, I asked them about their gut health.
Speaker 3: Almost universally there's gut health issues. I almost never see
Speaker 3: someone with a healthy functioning gut. If I ask, most
Speaker 3: of the icientists don't ask. In fact, I didn't ask
Speaker 3: until I, you know, learned about this stuff because it
Speaker 3: wasn't part of my training. But it's absolutely important, and
Speaker 3: ketogenic diet improves and changes microbiome composition in a way
Speaker 3: that improves brain health. We don't know all the details yet.
Speaker 3: I mean, if if we know all the details about
Speaker 3: the microbiome gut brain access in general we've had, we'd
Speaker 3: have very powerful treatments at our hands, and we're you know,
Speaker 3: you know it's powerful, but we're at the infancy of
Speaker 3: really understanding how to manipulate it and what really makes
Speaker 3: a healthy microbiome, what really makes you know, what really
Speaker 3: works for brain health. We just we're just seeing little
Speaker 3: glimpses of magic so far. We don't have all the
Speaker 3: answers yet.
Speaker 1: Yeah. Yeah, I think anybody who tells you they know
Speaker 1: exactly what a healthy microbiome looks like is full of
Speaker 1: my dog's cramp. That's my view on this. It's just
Speaker 1: as you say. It's it's in its infancy, but we
Speaker 1: know it plays a massive right.
Speaker 2: That's right, That's exactly how I see it.
Speaker 3: I mean, we can measure all the you know, all
Speaker 3: the bacteria species by you know, DNA analysis, and you
Speaker 3: can get this nice report and spend hundreds of dollars.
Speaker 3: But I think you're right in saying that if anyone
Speaker 3: tells you they know exactly what that means or exactly
Speaker 3: what you need to do to fix that, you know
Speaker 3: they're they're lying to you. You know, it's a nice
Speaker 3: story to say. Okay, now we can do all these interventions,
Speaker 3: but we just don't have the science to know that
Speaker 3: those interventions really make the changes in the microbiome that
Speaker 3: we need to make. It's all, you know, it's associational
Speaker 3: at this point. But we do know that avoiding the
Speaker 3: chemicals that ruin our microbiome, eating things that nourish our microbiome, fiber, polyphenols,
Speaker 3: you know, probiotic foods like fermented foods, We know those
Speaker 3: things are important for microbiotic health. We just don't know
Speaker 3: exactly how to manipulate it in a very specific scientific
Speaker 3: way yet.
Speaker 1: Now that leads to an interesting question. So depending on
Speaker 1: the type of ketogenic diet that people go on, you know,
Speaker 1: they could have very low fiber in this and some
Speaker 1: researchers around the GOT will go, well, you have to
Speaker 1: have a lot of fiber for a healthy gut, right
Speaker 1: the you know the count because and particularly around the
Speaker 1: short chain fally acids that are produced. But as my
Speaker 1: me professor Grantzcofil who's a big fan of the katogenic diet, says,
Speaker 1: you know, butter produces butta rate right and and and
Speaker 1: so there are things in a kidogenic diet that will
Speaker 1: actually supplant or or replace. Fiber is a substrate, but
Speaker 1: is the you know, and this might be just gaswork here.
Speaker 1: But when people have mood disorders and they go in
Speaker 1: a ketogenic diet, do we think the impact on the
Speaker 1: microbiome is more of they're now not eating all of
Speaker 1: that shit that is disrupting it, or is it? And
Speaker 1: the stimulation of certain things from elements of the ketogenic
Speaker 1: diet and independently, you know.
Speaker 3: I don't think we know the answer, but I agree
Speaker 3: with your first point that it's so powerful to remove
Speaker 3: the chemicals and the preservatives and all these things that
Speaker 3: we know are toxic to the microbiome. So at the
Speaker 3: very minimum, when we put someone on a ketogenic diet,
Speaker 3: they immediately are going to eat a lot less processed food.
Speaker 1: You can't eat ult process on the hyogenics.
Speaker 3: Right, You're going to be making much of your own
Speaker 3: food yourself, or you're going to be obtaining it from
Speaker 3: a place that's using whole foods because that's the only
Speaker 3: way to get the macronutrients right. And so most likely
Speaker 3: that's the biggest factor I personally, you know, And again
Speaker 3: I don't think the whole story is out here yet.
Speaker 2: I like to hedge my bets.
Speaker 3: I think there's some good evidence about fiber and polyphenols
Speaker 3: from plant foods being really good for our health in
Speaker 3: the long run. There's actually some interesting work on polyphenols
Speaker 3: giving signals to the mitochondria that are very similar to
Speaker 3: what ketones do to the mitochondria. The genetics overlap quite
Speaker 3: a bit. They're both hormetic things, hormetic stressors. You know,
Speaker 3: polyphenols are a hermetic stressor.
Speaker 1: But I think can can you talk a little bit
Speaker 1: about that because Mark Mattson, I remember cheeses twenty thirteen
Speaker 1: reading a research paper by Mark Mattson about hormetic dietary polyphenoes.
Speaker 1: And I'm a huge fan of horrors. Me and Grant
Speaker 1: who are talked about their starting a lab called the
Speaker 1: Hormees love it. So just go down that pathway a
Speaker 1: little bit for people and have that understanding, because, like you,
Speaker 1: I'm utterly convinced about polyphenols and the fiber story. We
Speaker 1: can see a healthy microbiome with less fiber and more fiber,
Speaker 1: and you know, I don't think we know all of it.
Speaker 1: But anyway, back to back to hormetic polyphenols.
Speaker 3: Yeah, so you know, polyphenols are compounds in plants.
Speaker 2: There's about eight thousand of them. They're just a you know,
Speaker 2: a group.
Speaker 3: Of chemicals, and there's eight thousand different types.
Speaker 2: Some of them have been.
Speaker 3: Studied to have, you know, some really interesting health effects.
Speaker 3: You mentioned curcuman before, for that's an example, Resvera trolls
Speaker 3: another example, Alison fore, you know, interesting you know, medicinal properties.
Speaker 3: But essentially, what they often are doing is they're causing
Speaker 3: stress or hermetic stress to the cell. And of course,
Speaker 3: you know, you know, and your audience notes, the idea
Speaker 3: of a hermetic stress is that it's going to cause
Speaker 3: a stress that the cell will need to adapt to
Speaker 3: and get stronger by adapting to it.
Speaker 2: Now, I think, you know.
Speaker 3: For some people, you know, a very you know, you know,
Speaker 3: who don't have a healthy gut, this can be problematic
Speaker 3: because if they're there's holes in the gut wall. Let's
Speaker 3: say these polyphenales are getting into the bloodstream unchanged, unmetabolized,
Speaker 3: because really what often happens is the polyphenals are getting
Speaker 3: metabolized by the microbiota their food for our gut bugs,
Speaker 3: and they're metabolized and them turning them into a different
Speaker 3: chemical that maybe could.
Speaker 2: Be useful for us.
Speaker 3: And so it's this is synergy between eating plant foods,
Speaker 3: a healthy microbiota, and a healthy gut wall, that may
Speaker 3: be what's really working. And so for some people I
Speaker 3: think it is really important they need to actually reduce
Speaker 3: their plant material and some people can heal their gut
Speaker 3: by going to a low plant, low fiber diet, these
Speaker 3: carnivore diets for example, and there's one hundred really interesting
Speaker 3: you know idea of you know, healing the gut that way.
Speaker 3: My hope is that for some of those people they
Speaker 3: can heal their gut and maybe get back to adding
Speaker 3: in some of these plant materials. Now a lot of
Speaker 3: them don't want to. They say, I've never felt better
Speaker 3: in my life. I am done with plants, you know,
Speaker 3: And they're never going to go back. And that's okay.
Speaker 3: I mean, they're doing great, you know, that's fine. But
Speaker 3: I do think there's potential benefits of these hormetic stress
Speaker 3: or polyphenols. I do think there are potential benefits of
Speaker 3: different types of fiber if the gut is functioning well
Speaker 3: and the microbiomes functioning well. So I like to include that.
Speaker 3: But if someone's really having gutshoes will start eliminating some
Speaker 3: things and the carnivor is really almost like the ultimate
Speaker 3: elimination diet to heal the gut.
Speaker 1: Right it is, Yeah, yeah, absolutely, And you will see
Speaker 1: a bucketload of people who say that they hate their
Speaker 1: gut on the carnivor. And I think you bring up
Speaker 1: a really good point, Matt, is that I think nutritional
Speaker 1: recommendations should be conditional, right, And so you talk to
Speaker 1: anybody who has a problem with fod maps and so
Speaker 1: so you know, you give them. So my wife has
Speaker 1: got a little bit of an issue with some of
Speaker 1: the fod maps. Things She eats garlic or onions, which
Speaker 1: she loves, and her stomach just absolutely blows up. Right,
Speaker 1: So this is the thing, were its conditional right. It's
Speaker 1: anybody who says always are never and it just should
Speaker 1: listen to them.
Speaker 2: That's right.
Speaker 3: There's no one diet that fits all. We need to
Speaker 3: individualize it to that person and for that time in
Speaker 3: their life, and it might change over time for them
Speaker 3: what's needed. But there's no that's really human diet that
Speaker 3: doesn't exist.
Speaker 1: Yeah, And there's no perfect human diet that that there's
Speaker 1: no one diet that is going to be optimal for
Speaker 1: you throughout your life course and you know, having certain
Speaker 1: conditions can then change it. Like you said, that's that's
Speaker 1: that's really important, and that that is a a a
Speaker 1: or force of the the impacts of of of the
Speaker 1: of the ketogenic diet and how they actually do it.
Speaker 1: So and then let's just talk a little bit about
Speaker 1: the mitochondria in general. How big a role do you
Speaker 1: think the mitochondria play and what other support other than
Speaker 1: a kidogenic diet. So just before you answer that question,
Speaker 1: and you said earlier on about light and the importance
Speaker 1: of light, I don't know if you've seen some of
Speaker 1: the studies around photo biomodulation and the use particularly of
Speaker 1: near infrared light for neurodegenerative diseases. Like I nearly fail
Speaker 1: off my chair when I've readen that, and I actually
Speaker 1: have a red and near infrared light panel that has
Speaker 1: actually been really useful for my recovery. But the shit
Speaker 1: that happens in your sales and with different wave lengths
Speaker 1: of light and how the mitochondria react to them, it's
Speaker 1: just mind boggling.
Speaker 2: It is.
Speaker 3: Yeah, the mitochondria are absolutely central to metabolic health, not
Speaker 3: just because they're the ones producing the energy in the cell,
Speaker 3: but they're involved in the whole process of energy accumulation, acquisition,
Speaker 3: and distribution, so many of the steps they're involved in
Speaker 3: the first steps of hormone synthesis, neurotransmitter release. They're turning
Speaker 3: genes on in the nucleus, turning them off. You know,
Speaker 3: they're they have an intelligence and they react to certain things.
Speaker 3: They get energy from wavelengths of light. As you were
Speaker 3: mentioning photobiomodulation, they're reacting to the stress in our lives.
Speaker 3: They've been able to actually see under the microscope mitochondria
Speaker 3: change when people are doing a meditation. They react to
Speaker 3: medical they react to someone meditating, They huddle around the
Speaker 3: vesicles as the neurotransmitters are going to be released. They
Speaker 3: have an intelligence. It seems that we're finding that I
Speaker 3: think we're again just scratching the surface, just like we're
Speaker 3: scratching the surface of the microbiota. And you know, I
Speaker 3: think all of the metabolic psychiatry program that that I
Speaker 3: want people to follow is focused on mitochondria. So ketogenic diet.
Speaker 3: Of course, we've talked about exercise, which is of course
Speaker 3: is huge for mitochondria and mind body practices which I
Speaker 3: just talked about. These mitochondria reacting to the stress response
Speaker 3: and the relaxation response and circadian rhythms with light, getting
Speaker 3: that morning sunlight, getting the hormones and balance cortisol and
Speaker 3: melatonin imbalance at the right times, and then also getting
Speaker 3: that direct energy source from the best source of light
Speaker 3: of all, which is our sun. You know, we need
Speaker 3: people outside more and so that's the whole program. That's
Speaker 3: what we do at a chord. It's all of those
Speaker 3: things and avoiding these metabolic disruptors like processed food and
Speaker 3: chemicals in the water and blue light at night and
Speaker 3: all these things that will disrupt our metabolism and our
Speaker 3: mitochondrial health. So if someone does all of it at once,
Speaker 3: that's the idea is that you know, immerse ones, immerse
Speaker 3: someone in the whole program and teach them how to
Speaker 3: do it so that when they go home they can
Speaker 3: continue all of these lifestyle changes that they made and
Speaker 3: continue to accrue the benefits over the course of many months.
Speaker 1: We need to take you and clone you and just
Speaker 1: have rapid reproduction. And so to tell me what sort
Speaker 1: of benefits are you seeing at a core like and
Speaker 1: what sort of people come to you guys, and what
Speaker 1: sort of results are you seeing because this is the
Speaker 1: most comprehensive mental health intervention that I've ever heard of.
Speaker 2: Thank you, Thank you so much.
Speaker 3: Yeah, we've had people with many different diagnoses, so we
Speaker 3: can take someone who has almost any mental health diagnosis.
Speaker 3: They have to be stable enough that they can do
Speaker 3: this program. They have to be motivated enough to want
Speaker 3: to do this program. So they have to have made
Speaker 3: a decision that they want to use diet and exercise
Speaker 3: and mindfulness and sleep rhythms to.
Speaker 2: Work on their problem. And we're going to help them
Speaker 2: do it.
Speaker 3: We're going to give them a lot of support and
Speaker 3: a lot of teaching, and we have a chef there
Speaker 3: is making delicious foods, so it makes it very easy
Speaker 3: to do the ketogenic diet when when she's cooking the
Speaker 3: food and we have a dietician crafting the meals. So
Speaker 3: we've had people with bipolar disorder type one and type two,
Speaker 3: skizo effective disorder, major depressive disorder OCD. Many of these
Speaker 3: folks have had comorbid PTSD. Because almost everyone in the
Speaker 3: mental health world has traumatic experiences.
Speaker 2: But we can take people who.
Speaker 3: Have you know, some anxiety and ADHD and they'll get
Speaker 3: a tremendous response and we've just seen incredible outcomes for
Speaker 3: the people who do the program. We're monitoring their blood work,
Speaker 3: we're monitoring their key tone levels, continuous glucose monitor, body
Speaker 3: composition scans, and mental health rating scales. So we're seeing
Speaker 3: the results and they're just really, really mind boggling results
Speaker 3: that we're getting through these interventions in ways that traditional
Speaker 3: psychiatrists just would not have expected. And you know, to
Speaker 3: be honest, I wouldn't have expected, you know, five six
Speaker 3: years ago, if someone told me that I was going
Speaker 3: to be running a program like this and getting these results,
Speaker 3: I would have left. Wow.
Speaker 1: And are these are they all impatient that they have
Speaker 1: to come in and stay with you guys to get
Speaker 1: the sort of full immersive experience.
Speaker 3: It is an immersive in person program we have. It's
Speaker 3: this very small program. We're just you know, we're just
Speaker 3: getting started here. But we have five beds and we
Speaker 3: can have people who live nearby can come for day
Speaker 3: treatment if they want, and just come and eat all
Speaker 3: their meals and get all the education and all the programming.
Speaker 3: They can then go back and sleep in their own
Speaker 3: bed at home if they want, if they live close
Speaker 3: enough by.
Speaker 1: Yeah, Yeah, that is amazing and tell me last question,
Speaker 1: what are you excited about in the future of the
Speaker 1: mental health landscape and what are you concerned about as well?
Speaker 2: Well.
Speaker 3: What I'm excited about is that right now, as we speak,
Speaker 3: in early twenty twenty five, there are many randomized controlled
Speaker 3: trials of the ketogenic diet in mental health with basic
Speaker 3: science components along with it, meaning they're doing neuroimaging, metabolomics,
Speaker 3: genomics going on right now.
Speaker 2: And so the.
Speaker 3: Data and the papers that are going to come out
Speaker 3: in the next couple of years, I'm just over the
Speaker 3: moon about what we're going to see in these papers.
Speaker 3: We're going to learn so much about what works, how
Speaker 3: it works, what's going on in the brains, what's going
Speaker 3: on in the metabolism during all of these interventions. So
Speaker 3: that science that's going to come out I'm just so
Speaker 3: excited about. I think what I'm worried about is I
Speaker 3: think what happened in the epilepsy world, which is that
Speaker 3: they knew that the ketogenic diets work, and they knew
Speaker 3: that they would work even when the medications wouldn't work,
Speaker 3: and even and there's you know, twelve randomized controlled trials
Speaker 3: showing that they work in kids and adults in epilepsy,
Speaker 3: and still it's not even in the first line treatment
Speaker 3: or the second line treatment or.
Speaker 2: The third line treatment.
Speaker 3: And so that's what I'm most worried about, is that
Speaker 3: we can show how effective this is and show how
Speaker 3: amazing it is, and the field of you know, my
Speaker 3: own colleagues are going to turn over and say, well,
Speaker 3: we can't get people to do it. It's too hard,
Speaker 3: So let's forget about it.
Speaker 1: Yeah, and let's go down to drug right, right.
Speaker 3: Or or some of the other exciting things. There are
Speaker 3: other exciting things happening in mental health with psychedelics and
Speaker 3: some brain stimulations. Some of the you know, mess studies
Speaker 3: that have come out are really exciting, and so you know,
Speaker 3: those are more medical. They're not diets, they're not exercise,
Speaker 3: and so I just worry that everyone's going to gravitate
Speaker 3: towards these you know, medical things that are exciting too
Speaker 3: and miss what I think is the headline, which is
Speaker 3: that the metabolism is the underlying you know, basis the
Speaker 3: foundation of the brain's health. Those other things are great
Speaker 3: if someone gets into trouble, but let's work on the
Speaker 3: foundation for everybody first.
Speaker 1: Yeah, Yeah, get your metabolism right, and your physical and
Speaker 1: mental health will thank you for it for your entire right.
Speaker 2: That's right.
Speaker 1: It just we just can't get away from the fact
Speaker 1: of what our genome requires. Going back to what we
Speaker 1: talked about earlier, exactly, Matt, this has been absolutely bloody awesome,
Speaker 1: eye opening and inspiring an equal degree. Where can people
Speaker 1: go to find more about you? Got you personally under
Speaker 1: core in general? And do you have any plans in
Speaker 1: the future to try to be able to scal this intervention?
Speaker 1: And I get the impatient requirement of the minute, but
Speaker 1: is there any plans on that.
Speaker 3: Absolutely, we love the idea of scaling this up, and
Speaker 3: I think we need to demonstrate what we can do,
Speaker 3: how powerful it is, what are the ingredients that are
Speaker 3: most important. So that's sort of the phase where the
Speaker 3: field is now. But people are absolutely very interesting, including myself,
Speaker 3: and figuring out how do we provide this to way
Speaker 3: more people at way less of a cost, How do
Speaker 3: we make this easier for people and especially people with
Speaker 3: a mental health condition. So again, you know, keygenic diet
Speaker 3: might be challenging for regular Joe out there, but add
Speaker 3: in this person has a pretty significant depression and it
Speaker 3: becomes even more challenging.
Speaker 1: So that's hence the requirement for the price.
Speaker 3: That's why it's not just online, you know, do it
Speaker 3: at home. You know, some people can do it that way,
Speaker 3: and I love it when people can do it that way,
Speaker 3: but many of the people that I work with, my clients,
Speaker 3: need more support than that to do it.
Speaker 2: At this point.
Speaker 3: In terms of where people can find me, I'm on LinkedIn.
Speaker 3: I'm not a big social media presence, so people aren't
Speaker 3: going to find me on you know, X and Instagram.
Speaker 2: I'm just not out there. But they can find me
Speaker 2: on Instagram.
Speaker 3: If anyone wants to message me on Instagram, I always
Speaker 3: connect with them there. And then people should look at
Speaker 3: the Accord web page. So Accord mh dot com is
Speaker 3: the web page for a Chord and that people can
Speaker 3: learn all about the program there and if someone has
Speaker 3: any interest in We've had people come from other countries already.
Speaker 2: You know, if someone from your neck.
Speaker 3: Of the woods or people listening all over the world,
Speaker 3: if they want to come to a Cord to get
Speaker 3: this treatment, we would love to have you. Unfortunately, at
Speaker 3: this point it is a private, pay you know, fairly
Speaker 3: pricey kind of program. Again, we'd love to make this,
Speaker 3: you know, easier and inexpensive for people. That is the
Speaker 3: goal for sure, But at this point this is sort
Speaker 3: of where we are. Was how we have to start.
Speaker 1: Yeah, yeah, I get that, and hopefully at some stage
Speaker 1: governments will then, you know, as you guys grow and
Speaker 1: get your efficacy, have a look at this and think
Speaker 1: about the longest Absolutely, yes, these these intensive interventions can
Speaker 1: be expensive, but what's the cost of somebody being having
Speaker 1: a serious mental health disorder for twenty thirty years and
Speaker 1: even just the cost of the medication.
Speaker 3: Costs of the medication is tremendous. But think about the
Speaker 3: lost productivity. Think about the costs of their families and
Speaker 3: the lost productivity there. Think about the pain and the
Speaker 3: anguish that they and their families have to go through.
Speaker 3: You know, we can avoid a lot of that, I think.
Speaker 1: Yeah. Awesome, doctor Matt Bernston, you have been awesome. Thank
Speaker 1: you very much. Thank you so I'd love to have
Speaker 1: you on again.
Speaker 3: It's I'd love to come back. It was a really
Speaker 3: fun conversation.
Speaker 2: Thank you.