Dr. Uma Naidoo: [00:01:01] Thank you, Maria, for inviting me. I’m excited to talk with you.

Dr. Uma Naidoo: [00:01:09] That’s a great question. You know, this is a more new nascent field in the area of mental health. Nutrition psychiatry is the use of healthy whole foods and nutrients based on scientific evidence that can improve your mental well-being. And it does not exclude the use of any forms of therapy that you might be using or medications that you might be prescribed.

Dr. Uma Naidoo: [00:01:36] I think to better answer that, I think that the gap and the niche that nutritional psychiatry fills is the fact that we have conversations with the doctors about type two diabetes, hypertension, weight gain, skin conditions. But we’re not really bringing one of the most important organs into that conversation, and that’s the brain. So there are multiple foods, as we have understood the gut-brain connection that affects how we think and how we feel. And when I answer the question around what are the foods we should be eating, I like to start with, there are also foods we should be careful about. Because we tend to again think about highly processed refined foods, refined sugars, processed vegetable oils, artificial sweeteners, in terms of our physical health. We think about our waistline or something else or type two diabetes.

Dr. Uma Naidoo: [00:02:25] But we now understand through the gut-brain connection that these conditions, these foods impact our mental well-being. So the first thing I’m going to say is, think about what you’re eating, think about what you can clean up a little bit. Start to cut back on and start to add in some good, wholesome foods. And top of my list are things like really adding the nutritional psychiatry plate. Really adding in those plant-based foods like vegetables, beans, not seeds, legumes, healthy whole grains, some berries because those contain fiber.

Dr. Uma Naidoo: [00:02:56] Fiber is great for your gut microbiome, so start with that then build in healthy fats from olive oil. If you eat seafood, you know omega-three fatty acids from fatty fish like salmon, anchovies, sardines or plant-based sources as well. Add in some spices, which actually help to improve mood, lower anxiety. So stop there to build in some things and another big group of prebiotic foods, probiotics, and fermented foods.

Dr. Uma Naidoo: [00:03:26] They are good for your brain, and there are some specifics in my list of foods around things that actually you’d be surprised might worsen certain symptoms in mental health and be surprised that are actually good for mental health. Like saffron. Saffron actually helps mood, so that’s not something we routinely think about.

Dr. Uma Naidoo: [00:04:21] Sure. So let’s start with understanding and unpacking the gut-brain connection. The gut and brain are different parts of the body, so we don’t intuitively think that they’re connected, but they actually arise from the exact same cells in the human embryo and then they divide up to form these two different organs. Then they remain connected throughout life by the vagus nerve, our tenth cranial nerve, which actually acts like this bidirectional or two-way superhighway, allowing for one of the things being chemical messages between these two organs. If you think about that for a second and then you realize that we call serotonin the happiness hormone, but 90 to 95% percent of serotonin is manufactured in the gut, as well as the receptors being there.

Dr. Uma Naidoo: [00:05:01] So you start to realize that that gut-brain connection may have something to do with that food-mood connection. When you take it a step further, you realize that food that we eat gets digested in our stomachs and in our digestive system. But the things that you’re eating a healthier meal, you’re adding in those probiotic-rich foods, fermented foods, veggies, healthy fats, the good bacteria in the microbiome thrive and they get fed. They break down products, good products for us, such as short-chain fatty acids that have a good impact on our gut lowering inflammation, helping the way that we feel.

Dr. Uma Naidoo: [00:05:39] But on days that you are really pursuing more of an unhealthy diet, the cookies, the candy, the ice cream, the fast foods, the junk foods, processed foods, all of the things we know, they actually do impact our mood. Because those foods feed the unhealthy, the bad bugs or the bad microbes in the gut. And those bad microbes thrive when they eat those foods, and their breakdown products are more toxic to our body and our brain. So things start to happen like the gut starts to get inflamed, the single-cell lining of the gut starts to get punctured and you get conditions over time, like leaky gut.

Dr. Uma Naidoo: [00:06:15] One of the things I see in conditions like that is you get an uptick of mental health symptoms, increased anxiety, worsening mood so those breakdown products are really not good for us because one of the underlying things we now understand is that conditions like depression, anxiety, even cognitive disorders are related to inflammation. And inflammation, one of the things that worsen inflammation is the food that we eat, so that’s how it’s connected to that gut-brain connection as well.

Dr. Uma Naidoo: [00:06:53] That’s right, they think I’m having a bad or it’s my personality. Or they’ve been told by their families, You’re so grouchy, you’re so prickly or whatever it is, and it might actually be more than that. So you’re so right about that.

Dr. Uma Naidoo: [00:07:38] Sure, absolutely. So when we think about those foods, you know, the trans fats, the packaged processed foods, things that basically come in a box. And if you look at the label on those boxes or those packaged goods, there are a very long list of ingredients and many you don’t recognize. So that’s a good tip-off that there are stabilizers, food colorings, dyes, preservatives in that that are probably not good for you, especially for your gut microbes. So think about it that way. Start to maybe pare back on those. But also things like artificial sweeteners.

Dr. Uma Naidoo: [00:08:11] So someone might think, look, I’m trying to cut back on sugar and let me get everything sugar-free. But unfortunately, certain artificial sweeteners drive symptoms of anxiety and other conditions. Processed vegetable oils. So fast-food restaurants traditionally use these processed vegetable oils because they’re less expensive. And when we’re eating those types of foods all the time and more often all you’re doing is those oils are pro-inflammatory, so they are causing more and more inflammation in your gut. You know, another category is just sort of the unhealthy, refined, and processed sugars because we often don’t realize. Even savory foods have a ton of added sugar. You know, ketchup, store-bought pasta sauces, salad dressings, a lot of those have added sugars you don’t even realize.

Dr. Uma Naidoo: [00:08:58] So being cautious of where you’re getting your natural sugars from, a piece of fruit, a little bit of berries becomes really important in understanding. So thinking about one of the things I can maybe switch out that I may have picked up during COVID. We’ve been quarantined, in isolation, so much stress. There’s so much anxiety going on just because of the situation that many people have suddenly started eating ice cream every night when that was not something I used to do. So that’s a good place to start and be aware and then walk yourself back, maybe from that habit, but then there are foods you can include too.

Dr. Uma Naidoo: [00:10:05] So let’s start with the fact that the ratio of omega-three to omega-six is important in the body. And what we want to do is we want to be eating those omega-threes, things like extra virgin olive oil from avocados, you know, basically from seafood like wild sockeye salmon anchovies. Plant-based sources have short-chain omega-threes. The conversion is less efficient, but you can find them in flax seeds, chia seeds, sea vegetables, walnuts, things like that. Those are the foods you want to be building in. You want to always have a greater… using portion control and staying within. Because, for example, we may love chia seeds or walnuts. All of those things are great for us, but we don’t want to eat buckets of them a day. You still want to stay within a portion control and be healthy about it.

Dr. Uma Naidoo: [00:10:51] But it’s the processed vegetable oils that’s one of the biggest culprits that are high in pro-inflammatory omega-sixes. So what happens is the omega-six ratio increases and they kind of really tip the balance so you have more omega-six fats in your body. And what that does is those tend to cause more inflammation, especially in the gut. We also know because of that gut-brain connection, the inflammation of the gut leads to inflammation in the brain. So you want to be thinking all the time, how can I make sure that I’m not tipping that ratio? And one of the ways to think about it is when you cook your food at home or you know how your food is being prepared, you know what oils are going in.

Dr. Uma Naidoo: [00:11:30] So if you’re using avocado oil at home, using extra-virgin olive oil for your salad dressings, you know the fats that you’re eating. When you go to restaurants, it’s not that obvious and at fast-food restaurants, especially. The problem with using those inexpensive oils is that they are really increasing your omega-sixes in the body. What the omega-three fatty acids do is they are reducing their anti-inflammatory. They have antioxidant-rich properties. These are great for your brain. These are great for your gut. So I think that the nuance around nutrition and mental health is that we might say, well, we know that staying away from trans fats is good for our physical health and our mental health.

Dr. Uma Naidoo: [00:12:12] But there’s a greater nuance in the fact that certain mental health conditions get tipped off and you may be eating a so-called sugar-free diet and you may have anxiety. You may not realize that the artificial sweeteners and those sugar-free sodas that you’re drinking or sugary drinks, or maybe it’s candy or something that you’re consuming, actually worsen your symptoms. And that’s sort of where nutritional psychiatry fills that niche and helps people understand there’s a greater connection between how you’re eating and your symptoms of mental well-being.

Dr. Uma Naidoo: [00:12:58] So some easy things to add in are fermented foods. An excellent and recent study published in a very popular and actually highly reputable journal called Self from researchers at Stanford University, looked at the addition of fermented foods to diet reducing inflammation. So fermented foods like kimchi, tempeh, miso, sauerkraut, kefir. These are easy to add into your diet, and fermented foods will lower the inflammation and help offset any symptoms of a low mood.

Dr. Uma Naidoo: [00:13:30] Then there are prebiotic foods, which many people don’t even think about because they think of that in terms of a supplement. But prebiotics you can obtain these from beans from berries, garlic, onions, dandelion greens, asparagus. These are great foods that are nurturing those gut microbes. Add those in because you know what I like to say Maria is a happy gut is a happy mood because really nurturing those gut bacteria and giving them the foods that they like keeps them fortified and helps them really defend our moods and defend our mental health.

Dr. Uma Naidoo: [00:14:02] And then it’s the healthy fats, the olive oil, the nuts, the nut butters, avocados, like we talked about. Fatty fish, like omega-threes, are rich in wild sockeye salmon and then also minerals and micronutrients like iron, magnesium, folate from leafy greens. People think, oh my doctor’s always telling me to eat a salad, but leafy greens, the greener the better, are rich in folate. No folate is associated with depression, so a good thing to add in and a spice like turmeric with a pinch of black pepper really has been shown to help start with a quarter teaspoon a day, a pinch of black pepper. Add to a soup, or smoothie or even a tea if you don’t cook with these. And then there are other herbs and spices that you can add in as well.

Dr. Uma Naidoo: [00:15:27] You know, the first point I want to make about this, Maria, is and I think what you said is so relevant because this is the generation where parents, grandparents, old aunts and uncles, I think there’s an error in how we’re thinking about it. Because we should be thinking about it as us included in that conversation. Because what research has shown us and what we understand is that many of us may be walking around at a younger age with some changes that are happening in our brain. They may not be symptomatic and they may not yet be causing any harm. But what happens is at a different stage of life when symptoms, when there are memory lapses, problems with recalling things, cognitive focus and a diagnosis of a cognitive disorder happens often it’s kind of pretty far along.

Dr. Uma Naidoo: [00:16:15] And the reason I say that this is important for us to be thinking about now is one of when you mentioned type-three diabetes, research is really showing us that one thing that we can actually adapt and change is lowering neuroinflammation. Now neuroinflammation gets up in the brain because of inflammation of the gut like we spoke about. But one thing we can change and that is we can improve is how we eat, because how we eat affects that level of inflammation. And it’s considered by Alzheimer’s researchers as something to be a powerful tool. So rather than just wait for symptoms to happen and then doctors are trying to catch up with medications to help that individual at whatever age with symptoms of cognitive problems or Alzheimer’s, start now.

Dr. Uma Naidoo: [00:16:59] Start cleaning up our diets now. Stop thinking about it now and as we do that, helping our parents, our grandparents. And one way to think about it is going back to cleaning up the diet, reducing the inflammation and inflammatory foods that you’re eating. Adding in the rainbow fruits and vegetables, the colorful vegetables that have plant polyphenols that are great for the gut microbes, that are antioxidant, anti-inflammatory, powerful tools to help us. Fiber-rich foods, daikon radish, jicama, radish, lentils, fiber feeds those gut microbes. Great to add in. Again lowering inflammation, helping with improving our diet.

Dr. Uma Naidoo: [00:17:44] Antioxidant-rich spices. Turmeric with a pinch of black pepper. Thyme, rosemary all have positive impacts in terms of our thinking. So those are worth adding in. Dark chocolate, I say 80 percent or darker, more natural chocolate. Extra-virgin olive oil. All of those are great to add in and are just some of the foods that help our cognition along. But rather than thinking we should be giving this to our parents, let’s all start eating it even now and improving things. Because that way we can at this stage of life, also be helping ourselves know that inflammation and what we’re doing is we’re fending off type-tree diabetes because really, Alzheimer’s is being considered to be type-tree diabetes because of this connection with neuroinflammation.

Dr. Uma Naidoo: [00:18:57] So if you are struggling like you just not thinking clearly, you’re not feeling great, then definitely be evaluated by a doctor, maybe a psychiatrist. Maybe the psychiatrist will refer you for more testing with the neurologist. It just depends on the level that you’re experiencing, but it’s best to get it evaluated. We don’t want to just assume it’s this or that, especially during COVID, where we’ve had less access to medical care because of the hospitals really being focused on COVID care. So check in with someone, get it evaluated. A psychiatrist will walk you through some tests in the office or on a telehealth appointment that can help with the diagnostic process.

Dr. Uma Naidoo: [00:19:37] But another part of this is also look at… So often people will come into an evaluation and tell me about those symptoms, but they haven’t looked at what they’ve been eating. One such patient, for example, was having tremendous… Very, very successful entrepreneur was working from home and hadn’t realized that because she was homeschooling her kids, she’d started to eat a lot of conveniently-based foods and sort of packaged processed foods in order to get dinner on the table in order to make sure the kids had snacks during the day. But what happened is she was eating these from being a very healthy eater, packing a lunch to go to work, a healthy salad, she was now eating at home. And over time, that sort of change also worsened those symptoms, and she was finding herself slowed in the afternoon, unable to focus.

Dr. Uma Naidoo: [00:20:28] So also, we have to look at it from many different ways. We want to be evaluated. We want to look at whether there are medical conditions we have, vitamin deficiencies, allergies, intolerances to food or other environmental things. But then we can also look at what am I doing differently? And despite being someone who’s smart and kind and really so on top of her game in terms of a job she had not realized until we had the conversation that her own diet had changed so significantly because of her situation. So it’s just worth looking at from many different angles.

Dr. Uma Naidoo: [00:21:17] Absolutely. So food is medicine. You know, we have a lot of power in how we’re eating, but I don’t want to mislead you into thinking that that’s the only thing because you might be severely depressed. You might be having active symptoms of severe depression, not being able to get out of bed, not being able to function. Or as one of my patients, she used to be so anxious that you couldn’t get on to Zoom meetings even though she was working from home. So first and foremost, be evaluated by your doctor. But while you’re doing that, you can absolutely, there’s no harm in cleaning up your diet and looking at things that you can do differently. But I want to make sure people understand that some more serious conditions still require medications, other forms of therapy, along with how you can change your diet.

Dr. Uma Naidoo: [00:22:15] So I prefer that people go to their diet first because it’s easy. It’s right at the end of your fork. You’re making adjustments, you’re improving things, and you can do this through how you eat. But I also understood over time that certain things like where you live and I think you do too in the far northeast and people might have more vitamin D deficiency. So test, don’t guess. Have it checked by your doctor. So there is a reason and an important gap that supplements serve for because our lives are not perfect. Our nutrition is not perfect, but we’re facing environmental stress. We’re facing so many things in our everyday lives. It’s worth checking with your doctor if something might need to be supplemented. So I’m not against them. I think there’s a place for them, but I would rather you start with your diet, try to improve things there and then branch out and have a check with your doctor.

Dr. Uma Naidoo: [00:23:18] So some of the surprising things that I found were, I always culturally grown up around using spices. So my aunties, grandmother, everyone who cooked in my family before I did, was always using spices. But I didn’t quite understand it when my grandmother was saying, oh, you know, add this to your milk. She would teach me how to make my golden chai and things like that. I didn’t realize that there was actual scientific evidence behind all of this. I thought it was more cultural and my grandmother was saying, drink a little bit of this or have that if you have a cold. But there was so much evidence behind it that I was impressed.

Dr. Uma Naidoo: [00:23:53] The other thing is that there were simple foods that people take for granted. Leafy greens, you know, there’s a significant amount of evidence behind the folate levels and depression. Blueberries. There’s good mounting evidence around incorporating those in steady and simple ways and the multiple different conditions that they impact. So those to me were surprising because I, like you said at the beginning, felt, oh, this is going to help me. It’s going to be good for, my overall physical health. Fend off other conditions. But when I went deeper into the research and the science behind it, I was often very surprised by the simple things that we overlook.

Dr. Uma Naidoo: [00:24:33] Another big thing that I realized was the importance of those gut microbes because many doctors who say went to medical school about two decades ago, gut microbiome was not part of the syllabus. This is newer science that’s emerged in the last two decades. And the amount of research behind the gut microbiome, the gut microbes, depression and other conditions is really burgeoning, and it’s on the cutting edge. So I’m very excited about that. And the newer things coming up about that research, too.

Dr. Uma Naidoo: [00:25:13] Absolutely, yeah.

Dr. Uma Naidoo: [00:25:23] So, you know, one of the things that I love to do because I feel it makes my life easier is I do a lot of meal prep. And I encourage people to do that whilst enjoying life. You know, 20 percent of the time in terms of what may happen in a given day for 80 percent of the time, I really think the more measured and balanced we can be around meal prep and having things in place is helpful for us. Because then you’re less likely to end up at a fast-food restaurant. You’re less likely to end up with a bad choice for meals. So some things that I do and keep on hand are my chia pudding. It’s one of my favorites. I make them ahead. I always have them either as breakfast or as a snack.

Dr. Uma Naidoo: [00:26:00] I love to keep lots of leafy greens in my fridge and then be able to toss together a healthy salad every day. So I have everything prepped. My favorite veggies, those prebiotic-rich veggies. I love to cut them up, keep them in my glass dishes in the fridge and toss together a salad. Then on the side of my salad, I change it up every day. I’ll have chickpeas or some types of lentils or tofu or something, and I love to lean into spices. So I make those things different by changing up the spices.

Dr. Uma Naidoo: [00:26:30] And some of my favorites for… I always have blueberries on hand and actually frozen wild blueberries have twice the amount of antioxidants. So when I found that out, I look for them frozen because they last longer and I have to worry about them less in the fridge because they’re pretty fragile and I keep them on hand. And I love raw nuts. So I like macadamias, keep those on hand. But I’m always careful with portions. I don’t count calories as much as I do. There’s a couple of tablespoons of nuts for a day. It’s quite a cup of blueberries as a portion. A little, little snack to have.

Dr. Uma Naidoo: [00:27:06] And then the evening is my fun time. So that’s where sort of because I love cooking and it’s my downtime at the end of the day. I kind of keep things that I can make. Lean into the spices. I’ll do cauliflower steaks, but with a tikka masala. I’ll do different veggies on the side. Other members of my… I happen to be vegetarian and the others members of my family eat other proteins, and I’ll prepare that but at the same spices so that I like to leave that a little bit of almost an open canvas in the evenings.

Dr. Uma Naidoo: [00:27:56] Absolutely. So I love ginger. I love fresh or powdered garlic, depending on what you have access to. Turmeric. I always add in, an easy hack, a pinch of black pepper, to make it much more bioavailable to your brain and your body. Saffron. I love saffron, but here’s the thing about it it’s expensive and the amount in studies that you needed to make an impact, it’s one of those few instances where a supplement is appropriate because there are levels that you need. But I love rosemary and I love thyme. So those are ones that I always have on hand because they’re pretty powerful and they pack a good punch.

Dr. Uma Naidoo: [00:28:34] But you know something, I love spices so much that you can ask me the same question tomorrow and I could come up with five others. So I love experimenting like you with them and adding the flavors in because they, like I said, one of the surprises was a lot of evidence behind how they can be helpful to our brains and not just our bodies. So I try to change those up a lot of the time as well.

Dr. Uma Naidoo: [00:29:13] You know, I think that smell… So one of the things we share is nutritional psychiatry. But my practice is really integrated and holistic. I really think about the whole person. So I love the idea of other forms of therapies being integrated with how you’re feeling and aromatherapy, the use of smell and the use of all of your senses become hugely important. So yes, you know, rosemary has been shown in studies. So if you know, if there’s rosemary oil available to you or some sort of scent, why not add that in? Because here’s my position on this food, you know, none of these things are going to harm you unless you have a food intolerance and allergy. You can’t tolerate black pepper or you cannot eat rosemary unless it’s those things.

Dr. Uma Naidoo: [00:29:57] My feeling about this is it’s not harmful to your body. And so adding them in whether it’s through aromatherapy, through whether you’re doing breathwork, yoga, whether you have learned a different form of dance that’s going to help you, all of these things make a big difference. But Rosemary is one of my favorites.

Dr. Uma Naidoo: [00:30:31] I feel like mindfulness. While people talk about it, they don’t often associate mindfulness with eating, and I think that that’s also a connection that is a little bit missing. You know, I think that mindfulness, yes, people hear about writing affirmations, waking up, thinking about gratitude, whatever works for you. I do feel strongly that it’s got to be something that that resonates with you. And if it resonates with you, you’re going to do it. That’s the whole purpose of me wanting to share this. I want you to be able to do it. But people don’t often associate mindfulness with eating, and I think that if we were more mindful, if we sat down when we were eating and I have to tell you as a medical student, and as a resident, I was such a horrible eater because the lifestyle is just so almost… It’s not even conducive to healthy habits. We really have to teach ourselves those.

Dr. Uma Naidoo: [00:31:22] So I say this from a humble point of saying, you know, sitting when eating, where you eat, enjoying your food, tasting it, savoring the flavors, having a conversation with a family member, having the television shut off, you know. All of those things become important because it impacts digestion. That’s how you sleep. It impacts the breakdown of all of your food interactions with the microbes. All of that becomes so important. Another thing that I think people need to be rethinking is rather than think, oh, I have to do hardcore exercise, just get moving. You know, we know that walking helps.

Dr. Uma Naidoo: [00:31:58] It’s everything you should be doing, but a person who is say, struggling with the low mood in winter, just getting out and going for a walk to get your cup of coffee, taking your dog out for a walk becomes really important and building that up to an activity that you enjoy. You know, yoga, tai chi, qigong, acupuncture, all of these things bring something to the table for people to help healing, to help different modalities in the body. So I ask people to list things they enjoy doing and from their build up the nutritional psychiatry plan for them so that they’re doing things they both enjoy, but also are going to be beneficial to them.

Dr. Uma Naidoo: [00:32:53] So melatonin, rich foods. I always say, flip your breakfast because melatonin-rich foods actually will help you with your sleep and you can have eggs for breakfast. You can add in some veggies to that that would help with your sleep. And tart cherries have actually been found to help sleep, and there are certain parts of the country in health food stores that you can find tart cherry juice. Just look for the sugar content in those. Helping with eating more anti-inflammatory foods will help you sleep. Also, this is important, you know, people who may be leaning on a glass of wine to help them fall asleep don’t realize that the wine will actually disrupt their sleep architecture. So being careful about that and then paying attention to sleep hygiene.

Dr. Uma Naidoo: [00:33:46] Often people want a boost in the afternoon and they’re eating or drinking something that is actually impacting their sleep. So that becomes important as well. You know, not leaning on alcohol, not having coffee too late. A good swap is green tea. Just have it early in the afternoon, often helps with focus and doesn’t give you the buzz that coffee does. So part of how we sleep is our sleep hygiene. And it’s not just sleep hygiene that day. That’s the other thing we fall into is let me clean up this sleep hygiene today and do something differently. It’s a pattern. It builds up over time. So not going shopping late at night under bright lights, all of that becomes important in how you are handling your sleep, over time.

Dr. Uma Naidoo: [00:34:42] I think that, most importantly, it’s one thing you can take away, it’s that know that brain health is really important for your overall health. It would be great to be the perfect way to have everything in our body functioning. But if we can’t think clearly or be feeling depressed and cannot function, it doesn’t help us. So you have the power at the end of your fork to improve how you’re feeling emotionally and how you’re eating is a really powerful tool because we now have all of this emerging evidence around the gut microbiome. So I hope you’ll take that away.

Dr. Uma Naidoo: [00:35:30] Thank you so much, Maria. It was lovely to talk to you.