Forget Dieting — Make Your New Year's Food Resolution About This Instead

How does food mix with psychiatry and mental health? I’m an Indiana farm boy turned New York City psychiatrist. Growing and preserving food was central to my life growing up, as my folks and I managed our farm and forest. Eating well has always been important to me, but nutrition isn’t emphasized in medical school. Twenty years ago I was a vegetarian, who ate mostly low-fat foods, tofu-pups, and SnackWell cookies. But when I moved to NYC for my residency at Columbia University, the science between omega-3 fats and brain health really intrigued me. I started introducing fish into my diet, and learning more about the research that connected illnesses, such as depression and dementia, to our food choices.

My first job out of residency was at a community mental health clinic in the Washington Heights neighbourhood of Manhattan treating patients with severe mental illnesses. Weight gain was a side effect of many of the medications I prescribed to them. While these medicines are often helpful for hallucinations, mania, and depression, many of my patients were unhappy about gaining weight. I started to see that I really was missing some crucial knowledge around nutrition.

Psychiatrists ask a lot of specific questions to evaluate patients, but one day it struck me: We never ask our patients what they eat.

As funny as it sounds, we don't talk about food in medicine and mental health, even though we talk about the compounds in food — omega-3 fats, b-vitamins, magnesium — a lot. Things really shifted for me when I realized food presented an incredible opportunity for patient empowerment and added a delicious method in my clinical toolbox, along with psychotherapy, medications, and other lifestyle interventions such as exercise, to help people.

It became part of my mission to understand how food affects mood, and to bring that information to physicians and patients alike. Because of this, I’ve spent a lot of my medical career as a psychiatrist focused on food and learning how to prescribe it. Using food in my practice allows me to help patients decrease their risk of brain illnesses, such as depression and dementia, while also helping them feel better physically.

In my clinical practice in psychiatry, food has become one of my favourite medicines for the brain and mind. The foundation of health is food, especially when it comes to how nourishment impacts our brain health and overall wellness.

The rumble of scientific evidence supporting the impact of nutrition on brain health is now growing into a roar. In 2017, the first studies of the Mediterranean diet as an intervention to treat and help prevent depression were published, and it proved what I had been finding in my practice. Participants who ate what I like to call “Brain Food” — whole grains, fruits, vegetables, nuts and legumes, lean meats, and seafood — reduced their symptoms of depression. A similar study, the HELFIMED trial, which ran over the course of three months, showed comparable results and proved that people can also change their eating habits pretty quickly. Moving away from foods associated with the Standard American Diet — empty carbohydrates, refined starches, and highly processed foods — and incorporating “Brain Foods” helped decrease participants depression scores by 45%.

So let's talk Brain Food 101. First, consider the idea that your brain is made of food. All the molecules in our brain, all the carbon, nitrogen, zinc, and magnesium come from food. When you look at the end of your fork ask yourself, is this what I want to put in my brain?

Foods that are high in nutrients such as long-chain omega-3 fats, zinc, magnesium, B12, iron, vitamin E, and folate are foods that I want fueling my brain. Having high levels of these nutrients in our bodies is linked to preventing and treating depression.

There’s also increasing data that certain foods and nutrients help our brain grow and recover from injury. Neuroplasticity means that your brain is constantly growing and evolving and new connections are being made. Certain nutrients, such as zinc, long-chain omega-3 fats, and certain phytonutrients (like resveratrol), induce more of a hormone called BDNF or Brain-Derived Neurotrophic Factor, which controls neuroplasticity.

If we look at traditional diets — the diets our grandparents and their parents consumed — we see that they’re superior for health. Diets based on whole foods, simple cooking, and seasonal variety are highly protective for the brain. These principles can be found in Mediterranean, Japanese, and Norwegian dietary patterns. And what do they all have in common? They’re all plant-based, absent of highly processed foods and empty calories, and encourage regular seafood and more mindful meat consumption.

There’s also the fundamental notion that food really connects us. In the above mentioned regions, people also eat with each other, are social around food, grow their own foods, or know the people who have grown their foods. It’s all connected. And nothing in my clinical experience helps people feel happier or healthier than being connected and part of a community. And that's really what the brain does, the brain is an organ of connection, and what connects us like food does?

So what can you do if you don’t live in the Mediterranean countryside? Based on our clinical experience and the robust evidence for nutrition as an intervention for depression, we work with patients to help them find a dietary pattern that works for them. We aren’t interested in fad diets or trends, but rather sustainable ways of eating that are also joyful!

I’m a farm boy and a New Yorker, so I certainly believe food is meant to be enjoyed! Dietary patterns, unlike restrictive diets, allow for flexibility because it’s not about scrutinizing everything you eat — for sure, eat the birthday cake! It’s about the overall pattern of your eating. Are you eating fish at least twice per week? Are you making sure to eat a variety of plants everyday? Do you include plant proteins such as lentils and beans? Fad diets and extreme dietary plans often cause folks to lose a sense of trust in themselves and their bodies. If we have to consult with experts about everything we eat, we must not know what’s good for us. This sort of dependency and loss of trust in our own ability to choose our nourishment is detrimental. My goal is to help you and my patients find a way of eating that feels good and makes sense.

Leafy greens, a rainbow of fruits and veggies, nuts, seeds, meat, seafood, legumes, and fermented foods are the categories we focus on. We choose to look at food in categories to avoid the nit picking that can be so common when talking about diets. Do you need to eat kale? No. Try arugula or spinach. There’s no one size fits all meal plan and we want to encourage people to really enjoy their food.

Finding healthy eating patterns that are good for you and make you feel good — both physically and mentally — is also about starting small and getting creative with the foods you love and that are accessible to you. For example, one of my favourite meals is spaghetti and meatballs (and not the gluten-free kind). In order to make this healthier, I add some carrots to the meatballs, or sometimes, I even sub out the meat for lentils. This wasn’t a hard switch on my time or my palette.

I also make sure I’m using grass-fed beef and use tons of veggies in my sauce. If you want, swap out your regular pasta for a gluten-free variety or try zucchini noodles. By doing all of this, I’ve increased the nutrient density of my meal. So, instead of telling myself, “Don't eat spaghetti and meatballs!” I’ve created something that can be a part of my daily dietary plan. It’s these types of swaps and tweaks that I suggest to my patients, and now you.

There's this notion that food needs to be this demon, and we have to control all of our urges and cravings. I don't like fear-based models when it comes to how we should all be eating. I like joy-based models. And while many people like to talk about supplements, I see them as an “insurance policy” for eating poorly. Targeted supplementation makes sense if you have a deficiency, but you should be able to get all of your vitamins from your diet and there’s no substitute for eating a brain-healthy diet.

My hope is that you’ll at least one thing here that resonates with you, and that you can integrate at your next meal. As the new year approaches, consider that your food can both have a positive impact on your mood, and be joyful. Instead of trying the diet dejour, feed your brain with nutrient dense foods like the ones I’ve provided from my book, Eat Complete, for Refinery29’s Clean Slate program starting on Jan. 1.

To help get you started, here are some of the foods I recommend patients add to their dietary staples:

Leafy Greens: When you use leafy greens as a base, you swap out a lot of the empty carbohydrates you get from things such as pastas or breads. They are also incredibly nutrient dense. Nutrient density is a measure of how many nutrients are in each calorie. The more nutrients per calorie, the more nutrient dense.

In a recent study by Tufts University, older adults who ate about one-and-a-half servings of green leafy vegetables per day had the cognitive functioning of people roughly 11 years younger than those who ate little or no leafy greens.

Rainbow Veggies: The colors in food signal medicine because natural pigments in food have different health-promoting molecules; lycopene is red and carotenoids are orange, and they’re both linked to a lower risk of dementia.

We often refer to these phytonutrients as “antioxidants,” but they are much more than that. They send powerful signals to our DNA that help quell inflammation and promote resilience at the cellular level. Some compounds in plants even promote the growth of new brain cells by promoting the expression of brain-derived neurotrophic factor (BDNF). The fiber from plants is also essential for good gut health, and we’re learning that a healthy microbiome can help our mental health.

Simply put, more colors on your plate means a bigger, better brain. Researchers at Harvard found that having higher levels of carotenoids in the blood is correlated with a more optimistic outlook. More rainbows also equal more smiles.

Fermented Foods: There's such a focus on and such a hype around probiotic supplements. Really the best data about how to take care of your gut and your microbiome tells us to eat more plants and fermented foods such as kefir, yogurt, miso, kimchi, and sauerkraut. We want more of those in our diets because those natural fermented foods are alive, as opposed to probiotics, which advertise the CFUs (colony forming units) at the time of packaging, not when you’re consuming them.

Seafood: Many eaters struggle with seafood. I get it. I didn’t eat seafood for years, but as a young doctor I learned about how omega-3 fats function in the body and quickly started integrating more seafood into my diet.

The average American should decrease their red and processed meat intake. One great way to do that is to replace meat with some seafood — wild salmon or wild shrimp. Mussels and oysters are some of my favourites because they’re so nutrient dense.

Legumes: People don't know this: The top antioxidant-containing food is not the blueberry. It's the small red bean. Traditional Mediterranean diets, Portuguese diets, you just see beans in there, even in the stews with the meats like feijoada. It's a great dish where again you have the flavorfulness of the meat, but it's not all meat.

These are just some of the food categories I focus on in my practice and why they are important to brain health, because as a psychiatrist, I truly believe that brain health is the foundation of good mental health.

Dr. Drew Ramsey is the author of Eat Complete: The 21 Nutrients That Fuel Brainpower, Boost Weight Loss, and Transform Your Health (Harper Wave, 2016). He is also the creator of Eat To Beat Depression.