Hope you’re hungry! Today’s episode is all about food, both how food impacts our mind, and how our mind impacts our relationship with food. To explore how what we eat impacts the way we feel, Bey and Kirsten sit down with psychiatrist Dr. Drew Ramsey to discuss nutritional psychology. Then, the two chat with self described anti-diet dietician and food writer Christine Byrne, investigating the ways language and societal pressure can negatively affect our relationship to food, and how we can combat these stigmas.
Links For Today’s Episode:
- Learn more about Dr. Ramsey‘s work
- Learn more about Bring Change To Mind‘s mission to end mental health stigma
- Learn more about Christine Byrne’s practice and writing
Resources For Today’s Episode:
- The National Eating Disorders Association offers a call line and various supports on their website
- Mental Health America’s eating disorder information + support page
- Project Heal for support and resources for those seeking eating disorder treatment
- the National Alliance on Mental Health for general mental health resources nationwide
Transcript
Hey, friends.
Speaker:Quick content warning.
Speaker:Today's episode has discussions of both eating disorders and disordered eating.
Speaker:If these are activating topics for you, please proceed with caution.
Speaker:We've also linked some support resources in the show notes for today's episode.
Speaker:Hey, welcome to the So Curious podcast presented by the Franklin Institute.
Speaker:I'm the Bul Bey.
Speaker:And I'm Kirsten Michelle Cills, and we are your hosts.
Speaker:Yeah, and today we're talking all about food.
Speaker:More specifically, how food can impact our mental health and vice versa.
Speaker:First, we'll be joined by Dr.
Speaker:Drew Ramsey to learn about how nutrition
Speaker:from the food we eat can impact our brains.
Speaker:And then we're going to be joined by self
Speaker:described anti-diet dietitian Christine Byrne, to learn about how the
Speaker:language we use to speak about food can impact our relationship with it.
Speaker:This is going to be good.
Speaker:What's your favorite food?
Speaker:And then when you eat it, how does it make you feel?
Speaker:Great question.
Speaker:I feel like an old man about to say this, but, Oatmeal.
Speaker:Oh, that was the one.
Speaker:Oatmeal! It's one of those things where
Speaker:when I have it, and especially if I dress it up nicely, with pecans or almond or
Speaker:cinnamon, bananas, fruits, different things like that.
Speaker:Berries, yeah, you name it.
Speaker:I feel really, like, good about what I'm eating.
Speaker:And those cold
Speaker:winter mornings, you got a nice bowl of oatmeal and it's made the way you like it.
Speaker:You dress it up how you want it.
Speaker:And I'll just rock out with that.
Speaker:I have my entire life been such an apple cinnamon oatmeal girl.
Speaker:And I just found out a couple of months
Speaker:ago that I am now in a naphylacticly allergic to apples.
Speaker:So oatmeal gives me nothing but sorrow now.
Speaker:So you got to eat enough for the both of us, bro.
Speaker:All right.
Speaker:Well, now that I'm very hungry, let's talk to Dr.
Speaker:Ramsey. Welcome to the So Curious podcast.
Speaker:Absolutely.
Speaker:Drew, can you tell us who you are and what it is you do?
Speaker:Well, hey, everybody. It's nice to be with you all.
Speaker:I'm Dr. Drew Ramsey.
Speaker:I'm a psychiatrist mostly, and a
Speaker:lot of people know me through my work in nutritional psychiatry.
Speaker:I've been a real advocate for utilizing
Speaker:responsible nutrition in terms of how we think about mental health.
Speaker:I'm an assistant clinical professor of
Speaker:psychiatry at Columbia University, and I founded the BrainFood
Speaker:Clinic, which is a digital mental health clinic.
Speaker:And I'm a husband and I'm a dad.
Speaker:Before we got on mic, we were thinking
Speaker:about all of the colloquialisms that come along with when
Speaker:you think of brain food, comfort food, and then we're
Speaker:You are what you eat!
Speaker:Oh, the stomach is the way to the heart or whatever you call it.
Speaker:And so we were like, oooh, I can't wait to get into this topic with you.
Speaker:What foods popped into your head?
Speaker:What did you guys start thinking about?
Speaker:So, we were talking about comfort food, and we were thinking like, well, I always
Speaker:think of mash potatoes and, I don't know, fried food.
Speaker:But then also we talked about why sweet things just make us feel happy.
Speaker:Yeah, I just crushed a doughnut before you came on.
Speaker:Yes, we did. Exactly.
Speaker:How are you feeling right now, Bey?
Speaker:Honestly, a little sedated.
Speaker:A little sedated, right?
Speaker:And it's funny, the different times when you eat, if you haven't eaten for a while
Speaker:or you're hungry and you eat a little sugar, you feel that rush.
Speaker:So it's funny, right?
Speaker:You guys are talking about nutritional psychiatry, this idea that everyone
Speaker:intuitively knows there's a little bit of how we eat that affects how we feel.
Speaker:Yeah. And in this moment, I'm thinking about,
Speaker:did that doughnut just doom my mental health?
Speaker:Am I going to spiral into depression based off of a sugary treat?
Speaker:The team did call me here for a reason, man.
Speaker:So we all know, we've all eaten donuts and our mental health has been okay.
Speaker:We also know we don't feel great after them.
Speaker:It's like fast food.
Speaker:You crush it because you're hungry and it's cheap, but you don't feel great.
Speaker:And the other way that we struggle with food is instead of thinking of that long
Speaker:game, alright this is about what's called nutrient density, thinking about the foods
Speaker:that you're looking at right in front of you.
Speaker:Do they hit a few criteria?
Speaker:And I would say in a way that people aren't selfish enough.
Speaker:People don't think, you've got it.
Speaker:You have got the most miraculous thing in
Speaker:the knowing human universe, like at your fingertips, you've got a human brain.
Speaker:It could do anything. You want to learn any language?
Speaker:Pick a language right now.
Speaker:You could in the next year.
Speaker:You become totally fluent.
Speaker:Your brain knows how to do that.
Speaker:The idea that we don't feed it and take care of it and prioritize that.
Speaker:We don't wake up with this first notion of like, man, I've got the specialist thing.
Speaker:I'm going to really nourish it, take care of it, rest it, exercise it.
Speaker:And instead of just thinking about your
Speaker:physical fitness, really feel like, how well can you nourish your brain?
Speaker:Those are incredible questions to ask.
Speaker:Have you found that food serves some kind of pathway to an answer?
Speaker:I think so.
Speaker:I think food, in some ways, is a bit of a mirror on this.
Speaker:In terms of if you look at your eating habits, everybody listening, just over
Speaker:your last week, and you think about, first of all, what was motivating that?
Speaker:Was it a lot of guilt, fear?
Speaker:Was it this like, I would say kind of
Speaker:boring, lame message about food we've gotten, right?
Speaker:Hate carbs or hate meat or hate vegan or whatever.
Speaker:Just not about people caring for
Speaker:themselves, not about people connecting to their food, but asking people to take a
Speaker:little bit of a step back from a lot of what's driving their eating behavior.
Speaker:So the short answer is yes, I think
Speaker:nutritional psychiatry and thinking about nutrition through the lens of mental
Speaker:health and vice versa, I think it does provide a lot of those answers.
Speaker:Are you able to walk us through some of
Speaker:the science behind how a food can lead to a certain mental or emotional outcome?
Speaker:Yeah, big high level concepts, first of all, that I think people are missing.
Speaker:When they think about mental health, they
Speaker:think a lot of time it's like serotonin and medications.
Speaker:They don't think about all the new science.
Speaker:So if you think about ideas like
Speaker:inflammation, your body's alarm systems, what regulates your body's immune system
Speaker:and your inflammation has a lot to do with what lives in your gut.
Speaker:So how does that affect mental health?
Speaker:First of all, all the building blocks of
Speaker:your brain, every single piece comes from the food you eat.
Speaker:If you stop eating B12, you will not have in a few
Speaker:months or years any B12 in, or vitamin C, 87 milligrams a day you need a vitamin C.
Speaker:It's not a lot.
Speaker:But a lot of people don't get it.
Speaker:Vitamin C is absolutely essential for all of the
Speaker:kind of bio-chemical things going on in the brain that support mental health.
Speaker:You can't make serotonin without vitamin C.
Speaker:You can't put the insulation around your brain cells without vitamin B12.
Speaker:You can't make all of basically the
Speaker:currency of what makes your moods and your cognition without the proper nutrients.
Speaker:And so, you can track something like triptophan or iron B12 from your fork all
Speaker:the way into your gut, all the way back up into your brain.
Speaker:It's fascinating.
Speaker:Along with this idea that inflammation is
Speaker:an issue, this idea that brain growth, that if you think about mental health
Speaker:issues through a lens of brain growth and inflammation, what controls brain growth
Speaker:in part has a lot to do with what you eat and the way you live your lifestyle.
Speaker:So, some of the basics, you're moving your body, you're eating a really nutrient
Speaker:dense, brain healthy diet, and you're sleeping, really high quality sleep.
Speaker:That's a brain that's primed to be in grow mode.
Speaker:Yeah. Are there foods that you notice in your
Speaker:own life, or a certain vitamin or whatever, that it's like...
Speaker:Let's go round, Robin.
Speaker:Let's everybody do one.
Speaker:Okay, I'm going to go first. I'm going to start hard.
Speaker:I think everybody should experiment with fermented foods.
Speaker:And that, for a lot of people, entry is Kombucha, because it's tasty
Speaker:and it is elusive that you're drinking live bacteria.
Speaker:Usually doctors aren't
Speaker:like, hey, I want you to go find a jar, 12oz of like, some live bacteria.
Speaker:I want you to drink it down real slow and think about it.
Speaker:I'm putting bacteria in your gut.
Speaker:That's not usually what we do.
Speaker:But yeah, I'm going to say some Kombucha. All right, that's one.
Speaker:All right, human to human, what's yours?
Speaker:All right, Bey, you go next. Uhhhhh... a cheesesteak.
Speaker:What's the food you think? Ugh, you're so Philly.
Speaker:God, a food you think makes you feel better.
Speaker:For their mental health. Yeah, for their mental health.
Speaker:Yeah. You're making a recommendation, doctor.
Speaker:Come on, take it seriously.
Speaker:This is public health right here, everyone's listening.
Speaker:Okay. Dr.
Speaker:Bey, what should we be?
Speaker:And what food do you eat for your mental health?
Speaker:A mango.
Speaker:I like mangoes. Mangos.
Speaker:A mango is a great example of natural sweetenness, right?
Speaker:When you're having that carb craving,
Speaker:and you're thinking, how can you extend - that's a sugary tropical fruit.
Speaker:It's great for you, full of all kinds of nutrients and phytonutrients.
Speaker:But also that thing about mango.
Speaker:Som I lived in Jamaica briefly when I was in college, and we'd go out every morning,
Speaker:we'd sit under the mango tree and the mangoes would drop and we'd eat them.
Speaker:And the mango is so full of fiber, right? There's so much in it.
Speaker:And as you're getting all that sugar, if
Speaker:you're having mango juice, it's just sugar water.
Speaker:But if you're having the mango, you're
Speaker:getting fiber in there, and you want to think of all the fun ways you can mix.
Speaker:Like, what's popping in my head is a
Speaker:mango, kinda ceviche or salsa over some seafood, mmmm, with a little rice?
Speaker:Yeah. All right, Kirsten.
Speaker:All right. I love lettuce.
Speaker:Lettuce and spinach, I want on everything. I love...
Speaker:Spinach doesn't have it, but like romaine
Speaker:lettuce, like the crunch, I think, adds to everything.
Speaker:Yeah. There we go.
Speaker:All right.
Speaker:One way we think about it, our nutritional psychiatry is thinking food categories.
Speaker:You're mentioning leafy greens. There's a whole food category.
Speaker:Leafy Greens are great because they demonstrate nutrient density.
Speaker:A cup of leafy greens has between 20 to 35 calories for a whole the whole cup.
Speaker:And there's just an incredible amount of nutrition.
Speaker:Vitamin K, vitamin C, vitamin A in the form of beta carotenoids.
Speaker:There's just all these phytonutrients.
Speaker:There's fiber and it's filling.
Speaker:I think between our 3 choice s, we made a salad.
Speaker:Yeah, look at us.
Speaker:Yeah, a little bit of salad, got some mango on there.
Speaker:We got a little bit of bread.
Speaker:I'm always going to add in seafood because that's a challenge for people.
Speaker:A lot of people listening, seafood is like, they haven't had a good experience.
Speaker:Or like myself, I was raised on a farm and there wasn't a lot of seafood.
Speaker:And so I really had to, over time, learn a lot about seafood, adapt my palate.
Speaker:Today, eat all types of seafood.
Speaker:There's a lot of great recipes.
Speaker:I'm a big salmon person.
Speaker:I love, yeah.
Speaker:Of all the meats, I feel like it makes me feel the least sluggish.
Speaker:So if everybody made that switch that you made, if wild salmon...
Speaker:I mean, that would be a little hard on the salmon population.
Speaker:But just say for you individually, as an
Speaker:eater, if you start upping your seafood, people, worry about meat.
Speaker:They worry about deli meat.
Speaker:They don't worry that they're not eating enough wild salmon.
Speaker:They don't worry that they're not eating enough anchovies and sardines.
Speaker:Why?
Speaker:Lower price point, don't worry about freshness, accessible to everybody.
Speaker:Buy it in Biden Walmart or Costco or any of the big box stores.
Speaker:And I think it's really important just
Speaker:from a food justice standpoint that everybody understands, if
Speaker:you add access to any food and food choices, you have
Speaker:some power to make choices about your mental health.
Speaker:I want to keep going and talking about nutrition, but I want to hold space for
Speaker:the mental health aspect of the conversation.
Speaker:On the subject of depression, how could
Speaker:people who are really struggling with depression make decisions and changes
Speaker:that are hard for them, but can be a like simple change that they can make?
Speaker:Well, thank you for that and that switch.
Speaker:It's important to get everybody's attention to talk mental health. So, I'm a
Speaker:big believer in small steps and daily steps.
Speaker:Mental health is a daily practice.
Speaker:People think about mental health as this
Speaker:thing, especially if you don't have it, that's elusive, it's out there.
Speaker:I've been in that space and I've been with a lot of patients in that space.
Speaker:And so it's important
Speaker:to know sometimes your mind and how you feel is not an accurate representation of
Speaker:what's going on and to really see that lens and then to focus on small things.
Speaker:Activities in daily living.
Speaker:If you're struggling with how you feel, making sure that the basics.
Speaker:If you're in bed too much, getting up and showering, and it sounds really simple,
Speaker:but you feel a little better, not all the way better.
Speaker:If you're suffering alone, you're not going to get better.
Speaker:And I don't say that to be pessimistic.
Speaker:I say that to be encouraging.
Speaker:The hardest thing to do when you're really suffering in some waysm is to reach out.
Speaker:I'd recommend people reach out to a friend who has some mental health savvy.
Speaker:Sometimes that person isn't in your circle.
Speaker:If you haven't reached out about your
Speaker:mental health and you're listening, that person usually pops into your mind, like
Speaker:somebody you respect, and just reach out to them.
Speaker:That's what I encourage everybody - because then you've got somebody that
Speaker:knows, and then you're a little accountable.
Speaker:And the nice thing is your brain is very resilient.
Speaker:You could take a multivitamin and a Metamucil and drink Gatorade
Speaker:and have a protein powder and drink Soylent, and you'd still run.
Speaker:You know, just like I could take the space shuttle and put unleaded gas in it.
Speaker:I don't know.
Speaker:We wouldn't make it out of orbit, but it'd probably still run a little bit.
Speaker:So, like I said earlier, you've got a gift with your human brain.
Speaker:What you can give back to the world is limitless, really.
Speaker:And so really providing the best fuel,
Speaker:it's not only good for you, it's good for the rest of us.
Speaker:Yeah, is there a way to adapt your palate?
Speaker:For people who are like, I
Speaker:really never grew up with the practice of eating these foods, so I don't like them.
Speaker:Are there ways to adapt your palate?
Speaker:Such a great question because it's asking
Speaker:people to have a potentially aversive experience.
Speaker:When I was a kid, I didn't like pie. Just conceptual.
Speaker:I'm not sure. I think it was like a texture thing.
Speaker:I've never tried it. I don't know.
Speaker:Fruit pie, chicken pot pie, just no pie? The whole category.
Speaker:I might need an extra session, doctor, after this one.
Speaker:Just to get into the whole - We'll put you on the schedule.
Speaker:Now, I like pies of all type, right, I didn't eat any seafood.
Speaker:So first of all, I don't care what it is.
Speaker:It takes at least 10 times.
Speaker:I do all these different weird
Speaker:activities trying to keep myself sprightly and youthful.
Speaker:And so it revolves around fun.
Speaker:I started mountain biking and horse jumping, oddly enough.
Speaker:And I'm not from that world.
Speaker:Now I'm one of those, riding around that ring.
Speaker:And what is happening takes more than 10 times.
Speaker:It takes 100 times until you're strong enough, until you're
Speaker:calm enough, until you're in touch enough with the horse, with the spirit, with the
Speaker:environment, all that stuff to really feel what's going on.
Speaker:And so, yes, it takes at least 10 times.
Speaker:And if you don't have the patience for that, you deserve that.
Speaker:You deserve that patience just for you.
Speaker:I wanted to circle back to depression
Speaker:really quickly, because it's such a timely thing.
Speaker:You know, the lockdown, the pandemic over
Speaker:the last few years has really affected a lot of people's moods and dispositions.
Speaker:And eating habits. And eating habits, right?
Speaker:And I guess I wanted to ask, how do you
Speaker:balance all the complexities of making food decisions in 2022 and beyond?
Speaker:I'm talking about, I don't have enough time!
Speaker:I live in a food desert!
Speaker:All these different complexities that play into trying to be well.
Speaker:And sometimes depression blocks your ability to see things clearly.
Speaker:So, what's a first step for someone who's in a deep depression?
Speaker:Yeah, I kinda want to combine both of those ideas, which is about how,
Speaker:especially if these are foods you're hearing you don't like, you don't like
Speaker:lentils and wild salmon, you shouldn't think that your mental health is doomed.
Speaker:We all know there's a heck of a lot of
Speaker:good, healthy, nutritious foods in between the glazed doughnut Bey ate, and
Speaker:this wild salmon mango-ceviche meal that we're dreaming up.
Speaker:We know so many people
Speaker:don't have access to treatment, people in low income countries, or not just in food
Speaker:deserts, but also mental health treatment deserts.
Speaker:I live and come from a place that had both of those.
Speaker:And so it really speaks to me, your question.
Speaker:I think the first we have to do with
Speaker:depression is make sure that people know about it.
Speaker:You are not alone.
Speaker:You can find anonymous support communities online.
Speaker:If you're in high school, you can reach out to Bring Change to Mind, which is this
Speaker:awesome anti-stigma organization that has mental health high school clubs.
Speaker:I've been working with them and with Glenn Close, who's their founder.
Speaker:Incredible. You can start following more people who
Speaker:care about mental health on your social media feeds.
Speaker:When I open up and I scroll through, I'm getting messages of affirmation.
Speaker:I'm hearing from different doctors who are like, preaching the good stuff!
Speaker:So I get a little more inspired as opposed to just negative stuff.
Speaker:I would say that in terms of food, simple things.
Speaker:One, if there are those processed foods,
Speaker:cookies, ice cream, sometimes when I'm down, those are real important.
Speaker:I have those at the end of the day. So don't hate yourself.
Speaker:Don't have guilt about those.
Speaker:I want you to focus on the wins.
Speaker:Think about simple stuff like you mentioned, cost and access.
Speaker:A couple of eggs for breakfast,
Speaker:plus a little olive oil, some salt and pepper, nice piece of whole grain toast.
Speaker:You can increase the price point or you can keep it really simple.
Speaker:Just drop in a little bit of flax, a
Speaker:little Drizel of honey, and some frozen wild berries.
Speaker:Stop. Jeez, what's going on here?
Speaker:I am hungry now.
Speaker:Well, you know, what happened, we could talk about why you are hungry.
Speaker:Your body got excited.
Speaker:You ate that doughnut, you saw it, it's fatty.
Speaker:Now, your blood sugar with a sugary
Speaker:doughnut actually isn't going to peak for another two hours.
Speaker:You're going to get shut down because...
Speaker:No offense.
Speaker:Because you have all that fat in there, so you're not really absorbing it as quickly.
Speaker:And then, people who wear the continuous glucose monitors, they post about this all
Speaker:the time, their blood sugar then spikes in a couple hours.
Speaker:So if you start feeling lik - buh bum, bum bum - heartbeat
Speaker:going up, and a little anxious and a little sweaty, that's your doughnut.
Speaker:So, the reason why that sounds good to
Speaker:you, Bay, is that we're loading you up with fiber.
Speaker:So slower burning carbs are going to keep you full.
Speaker:We're giving you lots of nutrients with those berries and more fiber with
Speaker:that flax and a little bit of a drizel of honey.
Speaker:So you get a little sweetness in your
Speaker:life, but you don't bump up the blood sugar and the insulin.
Speaker:I could do this all day!
Speaker:Thank you so much for being here. Seriously.
Speaker:Thank you so much, everybody.
Speaker:I'm up on the Gram, @Drew RamseyMD and drewramseymd.
Speaker:com. You all are great.
Speaker:Thank you so much.
Speaker:Thank you so much to Dr.
Speaker:Ramsey for coming on to the show and putting up with us.
Speaker:Hey Bey. What's up?
Speaker:Do you ever wonder whether this planet is even going to exist in 30 years?
Speaker:Mmmmm, I do.
Speaker:It can be overwhelming to think about how
Speaker:to deal with some of the biggest problems we're facing.
Speaker:Our friends over at the Franklin Institute
Speaker:talked to some of the sharpest minds working in science and technology, though.
Speaker:And I got to say, I think 2050 is going to be pretty cool.
Speaker:So check out the Road to 2050, a new docu -series from the Franklin Institute at fi.
Speaker:edu.
Speaker:Now, we are going to shift gears a little
Speaker:bit, from how our relationship with food can positively affect our mental health,
Speaker:to how the pressures of society can turn that into a negative relationship.
Speaker:We're here with Christine Byrne to explore that perspective further.
Speaker:Christine, thanks so much for joining us.
Speaker:Christine, can you introduce yourself?
Speaker:Tell us a little bit about who you are and what you do.
Speaker:Yeah, I'm Christine Byrne.
Speaker:I am a registered dietitian and a former journalist.
Speaker:I do a mix of both of those things right now.
Speaker:I became a dietitian and I still
Speaker:write a lot about nutrition for various outlets and my own website.
Speaker:But I also have an eating disorders private practice here in Raleigh.
Speaker:Wow. Awesome.
Speaker:Yeah, it sounds like you're in the thick of it.
Speaker:And, you are an anti-diet dietitian.
Speaker:So let's talk about diets.
Speaker:And where did that word start?
Speaker:Where did the idea begin?
Speaker:Can you talk more about the culture of diet?
Speaker:The definition of diet is really just what you eat on a daily basis.
Speaker:So, by definition, it's not a bad thing.
Speaker:But of course, that's not what it means culturally to us.
Speaker:Mmhmm So, I think the thing to really be aware
Speaker:of is that diets have existed for a long time.
Speaker:I can't tell you exactly when they started.
Speaker:And I mean diets in the food restriction sense, whether that's restricting
Speaker:how much you eat, or what kinds of foods you eat, or when you eat.
Speaker:That's kind of a newer thing, I think, stuff like intermittent fasting.
Speaker:But, it goes back.
Speaker:It is kind of a Puritanical ideal. So, early Americans, it was really
Speaker:food restriction and keeping your body looking a certain way was very associated
Speaker:with morality and being disciplined and having willpower.
Speaker:And that's how we sort of looked at these things.
Speaker:So we still have this big association with food and morality, I think.
Speaker:That is a through line that has lasted.
Speaker:Like, we see
Speaker:things labeled as "guilt free" or as "sinful", good foods and bad foods.
Speaker:So that's something that persisted.
Speaker:But I think, yeah, diets, as we know them,
Speaker:have definitely morphed and changed, and they still are.
Speaker:What I really appreciate about your answer, Christine, is you said diet
Speaker:is just the food that we eat in our relationship in terms of when we interact
Speaker:with it, all those different things .What's changed is the culture over time.
Speaker:So with that being said, from your perspective as both a nutritionist and a
Speaker:writer, how does the language that we use to talk about food impact our health?
Speaker:So much! It impacts it so much.
Speaker:I mean, 'cause, the way that we talk about
Speaker:things shapes the way that we think about things.
Speaker:I think maybe
Speaker:thinking of things as "guilt free" and "sinful", maybe we don't think that in our
Speaker:heads all the time, but we definitely think, "oh, I'm good for eating this.
Speaker:I'm bad for eating this.
Speaker:I should be eating this.
Speaker:I shouldn't be eating this.
Speaker:I shouldn't have eaten
Speaker:so much." We never really beat ourselves up for eating too little.
Speaker:I mean, I think, of course, there's exceptions to that rule.
Speaker:But the way that we talk about food is that a human can't be trusted to just
Speaker:eat what they want and what they feel like, it has to be this
Speaker:thing that you're constantly thinking about.
Speaker:You have to be policing yourself.
Speaker:So we've moved away
Speaker:from, I think, like dieting is not cool anymore in an official sense.
Speaker:It's not very in vogue to say, "Well, I'm
Speaker:on a diet, I'm counting calories, I'm not eating this.
Speaker:I'm not eating that." People still do it.
Speaker:But that's not really what's cool.
Speaker:It's more eating quote-unquote "good foods"
Speaker:and I'm good because I only shop at Whole Foods or I...
Speaker:Hit up the farmer's market, you know what I mean?
Speaker:Yeah, totally. That's a big part of it, too.
Speaker:And now we're getting into not just diet, but wellness culture at large.
Speaker:And there is this really , sort of, pure aura around all of it.
Speaker:If you look at a website, it's all smiles,
Speaker:and the sun is shining, and someone is on a beach eating this protein bar.
Speaker:So it's this - yeah, so much of that is marketing.
Speaker:And so I'm also curious about the
Speaker:difference between "eating disorder" and "disordered eating".
Speaker:Good question.
Speaker:Eating disorders, they have specific criteria.
Speaker:So they're designated in the DSM-5 that
Speaker:in order to have an eating disorder, technically, like that is a medical
Speaker:diagnosis, just like diabetes or heart disease.
Speaker:So you have to meet certain criteria.
Speaker:And there are different eating disorders with different criteria.
Speaker:And there are some that are a bit more catch all.
Speaker:So if you don't have anorexia
Speaker:or if you don't have bulimia, then you might have Otherwise Specified
Speaker:Feeding and Eating Disorder, which is like, okay, you have enough symptoms of
Speaker:these different disorders to have an eating disorder, but not
Speaker:perfectly fit into one of the boxes that we've set.
Speaker:Eating disorders involve disordered eating, right?
Speaker:But disordered eating is sort of the more
Speaker:zoomed out, less criteria-driven diagnostic term.
Speaker:And in terms of what is disordered eating, I think we could talk about that forever.
Speaker:Yeah.
Speaker:When you see a healthy person and an unhealthy person, are there
Speaker:conclusions that you can draw about their diet?
Speaker:Or is it - there's a ton of things pouring
Speaker:into this person's conditions at the moment.
Speaker:Or can you zero in and say, no, they need to eat an apple every morning?
Speaker:Yeah, it's a good question. And I think the first thing is, you can't
Speaker:really see, and I know you didn't mean this, but I just want
Speaker:to point it out, you can't see a healthy or unhealthy person.
Speaker:You can't tell from looking at someone what's going on with them.
Speaker:That's a really common misconception.
Speaker:And there's a lot of stigma wrapped up in
Speaker:like, if someone is in a bigger body, then they must be unhealthy.
Speaker:If someone is in a smaller body, then they must be healthy.
Speaker:And that's just not really true.
Speaker:So, I think more of what you mean is, if you're looking at someone's medical
Speaker:history and you ask them all these questions, and they have certain
Speaker:chronic diseases like diabetes or something like that, and maybe they're
Speaker:not as, quote-unquote "healthy", and I hesitate to even use that.
Speaker:No, the answer isn't just eat an apple.
Speaker:And I know you asked that sarcastically,
Speaker:but the collaborative approach is different for everyone.
Speaker:And I think at the center of it, and I
Speaker:know it's funny to hear this from a dietitian, is that you can't fix
Speaker:everything with food, and not all health problems are created by food.
Speaker:And that sounds so obvious, but
Speaker:people need to hear that more because I think we really do think
Speaker:that, oh, if I just eat a certain way and exercise, I think that's the other
Speaker:thing that people associate with health a lot.
Speaker:If I just eat a certain way and exercise, then I will never have any health problems
Speaker:or the health problems that I have will go away.
Speaker:When in reality, there's so many things that go into it.
Speaker:There's also sleep and stress.
Speaker:Those are sort of the other, more behavioral things.
Speaker:And then there's the social determinants of health.
Speaker:So, what's your income level?
Speaker:How much discrimination have you faced?
Speaker:Like racism, sexism, fat phobia, all these
Speaker:different things that actually can impact your health.
Speaker:How much access do you have to fresh food?
Speaker:Do you have time to cook, or are you
Speaker:working two jobs and taking care of two kids?
Speaker:And it's just so much harder than, well, this is a good way of eating.
Speaker:Here's what you should do, because everybody has different
Speaker:means, different schedules, different preferences.
Speaker:And a good approach to nutrition is very personalized.
Speaker:And I think we have to be careful not to make people think that there is this ideal
Speaker:way to eat, because that just makes people feel worse when they inevitably
Speaker:cannot do this perfect checklist of things.
Speaker:Since this whole season, we're doing all about mental health.
Speaker:In your experience, how does
Speaker:someone's relationship with food, what are some of the biggest impacts that you've
Speaker:seen as far as their mental health, the effects that that has?
Speaker:Oh, my goodness.
Speaker:Well, I work with both adults and
Speaker:teenagers, and I can tell you that it's very different working with the two,
Speaker:because, if I see an adult, they want to see me.
Speaker:They know that something is wrong.
Speaker:Whereas if I see a teenager, it's maybe their parents saying
Speaker:"there's a problem" and they're not so keen on addressing the issue.
Speaker:But yeah, it affects mental health in so many different ways.
Speaker:So, taking it to one end of the spectrum,
Speaker:if someone is really engaged in an eating disorder, they are not thinking clearly.
Speaker:They don't have enough food to power their brain, basically.
Speaker:Their cognition is impaired.
Speaker:That's just no way to live at all.
Speaker:I mean, that's beyond just mental health.
Speaker:That's basic functioning that can't really happen.
Speaker:Ideally, how would you like people to feel about food?
Speaker:I think I want people to not have to stress about food.
Speaker:So, there's so many mental health
Speaker:implications of disordered eating and diet culture, and
Speaker:there's so much anxiety around what to eat, and there's so much
Speaker:mental energy spent thinking about what to eat.
Speaker:So I think a good relationship with food
Speaker:is one where you're able to know what you want and how much you
Speaker:want, and it doesn't have to be perfect all the time.
Speaker:And you can listen to that, and eat based
Speaker:on that, and then just not have all these thoughts of, "Oh, I should be eating this.
Speaker:I shouldn't have done that." Feeling
Speaker:guilty about it after, thinking all day about what your next meal is.
Speaker:And a lot of people are struggling with that, of just thinking
Speaker:about food all the time and worrying about food all the time.
Speaker:You're raising your hand. Yeah.
Speaker:Nah, because I'm thinking about DoorDash and I order from there all the time.
Speaker:Every time I get it, I'm like, "Oh, this is terrible."
Speaker:Yeah.
Speaker:But it is interesting that you brought up the social determinants of health.
Speaker:Like, that is such a big...
Speaker:you don't think about the other end of that.
Speaker:You think about, Okay, the way that food
Speaker:affects our brain and stress is usually " get these away from me!
Speaker:I can't take this home, I'm going to be bad!" You don't think about, like you
Speaker:said, also the stress of when's my next fresh meal coming from?
Speaker:That's a really good point.
Speaker:I wanted to ask about, I guess, the
Speaker:relationship between the medical community and nutritionists.
Speaker:How has the medical community's
Speaker:understanding of mental health and nutrition changed over time?
Speaker:Well, I think it's so tempting to look at
Speaker:communities and populations, and that's what all of our data is.
Speaker:And I think it really depends on the individual doctor, and they are
Speaker:learning the same things about their field.
Speaker:We can't just tell people what to do.
Speaker:That doesn't work.
Speaker:There's so many things that go into what you eat, how you move.
Speaker:So I think the nutrition community, the
Speaker:mental health community, the medical community is all sort of learning together
Speaker:that we really need to listen to people, and to take into account
Speaker:all of the things that go into who they are and what their daily lives look like.
Speaker:And I think the mental health community is definitely the furthest along with that,
Speaker:because that's really core to what they do, paying attention to
Speaker:how people feel and what is getting in the way of their mental
Speaker:health and their anxiety day to day, things like that.
Speaker:And the nutrition and medical community is a bit slower
Speaker:on the uptake of that, like, well, we can't just be prescribing "do X, Y, Z and
Speaker:ABC outcome will happen" because that's not quite how it works.
Speaker:Everyone's different.
Speaker:Everyone's ability to do things is different.
Speaker:And one thing that I find very cool about
Speaker:your work is that you define yourself as a weight-inclusive dietitian.
Speaker:Can you explain to us what that means, where you get that?
Speaker:So weight-inclusive dietitian is someone...
Speaker:And a weight-inclusive anything, a weight
Speaker:-inclusive approach, a weight-inclusive physician, therapist, whatever, who
Speaker:doesn't use weight as a measure of how healthy you are or are not.
Speaker:So, I don't prescribe weight loss.
Speaker:I don't help people with weight loss.
Speaker:There's so much evidence to say that long term weight loss attempts don't work
Speaker:in most people. And now, we're starting to learn more and more
Speaker:and research more and more about how they can actually harm people.
Speaker:So it's not just weight cycling, which is like, your weight going up and then going
Speaker:down and then going up again, which happens a lot with diets.
Speaker:It's also the mental health impact and the
Speaker:increase in your risk of eating disorders and the stress you feel around food.
Speaker:And imagine if you've been on all the diets.
Speaker:So you've done Slim Fast, you've done Keto, you've done Intermittent Fasting,
Speaker:you've done Whole 30, and you have all these rules in
Speaker:your head about what you can and can't eat.
Speaker:And some of them don't even make sense together.
Speaker:It's like, Whole 30 says you can't eat
Speaker:bacon because there are nitrites, but Atkins says you can eat as much bacon as
Speaker:you want, and Slim Fast says you should be eating shakes for so many meals a day.
Speaker:So it's just like this word jumble mush
Speaker:of how you should and shouldn't eat in your head.
Speaker:So all of those things are
Speaker:negative consequences of repeated weight loss attempts.
Speaker:And the weight inclusive approach, it is very person centered and collaborative.
Speaker:So, what is your goal?
Speaker:Do you want to lower your A1C, which is a
Speaker:measure of your blood sugar that's related to diabetes?
Speaker:Do you want to lower your cholesterol?
Speaker:Do you want to lower your blood pressure?
Speaker:Do you want to - something I hear all the
Speaker:time from people is being able to walk up the stairs without getting out of breath.
Speaker:It's really about what is it
Speaker:that is bothering you and how can we address those
Speaker:things without talking about weight, without making the goal weight loss?
Speaker:What are the things that you want?
Speaker:How do you want to be healthier?
Speaker:And how can we reach those through behaviors, not just a weight goal?
Speaker:I love this. I love this.
Speaker:Thank you for this complete conversation.
Speaker:Christine Byrne, thank you so much for being here.
Speaker:Before you go, any final thoughts?
Speaker:Anything you want our listeners to walk away with?
Speaker:I hope someday we live in a world where food can just be
Speaker:food, and it can be something we enjoy but don't have to focus on all the time and
Speaker:feel like we need to police ourselves around.
Speaker:I love that. Thank you.
Speaker:I also hope that.
Speaker:Yeah, hopefully one day, right.
Speaker:Thank you for the work that you do.
Speaker:Seriously, I mean, you're killing it.
Speaker:I love that you are using these terms, like weight-inclusive and you're
Speaker:saying the anti-diet dietician, I love that.
Speaker:Thanks.
Speaker:Again, Christine, for coming on to speak with us.
Speaker:It's so interesting because the impact that language can have seems to keep
Speaker:coming up as a theme throughout all these conversations we're having this season.
Speaker:I feel like I see such a difference in language being intentional now.
Speaker:It's work.
Speaker:And it's one of those things where language evolves and grows over time.
Speaker:What a word means today isn't necessarily
Speaker:what a word means 100 years ago or even on the other side of the world.
Speaker:I mean, language is a funny thing.
Speaker:Well, be sure to tune in for next week's episode.
Speaker:We're going to be looking at grief and how
Speaker:dealing with a loss impacts our mental health.
Speaker:Loss is not something we can circumvent.
Speaker:It's not something that we can hop over.
Speaker:It's something that we really have to hold and mold and work through.
Speaker:Yeah, absolutely.
Speaker:Keep the tissues ready, but we'll keep it a little light.
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