PDF Summary:Change Your Diet, Change Your Mind, by Georgia Ede

Mental health struggles may stem from metabolic dysfunction rather than just chemical imbalances in the brain. In Change Your Diet, Change Your Mind, psychiatrist Georgia Ede explores the connection between diet and mental health, focusing on how insulin resistance, inflammation, and oxidative stress affect brain function. She argues that conditions like depression, bipolar disorder, and schizophrenia share metabolic roots with physical diseases like diabetes and cardiovascular disease.

Ede examines how different dietary approaches—particularly ketogenic, paleo, and carnivore diets—might address these metabolic issues and improve mental health. She explains which foods support brain function and which ones may harm it, then introduces her "Quiet Diet" plans as personalized strategies for reducing inflammation and stabilizing blood sugar. This guide offers an alternative perspective on treating psychiatric conditions through metabolic and dietary interventions.

(continued)...

Insulin Resistance & Brain Energy Dysfunction

Ede argues that the body’s resistance to insulin can result in brain energy dysfunction. While the metabolic disease insulin resistance can lead to diabetes, it can also cause other health problems even if it never progresses to diabetes. It's a key factor in the majority of Alzheimer's cases. As your insulin resistance increases, your brain becomes less capable of using glucose. The hippocampus, which plays a role in memory and learning, is especially susceptible to resistance to insulin. Insulin plays a vital role in forming, developing, and sustaining dendritic spines, which are crucial for learning new things. The hippocampus also needs extra glucose surges to do its work, and these surges depend on insulin. When your brain lacks sufficient insulin, or your hippocampus fails to react to its signals, it will be difficult to create memories.

Alzheimer’s Is a Multifactorial Disease

While insulin resistance is a risk factor for Alzheimer’s disease, it’s not a universal one. According to Gill Livingston et al., Alzheimer’s is a multifactorial disease, meaning that it’s caused by a combination of genetic, environmental, and lifestyle factors. The authors argue that no single mechanism can explain the majority of cases. Instead, they suggest that a combination of factors, including vascular health, inflammation, oxidative stress, and lifestyle choices, contribute to the development and progression of Alzheimer’s. This multifactorial perspective challenges the notion that insulin resistance is a key factor in the majority of cases, as it highlights the complexity of the disease and the need to consider multiple pathways and risk factors.

Dietary Components & Their Brain Impact

Ede explains that both macro and micronutrients are essential for proper brain function. Macronutrients, which include protein, fat, cholesterol, and carbohydrates, are molecules utilized by the body in significant quantities. Micronutrients are nutrients the body requires in limited quantities, including vitamins, minerals, and fatty acids essential for health.

Macronutrients act as foundational elements to create essential brain structures and can also be metabolized to produce energy. Micronutrients support the construction, upkeep, and stimulation of the brain's structure. Without micronutrients, the body couldn't utilize the macronutrients.

The Importance of Water for Brain Function

Another important dietary factor is water. Even mild dehydration can reduce blood flow to the brain and impair cognitive performance, especially on tasks that require attention and working memory. This is because water is essential for maintaining the brain's structure and function. It helps transport nutrients and oxygen to brain cells, remove waste products, and regulate temperature. When you're dehydrated, your brain has to work harder to perform the same tasks, leading to decreased efficiency and increased fatigue. Even a 1-2% decrease in body water can negatively affect mood, memory, and concentration.

Let’s examine which components of diet are detrimental to brain function and which factors are beneficial.

Detrimental Dietary Factors & Brain Health

Ede recommends steering clear of refined carbs, drinking alcohol, and oils from vegetables to protect brain health. These substances lead to oxidative stress and inflammation and can disrupt the balance of your neurotransmitters, potentially leading to psychiatric issues. To avoid vegetable oils, read nutrition labels to identify unhealthy foods and prepare your own meals.

(Shortform note: In Brain Food, neuroscientist Lisa Mosconi recommends extra-virgin olive oil as a key component of an optimal diet for cognitive vitality. She explains that olive oil is rich in monounsaturated fats and bioactive compounds that support neuronal membranes and bolster learning and memory. Mosconi cites research showing that diets high in olive oil are consistently associated with reduced risk of cognitive decline, particularly when used as the main added fat in daily eating.)

Additionally, Ede warns that grains and legumes contain lectins, which are toxins that can damage your gut, immune system, thyroid, mitochondria, and brain. Lectins can cause leaky gut syndrome, which occurs more often in those who have mental health conditions. They can also activate your immune system, causing it to generate antibodies that attack your own cells, leading to autoimmune diseases. Lectins can even penetrate the brain and damage brain cells. However, you can inactivate lectins by soaking these foods and cooking them in boiling water before eating them. Ede also notes that grains and legumes are high in carbohydrates, which may not be safe for those who are insulin resistant.

The Health Benefits of Beans

Nutrition researcher Virginia Messina argues that the health benefits of beans outweigh the potential risks of lectins. In a 2014 review published in the American Journal of Clinical Nutrition, Messina notes that higher intakes of beans are consistently associated with reduced risks of coronary heart disease, type 2 diabetes, and excess body weight. She also points out that clinical feeding trials show that incorporating beans into mixed diets improves serum lipid profiles and markers of glycemic control. Messina concludes that making beans a regular staple food is a safe, practical, and effective strategy for promoting cardiometabolic health in the general population.

Beneficial Dietary Factors & Brain Health

Ede argues that consuming meat provides essential nutrients for supporting the brain. It's a complete protein with the full set of nine necessary amino acids, along with lipids, sterols, and micronutrients. Meat is more digestible and is more nutrient-dense than plant-based foods. Additionally, it supplies the nutrients essential to us in their most absorbable versions, free from antinutrient interference.

Meat also contains the omega-3s eicosapentaenoic acid and docosahexaenoic acid, which are difficult to obtain from plant foods. DHA is especially crucial for brain growth, energy production, and cell communication. Furthermore, meat is a superior source of many essential nutrients, including vitamin A, B vitamins, vitamin D3, vitamin K2, and long-chain polyunsaturated fats. These nutrients are either absent from plants or not as bioavailable due to compounds that inhibit absorption. Our brains developed to need meat, and our bodies are designed to digest it.

The Evolutionary Need for Meat

The idea that our brains developed to need meat is rooted in evolutionary biology, particularly the “expensive tissue hypothesis” and the concept of evolutionary mismatch. In The Story of the Human Body, Daniel E. Lieberman explains that the human brain is metabolically expensive, requiring a significant amount of energy to function. To support the evolution of larger brains, our ancestors had to make trade-offs, such as reducing the size of their digestive systems and increasing their physical activity levels. This shift was made possible by adopting a diet rich in high-quality, energy-dense foods, including animal products and cooked meals. Lieberman argues that many modern health problems stem from a mismatch between our evolved biology and our current environment, which is characterized by sedentary lifestyles and low-quality, processed foods.

Dietary Strategies for Mental Resilience and Health

Next, we'll discuss how reduced sensitivity to insulin is connected with mental health disorders and why plant-based diets are not effective.

Metabolic Targets for Mental Wellness

Ede argues that resistance to insulin is linked to mental health disorders such as depression, schizophrenia, and bipolar disorder. People with these disorders have a higher chance of developing insulin resistance. This may be because insulin resistance creates a brain energy deficit, impairing control of mood, cognition, and actions.

In people with depression, the brain metabolizes glucose at a slower rate, and the hippocampus tends to be smaller. For those with bipolar disorder, the brain uses less glucose, and the hippocampus is smaller. In individuals with schizophrenia, the brain metabolizes glucose at a reduced rate, and they have smaller hippocampi. These individuals are at greater risk for age-related dementia.

How Scientists Measure Glucose Metabolism in the Brain

When Ede says that the brain “metabolizes glucose at a slower rate,” she’s referring to the results of imaging studies that use a radioactive tracer to measure how quickly the brain takes up and processes glucose. In The Student’s Guide to Cognitive Neuroscience, Jamie Ward explains that in positron emission tomography (PET) scans, a radioactive tracer is injected into the bloodstream. This tracer is similar to glucose, so it’s taken up by active neurons in the brain. However, once inside the neuron, the tracer gets trapped and can’t be metabolized further. This means that areas of the brain with higher metabolic activity will accumulate more of the tracer, while areas with lower activity will have less.

Specific Dietary Approaches & Patterns

Ede contends that plant-centered diets lack evidence. These diets encompass a broad range of eating habits, from Mediterranean diets that permit all animal products to vegetarian diets that include eggs and/or dairy, to vegan diets that exclude all animal products.

There isn't presently any scientific evidence that provides insights into how plant-based diets impact psychiatric disorders. However, many clinical studies have shown that plant-based diets can benefit things like cardiovascular illness and diabetes. It's valuable to examine this research further, because better vascular and metabolic health could lead to better mental health.

Plant-Based Diets and Depression

There is at least one study that suggests that plant-based diets can improve mental health. In a 2017 study, Jacka et al. found that a Mediterranean-style diet improved depressive symptoms in people with major depressive disorder. The study involved 67 participants with moderate to severe depression who were randomly assigned to either a dietary intervention group or a social support control group. The dietary group received nutritional counseling and followed a modified Mediterranean diet rich in vegetables, fruits, whole grains, legumes, nuts, fish, and olive oil, while reducing processed foods and sugary snacks. After 12 weeks, the dietary group showed significantly greater improvements in depressive symptoms compared to the control group, with 32% achieving remission versus 8% in the control group.

Next, we'll discuss the keto and paleo eating plans. Then, we’ll discuss the Quiet Diet and how it can be personalized to improve physical and psychological well-being.

Established & Popular Dietary Approaches

According to Ede, keto involves consuming fewer carbs and more fats, which can enhance mental well-being. It's a metabolism-focused approach with guidelines on macronutrients: low in carbs, medium protein levels, and elevated fat content. You may consume whatever foods you want, provided you follow those guidelines and achieve therapeutic ketosis. The ketogenic diet's aim is to reduce insulin levels. Carbs tend to elevate insulin levels the most, so cutting back on them is key. Most calories in a keto plan are from fat, which impacts insulin levels minimally.

(Shortform note: Therapeutic ketosis refers to maintaining a specific level of ketones in the blood, which is believed to provide health benefits. This state is achieved by following a ketogenic diet and is monitored through regular testing to ensure ketone levels remain within a target range. The goal is to reach and sustain a level of ketosis that is high enough to be therapeutic but not so high as to cause adverse effects.)

Consuming excessive protein can disrupt ketosis because it stimulates insulin, though generally not to the extent that carbohydrates do. However, protein is crucial, and it's the top nutrient in your eating plan, so having too little of it can be risky. The keto diet may greatly help those with severe psychiatric disorders, no matter what their symptoms are like or how long they’ve lasted. For most adults, it poses no risks, so long as it's made up of nourishing, unprocessed foods, has suitable protein levels, and involves easy initial measures to lessen typical discomforts as your body gets used to it. Your healthcare team should keep a close watch on your medications and current health, both mental and physical.

The Keto Diet and Lithium

While the keto diet may be safe for most adults, it can be dangerous for people with psychiatric disorders who take lithium. According to researchers, the keto diet can cause you to lose salt and water, which can increase lithium levels in your blood to a dangerous level. This can lead to symptoms like nausea, vomiting, diarrhea, tremors, confusion, and even seizures. Some clinicians recommend that people taking lithium should avoid the keto diet altogether. One academic paper suggests that if you’re taking lithium and want to try the keto diet, you should work closely with your doctor to monitor your lithium levels and adjust your medication as needed.

Ede also discusses the Paleolithic diet, which focuses on whole, unprocessed foods and can benefit metabolic well-being. It’s modeled on what our hunter-gatherer forebears ate before the development of agriculture and animal domestication. It consists of animal protein, marine life, bird meat, eggs, plant-based food, tree-grown foods, and edible kernels. It excludes grain, legumes, dairy, processed foods, refined carbs, oils made from vegetables, alcohol, and added sugar.

The paleo approach is a good foundation for a diet that benefits brain health and can be followed by people of all ages. However, it may not be suitable for people with gastrointestinal problems, food sensitivities, or autoimmune disorders, as it includes nuts, seeds, and a broad range of produce, which can be problematic. Its carbohydrate content might be excessive for those who are insulin resistant.

Origins of the Paleo Diet

The idea of a Paleolithic diet was first proposed in the 1980s by S. Boyd Eaton and Melvin Konner, who argued that many modern diseases stem from a mismatch between our ancient genetics and contemporary diets. They suggested that our bodies are best adapted to the foods our ancestors ate during the Paleolithic era, which excluded grains, legumes, and dairy. This concept gained traction as researchers began to study the diets of modern hunter-gatherer societies, finding that they had lower rates of chronic diseases like obesity, diabetes, and heart disease compared to populations consuming Western diets. The paleo diet gained popularity in the early 2000s as people sought to improve their health by returning to what they believed were more natural eating patterns.

Personalized & Adaptive Dietary Strategies

Ede offers personalized dietary strategies to improve psychological and bodily well-being with the Quiet Eating Plan. This approach includes three plans: the Quiet versions of Paleo, Keto, and Carnivore. These plans are crafted to support your metabolic, gastrointestinal, thyroid, immune, nervous, and mitochondrial health more gently. The Quiet Diet plans aim to decrease glucose and insulin levels, lessen inflammation and oxidative stress, minimize plant toxins and antinutrients, eliminate common food sensitivity culprits, and highlight gut-friendly foods that are easier to digest.

(Shortform note: The Quiet Eating Plan’s variations on Paleo, Keto, and Carnivore may work by changing the microbes in your gut, which send chemical messages to your brain. According to John F. Cryan and Timothy G. Dinan, these messages can affect your mood and how you handle stress. The Quiet Eating Plan’s focus on gut-friendly foods and reducing inflammation may help create a healthier balance of these microbes, leading to better mental health.)

The Quiet Diet method may be especially beneficial for those experiencing irritable bowel syndrome (IBS), fibromyalgia or persistent pain, migraines, ongoing fatigue, compulsive eating, resistant or unexplained physical or mental health challenges, or sensitivities to food or chemicals. The Quiet Diet plans have fewer naturally irritating toxins and are more digestible than typical ketogenic, paleo, and carnivorous diets. They're less likely to cause issues for individuals who have dietary sensitivities or complex medical conditions. The Quiet Diet plans aim to swiftly identify whether your symptoms of mental and physical health are linked to issues with food or metabolism, sparing you the tedious trial-and-error of eliminating possible dietary offenders one by one. If you notice improvements with any of these plans, you might try broadening your diet to identify the boundaries of what's tolerable for you.

(Shortform note: The Quiet Diet plans may not be suitable for everyone. For some, the emphasis on avoiding certain foods could trigger or worsen disordered-eating tendencies, such as orthorexia, which is an unhealthy obsession with eating only “pure” foods. This condition can lead to anxiety, social isolation, and nutritional deficiencies. The strict rules and restrictions of the Quiet Diet plans might reinforce these unhealthy patterns, making it difficult for individuals to maintain a balanced and flexible approach to eating.)

The Quiet Diet plan begins with Quiet Paleo, which is recommended for most people. Quiet Paleo aims to enhance the nutritional value of what you eat, minimize inflammation by emphasizing gentler foods for your gut, brain, and immune system, and decrease and balance glucose and insulin without inducing ketosis. It also serves as a two-week metabolic transition to Quiet Keto. Quiet Paleo resembles standard paleo by permitting the consumption of meat, seafood, poultry, eggs, fruits, and vegetables while excluding grains, legumes, dairy, refined carbohydrates, alcohol, vegetable oils, and ultraprocessed foods. However, Quiet Paleo restricts plant-based foods to a specific selection of “kinder, gentler” produce that contains less sugar and fewer protective chemicals that plants produce to fend off predators.

(Shortform note: In Fiber Fueled, gastroenterologist Will Bulsiewicz argues that the single greatest predictor of a healthy gut microbiome is the diversity of plants in your diet and that we should strive to eat at least thirty different plant foods every week—including fruits, vegetables, whole grains, legumes, nuts, seeds, herbs, and spices—in order to optimally nourish our microbes and, through them, support our metabolism, immune system, and brain. Bulsiewicz’s approach contrasts with Ede’s, as he explains that the phytochemicals in plants, which Ede claims are harmful, are actually beneficial for our health. He argues that these compounds, such as polyphenols, carotenoids, and flavonoids, have anti-inflammatory, antioxidant, and neuroprotective properties that support brain health and reduce the risk of cognitive decline. Bulsiewicz also emphasizes the importance of fiber, which is found exclusively in plant foods, for maintaining a healthy gut microbiome and supporting brain function. He recommends consuming a wide variety of plant foods, including beans, whole grains, and diverse fruits and vegetables, to maximize the intake of these beneficial compounds and support overall health.)

Stick with Quiet Paleo for a minimum of six weeks, then evaluate your metabolism along with your psychological and physical well-being. If your blood glucose levels are consistent and healthy, and you've seen improvements in your mental and physical well-being, you can choose to stay on Quiet Paleo long-term or start broadening your dietary options to see if you can handle a more diverse paleo regimen. Should Quiet Paleo lead to fluctuations in your blood sugar or make it rise too much, or if you aren't experiencing the desired wellness, you should think about changing to Quiet Keto.

(Shortform note: If you’re unsure whether to stick with Quiet Paleo, broaden it, or switch to Quiet Keto, consider treating each option as a personal experiment. Try each approach for a set period, such as a few weeks, and monitor how your body responds. Pay attention to your energy levels, mood, digestion, and any other symptoms you’re tracking. This hands-on approach can help you determine which dietary pattern provides the most stable and positive results for your unique needs. Remember, what works best for one person may not be ideal for another, so personal experimentation can be a valuable tool in finding your optimal diet.)

Quiet Keto is similar to other ketogenic diets in that it contains minimal carbohydrates, moderate protein levels, and is rich in fat. However, Quiet Keto builds on the Quiet Paleo food list (excluding produce higher in carbohydrates), which means it merges the quality of nutrition and metabolism. Quiet Keto aims to lower the glucose and insulin in your system enough to allow ketosis and to maintain this state for sufficient time to adapt, enabling you to examine the impact of ketosis on your mental health. Following six weeks of Quiet Keto, reevaluate your physical, metabolic, and psychological wellness. If you're happy with the outcome, you can either stick with Quiet Keto for the long haul or start slowly broadening your dietary options to determine if you can handle more varied ketogenic meals, all while retaining its advantages.

(Shortform note: The structure of Quiet Keto, which involves a strict phase followed by a gradual reintroduction of foods, is similar to the low-FODMAP diet used for irritable bowel syndrome (IBS). The low-FODMAP diet is a temporary eating plan that eliminates certain carbohydrates that are difficult to digest. The diet has two phases: an elimination phase and a reintroduction phase. During the elimination phase, you avoid all high-FODMAP foods for two to six weeks. This helps reduce symptoms and gives your gut a chance to heal. In the reintroduction phase, you slowly add back one FODMAP group at a time, usually over three days. This helps you identify which specific FODMAPs trigger your symptoms and which ones you can tolerate. The goal is to find a long-term eating plan that minimizes symptoms while allowing for as much dietary variety as possible.)

Quiet Carnivore contains no plants. The plan includes meat, seafood, poultry, plain broths, and salt, while excluding dairy, eggs, and processed meats, since these animal products are more likely to affect those with sensitivities.

(Shortform note: The Academy of Nutrition and Dietetics (AND) takes a different stance from Ede, recommending a diet centered on a variety of plant foods. In a 2016 position paper, the AND stated that “appropriately planned vegetarian, including vegan, diets are healthful and nutritionally adequate, can provide health benefits in the prevention and treatment of certain diseases, and are suitable for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes.”)