Healthy Eating Foundations (1-4)


Two things should be stated before I begin. First, when I discuss diets, I am NOT referencing diets that have been prescribed by a person’s medical doctor. These diets often save lives and DO work. If someone has a life-threatening illness or a severe food allergy, then following a doctor's orders is imperative. A person’s doctor knows his/her medical history, family history, food allergies and personal preferences. That is an entirely different scenario than someone buying a book or DVD on weight loss or better mental health through some arbitrary way of eating.* The second important point is that there is an enormous amount of hope in the data I’ve collected. However, to get to what works, what doesn’t work, and why, has to be covered. I don’t want anyone to lose hope in the beginning. Many people all over the world improve their mental/physical health and lose weight permanently. As I stated last week, I’ve lost nearly 100 pounds (7.14 stone or 45.4 kilograms), greatly improved my mental health and gotten into the best shape of my life by using the data from this week’s and next week’s posts, so I know it is possible.

Some may be skeptical of the claim that dieting, and even dieting and exercise, rarely work because we have all been told so often that they are what allow us lose weight, regain health and become happy. Saying that diet and exercise are what lead to better health is an extraordinarily dangerous half-truth. I’m going to provide a small sample of the data that proves diet and exercise are only part of the combination to unlocking better mental and physical health. Remember, there is an enormous amount of hope, but before I could start working on a real solution, I had to know what the problem was. The first step to solving any problem is to admit there is a problem, and as anyone will be able to see, there is a big problem.

We have been sold the idea that diets and exercise will fix what’s wrong with us for so long that many have come to believe it without question. I have tried more diets than I care to recall. From Pritikin to Atkins to Paleo to Veganism and everything in between.  I knew I wasn’t lazy, self-indulgent or stupid. Despite following these diets as prescribed, I found myself obese, unhealthy and miserable. I knew something was wrong. Thankfully, researchers all over the world had been coming to the same conclusion I had come to--DIETS DON’T WORK! Here is a small sample of some of the data that I came across in my search for an answer.  

The United States Government decided to find the best diet for people on Medicare (their healthcare plan) in an attempt to save money. Obviously, people who aren’t overweight tend to be healthier and spend less in healthcare dollars, so the government thought it would be wise to find the best diet to help people lose weight. They hired six researchers at the University of California, Los Angeles. They were tasked with combing through all the data to find the best diet for the government to recommend. After a lengthy study, the researchers were forced to come back to their employer without the requested report. They were hired to do a job that they had to admit could not be done.  After researching all the data, they realized there was no “best” diet. All the diets failed miserably at producing any lasting effect. They stated:
       
These studies show that one-third to two-thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.1
   
Since I’m already discussing my country, I’ll point out how incredibly hard we Americans have tried to lose weight. Last year alone, we spent over 60 billion dollars on diet books, DVDs and weight loss products.2 That’s more than some countries entire GDP. Obviously, with 60 billion dollars being spent, we are aware of the problem and are trying hard to make changes. If going on some sort of diet worked, Americans should be the slimmest, fittest and most vibrant people in the world. However, that is not the case. The reality is, depending on what variables are factored in, we are ranked in the top ten most obese countries in the world, every year. If 60 billion dollars is spent on a solution and the results are as abysmal as these, then obviously we need to focus on a better solution.

The researchers that the United States government hired to find the best diet are not alone in their analysis. It seems everyday another study comes out with a conclusion that sounds eerily similar to what Garner and Wooley reported in Clinical Psychology Review back in 1991. Their conclusion stated:
There are two indisputable facts regarding dietary treatment of obesity. The first is that virtually all programs appear to be able to demonstrate moderate success in promoting at least some short-term weight loss. The second is that there is virtually no evidence that clinically significant weight loss can be maintained over the long-term by the vast majority of people.3

What do they mean by, “the vast majority of people?” Most studies show that the failure rate is around 95%, long term. Those numbers are generated from studies done on the general public. I would hate to see just how horrible the success rate is for those of us who have a mental illness. Throw the stress of a restrictive diet on top of the stress that already exists when someone deals with a mental illness, and I tremble to think of what the failure rates would be.  

Enough with the doom and gloom. That is the problem, and it has been acknowledged. Now, why don’t diets work? I am going to oversimplify, to an absurd degree, the research of two neuroscientists who have thoroughly studied this question. If anyone would like to get deep into the details, I would highly suggest Dr. Robert Sapolsky’s book, Why Zebras Don’t Get Ulcers, Third Edition. Please understand before you spend your hard-earned money on his book that it is a science book. While he does make the data understandable, it is still a slightly technical science book. My wife is one of the most intelligent people I know, and she won’t get through the first chapter because she says it’s as dry as dirt. It isn’t about intelligence; it’s about whether you enjoy science books or not. I practically live in science books, so I find his work inspirational, but that’s me. I love science.

Before I get to Dr. Sapolsky, I need to quickly go over Dr. Sandra Aamodt’s work because she covers why it is so difficult for people to maintain weight loss. Her work also shows why the majority of people end up gaining more weight than they lost on any diet. She can be a bit pessimistic. Who can blame her? Researching people who are trying their best to get healthy and lose weight, and ultimately failing, has to be a tough job. However, even she admits that better health and weight loss are possible if a person will stop dieting and focus on eating healthy foods, mindfully. Her research points out that while it’s true that our weight depends on how much we eat and how much energy we burn, the deciding factor of how much we eat and how much energy we burn is often outside our conscious mind’s control. Our hypothalamus is the part of the brain that regulates body weight, and it produces around 24 chemicals that tell our bodies to gain or lose weight. It is our body’s fat thermostat. It adjusts our hunger and metabolism in an effort to keep our weight stable. When we force weight loss, our hypothalamus works overtime to protect us from what it perceives to be a famine. Our minds/bodies don’t hate us; they are trying to protect us! Up until one hundred years ago famines and food scarcity were common things. Our bodies are programmed to save us during times of famine and distress by releasing chemicals to conserve energy and maximize fat storage. That's why when researchers go back and check on people who went on a diet, depending on how far back they look, 40-70% regained MORE weight than they had lost. These people’s bodies were preparing for the next famine by packing on more fat. Diets are a TRAP! Even the diets that don’t restrict calories are often complicated and overly restrictive of the foods one is “allowed” to eat. Our brains register that information, and it often causes stress. That leads us to the data that Dr. Sapolsky has spent his life collecting.

His work points to the fact that the number one predictor of mental and physical health (obesity, heart disease, blood pressure, mental illnesses, immune disorders, ulcers, diabetes, elevated cholesterol, anxiety, reduced brain functioning, etc.) is NOT what we eat. It’s our glucocorticoid levels. It’s what Psychology Today classified as “Public Enemy Number One.” It’s low-grade chronic STRESS. So, it’s not just what we’re eating, but what’s eating us. Chronic stress has been proved to cause an unbelievable number of health problems and is the leading contributor to weight gain. It causes hunger, fat storage and sugar cravings. Reducing stress levels through wellness activities and by finding healthy foods and exercise that we love is the quickest and most assured way to improve mental and physical health, as well as the best way to lose weight. Please understand, as a man who does not accept anecdotal pseudoscience, I am shouting from the rooftops--THIS IS REAL! The research on stress and its effects on the body is hardcore, verifiable, reproducible, measurable science. {Please, note that no researcher is claiming people’s stress levels are the cause of mental illnesses. On the contrary, the little understanding that we do have shows that they are biological, genetic conditions. It is just so happens that those genes tend to express themselves more frequently in people who have experienced chronic stress. It is not your fault if you have a mental illness, and there is NO scientific data to suggest it is.}

For anyone who would like to delve a little deeper into the subject of how stress affects the body, but who doesn’t want to read a science book, National Geographic did a one-hour special on Dr. Sapolsky's work. It also incorporates the groundbreaking research done in the Whitehall Study. It is an enlightening video. The only problem is it doesn’t get into solutions. However, many of the solutions that are posted on this site are from Dr. Sapolsky’s work. So, if you decide to watch it when you're done reading, don’t get discouraged. He has many solutions, and many of my favorites are on this site.



The picture that I hope is becoming clearer is that, more often than not, the way to improve mental and physical health, and reduce weight, is not as simple as “diet and exercise.” Improving mental health, physical health and reducing weight is achieved through a healthy lifestyle, which consists of doing three things well (in conjunction with any medications one may be on). First, we have to reduce stress by participating in wellness activities that bring us joy. Notice, if you will, that of the listed topics on this site, wellness activities is the largest. There is a reason for that. Second, we need to find healthy foods that we’ll eat because we love them, not because we are forcing them down our throat due to some diet. I wrote about how I was able to drastically cut my sugar consumption and other junk foods, by adding in fruit and healthy foods that I love in Healthy Eating With Mental Illnesses.4  I didn’t talk about completely eliminating foods. I talked about adding in as many healthy foods, that I love, as possible. I hope the philosophy behind that post is clearer now. Finally, we need to find types of exercise that bring us joy. The reason I wrote The Best Exercise for Mental Illnesses5 was to discuss how I became a fitness explorer, looking for the exercises that I love. I never once discussed average calorie burns or muscle gains. I discussed having fun while exercising. Long term success stories of people who have achieved better mental and physical health contain some version of how they incorporated those three things. If we go about wellness activities, healthy foods and exercise with the mindset of finding ways to bring more joy into our lives, then they will make us healthier, happier, fitter and slimmer.

It should be more apparent as to why people are failing to achieve better mental and physical health through dieting, and why people write books that say if we simply cut out wheat or grains or carbs or fat or XYZ we will be thin and happy. It’s much easier than telling people they need to find ways to bring joy to their free time, to their healthy meals and to their exercise routines. It is much easier to say we should eliminate some subcategory of food. The average person wants a simple fix. The problem is, the “simple fix” has become a major part of the problem. I decided to find a way to rise out of the quagmire of average and do the right things, in the right way, to achieve better mental and physical health. I am so glad I did.

Next week will be packed with fantastic news! I’ll discuss how I was able to stop fearing food, and actually fall in love with it again. It is amazing how much that has helped my mental and physical health. I’ll also cover how I used the motto “take the best and leave the rest” to dissect many of the diets being sold today. I matched up what those diets prescribed with what the major population studies show and made notes of the correlations. In other words, I used the data on what the healthiest people on earth eat and matched it up with what these diets say we should eat. I was shocked at how little they had in common. So naturally, I also made notes on what was inconsistent with the best scientific data available. I use those notes to remind myself why I don’t want to go on each one of those diets, specifically. They help keep me strong if I am weak and tempted to jump onto one of them in hopes of getting a simpler fix. Next week will be about how I fell in love with food again to improve health, as well as what diets get right, and what diets get wrong. Hopefully, it will help.
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       As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click the link to the right and you will be directed to the International Association for Suicide Prevention. It is a fantastic resource and is staffed by wonderful people.
Feel free to send your questions or comments to:
questions@thementalrunner.org
*If a person has found a diet that he/she truly loves then it will most likely work because the person doesn't feel deprived, starved or stressed by it. Those are the rare success stories that make up the 5%. People who found a diet that they loved and can actually stay on it forever. As the numbers show, that is extraordinarily rare, but it does happen.


     Lying on a hospital bed in my fourth mental ward, as my mind raced wildly, I decided that, no matter what, I was not going to give up. That may have been one of the best decisions of my life. However, it did present a problem. My health was so poor that doctors kept informing me of how precarious my situation was. Honestly, I was barely clinging to life. When I was finally released, I found myself hobbling from the discharge area over to our car because I was morbidly obese and completely out of shape. I knew I was in serious trouble and eventually had to face the fact that I was, quite literally, in a fight for my life. It was time for action, but exercising wasn't much of an option in the beginning because of my poor health and weight. I realized the thing I would have the most control over, in the beginning, would be what I ate. That was not a comforting thought. I was filled with anxiety as I began pondering the questions that so many others have had. Why has every diet I've ever tried failed to improve my health? Why am I afraid of food? Why isn’t there any consensus on what healthy foods are?

     I went to the library in search of answers, not another ridiculous diet book. I was determined to find why diets had failed to help me achieve any degree of mental or physical health in the past, despite giving them my best efforts. I also decided to research what the populations with the fewest diseases and longest life-spans ate. I was curious if those populations shared similarities in their diets, and if so, what they were.

     I found answers. Thankfully, I found many answers, and they revolutionized my experience of life. I used them to lose the weight, improve my mental and physical health in ways I could have never imagined, and I was able to fall in love with food again. That’s right. I love food. I love everything about food. I love that it sustains life, brings people together, and highlights our cultural differences. I love the way it smells, the way it looks and the way it makes me feel. I am not afraid of food anymore. I am able to embrace it in a healthy way.

     Some of the answers that brought me the most relief were found in the data that I highlighted last week.1 Finding out that 95% of people who go on diets fail, long term, and that the majority of them end up gaining more weight than they lost, allowed me to breathe a sigh of relief. As I said, I knew I wasn’t lazy, self-indulgent or stupid. The more data I dug up, the more I realized that complicated, or overly restrictive, diets were clearly not the answer for the vast majority of people. What a relief, finding out it wasn’t all my fault.

     That data was extraordinarily helpful, but I still had to figure out what I was going to eat. I started looking into what people all over the globe were eating. I found it interesting that we are surviving on many different types of food in many different environments, all over the planet. From the Inuit to the Amazonians, we seem to be able to adapt to whatever food source we are presented with. We can survive on nearly anything. That’s one of the reasons there are over 7 billion of us in nearly every climate on earth. We can survive. The question for me wasn’t who was surviving. The question for me was, of those 7 billion, who was thriving and why?

     The answer was/is clear. Before I give it, please remember, I have no agenda here. I’m not selling a diet book or any supplements. I’m not trying to convert anyone to a way of life because I’m not a Vegan, Vegetarian or Paleolithic person. I am simply passing on the answers that I found by digging through the data. If someone out there has found that eating fried pig skins works for him/her, then my hat is off to them. The information that I use comes from some of the most respected, scientifically sound health and medical organizations on earth. Do with it what you will.

     With that being said, in nearly every study done to date, the populations of people who eat the most whole plant foods (fruits, vegetables, whole grains, nuts and seeds) are the healthiest and live the longest. Diet book authors who don’t like this fact claim that there are other contributing factors that cause this to be true. I agree, to a point. There are many factors that decide a person’s health. For instance, last week I mentioned the number one predictor of mental and physical health is glucocorticoid levels (stress levels). Another factor that is most likely contributing to these populations' health is that nearly all get a considerable amount of physical exercise, whether it be from their occupations or that they simply walk a great deal. Both of those factors, and others, undoubtedly play a role in these people’s health. However, that does not negate the fact that, overwhelmingly, the people who experience the fewest diseases, and enjoy the longest life spans, eat a diet that mainly consists of minimally processed plants.

     Study after study confirms this. The more I found the more excited I became. I had already collected many studies on how fruits, vegetables, nuts and seeds improve mental health. I began to see that there was a chance I could improve both my mental and physical health simply by eating more unprocessed, or minimally processed, plants. Of course, I was skeptical at first, but I decided I didn’t have anything to lose. Why not try eating more plants?

     In the beginning, all I did was try to stuff myself with as many whole plant foods as possible. I did not, and still do not, deny myself anything. I don’t count calories. I don’t obsess about food. I simply eat plant foods ninety to ninety-five percent of the time. And no, I don’t berate myself when I eat something unhealthy. If I’m traveling, or craving something unhealthy, all I do is eat as many plant foods as possible before I eat the unhealthy foods. I still get to enjoy them; I just eat much less of them. Below are exhaustive lists of fruits, vegetables, whole grains, nuts and seeds. I went through them and wrote down all the things that I would eat and could enjoy. It’s that simple.


     I have improved my mental and physical health to such a degree that now, I rarely want unhealthy foods. Usually, unhealthy food cravings come up when we travel. Traveling is a passion of ours. We love experiencing new cultures, climates and scenery. For example, when we’re in Southern California this summer, I promise you, I’ll be having In-N-Out (A fast food burger joint that I love). When we’re in Europe, there is no question, I’ll be having fish and chips, bratwurst, cafe con leches, baguettes, gelato and pasta. How could I travel through Europe again and not enjoy those staples? I intend to live my life to the fullest.

     If I haven’t traveled in a while or haven’t had a craving for anything unhealthy, I’ll go so far as to schedule something like eating pizza into my week. That helps keep me grounded and reminds me that I am not on a diet. Diets often lead to obsessing over and fearing food. If you think I'm exaggerating please realize that a new term has been coined by many in the mental health profession to describe that very phenomenon. It’s Orthorexia Nervosa. Orthorexia Nervosa is described as a condition in which a person becomes obsessed with eating foods that he/she considers healthy, usually from faulty information that was sold to them in a diet book. The people who suffer from this condition increasingly limit the foods that they will eat, often become critical of those who don’t eat the way they do and experience something akin to elation when they eat something that they feel is healthy. Their lives become consumed with the types of food they will allow themselves to eat, and they berate themselves if they eat anything not on their list of approved foods. These are the type of conditions that can help foster an eating disorder.

     The number of people with an eating disorder is skyrocketing. I certainly don’t have any cures or definitive answers, but I do have data. For instance, 80% of 10-year-old girls in the United States admit to having tried going on some type of diet, at least once in their life. That is a scary figure because we know that 95% of people who go on a diet fail. What's worse is, more often than not, they end up gaining more weight than they lost. So, what do they do? They go on another diet, and the cycle begins. People are failing on diets, getting fatter, sicker and becoming increasingly afraid of food. Those realities certainly aren’t helping to slow the number of eating disorders that are occurring. Enough! Let's fall in love with food again. When I did, I improved my mental health, lost nearly 100 pounds and recently got my first top ten finish in a race. To get started, all I did was find as many fruits, vegetables, whole grains, nuts and seeds that I loved and ate them as often as possible.* Life rarely gets much simpler than that.

     I am painfully aware that there are people out there selling countless books and programs that have conflicting data on what they say constitutes healthy food. Often, the authors of diet books are forced to bash the research of well respected scientific organizations, with anecdotal data, to try and support their claims. Robert Coleman Atkins was so upset that scientific bodies like the American Medical Association and the National Academy of Sciences opposed his diet that he said, “My sheepdog will figure out nutrition before the dieticians do.” When I hear statements such as those, I am reminded of what Steven Novella has to say to people like that: “What do you think science is? There's nothing magical about science. It is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. Which part of that exactly do you disagree with? Do you disagree with being thorough? Using careful observation? Being systematic? Or using consistent logic?” Are there areas in life that are outside the realm of science? Of course. Is what the healthiest, longest living people on earth eat one of those realms? No.

     Unfortunately, I am out of time, so I am going to cover what diets get right, and wrong, according to actual science, next week. Until then, just know, when I separated the people who had money tied up in selling me something from the independent and well respected scientific sources the answers became clear. The more whole plant foods [fruits, vegetables, whole grains, nuts and seeds] a group of people eats, the longer they tend to live and the healthier they tend to be. Period. Don't forget the added bonus, there is a mountain of verifiable, scientific studies that show whole plant foods have an incredible, positive effect on many mental illnesses. I highlighted a few in the post on green smoothies.2

     To sum up, I am posting a picture of a small checklist I designed to carry in my pocket. The list is based on what I like and what I need to fuel my workouts. I doubt there would be anyone on earth with the exact same list. I'm not prescribing meal plans. I'm demonstrating my philosophy. Instead of counting calories and worrying about cutting foods out, I focus on adding foods in. I concentrate on getting as many healthy foods, that I love, into my day, as possible. That shift in focus changed my life. It’s simple; if I can fit these foods into my day, in a way that I love, then everything else usually takes care of itself. If I do end up craving something unhealthy, I eat a piece of fruit first, and then I eat it. No big deal.
     As a side note: To help illustrate how easy this is, I’m going to start posting more pictures of what I am eating on Instagram and Facebook. I will also be adding Healthy Foods That Rock into the topic section, soon. In it, I will occasionally post easy recipes and tricks for awesome healthy foods. Hopefully, the pictures and the recipes will be helpful. I will be sure to post pictures of when I have an unhealthy meal, like a big slice of pepperoni pizza, as well as the healthy foods. I want everyone to know that a person can be extraordinarily healthy and fit while still having an occasional splurge with family and friends.
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      As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click the link to the right and you will be directed to the International Association for Suicide Prevention. It is a fantastic resource and is staffed by wonderful people.
Feel free to send your questions or comments to:
questions@thementalrunner.org
*I did gain a few pounds in the beginning because my leptin hormone levels had crashed, and my metabolism was shot. I didn't care. I felt better and was sure it would work itself out. Thankfully, I was right.


This week I'm giving a quick snapshot of the information that I have collected on what diet books get right and wrong, as far as mental and physical health are concerned. It is based on the best scientific data collected on the healthiest, longest living people on earth. I compared what foods were being pushed, or excluded, in those diet books to what the healthiest populations on earth eat. The point that should become clear is that diet book authors aren’t stupid! They know what sells and what doesn’t. They’ve thought things through. For instance, let’s suppose there were two books on a shelf, sitting side-by-side. One book says people need to find ways to reduce stress while eating plant-centered meals and exercising daily. The other book says that people can eat steaks wrapped in bacon and by doing so will burn more calories watching television than others do while exercising (That is an actual assertion made by a diet book that I will cover). Do you think they know which one the average person is going to buy? We have to rise above the gimmicks if we want to make real changes.
I began by looking at the populations that everyone discusses, the ones with the most centenarians. I’m speaking of those people living in parts of Sardinia, Greece, Japan, California and Costa Rica. Those were great places to start, but focusing only on those populations seemed too narrow for me, so I widened the search.
Thankfully, there is fascinating data on people in many other parts of the world.  There are groups of people thriving, despite their advanced age, in many parts of China, Africa and India. One of the most important factors for me was that they are doing it without the advantages of an ultra-modern medical system. I took out the groups of people who had easy access to the best modern medicine available because, despite what conspiracy theorists claim, modern medicine can drastically increase life expectancy. I wanted to know who was living the longest based on diet and lifestyle, not on the quality of a group's medical system. I admit that cut out more populations than I would have liked. However, doing so still gave me many more groups to analyze than what I started with. I was pleasantly surprised to find how much they all had in common, despite being spread across the globe.
As culturally and genetically diverse as these populations are, they share three things in common. Overwhelmingly, they tend to have found ways to lower stress levels, get daily exercise and eat mostly unprocessed, or minimally processed, plant foods. Fruits, vegetables, grains, nuts and seeds tend to make up the majority of their meals. Technically, they also seem to share one other characteristic. They don’t go on restrictive diets. In fact, I have yet to find a single study that documented any of these groups of people going on any type of diet. It seems to be a foreign concept to them. Thank goodness.
So, let’s compare what they predominantly eat with what the three main categories of diet books say we should eat. I’m categorizing all diets into three groups because the vast majority are just slight variations on the same three themes, which are Vegan/Vegetarian, Low Carb and Paleo/Anti-Grainers. I realize that there are others, but these are, by far, the most popular. Also, I’m summing up 173 pages of notes I’ve collected on various diets into one post. Grouping them into three categories is the only way I can do it.
Vegan/Vegetarian
The Good: By nearly every metric used to measure health, vegans and vegetarians do well. As a group, they tend to get high marks on health. Regardless of ethnicity or cultural background, vegans and vegetarians often live significantly longer and experience less disease than people who consume large quantities of animal products. There is also strong evidence that strict vegans can halt, and in some cases even reverse, heart disease. These diets closely resemble the way the healthiest and longest living people on earth eat. However, the overwhelming majority of those populations do eat small amounts of various animal products.
The Bad and the UGLY: Notice before that I said “nearly every metric used to measure health.” Oddly enough, there is a good bit of evidence that suggests vegetarians and vegans experience MORE mental health problems than those who occasionally partake in animal products. There are many different theories as to why this is true. No one is suggesting that these diets cause mental illnesses, but there is evidence that a low intake of fats, EPA and DHA in particular, can exacerbate existing psychological conditions. Psychology today published an article a few years ago that highlights a few of the theories surrounding why there is a higher prevalence of mental health issues in the people who adopt these diets.1 I found it odd that no mention was made in the article that people often express concern over this type of diet being exceedingly hard to follow and that it often causes elevated stress levels. Feelings of social exclusion and stress are often reported to researchers who are studying those who have adopted these diets. Feelings of social isolation and increased stress levels, much less the strict nature of these diets, are enough to explain why the majority of people are unable to follow these diets, over the long term.
A personal note: A few years ago I went vegetarian for nine months and then went vegan for three more. At the end of that year, I looked fantastic. I was slim, and my running times were excellent. Unfortunately, I was coming unhinged. For someone with my conditions, the struggle of always being the odd man out, always struggling to find foods I could eat, trying to consume enough protein and feeling just a little bit deprived caused me untold grief. In other words, I can attest to the reports of higher levels of stress and social isolation that researchers have often received from people trying to be a vegan or a vegetarian. I admire people who can eat this way without negative emotional side-effects. However, despite my best efforts, I was unable to find a way to do it. Since making peace with the fact that, occasionally, I need to eat animal products, my mental health has improved, and my physical health has improved. I’m also running faster now than when I was as a vegan!
Low Carb (Atkins, The Zone, etc.)
The Good: They all reveal the unheard of, stunning, unbelievable fact that refined sugars are bad. I hope you detected my sarcasm there. The healthiest populations on earth don’t have high intakes of refined sugars. So, I suppose they did get that right.
The Bad and the UGLY: I could write four posts on how dangerous and ridiculous these diets can be. They aren’t new. William Banting wrote Letter on Corpulence in 1864. These type of diets popped up again in the 1920’s, 40’s, 60’s, 70’s and then in 1992 Atkins reissued his book as Dr. Atkins New Diet Revolution. It became the best-selling diet book in history, despite the fact that the “new diet revolution” wasn’t all that new. The National Academy of Sciences, the American Medical Association, the American Dietetic Association, the National Institutes of Health, the American College of Sports Medicine, the American Cancer Society, the Cleveland Clinic, Johns Hopkins and the American Heart Association have all made their opposition to this diet known. The Secretary of the AMA’s Council on Food and Nutrition said, “The whole diet is so replete with errors woven together that it makes the regimen sound mysterious and magical.” The Journal of the American College of Medicine published a report in 2003 that stated: “Carbophobia is a form of nutritional misinformation infused into the American psyche through...advertising...infomercials...and best-selling diet books.”
Wild claims are often made about ketosis, insulin sensitivity and other medical terms. The Zone was speaking of ketosis when it claimed on its back cover that: “You can burn more fat by watching TV than by exercising.” Jeffery Prince, a spokesperson for the American Institute for Cancer Research, was talking about low-carb diets and their ridiculous claims when he said, “When unproven science becomes a sales pitch some people get rich, and the rest of us get ripped off.”
Over fifteen million Atkins books have been sold, not to mention all the other books that simply tweak the same concept. Of the tens of millions of people who bought those books, how many can the National Weight Control Registry find who have lost weight, long term? After a decade of following people who have successfully lost weight, and kept it off, a chief investigator reported, “We can’t find more than a handful of people who follow the Atkins program in the registry and, believe me, we’ve tried.” What about the other low-carb diets? They report “Almost nobody’s on a low carbohydrate diet.” In fact, they found that most people who were successful in losing weight long-term were eating HIGH carbohydrate diets. This is an organization that is funded by the National Institutes of Health. We are talking about real researchers and scientists who are looking for real answers, and their message is clear. Of the estimated 26 million Americans who are currently trying to follow a low-carb diet, they have only found a “handful” who have had any long term success.
It’s not just American scientists and nutritionists who abhor this type of diet. In Europe hospitals are banning the Atkins diet. The British Nutrition Foundation and the British Dietetic Association has called the Atkins diet negligent, nonsense, pseudoscience and a massive health risk. The Australian Heart Foundation and the Australian Medical Association supported the Victorian Health Minister in issuing a warning to people of the dangers of high-fat fad diets. Some of the warnings of the short-term effects included things such as constipation, dehydration, low energy and poor concentration. Some of the long-term warnings included the increased likelihood of cancer, heart disease, depression and osteoporosis. The minister has explained, “When we know something is bad for people, like smoking, then we let people know what the health risks are.”
I’m trying not to bang my head on my desk as I’m writing this, so I’m going to stop now. It’s simple, I have yet to find anyone, who isn't selling gimmicks, that isn't horrified by the nonsense in these books. Not only is long-term success on these diets as rare as sightings of the Loch Ness Monster, but the health risks are unbelievably high.
A Personal Note: Please, for the love of God, don’t do this to yourself!
Paleo/Anti-Grainers
The Good: These books cut out all highly processed foods, from refined sugars to refined grains. They also suggest eating wild game or pasture-raised animals. Cutting out processed junk food and meat that can be laden with growth hormones, antibiotics and pesticides is sound advice that can be backed up by solid science.
The Bad and the UGLY: Of all the diets U.S. News and World Report researched, they gave the Paleo diet the lowest marks. It’s because very little food that is available today was available to cavemen. That means the diet is inherently complicated, hard to follow consistently and the most expensive, by far. Also, many on this diet use eliminating refined foods as an excuse to eat loads of meat that has little resemblance to that of prehistoric wild animals. This has led some to label the Paleo movement as Atkins Light. Not to mention there have been no randomized controlled trials, much less meta-analyses, done on this type of diet. So, no one knows for sure if it’s healthy. Naturally, it’s assumed that those who lean heavily on eating fruits and vegetables and add in pasture raised animal products will do beautifully in future tests because those types of eating patterns fall in line nicely with what the healthiest people on the planet are eating. Those who turn the Paleo movement into Atkins Light may not be so lucky.
The lack of consensus on what the Paleo diet actually is does presents researchers with a problem. Some on the diet focus on fruits and vegetables while others eat plates full of bacon and eggs. Which one of those groups best represents the Paleo movement? Many in the Paleo movement will say that both groups are correct. Often, they will throw out a catchphrase to try and define their diet. It’s, “If a caveman wouldn’t eat it then you shouldn’t eat it.” What does that mean, exactly? That’s the problem. No one actually knows.
One of the more glaring problems that hangs over all the Paleo diet books is their stance on grains. To their dismay, grains are eaten by nearly every group of people on the planet that live the longest and are the healthiest. Often, the authors of these books use terminology to describe grains in a way that makes it seem that new revelations have been uncovered as to how unhealthy grains are. There haven’t been. 

Just because the authors throw around old terms, like they’re new, such as anti-nutrients, phytic acid, gluten and lectins doesn’t mean that grains are unhealthy. On the contrary, for the vast majority of people grains have been shown to lower the risk of heart disease, blood pressure, premature death and reduce the risk of many types of cancer. What isn’t mentioned in these books is the fact that lectins, phytic acid, amylase inhibitors, phenolic compounds and saponins have been shown to reduce blood glucose and insulin responses, as well as cholesterol and triglycerides. There is also a strong relationship between phytic acid, phenolics, saponins, protease inhibitors, phytoestrogens and lignans to reduced cancer risks. There have even been suggestions that antinutrients be renamed because of the false impression the name gives. Did you like how I used their technique of using scientific wording to make my point sound slightly magical and profound? As Einstein said, “If you can’t explain it simply, you don’t understand it well enough.” Here is the simple truth. For the vast majority of people, grains are associated with good health, not poor health.
What do I mean by grains are healthy for the vast majority of people? Well, the Columbia University Celiac Disease Center puts the percentage of people who have celiac disease at .55%. That's right, a half of one percent. The Center for Celiac Research at the University of Maryland estimates that around 5% of the population has some degree of sensitivity to gluten. These are two research institutions whose funding depends on studying people with gluten sensitivity, and they put the number of people who may be negatively affected between a half percent and five percent. That means the number of people allergic to dairy dwarfs the number of people who are allergic to gluten. When someone gets a rash or a tummy ache from dairy, they often make a wise decision; they don’t eat it anymore, and the rest of the world goes on about its business. However, due to the clever marketing of old terminology that sounds scary, people all over the world are terrified to eat grains. 

It's quite simple. The science does not support the view that grains are unhealthy. In fact, many of the healthiest populations on the planet not only eat grains, but many of them also eat refined grains, such as white rice and various types of bread. Unfortunately for the authors of the anti-grain books, the large-scale studies don’t match up with their small scale, and what often appears to be cherry-picked, research.
In case anyone out there has missed out on this whole phenomenon, let me give a sampling of some of the lines directly out of Grain Brain: “I’m referring to all the grains that so many of us have embraced as being healthful - whole wheat, whole grain, multigrain, seven-grain, live grain, stone-ground and so on. Basically, I am calling what is arguably our most beloved dietary staple a terrorist group that bullies our most precious organ, the brain.” “I will demonstrate how fruit and other carbohydrates could be health hazards with far-reaching consequences.” “This is a game changer.”  In a radio interview, he stated, “We’ve never in 99.9 percent of our time on this planet eaten carbohydrates. They weren’t available.” The only problem with that assertion is--nearly everything! The small amount of data we have points to the fact that, as hunter-gatherers, we predominately ate carbohydrates in the form of fruits and vegetables. Hunting was much more dangerous and labor intensive than picking up fruits and vegetables off the ground. Good grief. This isn’t rocket science!
After striking terror into the hearts of many readers, the author of Grain Brain (I can’t bring myself to write his name) brags on the Mediterranean Diet. He then has to concede, “Although it does allow room for grains, it’s very similar to my dietary protocol. In fact, if you modify the traditional Mediterranean diet by removing all gluten-containing foods and limiting sugary foods and non-gluten carbs, you have yourself the perfect grain-brain-free diet.” Wait. What? Apparently, they have a fantastic diet that has been getting wonderful results for millennia. All we have to do is overhaul the majority of it, and then we can have a diet that meets his new standards. Does anyone else feel like a slick salesperson is trying to sell them a bill of goods? I want the truth, not a sales pitch.
Is anyone wondering what other scientists and researchers have to say about the anti-grainers? Here is a small sample. In 2014, the American Journal of Cardiology published a commentary on Grain Brain that stated: “The declaration that a single, simple ‘cure’ can successfully treat numerous diverse diseases and symptoms is reminiscent of the oratory of the ‘snake oil’ merchants of generations ago.” David Katz, a Yale physician and nutrition researcher, had similar sentiments. He dismissed Grain Brain outright when he said, “I also find it sad that because his book is filled with a whole bunch of nonsense, that’s why it’s a bestseller; that’s why we’re talking. Because that’s how you get on the bestseller list. You promise the moon and stars, you say everything you heard before was wrong, and you blame everything on one thing. You get a scapegoat; it’s classic. Atkins made a fortune with that formula.” And finally, Jonathan Eisen, who is a microbiome expert at the University of California, stated: “To think we can magically heal diseases by changing to a gluten-free diet and taking some probiotics is idiotic, quite frankly. It resembles more the presentation of a snake-oil salesman than that of a person interested in actually figuring out how to help people.”
A Personal Note: I am friends with several level-headed paleo eaters. We have a blast and often eat the same things. They focus mainly on eating fruits and vegetables and pasture raised animal products. What’s not to love about that? I will say that they are affluent and have a great deal of free time to devote to eating this way. That certainly helps. As with anything, the trouble begins when things are taken to extremes and wild and ridiculous claims are made.
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      As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click the link to the right and you will be directed to the International Association for Suicide Prevention. It is a fantastic resource and is staffed by wonderful people.
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(This is a picture of my favorite green smoothie ingredients, which I snapped for this post today)

       Many readers have requested a more specific list of what I eat daily. I don't like labeling myself. I'm am not a raw food person, a vegan, a vegetarian, a paleolithic eater or any other label that is out there. What I do is eat the healthiest foods that are available to me, as often as I possibly can. I have to keep it that simple. I do admire people who are able to live by a strict set of guidelines, and I see the benefits of doing so. With my conditions however, I find that trying to live with those kind of restrictions only causes me headaches and heartaches. That means getting into the specifics of what I "always" or "never" eat becomes nearly impossible.

       That being said, there is one type of food that I eat everyday. I have yet to find an eating plan that doesn't consider this type of food healthy and beneficial, especially to mental health. I view this food source as a medicine, as much as any pill I have ever taken. The one thing I eat everyday is dark green leafy vegetables. I do however, have a confession to make. I don't like dark green leafy vegetables. In fact, I don't care for them at all. 

       I tried every way I could think of to get around the research that I kept coming across. Nearly every nutritional article written about how to reduce symptoms and improve health involved these vegetables, such as spinach and kale. There were some that involved fruits as well, but the overarching theme was whole produce. So, before I go into how I overcame my aversion to these vegetables, let me do as I always do, and give the science behind why I decided I must find a way to include them into my meal plans.

       In the study, Antioxidants as potential therapeutics for neuropsychiatric disorders, it is stated, "Accumulating evidence indicates that oxidative free radicals play important roles in the pathophysiology of various neuropsychiatric disorders including schizophrenia, bipolar disorder and major depression." That is an enormously broad statement on the importance of antioxidants for mental health.

       There was a large study done by Canadian researchers entitled, The association between fruit and vegetable consumption and mental health disorders: evidence from five waves of a national survey of Canadians. It involved three hundred thousand people across the country. This is a snippet from the study, "In this large population-based study of Canadians, greater fruit and vegetable consumption was associated with lower odds of depression, psychological distress, self-reported mood and anxiety disorders and poor perceived mental health." Their conclusion was that, "A healthy diet comprised of a high intake of fruits and vegetables is rich in anti-oxidants, and consequently may dampen the detrimental effects of oxidative stress on mental health..."

       I had originally hoped that I could simply bypass the dark green leafy vegetables by taking antioxidant pills. That does not seem to be the case. In the study, Fruit, vegetable, and antioxidant intakes are lower in older adults with depression, it was shown that only food sources of antioxidants were inversely associated with depression. That indicates that the form of the antioxidant, and how they are ingested, is crucial. The study reports, "These findings point to the importance of antioxidant food sources rather than dietary supplements." Interestingly, the researchers also pointed to the folate that is found in fruits and vegetables as being a major contributing factor to mental health. That is important.

       In the study, Dietary pattern and depressive symptoms in middle age, it was concluded that, "In middle-aged participants, a processed food dietary pattern is a risk factor for CES-D depression 5 years later, whereas a whole food pattern is protective." The researchers associated this protection as coming from antioxidants and folate.

       In another study, it was shown that participants with a low dietary folate intake had three times the risk of being diagnosed with depressive disorder as those with a higher folate intake. Again, it should be noted that the results from all of these tests were from whole food sources and not from supplements.  

       In a double blind placebo study (the gold standard of scientific studies) entitled Folic acid supplementation for prevention of mood disorders in young people at familial risk: a randomised, double blind, placebo controlled trial, the researchers found, "There was no evidence that it [folate] reduced the incidence of mood disorders compared to taking placebo." Their conclusion stated the result was due to the fact that, "Folate is a general term for a group of water soluble B vitamins, also known as B9 and is found in leafy vegetables like spinach. Folic Acid is the oxidized synthetic compound used in food fortification and dietary supplements." It seems clear that the source of the folate, and the antioxidants, needs to come from a whole food source.

       I found mounds of data that all read just like what I listed above, but that meant I had a big problem. I knew I had to find a way to add these dark greens onto my plate, but I had no idea how to do it. I dislike them that much. Then I came across a recipe on the Mayo Clinic's website for a green smoothie. I was immediately intrigued. I had to try it. Here is a link to the recipe if anyone wants it: Mayo Clinic Green Smoothie. I was amazed at how much I liked it. I had my solution. I have tweaked the recipe many times to get it just the way I like it.

       Since putting them into smoothies is the only way I can make myself eat these particular vegetables, I do add much more of them to the recipe now. Here is my favorite recipe, as pictured above: 8oz spinach, 1 banana, 1 cup frozen blueberries, 1 cup frozen cherries, 1/2 cup frozen carrots, 1.5 cups water. I blend it until it's smooth. Cherries can be expensive and I only use them for recovery after a long run. Obviously, they can be replaced with a more affordable substitute. I would like to add that, like with most everything I do now, I had to work my way up to this point. I don't suggest anyone start with 8oz. of spinach.

       I have found the effects of this type of smoothie to be astonishing. After only a couple of weeks, I noticed a significant difference. I also found that I could tell a marked difference the few times I was forced to miss one. I go to great lengths not to let that happen anymore.

       I was lucky that I found this way of eating these vegetables. It seems that ingesting them this way can be even more beneficial than eating them in their whole form. In the study, Solubilization of carotenoids from carrot juice and spinach in lipid phases: I. Modeling the gastric lumen, it was demonstrated that 40 seconds in the average blender will break spinach down to a sub-cellular level. This is important because the nutrients can be absorbed and processed at a much higher level in this state. 

       A great example of that can be found in another study entitled, Bioavailability of folate from processed spinach in humans. Effect of food matrix and interaction with carotenoids. In this study people were fed a cup of spinach a day for three weeks. As was expected, their folate levels went up compared to the control group. Again, that level has been shown to have a direct correlation with mental health. That is wonderful news, of course, but the researchers took their study a step further. A third group of participants were fed spinach that was minced before it was served to them. Their folate absorption rate was twice as high as those who were given the spinach in its whole form. That is profound.

       There are two caveats to this that I feel I should cover. First, it has been demonstrated that smoothies that are primarily made up of overly ripe fruits cause blood sugar to rise. So, if someone is a diabetic, or watching their sugar consumption, that should be factored in. Less fruit, that isn't overly ripe, and more greens seems to be the key to the healthiest smoothies. Also, if an overabundance of citrus fruit is used repeatedly, then there has been evidence of tooth enamel being weakened. I don't think anyone wants extra trips to the dentist if they can be avoided.

       While this is not the exact list that has been so often requested, I do hope that giving my most important meal of the day is beneficial. Again, I eat the healthiest foods available to me, as often as possible, in whatever situation I find myself in. I keep it that simple. I believe that most people are educated enough to know what those foods are. The only steadfast rule I follow is to have a green smoothie every morning.
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As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click the link to the right and you will be directed to the International Association for Suicide Prevention. It is a great resource, and is staffed by wonderful people. 

Feel free to send your questions or comments to: