Speaker 2
a great story and I know we'll unpack it a little bit later and I find it great that you didn't have any background in it at all and there's some of the keys to life as well you know what they say ignorance is bliss but sometimes you find yourself in situations that work out for the best we can always go back and connect the dots but it's very hard to look for and connect the dots in the future so congratulations with all the work you've done through there. Can you touch on a little bit about your early work how you came into linking a nutrition with mental health as well? Yeah
Speaker 1
so when I was doing my psychology undergrad I ended up through a funny set of circumstances doing work experience if you like with a newly set up research group in the area that I live in and led by a very well-known and fabulous psychiatry researcher and so I came into research I was still in my undergrad and I'm looking around and I'm reading and starting to read papers and things and I'm thinking this is really interesting there's no no real data or certainly no good quality data on the possible role of diet and nutrition in mental and brain health and I remember as an undergrad going to a seminal lecture by a wonderful researcher Izzy who later died unfortunately but he talked about the framework for understanding mental disorders and all these different aspects to them and one of them was how we were starting to understand that the immune system was really important in our mental and brain health and not just our body and then of course our stress response system and then things like not just neurotransmitters but this new understanding that there were parts of the brain that actually grow new neurons throughout life and that these are involved in mental health as well as learning and memory and as I listened I realized that pretty much all of the aspects of what we were starting to understand contributed to mental disorders were affected by diet so there was new information and research coming out of the US in animals showing that if you manipulated diet you would really have an impact on this key area of the brain the hippocampus that is so key in learning and memory but also mental and brain health and this field that I mentioned psychoneuro immunology this understanding that there's this bi-directional very close relationship between our immune system and our mental and brain health and of course diet is really important in our immune system and then of course there's an aspect of neurotransmitters being produced by tryptophan in the gartan there were a lot of different strands where I could see that diet was related to these mechanisms these factors in the body but had never really been investigated as possible contributory pathways to mental disorders and of course this is before we understood about the gut and the microbiter that live in the gut and how that kind of ties all those things together so I set out with my PhD study I proposed to look at diet and the whole of diet quality and how it related to clinical depressive and anxiety disorders in this large very well characterized study of women that was very representative of the Australian population so women right from age 20 up into their 90s and everyone thought I was a bit bonkers because it really just hadn't really been looked at but that's what I did for my PhD and it ended up being a very influential study was published on the front cover of the American Journal of Psychiatry it had a big impact it was one of those things of being in the right place at the right time with the right idea and I think being old enough because it was my second career to look the naysayers in the eye and say no there's a good reason for looking at this we're going to do it in a very rigorous scientific way to really evaluate this hypothesis that what we eat is related to our mental health yeah
Speaker 2
thanks for sharing it's such an amazing story one of the things you talk about is the similarities you had doing the research with women similar characteristics from the same town same diet same things and they all had sort of one thing different what was those differences in the finding that you
Speaker 1
came up with what we found I think really was concordant with the hypothesis which is that the quality of women's diets was related to whether or not they had a clinical major depressive disorder or an anxiety disorder of some sort and really importantly what I did was take into account all these other factors that could explain that link for example their level of education income very importantly their body weight people imagine that the quality of our diets is related to mental health by a body weight that doesn't seem to be the case and later on when we did the intervention study the smile study we also found that by improving diet we could have a major impact on people's major depressive disorder without them changing their body weight at all so that was really an important finding that this was this link wasn't being explained by other factors such as where people lived their income education etc other sorts of health behaviors like the cigarette smoking or physical activity and so then we looked at particular components of diet as well and one of the most interesting findings to me because I was brought up as a vegetarian and I've lived my life mainly as a vegetarian was that there was a really clear u-shaped relationship between the amount of red meat so this is beef and lamb that women were eating and whether or not they had a mental disorder we took out the 20 or so women who were vegetarian so we were just looking at this more than a thousand women those who had less than the dietary guidelines those who were eating roughly the dietary guidelines which is a three to four palm sized servings of red meat a week and those that were eating more than the dietary guidelines and then we took into account their overall diet quality because of course there could be lots of meat but also lots of veggies and beans or lots of meat and lots of fries and everything else and what we saw was this very clear u-shaped relationship so women who having less than the recommended intake or more than the recommended intake were twice as likely to have of these clinical depressive or anxiety disorders now of course that doesn't prove that red meat actually has a causal role in mental disorders to show that you would need to do a randomized control trial and that's very difficult because you'd have to randomly assign women to either eat meat or not eat meat or eat different amounts of meat for a long period of time and see whether they developed a mental disorder so for obvious reasons that would be a very difficult study to do but it is interesting how striking it was across all of the disorders major depressive disorder bipolar disorder anxiety disorders now remember this is in women so it may if it is a causal relationship when we don't know that for sure but it may be to do with menstruation particular needs of women so what was an interesting finding that was not concord with my hypothesis and in science that's always the most interesting thing when you see something that doesn't fit and you go oh that's interesting yeah that's really
Speaker 2
important for people like yourself doing decades of research in long-term studies and not jumping to conclusions but seeing results that come out of the box from that as well jumping into brain changer when did the book come out and what was the motivation
Speaker 1
to writing so it was published in 2019 and I wrote it in a pretty short time frame I just took myself off and worked 10 hours a day over a period of about five weeks to just smash it out because I wanted people to have evidence-based information what I see out in the internet and it's only gotten worse is a huge amount of misinformation particularly promoted by American influences and things like this because I'm a scientist and I really pride myself on very rigorous science and because I've done many studies so it's not just that first study in adult women was very influential but then I went on to show that early life diet so what women eat during pregnancy what kids eat in the first few years of life is related to children's mental health and that's now been shown in many other studies as well that adolescents mental health which is often when people develop a mental disorder for the first time that was very clearly linked to their mental health and we ruled out reverse causality as being caused here so people eating differently because they have a mental disorder and then of course I went on to do the smiles trial which was the first randomized control trial to show that you could take people with moderate to even very severe major depressive disorder helped them to improve their diet and that had a major impact on their mental disorder so I wanted people to have the evidence to know what we knew and what we didn't know and to say where there wasn't enough evidence to be sure or where we didn't know whether this was a causal relationship or it was really about educating people in a way that was very accessible about science how you do science to show something or to disprove something but also to talk about how this came into being and the whole field because I've led all of those seminal landmark studies and then set up the society etc. I'm in a very good position because I have an overview of the whole field and so I was able to describe all the different studies and what it might mean for people and give them information that they could take into their own lives to make changes and I've had emails from people all over the world talking about what a difference it's made when we'll change their diet but it achieved its aim for me in that regard. Yeah
Speaker 2
congratulations on the book and we'll deep dive into some of the chapters soon talk to me a little bit about the food and mood center when did that start and what's your role in the food and mood
Speaker 1
center. So 2017 which was when the smiles trial was published it was I was just working on two fantastic PhD students and again because of science communication and the need and the desire to have evidence-based information out where people could access it. I wanted to set up a website that had links and resources and maybe some blog posts and somewhere where people could go to actually get information that wasn't coming from an influencer with some supplement to sell or some diet book to sell and so I went to set up a website and I was working with the communications team at my university Deakin University and I was going to call something like Center for Nutritional Psychiatry and they said oh don't be silly no one's got to look at that. We call it the food and mood center and went sure so we set that up and of course then that started to really attract teachers and students and so the food and mood center has grown incredibly quickly between 2017 and now COVID notwithstanding I've also had breast cancer twice so there's been some interruptions but we're now I think by the end of this year will probably be about 60 pictures and staff students all working on nutritional psychiatry where the only center in the world doing this we're really leading in the world we've got a very high international profile our work has been cited in more than 80 very high-level policy documents around the world I'm working with the world economic our work has influenced clinical guidelines in psychiatry so in Australia the Royal Australian New Zealand College of Psychiatry clinical guidelines so they're guidelines for clinicians and psychiatrists around how to treat mood disorders so depressive and bipolar disorder they now have what is essentially lifestyle medicine as the foundation so diet movement exercise smoking cessation sleep is really the foundations and they call it the foundations and they say this is non-negotiable you have to address this before you go on to do anything else with these patients not instead of but as the foundation like you got to get that right because everything else will then work but of course this is huge education gap because doctors and psychiatrists they generally get about two hours of nutrition research in all the years of training and they know as much as your hairdresser most of the time about nutrition that doesn't stop them of course going on the internet and writing books and saying all sorts of things that don't necessarily have an evidence base but so one of the things we're doing at the Food and Mood Centre that's very important is a lot of education and training so we've done a free online course on food and mood which is now one of the most popular in the world it's enrolled nearly 80,000 students from more than 180 countries we've got now accredited training for physicians that was developed with the college so we're really trying to address that knowledge gap and make sure that physicians have the information the evidence-based information to put it into practice with their patients and so people know what we know as scientists about what you shouldn't eat for good mental and brain health.