Why You Probably Need More Omega-3s In Your Diet

Coming up on this episode of the Doctor's Pharmacy.

When they started separating out people who had a couple of portions of fish a week from those who didn't.

The ones who didn't eat fish and took the fish oil supplements got better. Hey everyone, it's Dr. Mark. I know a lot of you out there are practitioners like me helping patients heal using real food and functional medicine as your framework for getting to the root cause. What's critical to understanding what each individual person and body needs is testing, which is why I'm excited to tell you about Rupa Health. Looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables can help us find the most effective path to optimize health and reverse disease. But up till now, that meant you are usually ordering tests for one patient from multiple labs. and I'm sure many of you can relate how time consuming this process was, and then it could all feel like a lot of work to keep track of. Now there's Rupa Health, a place for functional medicine practitioners to access more than 2000 specialty labs from over 20 labs like Dutch, Vibrant America, Genova, Great Plains and more. Rupa Health helps provide a significantly better patient experience and it's 90% faster, letting you simplify the entire process of getting the functional medicine lab tests you need and giving you more time to focus on patients. this is really a much needed option in functional medicine space and I'm so excited about it. It means better service for you and your patients. You can check it out and look at a free live demo with a Q&A or create an account at RupaHealth.com that's R-U-P-A-Health.com you're unique which means your health and wellness plans should be unique too. But it can be tough to optimize your health and nutrition programs because it's often difficult to get the data you need. And even if you do get your numbers, you actually have to understand them and then be able to make meaningful action based on them. This is where InsideTracker comes in. InsideTracker is a wellness tracker that uses science and technology to deliver ultra-personalized healthcare guidance. They can analyze your blood, your DNA, your lifestyle habits, and give you actionable recommendations to help you meet your health and wellness goals. They'll tell you what you need to do and why, and you can track your progress and adjust your plan based on real-time feedback from your own body. Since 2009, their science team at Harvard, Tufts, and MIT have been bringing personalized nutrition and wellness to the world with their powerful evidence-based digital platform. InsideTracker is simple, customizable, and most importantly, it's based on you and your body. If you're curious about getting your own health program dialed in to meet your unique needs, I highly recommend checking out InsideTracker. Right now they're offering my community 20% off at insideTracker.com/DrHyman. That's I-N-S-I-D-E-T-R-A-C-K-E-R.com/D-R-H-Y-M-A-N and you'll see the discount.

Code in your cart. hi, this is Lauren F. Pheasant, one of the producers of the Doctors Pharmacy podcast. There are many benefits of omega-3 fatty acids. As an important component of cell membranes, they are used by the body in a lot of ways and are especially prevalent in the brain. But unlike most fats, your body can't manufacture omega-3s. Instead, they are an essential nutrient, which means the only way to get them is through your diet or supplementation. In today's episode, we feature three conversations from the Doctors Pharmacy pharmacy on why we need omega-3 fatty acids to optimize our health. Dr. Hyman speaks with Paul Greenberg on fish consumption and supplementation of omega-3s for heart health, with Dr. Andrew Huberman on the importance of essential fatty acids for optimal sleep, and with Dr. Daniel Amen.

On omega-3s and brain health.

Let's dive in.

Let's talk about fish oil. Yes. Because you wrote a whole book about this. I did. The omega principle. I did. And as a doctor, I think that omega-3 deficiency is a huge contributor to all sorts of problems my patients have. And over the years, I've tested thousands, tens of thousands of people for their levels of essential fatty acids, including omega-3 fats. And I found significant deficiencies among across a wide range of populations, especially vegans. I mean, they're like zero.

Yes, yes, yes.

And that affects mood, brain development. nerve function, regulates inflammation, heart health, brain health, dementia, depression, cancer. I mean, and yet so many of the studies that have come out that have been published recently have seemed to debunk the idea that omega-3 fats are beneficial for heart disease or cancer or anything else. So the population is left confused, as usual, by nutrition advice, because we're all told that fish is healthy. They eat, if you eat fish, looking at the studies on fish, you will have better health outcomes, but then there's all this contradictory information that if you eat omega-3s from pills, it doesn't do anything. So what's the deal?

Where are we at? Okay, well first of all, let's just clear the air about fish. Fish is just great because it's a lot of protein per calorie, it's a lot of nutrients per calorie, and if you're eating fish for your, you know, often for dinner, you're not eating other bad stuff, right? So if you swap in fish for beef, I think generally speaking, you're gonna be ahead of the game. That's just sort of my general opinion on this.

You may differ from me. I would say, I would qualify that saying, in a perfect world, yes. Right, but in a world of factory farm meat and pristine fish, 100%.

Yep.

In a world of, you know, we generally raise grass-fed meat, versus polluted ocean fish, I'm not so sure.

Right, right, okay. But let's keep in mind what the average American is doing, right? The average American is having feedlot meat. And if they have a choice between say like cheapish wild fish that they could pick up in the market versus that feedlot beef, I think they're ahead. So there's that. The omega-3 question, I think has a lot to do with what people have called the threshold effect. It's very true that if you go on a vegan diet, that your Omega-3 levels are just going to plummet. And I know this personally because I actually have been experimenting with a vegan diet. My body is a laboratory.

You have no Omega-3s but no mercury now.

Right, exactly. I went to OmegaQuant, which is one of the tests. You can just like a finger prick test. And I had below 5% blood Omega-3 blood lipid levels, which, you know, I would say you would qualify as being deficient, right?

Yeah. Are you more depressed?

That's a whole other story. But when I was eating fish every day, meanwhile, for three meals a day, my Omega-3 blood lipid levels were 11-12%.

Yeah.

You know, somebody said to me when they saw that, probably similar to those of a Sicilian fisherman, Circa 1890, you know, that's, that's And then probably what we should have had maybe in the Paleolithic times. So in between vegan and fish every day though, I think that there's a compromise which is equivalent to about two portions of oily fish per week. And that if we do that, I think we'll probably hit that threshold of fat.

A couple of cans of wild sardines.

A couple of cans of wild sardines, a couple of cans of wild salmon. I think we'll probably hit that threshold effect. Now, where it gets sticky with the omega-3 supplements is when they start to do some of these randomized control trials around omega-3 supplements, I think a lot of times they don't necessarily take into account who's eating fish and who's not eating fish, and they throw the supplement on top of everything. So like most recently, there was the VITAL study, which came out of Brigham and Women's Hospital. So, you know, in that case, they actually did keep track of who was a fishery, who wasn't. But across the whole spectrum, they showed pretty much a null effect when it came to coronary heart disease, right? From five years of taking a gram of omega-3 every single day for five years. So pretty significant null result. I should qualify that by saying that when they took out strokes, they did show something of a degree of effect on heart attacks. overall, that was my reading of this study.

Yeah, there's been other studies that have shown benefits for people who've had a heart attack, preventing secondary attacks like the JUSS study and others.

Yeah. But so anyway, when though you start looking, when they started separating out people who had a couple of portions of fish a week from those who didn't, the people who didn't did show significant effect on cardiovascular disease.

So the ones who didn't eat fish, and took the official supplements and got better.

Right, because they crossed the threshold.

Right.

Because that Omega-3, and what's really interesting.

Was, did you look at that?

That didn't come out in the headlines.

Didn't come out, well, you know, do we have to talk about headlines?

I don't know, you're the journalist. Well, I don't write the, you know, I don't get to write the headlines. All I do is write the stuff and they stick the headline on top. But then I thought it was really interesting, and I'm surprised that there wasn't more agitation in the African-American community where they showed a huge effect was in the African-American population. A benefit. Benefit of omega-3 supplementation. And I think there are two reasons for that. One, I think that that population is probably not eating oily fish. You know, if they're eating fish, they're probably eating like, you know, frankly, it's the economically lower, you know, lower income strata. So they're going to be eating things like tilapia. They're going to be eating things like catfish that have lower levels of omega-3. So they're not getting it. The other thing is I think that like, Generally speaking, the African-American community doesn't get adequate attention from the medical community. So just the mere fact of having regular contact with the medical community, I think had a calming effect. I think it did something. But nevertheless, I think that those two results that the non-fish eaters and the African-American community both showed more than a null result. To me, doesn't necessarily mean that the whole thing was a waste of time. It shows that there is this threshold effect.

Well, that's why I say if you don't have a headache and aspirin doesn't do anything, right?

Correct.

It's like, well, if you have plenty of levels, high levels of omega-3 fats in your blood, you're not gonna see an incremental benefit. That's right.

If you have zero, you're gonna see a significant benefit. That's right. And that's why, like my own personal experience, you know, when I went and.

Ate fish every single meal for a year- you- banked your omega-3s. And then you, for the-- no, but.

Prior to that I was a fisherman and I ate fish twice a week. Just that was part of my thing. So the rise in Omega-3 blood levels that I achieved as a result of that diet, in the end, I saw no change in cholesterol, I saw no change in blood pressure, and none of the typical things that are often associated with Omega-3 supplementation.

It depends on what else you're eating. Right, right. So, I mean, that's the other thing with these studies is like, Okay, well if everybody's eating the standard American diet and you throw in a bit of fish oil pill, it ain't gonna do anything. It ain't gonna do anything. If you're eating processed food and sugar and starch and yeah, you're not gonna.

Have a reduction in any disease. Which brings me to what I think is the ideal diet. Okay. I'm gonna roll it out for you. All right. Let's go. Which is that, so I've been on a vegan diet for the last eight months and I have seen my LDL cholesterol plummet. I've seen my blood pressure go down. I've seen my weight go down. All these different things. I did see my omega-3 levels drop significantly to the point of actually, I actually did start an algal oil omega-3 supplement to bring my levels up. I believe that the ideal diet would be mostly vegan with a couple of portions of oily fish per week. I even have a name for it.

Pescatarian?

Pescatarian.

Pescatarian.

Yeah. Pescatarian. Because when you think about it, I'm actually writing an article right now for Eating well Magazine where I went to Crete this summer. 15 students from Northeastern to Crete and we sort of retraced the steps of the Mediterranean diet. And I've been spending the last few weeks at the Rockefeller Archive in Sleepy Hollow looking at the results of the original all-bau numbers out of Crete. You look at their diet, right? It's mostly legumes, well, first of all, it's mostly soluble fiber, barley, whole grains in their bread. Then you have a lot of legumes, a lot of nuts, and a little bit of animal protein. So what I would suggest, given the state of our industrial meat sector, if you had that little bit of protein, two portions a week, that was really well-sourced fish or shellfish, things like mussels, for example, which are a really good choice, that that would give you everything you needed. You know, you wouldn't have to take a B12 supplement. Like, there's, I mean, I've been struggling with veganism all year because I feel.

Like- why did you do it?

Well, Partially because...

Writing another book?

No, well, no, you know what happened is I just, you know, I turned, I'm 52 now, so like all those mid-life crap that you start to see showing up in your blood numbers bothered me, right? So my cholesterol was high, my blood pressure was borderline, and then I did, I had a calcium score.

Yes, of course.

So, and my calcium score was like 90.

Oh.

So, you know, I don't know how.

You would, I don't, it's not terrible.

But it's not great. It's not great, right? So they immediately wanted to put me on statins and they want to put me on blood pressure medication. My blood pressure was varying between say 130 over 80 and 140 over 90. So again, you know, duh, duh, duh. So I was like, I don't want to go on blood pressure medication, I don't want to go on statins. I've heard good things about a vegan diet. I want to see can I address these things through a vegan diet. So I did, and largely my cholesterol went from total cholesterol of like 260 to about 185. My blood pressure more or less normalized around 130 over 80. Yeah, yeah, yeah. Blood pressure goes all over the place. Calcium score is obviously probably not going to change, although the Ornish studies say that, right, maybe it will relax my veins and arteries and blah, blah, blah. I don't know. My one struggle that I had with a vegan diet is like, how can a frickin diet be good if I have to take a B12 supplement and.

I have to take- and vitamin D and iron and omega-3 fats and many other things.

Exactly, so that's why I thought a pescatarian diet, where I'm basically vegan but.

Having a couple of portions of fish each week might be the way to go. That makes sense. I mean, I call it the Pegan diet, which is sort of paleo-vegan. But, you know, I think there's something called the vegan honeymoon. When people go from eating a traditional American diet to eating a whole foods, plant-based diet. Because, you know, Coke and chips are vegan, right?

Absolutely.

So, you know, you could be eating pizza and pasta all day. You know, if it's, it's a fake cheese, you could certainly be vegan. And that is not healthy. Right. But, but when you get over this vegan honeymoon, over time, I see these massive nutritional deficiencies, B12, iron, zinc. vitamin D, omega-3 fats, and it has serious health consequences. And I think that, you know, I've written a lot about this. I think the question is, you know, is grass finished, regenerative beef harmful to your health? And I think the evidence just really isn't there. I think, you know, it's been, you know, massive large reviews of the data.

Yeah.

And when you look at it objectively, there may be some signal of harm for some studies, not for other studies. And it's not a robust signal. In other words, with smoking it was a 20 to 1 effect. Well, this is a 0.2 or 0.3 or 0.4, which is, you know, doesn't mean anything in an observational study. Probably not that much. And I think that, you know, it's the quality of the food we're eating that matters.

For sure.

And I think if you're eating a little bit of grass-fed meat in the context of a plant-rich, mostly plant-based diet, which is what I do, I think that makes sense. That were your numbers?

And yes, I shared mine.

What are you? I mean, my blood pressure is like 100 over 70 or 60. Amazing. And my lipids, my HDL is very good, my triglycerides are low. I think I'm one of those people that's called lean mass hyper-responder, so if I eat too much saturated fat, my LDL goes up. But I think it really is very individual. Some people I put on a butter and coconut oil diet and their lipids drop like a stone.

Really? Interesting.

Yes. I think there's a lot of heterogeneity and variation genetically in the population how people respond to different foods and diets. So, there's not like one perfect diet for everybody. Some people need more carbohydrates. I think it's really individual. And I think the last question I want to ask you is, and I think the take-home for me is, Check. Check your Omega-3 levels. See what your ratios are. See if you have trans fat in your blood. If your Omega-6s are high, look at what's going on with your levels and then do something about it. Eat anchovies, mackerel, I call it the smash fish. Wild salmon, mackerel, anchovies, sardines, and herring.

I would throw mussels in there. Mussels, I love mussels. High in Omega-3 is super cheap, by the way. And also, did you know mussels have.

A carbon footprint footprint lower than lentils. And what about the whole idea of these being filter feeders?

Well, mussels are grown- They have high levels of toxins. I mean, you know, mussel, there are, it depends, you know, there's the old Yiddish expression, don't s**t where you eat, right? Right. To me, mussels and all the shellfish that are out there are kind of a reminder to us that the ocean should be a food system and not a waste disposal system. You know, of course, nobody wants to eat something disgusting, right? But it's a constant reminder that we need to keep our waters clean. And there are clean waters out there. Mussels are grown in suspension on ropes, so they're not sitting in the sediment. So they have the potential to be super clean and good.

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You'll even find a sampler there with all of my favorites. And now let's get back to this week's episode of the Doctor's Pharmacy. The literature that impresses me the most in terms of diet and the brain and brain states are the studies that look at EPA essentral fatty acids and the gu microbiome. Those are the two things that to me, it's like it's undeniable. I don't understand how anyone nowadays could even question the idea that getting proper lipid intake, you know, essentially lay is fa. Yeahs. The Omega threes are so important. I mean, in in a double several double blind placebo controlled studies that I've read. it appears that getting 1,000 milligrams or more per day of EPA, so not just taking 1,000 milligrams of fish oil, but making sure that you're getting above that threshold of 1,000 milligrams of EPA from quality sources, compares just with similar effect as SSRIs, prescription antidepressants, but without the side effects, which is incredible. And that if you are taking SSRIs, it allows you to take a much lower dose to still be effective. To me, it's incredible data. And then the other one is that getting ferment, ingesting fermented foods, one or two servings a day. Sauerkraut for the brain. Yeah, sauerkraut for the brain or whatever given culture. Because what I learned, and this is very new and emerging data, there's a guy at Duke, he's incredible. He was a nutritionist, but then he has PhD nutrition, excuse me, and now he's a neuroscientist. His name is Diego Borges, not to be confused with the Argentine writer Borges. He's Ecuadorian and he found that there are neurons in our gut of the vagus nerve. So these are neurons that live in the gut and to endothelium and they sense three things. They fire electrical signals to the dopamine centers of the brain in response to fatty acids, right? when fats are, you know, meats and things are broken down and the fatty acids, amino acids of other kinds, so from protein and sugar.

Sure.

And so these neurons can easily be tricked into signaling the brain to release more dopamine. And because dopamine is really the molecule of craving, into craving more of whatever activated those neurons. And so if you give these neurons enough EPA, or enough amino acids, so protein and essential fatty acids. The dopamine centers of the brain are just firing like clockwork, which is going to enhance mood, motivation, energy. I mean, dopamine in proper amounts is a beautiful thing.

Too high, obviously, you don't want, but.

You'Re not gonna get it too high. People don't get addicted to chicken breasts, but they get addicted to sugar. Right, and I actually think that's because these neurons seem to be responding best to particular amino acids. They seem to want glutamine. of all things. They seem to want the Omega-3s. And what's interesting is that even if they numb the taste so that people can't taste sugar, if people ingest sugar.

These neurons- Sugar receptors in your gut, right?

And they crave more sugar even if they can't taste the sugar. So I always thought that the dopamine release to sweet things was because it tastes so good. But the Borges lab results and some other work on dopamine more generally from my colleague Anna Lembke at Stanford shows that dopamine isn't so much about pleasure. We all, including myself, were taught it's about pleasure. Dopamine is about craving more of whatever it is triggered dopamine release.

Yeah, whether it's heroin or cocaine or sugar. Right.

And so these neurons that trigger dopamine release, they are powerfully affected by bio these quality omega-3s and by amino acids. And then what's really interesting is that they trigger the release of dopamine, but then you say, well, okay, that should be pretty simple. We should, like you said, people don't get addicted to chicken breast. And I wonder whether or not that's either because omega-3s are too low. So these neurons are not, the full concert of these neurons is inactive. Or it could be that for some reason that the other things that people are ingesting has messed up these neurons. And so the whole brain-body relationship is disrupted. And it's, I guess Robert Lustig is his name at UCSF.

Yeah, yeah.

And others are now showing that some of the emulsifiers in foods and other things like that, what they do to the gut endothelium, I never really understood how the gut brain thing works. But what I realize is that these microbiota, they don't care about us. What they do is they're trying to find conditions in the gut where the mucus is, pH of the mucus is just right. And that if people ingest emulsifiers and sugars, what happens is these neurons and Boris Lab has shown this that these neurons that are in the gut endothelium and can sense amino acids and can sense essential fatty acids, they actually start to retract their processes into the deeper layers of the gut. In other words, if you ingest the wrong things, pretty soon the neurons in the gut remodel the bad kind of neuroplasticity and you lose your gut brain sensing system. And so it's not just a matter of giving it the right things, it's really about for many people, it's going to be about repairing this system and allowing this portion of our nervous system to grow back. Now, the nice thing about peripheral neurons is that they grow back.

I just gotta unpack that because what you said was just so profound right there. Basically, you're talking about uncoupling the natural ability of our body to sense its environment and to self-regulate in the right way to create health when we eat processed food that contains ingredients that screw up the gut microbiome or the lining and all of a sudden that the brain in the gut or whatever you want to call it, the neurons in the gut start to change as a result of the crappy food we're eating and make us less able to seek out and want the foods that are good for us and tend to make us seek out and want the foods that bad for us.

Exactly.

That is a massive brain state shift for me because I never really understood the mechanics of how that happens. But it's clearly true when people are eating bad foods, they want more bad foods and they keep eating more and more of them. And there are many reasons for that, but the gut story is just fascinating.

Yeah, these neurons and really, I tip my hat to the Borchardt lab. It's cool, you know, science as you know can get really entrenched and then someone comes from a completely different perspective of, you know, his background in nutrition. And he described, it actually, it's a relevant story here. He had a friend who was, she was very overweight and she ended up having a gastric bypass surgery and she lost a lot of weight and her diabetes went away. But she also started craving runny eggs, you know, easy over runny eggs. But previously, just the thought of runny eggs made her nauseous, made her want to vomit. And he heard that story and he realized that cravings themselves are modified by the conditions of the gut. How could this be? So he started exploring, what are these neurons in the gut? What brain areas are they talking to? It's very clear that these neurons that innervate the gut, they're part of the vagus nerve, connect to the brain areas that release dopamine and create craving. and so the health of these neurons in your gut is strongly going to impact what you want. And so what I love about the literature, and I haven't had anything to do with the research I'm describing, but I've spent a lot of time with that work. What I love about the work that he's doing and others are doing is that it really points to A, the brain-body connection is mediated by neurons, B, that what we crave and what we seek really can change. I think that a lot of people that are having a hard time shifting towards healthier eating or healthier relationship to light, as we talked about a few moments ago. It starts becoming reflexive because not just because it's better for us, but because our nervous system actually remodels itself in ways where the good stimulus starts to evoke dopamine release.

Yeah, I find that for so true. If I go off track, I just want more of the bad stuff. If I stay on track, I want more of the good stuff. Like I naturally will crave the things that are good for me. But I think what's happened through, through our radical dietary changes is we've gotten so far away from our natural sort of ability to seek out things that nourish us. And, and we've lost that. Animals have that. They're not going to be running around eating things that are going to make them sick and gain weight and cause damage to their gut microbiome or whatever. But they're not thinking about it. Their body naturally will seek out, oh, I want this plant because it's got this nutrition in it, or this one has this phytochemical. They're not thinking that, but their body is telling them where to go, where to look, and what to eat. We've sort of really decoupled our ability to be in touch with our natural healthy cravings and have been hijacked by the food industry to desire all these foods that are driving us into worse and worse states of dysfunction, poor health, and poor brain states, and poor brain function.

Yeah, it's interesting because the discussion about light and the discussion about food are remarkably similar from the perspective of these neurons in our eye, they don't think. They'll respond to light at 1:00 a.m. when you're watching Netflix just as well as they'll respond to sunlight because of their sensitivity at that time of night. They don't care. They'll work for you or they'll work against you. They don't have a mind of their own. They're just cells. These cells in your gut are the same. And so I think that what's exciting as more and more of the neuroscience emerges and these other fields like nutrition start to really infiltrate neuroscience in a positive way, we're starting to realize that giving the brain and the body the proper stimulus and there is a proper stimulus, there is a right time of day to get sunlight and light in your eyes and there's a wrong time of day. There's a right time of, there's a right set of nutrients, amino acids and fatty acids are what your body really craves. but we've been giving it decoys, right? Sugar is a decoy. It really is a decoy. These neurons, unfortunately, respond to sugar, connect to the dopamine centers of the brain. And as I mentioned before, even if we don't taste the sugars, they're triggering these mechanisms. So I think that neurons are both beautiful and remarkable, but they're also dumb. They'll send these signals to your brain to a variety of things that you give it. wanna know what is the proper input? Like, what do I need to give these neurons? When do I need to give it sunlight or amino acids, essential fatty acids? Because that's really what we crave. There's no essential carbohydrate. And I'm not an anti-carbohydrate person. I eat starches. I actually find them very useful for.

Falling asleep at night. They really help. Well, it's not only what to eat, it's what to eat when, right? We're totally flipped in this country.

We eat all of our sugar and starch and carbs in the morning.

Right, so much.

Yeah, I tend to do it the opposite. I'll fast in the early part of the day and then I eat meat and vegetables throughout the day and then starches at night. That's just what works from a neurotransmitter perspective to be alert and then asleep. The other thing I realized the other day is that it's weird because really healthy, clean proteins taste better than dirty proteins. But really healthy, clean carbohydrates, they don't taste, they're not as intuitively tasty as like chips and things like that. Like what? well, I feel like a really good, I eat meat, so a really good steak tastes delicious. A lousy steak or like beef jerky is never as good as a steak. Whereas a bowl of white rice is like, maybe it's just the way I cook it, is not as tasty as.

A bag of potato chips, right? For me, I'd much rather eat a.

Sweet potato than a bag of potato chips.

Yeah, I probably need to up my culinary game. I mean, it's interesting, you know, We think, you know, we sort of willfully want this or that food. I know I'm wanting this, but it's actually our brains are sort of taken over because we've not been treating them properly and we're craving all the wrong things and we're not craving the right things.

Yeah, absolutely.

And I've said this before, like when I walk by, for example, like a Starbucks display and I see all the muffins or anywhere, you know, like any croissant, it just doesn't look like food to me. yeah.

Like, why would I eat that rock? That stuff has lost its appeal to me as well. One thing that's, that's relevant here that I think actually is useful knowledge. My, and my colleague, Anna Lemke, who's a psychiatrist, studies dopamine and, and craving. She explained something to me that it, it makes sense when you hear it, but it's not intuitive before that, which is, if you've ever tasted, like, a delicious piece of chocolate or you've had a delicious experience. I'll let people use their own mind to that. Or something really, really wonderful that you love. The sensation in your mind is not one of pleasure, believe it or not.

What is it?

It's a sensation of craving more. And you can do this if you're a chocolate lover. I don't want to send people on a chocolate.

I can eat too much chocolate. There's a point where I'm like, I'm all for this.

Sure. But. Absolutely, there's a point where you hit a threshold. But dopamine, we know this from animal studies and human studies, and this is one of the reasons it can create addictions in its extreme form, is that pleasure and pain have this reciprocal relationship. And when you eat something that tastes really delicious, if you just insert your mind into the process for a second, unless you're being very mindful and really kind of doing the Buddhist thing of really just tasting it, The way dopamine release works is it makes you think about the next bite. And this is true. Imagine any experience. Oftentimes, it's not just about the presence of the thing you're in unless you've done a lot of conscious work around experiencing pleasure and all its immediate container. And this is why people gamble. This is why people eat more sugar. This is why people get addicted to anything. And so I mention it because the first time I heard it, I thought, no, that's not true. I really love this experience or this thing. But then I started to pay attention, start to realize that oftentimes our mind goes to yes and more please. Yes and more please as opposed to just, and that's dopamine release in full form. And so dopamine release is a little bit of like a jet pack that gets attached to us that puts us toward a destination. And dopamine isn't bad, but I think once people understand the nature of craving, they can be in a position to to maneuver around it better.

97% of the population's low in omega-3 fatty acids. They have suboptimal levels. I actually did a study of 50 consecutive patients who came to our clinic. We're not taking fish oil. 49 of them had suboptimal levels.

I mean, it's striking when you start to look and test, which most doctors don't. I mean, you actually are scanning people's brains. I scan their bodies through testing that looks at all these variables that most doctors don't look at.

Right?

How many doctors look at omega-3 levels in your body? Most don't. But it's essential for my practice because I can't tell what's going on if I don't know what's happening.

Now, it's 25% of the membranes in your brain are made of omega-3 fatty acids. And so if they're low, your brain's not going to talk very well to itself.

Yeah. I mean, if you're listening, I think most people, and I think this is true. I've seen in my family, I've seen it in my patients, most people with some type mental disorder, there's a stigma. There's a sort of a blame game going on, and there's a shame about it. What your work is really doing is stopping that, saying that's just nonsense. It's like, would you shame somebody for having cancer? or diabetes, or an autoimmune disease? No, you wouldn't. You would try to sort through what's going on and look at the biology, and that's what you've done. So tell us why people suffering from things like depression, anxiety, bipolar disease, ADD, panic disorders, bipolar, schizophrenia, even addiction, why should they be hopeful now?

Because if they see it from a brain perspective, what we've learned is you're not stuck with the brain you have. Probably the biggest advance in neuroscience over the last 20 years is this concept of neuroplasticity, that you are not stuck with the brain you have. You can make it better. And every day you're making about 700 new hippocampal cells. So the hippocampus has stem cells and the hippocampus, you know, is Greek for seahorse. So every day you're making about 700 new baby seahorses and your behavior is either helping them grow or it's murdering them. And one of the things I think is really interesting, my 16 year old daughter, she and I, I'm 65, we're both making about 700 new baby stem cells in our hippocampus. Hers are more likely to stick around than mine. because of blood flow. So new research, brain cells don't age. It's your blood vessels that age. So anything that damages your blood vessels damages your brain. So if you know how to increase blood flow, so things like exercise and ginkgo and beets and rosemary and pepper, I mean, really simple things can actually help improve the function of your brain.

Ping pong, that's your thing.

Table tennis. But you're not stuck with the brain you have. You can make it better. And most people don't know that. I was just in Florida.

By the way, Dr. Amen is a mean table tennis player who whips my ass every single time. It's embarrassing.

And there's actually a study from England on who lives the longest. So they looked at sports. And so, if you don't play any sports, you don't live long.

Tennis players live seven years longer.

If you play football or soccer, you don't live longer than anybody else.

Because you're butting your head with the ball.

People who play racket sports live the longest. And that's why I play table tennis. Because you got to get your eyes, hands, and feet all to work together. While you think about this spin on the ball.

Yeah, I picked up tennis when I was 45, and I worked out at as much as I can. It just makes me so happy and I think it has kept me younger. Well, it activates your cerebellum.

And the cerebellum, you know, the young people listening, you're not gonna know who this is. It horrifies me. I call the cerebellum the Rodney Dangerfield part of the brain. It gets no respect. Even though it's 10% of the brain's volume, it contains 50% of the brain's neurons. And the cerebellum is not just involved in coordination, it's involved in processing speed and thought coordination. And so when you play tennis, you're activating the cerebellum, which oh, has reciprocal connections with your frontal lobes. So it's actually making you smarter, more focused. It's really a great game.

Yeah, I get so... And there are.

No head injuries with tennis or table tennis.

You're not paying attention and the ball hits you. No, sometimes actually, when I'm really clumsy, I'll hit myself in the head with a racket. But that's not usual. So this conversation is fabulous because we're reframing mental illness to brain health. And you have in your book, the End of Mental on this simple way of thinking about this you call Bright Minds, the 11 risk factors that steal your mind and how you avoid them. Can you take us through that?

So a number of years ago, I realized if you want to keep your brain healthy or rescue it, if it's headed to the dark place, you have to prevent or treat the 11 major risk factors that steal your mind. And bright minds is the mnemonic we came up with. And the B is for blood flow. Low blood flow is the number one brain imaging predictor of Alzheimer's disease. It's also associated with addictions. It's associated with depression. It's associated with ADHD and schizophrenia. So you want to do everything you can to protect your blood flow. And 40% of 40-year-old men have erectile dysfunction. Do you know what that means? 40% of 40-year-old men have brain dysfunction. If you have blood flow problems anywhere, it likely means they're everywhere. So you know you have blood flow problems. If you get a scan, because Spect is a blood flow study, if you have hypertension, if you have any form of heart disease, if you don't exercise. So it just gives you some very simple things to do. The R is retirement and aging. When you stop learning, your brain starts dying. And, you know, I turned 65 this year, and I've seen thousands of 60, 70, 80 year old brains. And the news is not good. It's sort of like, you know, as we age, our skin begins to fall off our face, the same process happens in the brain, unless you're serious about it.

Right?

I mean, I have your scan 10 years apart, and as you got older, your brain got better. Well, how exciting is that, that you're.

Not- Make me happy. I'm very competitive.

-With the brain you have. The eye is inflammation. that, I mean, both you and I know it's a disaster. Inflammation is a disaster for every organ in your body.

It's true.

Including your brain. And so people can measure their Omega-3.

Index, and before you go on to what you can do, it's important to underscore this. We know from the research today that depression is inflammation in the brain, that autism is inflammation in the brain, that ADD and dementia are inflammation in the brain. And if that's true, then the question is, what's causing the inflammation? How do you stop it? And how do you fix it? So tell us about that.

So if you have a low Omega-3 index, taking Omega-3s can be really helpful. You have to get your gut right, because having this thing, and I'm a psychiatrist, I didn't know one thing about leaky gut until I read the Ultramind Solution. And then I'm like, oh, you have to you get your gut right, because if your gut's not right, your brain's not right, you're likely to have things get inside your body that have no business in your body, which causes an autoimmune or an inflammatory response. So food really matters. Sugar is pro-inflammatory and foods that quickly turn to sugar, bread, pasta, potatoes, rice, you want to, you often say, eat them like a condiment. Recreational drug.

They're not even a condiment. Sugar is a recreational drug. It's fine, but...

Didn't you say the four white powders?

Yeah, the deadly white powder.

Deadly white powder, white flour, white sugar.

Cocaine, and too much salt.

So diet really does matter, and our processed foods are loaded with pro-inflammatory omega-6s. So corn and soy, we're overloaded with them. I mean, not that they're evil, but- It's a balance. They're not the right choice as primary staples in our diet.

But also things like infections and mold and other things.

We're gonna get there. So the eye is inflammation, and so get your gut right, omega-3 fatty acids, the G is genetics. And the big lie with Genetics is I have obesity in my family and that's why I'm fat. Well, the fact is I have obesity in my family. I have a brother and sister who are 150 pounds overweight, but I'm not. Why?

You're wearing a skinny suit.

Because I know the behaviors that make it likely to be so. So genes are not a death sentence. What they should be is a wake up call and tell you what you're vulnerable to so that you get serious about prevention.

I mean, you're in better shape now than when I met you 15 years ago. You lost more weight, you get more muscle, and you're 15 years older.

And I work on it. Right, but because I love what I do. And quite frankly, I have four children. I never want to live with them. I love them. I want to be independent for as long as possible. I don't want them being worried about taking away my driver's license. That means I have to take care of my body 'cause my body will then take care of my brain. But that causes you to think ahead, which is of course a brain function. The H is a national epidemic that nobody knows. It's head trauma. Head trauma is a major cause of psychiatric illness and nobody knows about it 'cause psychiatrists, psychologists, marriage and family counselors, counselors, they never look at the brain. And so that fall out of a second story window that caused you to be angry depressed, nobody's thinking about rehabilitating the damage that occurred. That's why you really shouldn't let your children hit soccer balls with their head, play tackle football. And if you've been in a car accident and then you got depressed, somebody should look at your brain and then you should go about rehabilitating it. That's what I did with the big NFL study. And we published a study. 80% of our players get better in as little as two months.

It's amazing.

By putting them on our Bright Minds program. So I'm pretty excited about that. The T is toxins. And when I first started scanning people, I mean, it was really clear that marijuana, alcohol, cocaine, methamphetamines, heroin are bad for your brain. But then I would see these toxic scans of people who never use drugs. And I'm like, oh no. I had not one lecture on mold exposure when I was a psychiatric resident or heavy mercury or mercury poisoning or lead exposure. None of that. And so we often find ourselves working up a toxic brain. And did you know 60% of the lipstick sold in the United States has lead in it? So I think that is the kiss of death. And so I know you know this app, Think Dirty. And when I downloaded it, you can scan all of your personal products. I threw out half of my bathroom because it was basically toxic. Things like parabens and phthalates, they're called hormone disruptors, which we're going to get to in a second, but you don't want whatever goes on your body goes in your body and affects your body. So you have to get rid of the toxins. And basically it's decrease exposure and support the four organs of detoxification: kidneys, drink more water, God, eat more fiber, liver, stop drinking. I'm just not a fan. I mean, we can talk about it. But it disrupts liver function and sweat with exercise or take saunas. People who take the most saunas have the lowest incidence of Alzheimer's disease. So M is something I call mindstorms. It's abnormal electrical activity in your brain. So if you have a hot spot, in your temporal lobes or cold spot, what we see, it's akin to seizure activity. So sometimes anticonvulsants can really help. A ketogenic diet has anticonvulsant properties. There's this great book, it's written in 1980 by Jack Dreyfus, who's the founder of the famous Dreyfus Mutual Fund. And he said, A remarkable medicine has been overlooked. And it was Dilantin. which is an old anti-convulsant. He'd been going to see psychiatrists forever. He said three days on Dilantin, he didn't need a psychiatrist anymore because it had balanced his brain. And so the second I is immunity and infections. If you look at a map of the United States and you look at the highest incidence of schizophrenia, overlay the highest incidence of Lyme disease, they're identical. It's incredible. Anybody in the West or the Northeast or the northern Midwest should be screened for Lyme if they have a psychotic disorder. You just need to screen them for it because if they have it, treating it may actually treat their, quote, mental illness that is not mental. It's brain.

The body you treat the brain.

Yeah. And is neurohormone deficiencies. D is diobesity. You know, as your blood sugar goes up and your weight goes up, your brain gets smaller as we talked about. It's getting your weight right, your blood sugar right, and S is sleep. This is how you keep your brain healthy.

I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in.

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