Exclusive Dr. Hyman+ Functional Medicine Deep Dive: Food And Mood

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Hello everyone. I am Dr. Deanna Minich and I would like to thank the Dr. Hyman team for this invitation to talk with you about food and mood. Many people know me within the functional medicine space as the Rainbow Doctor or the person who talks a lot about eating the rainbow. I do a lot of speaking, lecturing. I'm a nutritionist and author. Now, one of the things about this presentation is that it might pique your interest from a personal perspective. Keep in mind that everything that I'm going to talk about in this presentation is to be used for educational material, informational purposes only. And it's not intended to take the place of the advice from your own healthcare practitioners or even to be a means of diagnosing or treating an illness. So if there's something here that piques your interest, talk with your practitioner about it. Within this presentation, I'm going to cover a lot of ground. I would like to talk about the scientific mechanisms for why mood disorders exist. I'll talk about some eating strategies to help with mental health. and I will showcase to you some of the clinical tools that I have used over the years with people in order to help them with their foods and moods. I'll also bring forward some of the key nutrients and a list of foods that contain those nutrients to help you with mood. So first let's talk in a more functional medicine way about the root causes related to mental health. There are three that I'd like to discuss. right now within this presentation. The first one is to talk about inflammation. The second is to get into the gut and imbalances within the gut, like the gut microbiome. And then we'll talk about certain nutrients which can be insufficient, deficient, or even out of balance with each other that could cause some issues with mental health. So let's first talk about inflammation. There is this connection between the brain inflammation and cortisol, which is the stress hormone. if you can imagine them like a triangle. So when there are changes in the brain, we can see changes with inflammation and cortisol. When we see changes with stress, we may also see changes with inflammation and the brain, and similarly with inflammation. So in general, this is more or less the cascade of how all of that happens, what that triangle looks like in action. Often we refer to this in functional medicine as brain on fire. So when we have something stressful that happens to us, something that threatens us or that gets our emotions engaged through the limbic system. We can see that the amygdala response changes. You then start to see that there's this two-prong approach within the body. One is a more nervous system approach where we engage the autonomic nervous system. We start to put out things like adrenaline and noradrenaline in order to change the blood pressure, heart rate, muscle contraction, glucose, metabolism, all of those things. There can also be a separate track of the endocrine system where now we start to see that the steroid hormone production in the body changes. We get the release of glucocorticoids, which are shepherding our body's energy stores to the forefront so that we can deal with the stressor. And by way of that happening, what can happen is the liberation of certain immune cells and inflammatory cytokines, which upon circulation in the body, ultimately what can happen is that you start to affect different tissues, different organs, and in fact, you can even influence the excitotoxicity of the brain. The microglia, the neurons, the synapses can change as a response to this immune inflammatory cascade. So the goal with this triangle of inflammation, the brain and cortisol is to create this stop to this whole loop. Ultimately, what we want is to stop to produce these glucocorticoids. We wanna stop the stressor and we wanna get the brain back in balance. But first and foremost, we really have to acknowledge that stress states can prime the brain to having imbalances and exhibiting issues with mental health. Now we are going to talk about food of course. So one of the first things that happens when people are stressed is that they tend to eat less healthy food and they tend to make less healthy lifestyle choices, which perhaps seems very intuitive and quite honestly it's the time that we most need to be taking care of ourselves when we are stressed. What we see through the scientific literature And even in clinical practice, I have seen this, that high calorie food with unhealthy sugars and fats are the types of foods that are preferred when people are stressed, especially women. For men, there are other stress coping behaviors that include smoking and alcohol intake more than eating. And if you look at people, many times what you see is that when they're under stress, either they can be a high cortisol reactor and responder, or they can be a low cortisol reactor. So the high cortisol reactors tend to consume more food, more energy under stress than the low cortisol reactors. And that makes sense because cortisol is trying to get us to get energy. So it makes sense that appetite would change. So as you can see here, and this is kind of interesting to see how the desire for food changes with stress level. So here you see two columns. The one on the left shows moderate stress conditions in three different situations, whether the person is less desire for food, the same desire for food, or greater desire for food. And under high stress situations, which is the second column, what you see is that there's a shifting of those categories with respect to choice. And what you see specifically is that there tends to be a greater desire for food when people are stressed. So, and there's also, as you can see at the bottom here, less desire for food. There can be this bidirectional flow depending on that individual and how they uniquely respond to stress. Now, when you whittle that down a bit more and you say, okay, well, if eating is changing and people who are highly stressed are eating more or desiring more. What are the foods that they're desiring and what are they eating less of? This particular graphic shows the different food categories. So you see carbohydrates, fruit and vegetables, meats, milk and dairy, salty snacks, sweet treats. And for the most part, there are some changes throughout, but the one that is most significant, as you could see with the star here, is the consumption of fruits and vegetables, which significantly changes under high stress. People are not consuming as much in the way of fruits and vegetables. And you're going to see why that is such a problem as I start to dive into the rainbow. So emotional eating. Emotional eating first. Let me just define it. Emotional eating is defined as eating instead of having those emotions and expressing those emotions. And it's been estimated that over 75% of overeating can be due to emotional reasons. Now, emotional eating wouldn't be an issue if people were responding to that emotion by ultimately having spinach or broccoli or berries or foods that we would consider to be healthy. However, what we see is that emotional eating can lead to eating high energy, low nutrient foods. emotions in general, the way I see it is that they're immediate. They are quick. And oftentimes we can respond in the moment to those quick emotions like energy in motion, emotion. Moods are a bit more prolonged. And that's why we think about the influence of those, that those emotions expressed as the mood over a longer term with our eating. So in general, what we see is that emotional eating can present as eating these high calorie, intensely tasting foods rich in sugar and fat. in response to emotion. And there can be a positive or a negative response, even positive emotions like joy. Think about being at a birthday party and partaking in having the cake and the ice cream and a lot of the sweet tasting foods that taste good and that you feel this groundswell of having them, right? Having that positive emotion. And what we might perceive as negative emotions, things like anger, sadness, irritability, fear could also lead to a more sustained intake of certain of these foods. So typically the two buckets of foods that people are inclined to emotionally eat are sweet tasting foods and salty foods. Not exclusively those, but they tend to be more or less the majority. Now, another thing I'd like you to keep in mind is that when we are feeling emotions, that can affect taste. If you can think about that further, that if your taste is changing when you're feeling emotional, you might tend to eat even more of certain foods to get that same level of taste when you aren't having those emotions. So this is a very interesting experiment that these researchers did. There were 550 hockey game attendees. There were a number of different wins, losses, there was a tie. And what these researchers had the participants do was to rate their emotions based on the outcome of these games, and then to try food and to state whether or not they had a more heightened experience of certain tastes or a lesser experience. And what the outcome of the study showed was that positive emotions were associated with more sweet, and less sour taste intensity. In other words, when you were feeling positive, when we have that surge of happiness or exhilaration, you know, the home team won, that there can be more of an amplified positive taste for sweet, but less sour. And they also found that negative emotions had a response as well, that negative emotions were associated with more sour and less sweet taste. So again, the takeaway is that your emotions can drive your taste. And I think it's kind of interesting because we're learning so much about things like bitter taste receptors, sweet taste receptors, all these different taste receptors that live beyond the tongue. And I'm curious how emotions might actually be changing the configuration or the receptivity of these different taste receptors. We don't know enough about all of those connectors at this point. I'm just for now, I'm just postulating based on what I know about some of these receptors. I think it might be interesting to do some of that research and to learn more. Taste can be affected by mental or physical stress. So there are different kinds of stress that we have. In this particular experiment, the researchers were looking at a mental stress, on a computer or a physical task on an ergometer. And that was for 10 to 40 minutes. And what they found was actually quite interesting. So the mental tasks led to a lesser duration of bitter, sour and sweet taste compared with the control. And the amount of each of those flavors was also decreased. So overall, there was a blunting of taste, there was a dampening of the taste from foods. But that was just after the mental stress, after the physical stress, just the sourness had shortened. So the physical stress in the way of a physical activity had actually, in some ways, improved taste. Now, moving away from that a bit, I wanted you to be aware of some of the literature on emotional eating and how that connects to taste. We really do need to acknowledge that when we're talking about inflammation in the body, that there may also be changes in psychology and behavior. After all, body and mind are truly one. They're one and the same. And some of the research would suggest that inflammation in the body is connected to greater impulsivity. So not only greater impulsivity, but as you could see here from the article in Scientific Reports, less ability to be in the present and less ability to delay gratification. So when somebody is physically inflamed, we might start to see these kinds of changes in, in behavior or in psychology where we become more impulsive and quick and reactive. And so just by observing somebody, we might be able to say something about physical inflammation. I think that this biology and psychology interrelationship is very interesting and it can tell us so much about who we are in the moment and what is underneath at our foundational level. So if we deal with the inflammation, we deal with that physical inflammation, we might be better apt to make more sustainable lifestyle changes is what I would think. So I want to show you two profiles here as it relates to the physiology, the body and the psychology, the mind, and how you see different portrayals depending on the level of stress. So in chronic stress states, in this amplified high cortisol state, what we tend to see is high glucose and insulin because we're trying to get energy, greater free fatty acids, we're liberating those free fatty acids, that's a great source of energy when we are stressed. And as a result of this metabolic cascade happening, we might start to see some changes in insulin receptivity at the cellular level. Remember that insulin is needed in order for the cell to become sensitive and open to receiving energy, that glucose. So we might start to see some changes in insulin resistance. We can also see changes in some of the other types of hormones like catecholamines, adrenaline, and there can be some changes in the cardiovascular parameters like increased heart rate, increase blood pressure, increase heart rhythm. And if you look on the other side, the psychological display may also reflect some of this physiology that I'm describing. So I'm looking at here more of a type A behavior where the person is finding it very difficult to relax. They're very reactive, they're agitated, they're anxious. Here's where the mood enters in. Here's where the emotional state, we can start to see that change. We become more impatient, we become more nervous and irritable. Now, after some time, let's just say that we've experienced stress for years and years and years. What can eventually happen is we start to get a decrease. We start to get a down regulation of receptors within the brain. We start to see a change in the whole feedback loop, and we even see structural changes like the adrenal glands. begin to atrophy certain parts of the adrenal gland or even the entire adrenal gland. So overall there's reduced synthesis or depletion of certain stimulating factors and hormones. Some of the things that we need from the brain, from the pituitary gland to inform the glands like the adrenals. So overall the body is tired, it's fatigued, there's no longer that strong cortisol response to stress. So how does that look psychologically? Well, that can look like a lack of interest in the things that we would normally enjoy doing. It can be debilitating fatigue, not just getting a little bit tired, but literally not being able to have any energy to get out of bed and function. Having low self-esteem, self-blame, guilt, difficulty with brain fog or a difficult time concentrating or having a sense of focus. There might be some thoughts of or suicidal behavior, changes in sleep, appetite, weight, and even changes in libido. So you can see that when our physiology is down, reduced, depleted, our psychology begins to take that on as a phenotype. So truly, again, there's no difference between the body mind. This is psychoneuroimmunology. so, as I mentioned, when we are stressed, many times we're not eating the best food. And in fact, stress we know can get in the way of eating healthy. And then the choices that we might make, which might be more high sugar, high fat foods, that only leads to more inflammation, more stress. So we have this endless cycle. Now, eating in and of itself can initiate inflammation. And in fact, I find it very powerful to think of how just one meal can change our physiology and our psychology. So as we know, food is more than calories. It connects to our whole self. You can see all the many things that food is connected to. The thing that we're talking about right now is food and mood. However, food is life. It is how we live. How we eat is how we live and how we live is how we eat. and the process of digestion requires so many different steps. And in that whole process, what we could find is that we're not very good at digestion. Most people do not have good gut health. And as we get older, this becomes less and less efficient. We are less capable and able to take up and have better bioavailability of certain compounds. So the entire digestive process becomes much more challenging, which means that we leave ourselves open to much more in the way of an immune inflammatory reaction. So instead of the food becoming us, becoming self, it remains non-self. And when it is non-self, that creates this type of immune reaction with a meal. It is seen as antigenic, or even allergic. So indeed, one meal can result in postprandial inflammation. We can have for hours on end this feeling of sickness or lethargy or digestive distress. On average, most of your food is going to be digested and assimilated within the first, I would say, four to six hours is key, but even within 12 hours. to look at the complete absorption and digestion of a meal that could take up to three days depending on its contents. So just think of it, you have one meal and you could have some long lasting inflammation. So as you can see here with, let's just say a fast food meal that's high in fat and not enriched in anything that would be considered to be antioxidant in activity or nutritious, what we could see is that we have this this type of meal and then for hours on end, we can see that there could be changes in glucose and lipids and a number of different hormones, inflammatory mediators all going up with some of the big ones being increased like lipopolysaccharide, especially if we have an unhealthy gut microbiome, TNF alpha, tumor necrosis alpha. So a number of things can happen just right after a meal and even extend beyond that one meal. So here's another study in which they showed that a single fast food style meal, which if you look below these different bullet points, these are some of the sample meals that they included, that when people had these kinds of meals, that there was an increase in one of the inflammatory cytokines known as interleukin 6 by 100%. And that peaked at about six hours after a meal. Now, you look at some of these meals and you would say, well, those are kind of, you know, I wouldn't eat those, but for the majority of people, there are some common threads here of what people are eating and what kind of response they may actually generate from that meal. Now, the format of the food is essential to consider with inflammation. So not all hamburgers may provoke that same inflammatory response. And so we need to be thinking about the quality of food, what are we having certain foods with? And even if we take one food, if we just look at in a very simplistic format here, let's just talk about apples. And in this particular graphic up at the top and then at the bottom, we have glucose and insulin in response to three different formats of an apple. So one is a whole apple, one is apple sauce, one is apple juice. And what you see up at the top here is that glucose goes up more or less at the same level for all three of them. However, the difference here that you see is that there is this greater decrease, greater hypoglycemia with apple juice. So that's not so good. It's not so good to have a spike and then a precipitous drop. Now at the bottom, this is where things become even more apparent that in order to maintain those glucose curves, the body needs to release much more insulin with the apple juice compared to the whole apple or apple sauce. So again, if we are tugging on glucose insulin, we tend to be tugging on inflammatory processes in the body. So even the format of the food can make a huge difference. This is where we want to consider things like glycemic impact. If we're going to have juice, then we have it within the context of a meal, in order to bring down the glucose and the insulin. So there are a number of different inflammatory foods that I would just consider to be not so healthy for most people. This is my short list. So up at the top we see sugar. Of course, sugar in all of its many forms and names I see is propelling that high glucose, that high insulin, and enhance inflammation. A lot of the high omega six cooking oils can be problematic because a number of those omega-6 fats are shunted into inflammatory pathways, especially when they're out of balance with omega-3. So the other thing that I think about too is cooking in oil. And even if it's a high smoke point oil, you can still get the creation of different damaging inflammatory compounds. Trans fats are just notoriously or infamously I should say, inflammatory. And now they are labeled on products. So you can actually see if there are trans fats per the Nutrition Facts label. But you may actually need to read the ingredient list as well to look for partially hydrogenated oils because that would be your tip off that there would be some degree of trans fats in that product. White flour, anything that's been stripped of its nutrients, refined grains, as my mother would say, the whiter the bread, the quicker you're dead. So when we have this white flour and we're taking out the fiber, then we are removing what slows the release of the sugar within that, right? So now it just becomes much more high glycemic. I think that excessive alcohol is problematic. It can cause all kinds of gut issues and can lead to inflammation, particularly in the liver. and what I'm going to talk about a little bit here is the one that I believe most people can change, which is the cooking of their foods, refraining from browning, grilling, frying, broiling, all of those dry heat methods which cause the, the food to produce what would be called Advanced glycation end products. So I'll, I'll talk a bit about those. So these Advanced glycation end products, what are they? Why are they inflammatory? Why would we be thinking about them and talking about our mood? well, as it turns out, what happens in food is because we've got protein, we've got fat, we've got carbohydrate, we've got a bunch of different compounds in there. And so what can happen under the, the Catalyst of heat is that you can get a complex that can form with some of these sugars, with protein and or lipid, this, this fat in the food. So this complex that forms is referred to as an advanced glycation end product. Now, just a second, I just want to explain something. If we think of hemoglobin A1C, which many times is seen as a chronic marker of hyperglycemia or just not being in balance with blood sugar, that's essentially a glycated protein. You have sugar attached to the protein and it makes it less functional, it makes it more inflammatory. Same thing here with food. Now we actually create these ourselves in food through cooking and then we ingest them. And it's been shown there is so much information on advanced glycation end products. I love that the acronym is AGE. These things do age us because of that inflamm-aging. So these ages are related to things like accelerated aging and accelerated aging conditions like type two diabetes. and that could be because of the gut issues that they can create, the permeability at the cellular level. There can be an upregulation of inflammation and even oxidative stress. So keep that in mind that even reducing the heat of cooking can reduce the heat of inflammation in your body. Now, what if you know that you're going to have grilled foods? What if you're going to have grilled vegetables. What do you do in order to buffer those effects from dry hot heat? Are there any hacks? And as it turns out, there are. As you could see at the bottom here, the use of phytonutrients can help to buffer the effects. So adding in herbs and spices before cooking can be important for helping to reduce glycation products that would normally form with the heat. So if you choose to have a grass-fed hamburger before cooking that burger in high heat, adding in things like spices and herbs before cooking to help offset the production of glycation products. So even doing that can help with reducing inflammation in our everyday. So you can see here that there are a number of different types of spices that have been tested. I would say just use any spices that you like, that you like the taste of, and try to rotate them. Can, you know, look at your spices in your spice rack or in your cabinet in your kitchen. Just check those expiration dates. Make sure that they're not rancid, that they're not caked together, that the lid is properly tightened so that no oxygen is getting in. Because the anti-inflammatory effect of these spices are, it's only going to be as good as the spice itself. So some of the general principles that I want to leave you with, and I'm going to come back to some of these as we get a little bit deeper in some of the other topics, but some of the principles of an anti-inflammatory diet would mean, as I just discussed, I think it's a big point and undervalued, underestimated, and actually underutilized, and that is less high heat cooking and frying, having a better ratio between omega-3 and omega-6, is also important. There are very easy ways that you can get that tested in yourself, but just making sure that you're not taking in a lot of those high omega-6 seed oils. That's important. Having higher dietary antioxidants will be beneficial. So that's where a lot of the plant compounds come in. Reducing glycemic index, as I showed you with the apple juice. Reducing or avoiding ultra processed foods. This would be the white salt, white sugar, white flour kinds of foods. I'm going to talk about eating the rainbow in a little bit. Of course, I can't resist talking about that. And avoid things that are allergic or things that you're intolerant to. Some people are sensitive to foods. They could be intolerant or they get bloated or they're just outright allergic. So if you're outright allergic where you've got some kind of IgE, IgG response, then you're definitely pulling on the inflammatory response. So you want to be attentive to that. be working with a practitioner who can assess that for you. Now, I just want to mention here, as I already did with the oils in our diet, that the total amount and balance of omega-3 fatty acids in the body is important for our inflammatory status and also important for mood. And what we see is that for many people eating a highly processed food diet, that dietary omega-6 fats typically exceeds that of Omega-3s. So Omega-3s the way I think about it is that they're more anti-inflammatory and Omega-6s are more inflammatory. But there are some properties of Omega-6 that also make them anti-inflammatory it's just that they're in such high levels that they're out of balance with Omega-3s. So the typical ratio is, there's a bit of a range here, but basically we're looking at 20 to 50 of Omega 6 to 1 of the Omega 3. So that n is, you can just substitute Omega or n. There are two different configurations there. So we know just over the course of looking at epidemiological literature and other studies that higher ratios of Omega 6 to Omega 3 in modern diets translate into greater allergic inflammatory, proliferative, and cardiovascular symptoms. So getting that ratio in check, getting it at a more modest level, more of that four to one or five to one, or I would even say two to one or three to one, can be important for bringing your body back into balance. And it's better for your brain because most of your brain is comprised of fat and you want good healthy fats in the brain. So how do you know if you have enough of these omega-3s? Well, you can get your omega-3 index tested. This is the percentage of some of the long chain omega-3s, the EPA, the DHA. This is assessed in red blood cells. So it's a really easy test to do. It's used as an index of coronary heart disease mortality. The average omega-3 index in the United States is about 4%. And I can tell you that I have seen people who supplement with omega-3s and they have difficulty getting beyond six percent. So you really need to be attentive to your levels and how much you actually need to supplement because what we're looking for, the threshold here would be about eight percent. You want about eight percent EPA and DHA in your blood. And the risk for even fatal coronary heart disease can be reduced by about 30% with shifting from four to eight percent. So it may not seem like a lot, like just four to eight percent, but the reduction, the significance, the impact there is great. So yes, I have seen through personal clinical experience that those who are relatively healthy and even supplement with Omega-3s may have lower levels. So don't think that just because you're taking Omega-3s that you're in good shape. You need to get that level tested. And, you know, again, that can easily be done with your practitioner, can be done online. so when we think of the, the brain and we're thinking of these Omega-3s and we're thinking about digestion, all of these different aspects that all accumulate into our mood state, the barriers that we have in the gut are Paramount to healthy mood. So having a good, healthy gut lining. with tight junctions, not letting in a number of these maybe undigested particles or microorganisms that start to take up residence in the gut. That will ultimately protect the blood-brain barrier, right? So if we can take care of the gut by establishing that good, healthy lining through good, healthy digestive processes and reducing inflammation overall, then in essence, we have this layered effect where we have less inflammatory markers in the blood and less ultimately that can get into the brain. There are many pathways to depression that can be arrived at through the gut. So the gut really is a portal to so much of our mood. So looking at the stress state overall through the vagus nerve, looking at the many different neurotransmitters that are produced and regulated here, inflammation, which we've been talking about just outright, and then changes in metabolism or dysbiosis or the overall gut milieu. So working with a practitioner on the gut is monumental to our mood state. And you can see how all of these arrows are going into the brain. And in fact, many different gut issues issues with the gastrointestinal tract are connected into mental health issues like anxiety and depression. In fact, as you can see here, there has been some work looking at how the gut microbiome, intestinal permeability, and different psychiatric disorders are related. Anxiety can be caused by a disturbance in the gut microbiome and by gut inflammation. So sometimes anxiety is not a brain thing. It's a gut issue that needs to be solved. So having mood disorders like anxiety and depression as well can lead to changes in the gut microbiome and result in dysfunction. This is why we really want to work on that gut layer, that intestinal barrier, to prevent things from getting in because it's going to help with mood. I mean, if we even think of one of the gut type of conditions that so many people have. I had this back when I was a teenager, irritable bowel syndrome. What are we irritable about? What is within our gut that is emotionally at distress? We're in this kind of upheaval. So what is going on in irritable bowel syndrome? Is that just emotional? Are there other things? Well, there are. There can be so many things at play here. There can be stress, circadian disruption, physical inactivity, there can be food issues, there can be other imbalances within the gut itself. So that's why these types of gut conditions aren't always straightforward. They involve multiple root causes that are connected into so many different aspects. And it requires that we act as a detective for our own health and work with a practitioner to go through and to figure out how is this inflammation? How is the mood state being generated? So here is also just showing you that for people with inflammatory bowel disease, that typically when they have active disease, there tends to be anxiety and or depression present with that active disease. When their disease is inactive, as you can see here by the second bar, that risk of anxiety and depression goes down. So again, they're concurrent that the gut dysfunction oftentimes is connected to mood disorders. Now, one of the things about food and the gut and the inflammatory interface is this whole concept and even what we see play out in people, this process of metabolic endotoxemia. You might have heard of this. Essentially, this is where we generate inflammation, we generate endotoxins through the microorganisms in the gut in response to a meal. So this has been seen under extreme conditions where there are high fat meals, typically high saturated fat or different types of fat, but just high fat in the absence of other things. in showing that high fat meal can impair vascular function. So things like systolic blood pressure, diastolic blood pressure, total peripheral resistance in healthy normotensive people. So having things like polyphenols or plant compounds or other phytonutrients can help to reduce or offset some of those inflammatory effects. One of the other things that can help the gut is fiber. Fiber restores the gut and brings it back into balance. And as you can see up at the top here, this long chain of fiber, which is typically a complex carbohydrate, right? It's got a lot of, you know, long chains that looks like branches. And so this is a lot of substrate for the gut microbiome to be chewing up. All of the different microorganisms can be working on those bonds. within that fiber and producing things like short chain fatty acids like acetate, propionate, and butyrate. So as you can see here, there's a ripple through effect that can happen from even dietary fiber. We can see off to the far left here, greater integrity of the epithelial lining, which is great because you want the formation of those tight junctions. You want that integrity, that barrier strength in the gut. you can also see some changes in the mucus layer. So we need that very distinct barrier of mucus in the gut, not in a pathogenic way, but in a healthy way to prevent the translocation of pathogens closer into the enterocytes. We also see here direct modulation with immune responses. So a lot of the compounds that are formed, the short-chain fatty acids, can have direct modulation there. Here we can see pathogenic adhesion going down, commensal adhesion going up, so we can create a better milieu. And that's favorable overall for changing pH and absorption, bioavailability, and all of those kinds of things. The microbiota can diversify here. So in that, as I've been mentioning, the short-chain fatty acid production, I'm going to show you some of the all the many things that can happen with that. so in general, one of the first line approaches to helping the gut to restore itself, meaning that ultimately we are going to see some changes in things like mood state, is just by having different dietary fibers. That fiber, which is creating the acetate, propionate and butyrate, is having this cross talk effect with the brain. So not only is it fortifying the gut lining, but we're also seeing improvements in the blood-brain barrier, reduced inflammatory signaling amongst the different brain cells, better, I would say, overall function, plasticity, and genesis of certain nerve cells within the brain. So that's all because of what we take in and what we are doing to change the signaling in the gut. So as it says here off to the left, the gut-brain axis is a bidirectional information regulatory pathway composed of the central nervous system, the neuroendocrine system, the neuroimmune system, autonomic nervous system, and enteric nervous system. So we've got a lot of different nerve groups all communicating through that level first established in the gut, and I would say propelled or catalyzed forward through something like dietary fiber. But everything we take in can be changing the signaling from the gut to the brain. So let's just talk about short chain fatty acids briefly and how they do play a role. I've already mentioned a number of these. So again, stimulating the production of good healthy mucin layers, we're getting those peptides, so tight junction proteins to create better integrity. they can also be an energy source for the colonocytes. We can see changes in immune function just outright, just having them be signaling molecules. And I think that the last two here are really interesting, that we see a reduction in the production of cortisol. So the stress hormone that can lead to these inflammatory Cascades. Right. So even seeing that type of change. And short-chain fatty acids like butyrate can also help to enhance the production of brain-derived neurotrophic factor, which is a compound that helps with nerve growth. So all in all, can't go wrong with fiber. I think it's so key for establishing a healthy gut and establishing a healthy mood. You can see here that we're looking at depressive Symptoms here and this, this bar going down reflects the, the level of fiber intake coming from fruits and vegetables. The red bar would be that coming from cereal fiber and we can see a much better response in depression when we have both fibers, but especially the fruit and vegetable fiber sources.

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