Dr Rupy: Hey, it's Dr Rupy here and we're doing something slightly different on this week's episode of The Doctor's Kitchen podcast. We asked some of the brilliant minds we've had on previous episodes, doctors, neuroscientists, psychiatrists, and nutritionists, one question. What is your number one tip for better mental health? And we're of course doing this for mental health awareness week. Now, the truth is, there is no single fix. Mental health is a mosaic of biology, lifestyle, connection, meaning, nourishment. It's not something that we just deal with when things fall apart. It's something that we need to tend to every single day, just like we do with brushing our teeth, watering plants, or going to the gym. These are insights that we're sharing today that our experts live by themselves. They're not only evidence-based, but they're deeply human. And I hope you find something in today's episode that resonates with you, whether it's a small shift, a fresh perspective, or a reminder.
Dr Rupy: Hi, I'm Dr Rupy. I'm a medical doctor and nutritionist. And when I suffered a heart condition years ago, I was able to reverse it with diet and lifestyle. This opened up my eyes to the world of food as medicine to improve our health. On this podcast, I discuss ways in which you can use nutrition and lifestyle to improve your own wellbeing every day. I speak with expert guests and we lean into the science, but whilst making it as practical and as easy as possible so you can take steps to change your life today. Welcome to The Doctor's Kitchen podcast.
Dr Rupy: Today you're going to hear from TJ Power, who is a neuroscientist, Julia Samuel, who is a psychotherapist, and Dr Megan Rossi, to name a few, who's a dietitian and a researcher. Now, mental health is often understood in the context of conditions like depression, anxiety, bipolar disorder, schizophrenia. These affect a significant portion of the population, around one in six people in England have experienced a common mental health issue in the last week, according to the adult psychiatric morbidity survey. But mental health isn't just the absence of mental illness. It's a dynamic state of emotional, psychological, and social wellbeing that influences everything, how we think, feel, act. A healthy mind supports better decision making, learning, relationships, and even physical health, including reduced risk of chronic diseases like cardiovascular illness. So this isn't just something that is in the brain and the mind, it is something that is absolutely holistic. Nurturing our mental health involves cultivating daily habits that support emotional balance and resilience. Just as a thriving garden requires good soil, sunlight, and regular care, our mental state relies on a strong foundation where nutrition plays a vital role. And I hope you'll get some insight into this holistic picture from our guest contributors. But I'm going to start off by leaning into my bias and focusing on the impact of diet to start this episode.
Dr Rupy: Scientific evidence is increasingly validating this connection between food and mental wellbeing. And I think inherently a lot of people would have thought that what they eat is having an impact on their cognition, their mood, their overall wellbeing, but perhaps didn't have the scientific evidence to support this notion. And it is literally validating to have this. In fact, we did a lot of work internally by doing literature reviews that we had externally validated when we were creating the mental health goal on The Doctor's Kitchen app. And although mental health conditions are multifactorial, as I've mentioned earlier, they're shaped by genetic, psychological, and environmental elements, nutrition is certainly emerging as a modifiable factor influencing several biological pathways. And I thought I'd start this podcast that is obviously going to span a number of other notions by just diving into how diet and mental health intersect. Now, the first thing is the immune system and inflammation. Chronic inflammation is a key factor linked to mental health conditions such as depression and schizophrenia. I'm sure that we're going to find more links across a wider range of mental health issues, but we can say with some degree of certainty that depression and schizophrenia are linked to chronic inflammation. Inflammation is also linked to poor dietary choices. Processed foods, trans fats that are still somewhat in our food supply chain, and sugar, and I just want to emphasise the excess of sugar, not the presence of sugar per se, can disrupt the gut microbiota and increase gut permeability. This is colloquially known as leaky gut. Now, why is our gut microbiota related to our mental health? Well, our gut microbes are communicating to our brain both directly and indirectly, via the vagus nerve, which is a long winding cranial nerve that goes all the way from your brain down into the enteric nervous system and into the gut, but also externally as well, outside of the gut and outside of a direct nervous system, through chemical messengers that are created by microbes and can pass in the bloodstream. This leads to systemic inflammation that drives pro-inflammatory cytokines that can also cross the blood-brain barrier and alter neurotransmitter activity that influences mood and cognition. This is all a fancy way of saying, if your diet is poor, it can lead to poor mental health outcomes, or at least put you at higher risk of them anyway. Just because you have a poor diet is not the only explanation, and I know you're probably going to hear me repeating that throughout this episode, but I think it's very important to just drive the fact that it's not a basic equation, but it is an important factor when it comes to treating the overall person. And I think psychiatrists are waking up to the fact that we really need to look at diet as this important lever when it comes to prevention, but also management of established mental health issues. Diets, conversely, that are rich in fibre and phytonutrients that we get from colourful fruits and vegetables, not always colourful, like mushrooms and onions, these don't have colours typically, but they are rich in phytonutrients, healthy fats, like those found in a diet which has got extra virgin olive oil, nuts and seeds, these all support microbial diversity, they reduce inflammation and potentially lower the risk of depression and anxiety. And we have a number of different trials that actually show this as well. The SMILES trial is a landmark trial that we've spoken about at length before. It was a randomised control trial that showed that participants with moderate to severe depression, I just want to emphasise that point because we're not talking about mild depression, we're talking about moderate to severe depression, those who switched to a Mediterranean-style diet that was rich in phytonutrients, rich in fibre, and healthy fats, experienced significant improvements in symptoms compared to a control group receiving social support. And in some circumstances, the improvement was so significant that medication was reduced or stopped entirely. That's a landmark trial, and it is really impressive to see that diet could have that much of an impact. The other concept that is important within the conversation of food as medicine and food and mental health is oxidative stress and antioxidants. And this is in some way related to our immune system and inflammation. Oxidative stress occurs when the production of free radicals, also known as reactive oxygen species or ROS, overwhelms the body's antioxidant defences. And this imbalance can directly damage brain cells and is commonly observed in individuals with depression and schizophrenia. So there's definitely an association there. Antioxidant-rich foods, such as fruits, vegetables, whole grains, nuts and seeds that are all in their whole form, contain compounds, yes, like vitamin C and vitamin E that are the essential micronutrients that many people have heard of, but they also contain these polyphenols that help restore this balance and protect our brain cell integrity. And these polyphenols, they include flavonoids, anthocyanins, isoflavones, they can also enhance the body's intrinsic antioxidant systems. So this is all to say that the fruits and vegetables that you're consuming don't necessarily have the direct antioxidant effect. What they do is they ignite the machinery that we have within ourselves that are antioxidant defences. So there is a bit of a two-way mechanism there, which is really interesting to understand because it's not just a case of flooding your body with vitamin C that many people try to do with supplements. It's really a case of getting a real mixture of these different plant compounds that we know can help our body help itself. The third concept pertains to hormonal balance, particularly via the HPA axis. This is the hypothalamic-pituitary-adrenal axis. And this regulates our stress response through the hormone cortisol. Now, chronic stress is something that we know can damage this axis. We know that is linked to a number of different issues, heart health issues, brain health issues, skin issues, but also dietary deficiencies can lead to this dysregulation of this axis that contributes to persistent anxiety, depression, and poor sleep. And there is some research that suggests that nutrients such as vitamin C, omega-3 fatty acids, and certain polyphenols can reduce cortisol levels, enhancing that stress resilience in both healthy individuals and those with mood disorders as well. So there is some connection between hormonal balance, the HPA axis, and certain nutrients that we typically get from a diet that is Mediterranean in style, that has those fatty acids that we get from fish. You can supplement with if you are vegetarian or vegan, and I highly recommend people get algae supplements that are high in EPA and DHA, and vitamin C is something that you get from fresh fruits and vegetables. I'm not a fan of getting high-dose vitamin C in unless you have a specific reason to be doing so. And that's usually because of an immune disorder rather than not getting it from your diet because you have this absolute plethora of all these other chemicals that we know are going to be contributing to a healthy state of mind and a healthy state of body. The fourth thing is neurogenesis and brain plasticity. So the formation of new neurons, which is known as neurogenesis, and the brain's ability to adapt, which is neuroplasticity, are vital for memory, learning, and mood regulation. There is something called BDNF, brain-derived neurotrophic factor, and this is a key molecule in these processes of neurogenesis and neuroplasticity. And they do appear to be somewhat influenced by dietary intake. For example, diets that are high in omega-3s, so these are specifically EPA and DHA, these are the long-chain omega-3 fatty acids that we know are anti-inflammatory, they provide the building blocks for anti-inflammatory molecules like resolvins, flavonoids that you find in berries and other brightly coloured fruits and vegetables, vitamins E and D. Vitamin E you tend to find in nuts and seeds, and D is kind of hard to get from the diet, but you can get it from egg yolks and oily fish. These have been shown to increase BDNF levels in both animal and human studies. And in one trial, and I just want to heighten this is just one trial that I'm looking at, individuals with schizophrenia who improved their diet by increasing fruit and vegetable intake showed raised levels of BDNF after four weeks. Now, there are a number of other things that you can do to increase BDNF, namely exercise. And I would say that's probably the most effective way of increasing BDNF, which is why it's one of the core pillars, I would say, of any mental health intervention. But it is really interesting to note that there are some nutrients that we can get from our diet that can contribute to increasing BDNF as an add-on as well. Additionally, there is some intriguing evidence looking at intermittent fasting, which the most common way of intermittent fasting is time-restricted feeding, which is where you eat within a defined window of time during the day. So it could be a 10-hour window, which lasts between 8 a.m. and 6 p.m., or caloric restriction, which is where you purposely count calories and reduce them below your current needs. These two practices may also enhance BDNF expression and synaptic plasticity. The mechanism behind which I'm not clear on, and there are some hypotheses, but it does offer another potential dietary approach, well, it's not really any addition of ingredients, but it is certainly a dietary approach with potential mental health benefits as well. So if you like intermittently fasting, or you find caloric restriction is something that you want to engage in because of body composition outcomes that you're looking for, or you want to stop overeating, and that's why you're doing a time-restricted feeding approach, then there are some additional mental health benefits that you could potentially also benefit from as well. Another mechanism that is getting increasingly more attention is mitochondrial function. So mitochondria are our cellular powerhouses. I mean, they don't just generate energy, they're actually signalling molecules, they're innately important to our immune system. But mitochondrial dysfunction is increasingly recognised in mood disorders and cognitive impairments, contributing to symptoms like fatigue, brain fog, poor memory, but also mental health symptoms as well. Diets that are rich in these phytonutrients, such as resveratrol that we find in red grapes and peanuts, or quercetin found in apples and onions, these have been shown to support mitochondrial biogenesis, so that's the production of mitochondria, as well as their function in preclinical models. So this is not heavily evidence-based within the human clinical literature, but there is the hypothesis that if we can improve mitochondrial function, which we may be able to do with diet, then it stands to reason it could be having a beneficial effect on our brain and potentially our mood as well. So by enhancing mitochondrial resilience, nutrition may mitigate some of these cognitive symptoms of mental health disorders. But again, I actually think, to caveat myself here, the best way to improve mitochondrial function is through exercise. We actually had a really good discussion on the podcast looking at different forms of exercise as a means to improving mitochondrial function. And it is a novel type of exercise that I think has fallen out of fashion called zone two training or steady state cardiorespiratory exercise. This is where you are running, for example, swimming or cycling at a very comfortable pace where you can speak in two to three word broken sentences and it doesn't feel like you're about to pass out at any point. It feels like you can continue at that pace for a long period of time, hours and hours and hours. This is something that we recommend at The Doctor's Kitchen doing twice a week in 60-minute intervals. So it is quite a lot of training per week to do, you know, two hours of this, but there are some clear benefits to our mitochondria and as it pertains to longevity outside of the mental health question, I really think that this stands to reason that it's worth the investment in time. I actually quite like my zone two training now. I listen to podcasts, I kind of zone out, it's very meditative, and it doesn't feel like I'm overly pushing my body. And in fact, I try to do this training on days where I'm trying to recover and allow my body to rest from higher intensity workouts and certainly from heavy resistance workouts as well. So my key takeaway from this episode is diet is your daily act of mental care. Your plate is a powerful agent of change, like I always say. Mental health is deeply interconnected with what we eat. The evidence underscores that nutrient-dense, whole-food dietary patterns that we try and emphasise at The Doctor's Kitchen and The Doctor's Kitchen app and all the things that we do to make healthy eating as easy as possible for you, can modulate inflammation, reduce oxidative stress, rebalance hormones, neuroplasticity and increasing that, and support mitochondrial function, all of which we know play somewhat of a role in cognitive and mental wellbeing. And rather than viewing food as simply fuel or weight control, like a lot of people do, I really think we should look at every meal as an opportunity to nourish our brain and fortify our mood. So some practical tips for a brain and mood healthy diet are eating the rainbow, incorporating a wide range of colourful vegetables. And one of my things that I'm trying to get out there into the masses is BBGs, getting beans, berries, greens, and seeds at every, in every day. You know, just a handful of each is all you need to give yourself that variety that your microbes absolutely love. I would also prioritise omega-3 fatty acids. We find this in oily fish, things like sardines and anchovies, but you can also find short-chain omega-3 fats in walnuts, chia seeds, and flax seeds. And if you want to get a decent EPA and DHA dose, if you are vegetarian or vegan, I highly recommend you take algae supplementation. These have the long-chain EPA and DHA that you want to be looking for on the ingredients label. I'd also recommend choosing whole grains, things like brown rice, oats, quinoa. They not only provide fibre, but they also have B vitamins, which is great for stable energy. Fermented foods, yogurt, kefir, kimchi, sauerkraut as a side, support your microbes that are also having a demonstrable impact on your mental wellbeing as well. In terms of what I would say you should remove, ultra-processed foods are a big, big no-no. I'm not saying that you can't ever have an ultra-processed food in your diet, but it certainly shouldn't be a daily staple. And a big culprit for this are industrially processed breads that are marketed to us by supermarkets as being healthy and whole grain, which, unfortunately, the majority of them are not. At this point, I think it's important to emphasise that whilst I talk about food in a nutritional medicine context that is very scientific and accurate and matter of fact, I really think it's important to remember the pleasure of food. I mean, some of my earliest memories of food are around the dinner table with my family, enjoying the sights, the smells, the cultural history, recognising just how far these ingredients have come to be on our plate, on our table. It's a real privilege to be in countries like the UK and the US where we have access to so much variety of food. And the best way to pay this forward is not only to pay homage to the farmers and the purveyors of our food and the production process, but also enjoy this grand variety that we absolutely have as well. So the pleasure of food is something that I think is medicinal in and of itself as well. And one of the ways in which I feel we should be re-establishing a connection with ourself, being a lot more interoceptive, and actually appreciating the textures, the sights, the incredible flavours of food, is something that I've been leaning into a lot more recently. And that's silence. It's boredom, if you like. It's removing entertainment opportunities that are ever present with the advent of smartphones and other devices that never allow our minds to truly switch off, which is a good and bad thing. But I think our over-reliance on some of these devices and something that I've certainly realised in myself is something that is actually taking and stealing away from the simple pleasures of life that are absolutely stunningly beautiful. And so what I'm trying to do, particularly at weekends now, is take my phone away from me when I'm eating. And I think this is a great way of re-establishing this connection to the self, but also with our food so we can truly enjoy the pleasure of food, the enjoyment of food, and the conversation around food, because that is another tenant of the Mediterranean diet that's heralded as one of the best diets out there to support not just your mood, but cardiovascular health, brain health, and other elements of our wellbeing as well. That's enough from me. I want to introduce our wonderful expert guests that are going to provide their one mental health tip in awareness week for mental health and wellbeing. I really hope you enjoy them.
TJ Power: I'm TJ Power, founder and neuroscientist at The Dose Lab, and my tip is about your dopamine levels. Dopamine has this massive impact on how motivated we feel, how focused we are. And I want to give you a specific challenge to attempt today to support rebalancing your dopamine. Now, this challenge is called meals, bedroom, bathroom. And it's all about how you're interacting with your phone and with screens. Often when we're constantly opening our phones and going on social media and email and WhatsApp and all the different apps, we're overstimulating dopamine, we're exhausting this brain chemical, which is making us feel quite flat and low and demotivated. Meals, bedroom, bathroom is a simple challenge where for 24 hours, you attempt to not look at a screen in any of those environments. So if we take the first one, meals, that means your three meals today, going into tomorrow, you can't look at a screen whilst you're eating. Maybe that's doable. For me, I've struggled a bit with wanting to watch YouTube whilst eating, maybe a video like this. So meals is step one. Bedroom is step two. That means in your bedroom, just for one day, you just try and have no screens, no iPads, no phones. You try and get into bed, take some deep breaths and fall asleep with no stimulation. Then the final one, bathroom. We all go to the bathroom a few times a day, and how tempting is it becoming to just sit there and go on our phone during those moments. One day, 24 hours, meals, bedroom, bathroom, no screens. This is going to reset your dopamine system and help you feel happier and more motivated as a result.
Dr Romaine Gadarrab: Hi Rupy and The Doctor's Kitchen. My name is Dr Romaine Gadarrab and I'm a consultant psychiatrist, particularly interested in problematic uses of the internet. I know this is a very big topic and one that many people have opinions on. We are living in a world with constant connectivity, endless scrolls, non-stop notifications, and I want to encourage people to find a way to introduce more slowness into their daily life and opportunities for daydreaming. Um, because I think this is important for not only our memory, but for creativity. Um, I think we all think that we're very good at multitasking because we're doing it all of the time, but there are actually studies that have linked constant multitasking to poorer cognitive abilities and engaging in really hyperlinked digital experiences, for example, online shopping for around 15 minutes, can narrow our attention even after we've logged off. So I want to think about activities that we can do that aren't propelling us forward by algorithms, um, and allowing us to kind of engage with things in a slower way, which I think is very important. Uh, there are even things like leafing through a magazine, for example, where there are no hyperlinks, there's no reward mechanisms. I think is important. There is an area of the brain called the default mode network that is activated when we're not doing a certain task. So when we're resting, when we're doing nothing, when we're imagining, when we're daydreaming, and this has been linked to not only memory, but to creativity. So I think it's important we find opportunities to activate this more often. So perhaps we can reclaim our time and instead of filling every single moment with a screen, we can think about opportunities to daydream.
Kieran: Good morning, everybody. My name is Kieran. I have a background in sport and exercise physiology. And my mental health tip for the week is revolved, as you can imagine, around exercise. Now, exercise doesn't mean doing something that's going to get you out of breath or something that's going to get you in a sweat. The journal in the American Medical Association of Psychiatry has shown that something as simple as 15 minutes of brisk walking per day was associated with an 18% decrease association with the risk of depression. So finding 15 minutes in a day to go out for a walk is a big, big tip that I'd like to share with my clients. So find some time and get out there walking. Thanks, everyone.
Julia Samuel: Hello, I'm Julia Samuel. I'm a psychotherapist who for 35 years has specialised in grief. And my top tip is to recognise that when we're grieving, it is an embodied process. We often get caught up in our thinking, wanting to make sense of things that often there's no sense that can be made of, wanting to have power when we feel powerless, wanting to kind of think our way through the grieving process. So my top tip is is to do this what I'm going to do now, which is to close your eyes, take a deep breath, and move your attention internally, drop down into your body, and then find the place inside that you feel most sensation. Breathe into that place, and try and find a handle for it. Is there a word to describe it? Is it hard? Is it soft? Is it, is there a colour? Breathe into that, and then you can ask it what does it want to say? It may not have words, it might, but often when you breathe into your body and invite the expansion of that, the wisdom of your body speaks to you. And it actually can find words that we don't have words when we just go into our kind of monkey busy mind. So I do this all of the time. It takes like two minutes. I do it before I go to bed to calm me down. I do it in the morning. Um, I do it before I go into meetings. I hope this is helpful and I send you all lots of love for mental health awareness week.
Dr Megan Rossi: Hi there, my name is Dr Megan Rossi and I'm a gut health scientist, dietitian and nutritionist. And my hot tip for you is to think about nourishing your microbiome every time you eat something. Now, that doesn't mean you can't enjoy your favourite foods. I still enjoy white chocolate, but it's thinking about, well, can I also have a handful of almonds or literally buying on a carrot? Because each time we eat, our microbes also need to be fed. And the research is exploding in terms of how important feeding and nourishing these microbes with plenty of fibre and plants is for things like our mental health, our cardiovascular function, our skin health, our hormonal health, and so on. So next time you go to eat something, think about treating those microbes, because if you look after them, they certainly will look after you.
Dr Amrita Vijay: Hi everyone. My name is Dr Amrita Vijay and I'm a gut health scientist. My top tip for mental health awareness week is to step outside and take a walk in nature whenever you can. Spending time in nature not only boosts your mood, but also has direct impacts on your gut-brain axis. Research has shown that spending time in green spaces helps reduce stress hormones like cortisol, which can positively impact your gut health. A healthy gut and a healthy mind helps support each other from emotional balance, helping you to really reset, pause, and activate that parasympathetic nervous system, and of course have positive impacts on sleep, immunity, and your overall wellbeing. Personally, I take about 10 minutes out of my daily schedule to just take a walk outside in the park, just for me to reset, realign with myself, and boost my mood.
Dr Drew Ramsey: Hey there everybody, I'm Dr Drew Ramsey. I'm a board-certified psychiatrist and one of the early founders of nutritional psychiatry. My top tip for you is I want you to build your mental fitness. That's been a new focus of mine. I love the idea of feeding our mental health, that there are certain foods that are just better for our mental health. And it comes to be the truth in all of the science that there are a lot of things we all agree on, moving our bodies, getting out into nature, connecting, they're also great for our mental health. And we can use new science and the new research, just like with nutrition, to do a better job taking care of our mental health by building our mental fitness. That's what I hope for you this month, mental health awareness month, is you take a step back, that first tenant of mental fitness is self-awareness, and you think about the ways that you're doing a great job already in taking care of and healing your modern brain, but also where some of your challenges are and how you can do a better job. There are nine tenets of mental fitness, and I hope this message encourages you to get after it. Thanks, Rupy and your team for focusing on mental health and doing such a great job being a positive influence for all of us who are thinking about all the great nutrition and great healthy ways to get protein. I'll see you all down the road. Have a great mental health awareness month.
Dr Miguel: Hello, I'm Dr Miguel, and I'm here to talk about food. And food is an incredible tool that allows us to support our brain, our gut, and the rest of the body. But the reality is that it is only one piece in the puzzle. You could have the most beautifully arranged plate with every nutrient in place. Uh, you could have the perfect supplement protocol with all the latest trends, um, right there to support you fully. But if you are, uh, emotionally wrung, if you are, uh, sleep deprived, if you are tangled in self-criticism, there's only so far that even the best nutrition is going to take you. The reality is that nourishment is about much more than what you eat. It's about how all parts of your life begin to move together in a way that may not always be in perfect harmony, but that has its unique rhythm that is yours and, uh, feels right for you. So my message for this year's mental health week is simple. Choose kindness over perfection, choose compassion over control, and let nourishment begin, um, not just on your plate, but in your nervous system, in the relationships with yourself and others, and in your connection with nature. So thank you, Rupy, for having me contribute with my thoughts. Take care, all the best. Bye bye.
Dr Rupy: I really hope you enjoyed today's mental health awareness week episode with our wonderful guests. A big thank you from me and the team to all of our wonderful contributors. If you think that we've missed one important mental health tip, let us know by leaving us a comment on your podcast player or shooting us a message on Twitter or Instagram. We love hearing from you guys and I will see you here next time.
