Functional medicine to treat mental health and medical conditions

[Mrs. Healthywealth]

I sometime read threads about folks experiencing depression, anxiety, autoimmune disorders, etc. I recently was diagnosed with Hashimoto’s...had gone to my regular doctor who said that my fatigue could never go away because I had a thyroid condition. She failed to mention it was Hashimoto’s. Gratefully, I went to a DO who specializes in functional medicine. I paid about $2000 for the supplements initially, had to go on a paleo low carb diet, and  begin fasting. I ate healthy, but this lifestyle kicked my ass. Within a few weeks though, from probiotics alone, I had less anxiety, no brain fog, didn’t get hangry, and had more energy. After a few months all my labs are showing major improvements.

Since then I’ve read a shit ton of books on functional medicine, paleo/keto diets, leaky brain, leaky gut, and the gut brain connection is very real. So many mental health symptoms, anxiety, depression, PTSD, OCD, ADHD, can be addressed or managed with fewer side effects. I know cause I also referred folks with MH conditions to them and they started feeling great within weeks too. It’s just challenging to change to a paleo diet, but that alone can make a difference. If ur saving up for FIRE, it’s worth spending money on good medical care. You can look into functional psychiatrists. It’s worth a shot at least. Kelly Brogan has a website and she does functional psychiatry. My doc is amazing, not all of them are, it’s worth shopping around.

I sorta wish I could scream this out to the world. Get 2nd opinions from folks that are NDs, OD, or MD that do functional or system’s medicine. Google this and learn, please. I work in this field, and we are really trying to get doctors onboard to focus on root cause vs just bandaids on symptoms.

Can’t imagine how many folks suffer from diabetes, arthritis, IBS, MS, and so many more ailments. Wish this shit was common knowledge, I didn’t know about it till more recently.

Wonder how many of u changed to a paleo/keto lifestyle and take supplements to improve your health. Yes, therapy helps a bunch too. Not saying medication isn’t needed, but treating root cause is also important to strive for. Hoping the best for all of you!

[Anette]

Pt f

I will look into that!
I was recently diagnosed with a second auto immune disease ( have had Hashimoto for about 8 years) and started to read a bit to find out about causes.
Last week I started to eat glutenfree, carbohydrates only from fruits/veg., and trying to eat 70% waterrich.
Also started supplementing a few things since reading "Optimum Nutrition for the mind"

I am taking L-Thyroxin 75 each day (not certain what this medication is called in the US). Have you been able to get off medication?
Thanks so much for starting this thread, just what I needed!

[EscapeVelocity2020]

Also PTF.  I was diagnosed with Hashimoto / high-TSH in 2013 and didn't do much about it.  I always ate reasonably well (whole foods, mostly salads, fruits, and vegetables), exercised significantly, and maintained a healthy weight, but by 2014 my muscles were cramping and I couldn't fight it anymore.  Nowadays I am on 112 Levothyroxin and feel fantastic, weight is easier to maintain and half-marathon times are back to PR's, but I am curious to further improve my health.  Incidentally, I have a co-worker that is going the ultra-paleo route (his diet had a three letter acronym that escapes my mind).  Talk about a tough lifestyle with a family!  He spends a majority of his day shopping and preparing his meals, restaurants and vacations are a minefield.  I'm interested to hear more details on your experience and any tips to make it easier.  Is this an all-or-nothing for you also?  I am about 75% into it, but that last 25% would really require a lifestyle overhaul.  I am also turned off by all the meat paleo typically includes.

[partgypsy]

I've never done the paleo diet, and to tell the truth it's not clear how hard that kind of diet is on your kidneys long-term. For example I helped run a study with people on very low carb diet and we had to take their labs every 8 week to monitor creatinine, to make sure they were not dehydrated, etc. The positive thing about the study, is that the low carb diet worked just as well as medications in controlling blood sugar for people with out of control diabetes, with less side effects. It is such a strict diet you do need supervision to do so.

The vast majority of Americans are overly sedentary, too much screen time and eat non-optimal diets. I would suggest to anyone who wants to improve health (which I need to do myself) start with physical activity most days for 20-60 minutes a day that includes both cardiovascular and some weight bearing exercise. Be outside more, and look at screens less. Cut out fast food and greatly reduce refined sugars, substitute in instead fruit and produce, legumes.

Once you get past that, people are individual in how they respond to diets.  I would personally hate being on a paleo diet (I just don't like meat, animal products that much).  I would not say there is a one size fits all diet.

[wenchsenior]

Also PTF.  I was diagnosed with Hashimoto / high-TSH in 2013 and didn't do much about it.  I always ate reasonably well (whole foods, mostly salads, fruits, and vegetables), exercised significantly, and maintained a healthy weight, but by 2014 my muscles were cramping and I couldn't fight it anymore.  Nowadays I am on 112 Levothyroxin and feel fantastic, weight is easier to maintain and half-marathon times are back to PR's, but I am curious to further improve my health.  Incidentally, I have a co-worker that is going the ultra-paleo route (his diet had a three letter acronym that escapes my mind).  Talk about a tough lifestyle with a family!  He spends a majority of his day shopping and preparing his meals, restaurants and vacations are a minefield.  I'm interested to hear more details on your experience and any tips to make it easier.  Is this an all-or-nothing for you also?  I am about 75% into it, but that last 25% would really require a lifestyle overhaul.  I am also turned off by all the meat paleo typically includes.

Yeah, I think the amount of meat alone would make a 100% paleo almost impossible for me, though I have considered it b/c of two confirmed autoimmune conditions (they are currently minor, but of course these things can cluster so I worry about developing more serious ones).  I do try to eat higher protein/fat, lower carb/sugar in general, though.

[EvenSteven]

I know health can be a touchy subject, so first of all, I'd like to say that I'm glad you are feeling better.

I'll drop this link as something for you to consider.

https://sciencebasedmedicine.org/functional-medicine-the-ultimate-misnomer-in-the-world-of-integrative-medicine/

[Habilis]

Paleo does not equal high protein or high meat. It mostly refers to what NOT to eat, such as grains, dairy, sugar, in other words all of the stuff that was not available to paleolithic people. In practice people all over the world ate vastly different diets and were very healthy, some were 95% or more carbohydrates in the form of yams/sweet potatoes, others were very high fat/protein, but none included significant amount of calories from grains, dairy, sugar.

[EscapeVelocity2020]

Paleo does not equal high protein or high meat. It mostly refers to what NOT to eat, such as grains, dairy, sugar, in other words all of the stuff that was not available to paleolithic people. In practice people all over the world ate vastly different diets and were very healthy, some were 95% or more carbohydrates in the form of yams/sweet potatoes, others were very high fat/protein, but none included significant amount of calories from grains, dairy, sugar.

Although you are technically correct, it gets even harder to go Paleo if you don't include meat.  Maybe Impossible Foods or Beyond Meat makes this more accessible in the future, but can you offer a near term solution other than tofu?

[Lookilu]

There's a very current article on Hashimoto's and an autoimmune diet on Pub Med Central. The study group was quite small (n=16) but the results look interesting: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592837/

[Mrs. Healthywealth]

In terms of Paleo vs keto vs vegan, who gives a shit, just eat healthy. My doc works with tons of vegans. The clinic asks all patients to stop gluten, dairy, lentils, and grains for at least 30 days. Then reintroduce food to see what you respond to. If you have gas, stomach cramping, bloating, then your not digesting it well.  Gluten and dairy tend to kick your ass if you have and autoimmune disease—I have several second and third opinions on this, plus you can look at the research. I’ve had a lot of folks say paleo is too much meat. Actually,  meat intake is usually a quarter of my plate the other 2/3 is veggies.

I was totally against paleo and keto, ate “healthy”, but this changed my life once I started it. Low carb doesn’t have to be 20grams like in keto. I keep mine around 100-150g, which is a ton of carbs when you really look at it.

I agree, not one diet fits all, but these are better options. An unhealthy gut leads to a ton of bad stuff. If your in the mental health field then you probably know about all the research on depression and the gut.  It’s fascinating stuff. Work with a medical professional. My friends going to Cedar Sinai and her medical doc thinks it’s all rubbish. She went to a neurologist at UCLA, he told confirmed that gluten and dairy cause a lot of inflammation and havoc. Work with a truly integrated medical professional.

Intermittent fasting has also been a huge life changer in terms of energy. I work out 5-6 times a week in a fasted state. The doctor makes sure everything I’m taking and doing is working towards putting the Hashimoto’s into remission. Pretty sure there was some fibromyalgia in the past too.

[Mrs. Healthywealth]

As for the Hashimoto’s, Isabella Wentz has a Hashimoto’s protocol book. This was a very similar refining  my functional medicine doc put me on. Her book will walk you through the supplements and her website has a directory of where you can find a functional medicine doctor. Many (I don’t know about all) autoimmune conditions have potential of going into remission. Thyroid medication alone is complicated, it’s specific to the individual but most just get levothyroxin or synthroid. I was put on Naturethroid to boost T3, that helped too.

Here’s her website for Isabella Wentz, she focuses on thyroid: https://thyroidpharmacist.com/

Mark Hyman, Dr Perlmutter, Kelly Brogan address mental health issues and forms of treatment.

The whole reason I want to FIRE is so I can pretty much do the same job I do now, but with functional psychiatrists and doctors.

Currently, I help patients who have medical and mental health issues. Things like diet changes are soooo hard, we help with that, along with the harder stuff like people learning that they have stage 4 cancer. I’m limited in my current setting. Look forward to doing more in the future. Writing in a forum is a step.

Reiterating that it’s easier to do all this with a medical professional.

[Mrs. Healthywealth]

Paleo does not equal high protein or high meat. It mostly refers to what NOT to eat, such as grains, dairy, sugar, in other words all of the stuff that was not available to paleolithic people. In practice people all over the world ate vastly different diets and were very healthy, some were 95% or more carbohydrates in the form of yams/sweet potatoes, others were very high fat/protein, but none included significant amount of calories from grains, dairy, sugar.

Although you are technically correct, it gets even harder to go Paleo if you don't include meat.  Maybe Impossible Foods or Beyond Meat makes this more accessible in the future, but can you offer a near term solution other than tofu?

Please don’t hate me lol Impossible foods and Beyond Meat, in terms of what we are taking about, has stuff that for sure wouldn’t be paleo (due to all the chemicals/additives), and I can guarantee jacks up your gut. Tofu (waah) is also highly processed. What’s interesting is a lot of the folks who write about autoimmune disease, they have it, and were vegan—the soy, and tofu added to their inflammatory response. There are alternatives, and there is tons of info on what to eat if you’re a vegan or vegetarian, as well as what supplements are necessary. For folks with Hashimoto’s Izabella Wentz gives stats on the most reactive foods. I’m also working with someone who has helping me with the lifestyle change (I practice what I preach, so if I help others with this, I will get help as needed too). It’s been 10 months, after the first 6 months, it’s been easier. Plus, since I started the diet change a bunch of friends and family have gone to other integrative specialist and been told to make the same diet changes.

[Mrs. Healthywealth]

I know health can be a touchy subject, so first of all, I'd like to say that I'm glad you are feeling better.

I'll drop this link as something for you to consider.

https://sciencebasedmedicine.org/functional-medicine-the-ultimate-misnomer-in-the-world-of-integrative-medicine/

I actually read this guys website when I was first started the treatment. It scared the shit out of me, then realized he’s just a guy, and my lab results and how I felt were a lot more telling. When your read more, he seems a bit more questionable.  Functional medicine is looking at the whole body, not just one symptom. Also it can go by many different names, naturopathic medicine, alternative, integrative medicine, etc. Its being taught to Harvard Medical students now, as well as the residents that I work with. In the end, all it is about is eating healthy unprocessed foods and giving your body the right nutrients and support it needs. It doesn’t mean you might no longer need meds to treat schizophrenia, but that there is an additional support that might cause fewer side effects or increased  overall well being. There’s a place for both kinds of medicine, utilizing both, seems optimal.

[EvenSteven]

I know health can be a touchy subject, so first of all, I'd like to say that I'm glad you are feeling better.

I'll drop this link as something for you to consider.

https://sciencebasedmedicine.org/functional-medicine-the-ultimate-misnomer-in-the-world-of-integrative-medicine/

I actually read this guys website when I was first started the treatment. It scared the shit out of me, then realized he’s just a guy, and my lab results and how I felt were a lot more telling. When your read more, he seems a bit more questionable.  Functional medicine is looking at the whole body, not just one symptom. Also it can go by many different names, naturopathic medicine, alternative, integrative medicine, etc. Its being taught to Harvard Medical students now, as well as the residents that I work with. In the end, all it is about is eating healthy unprocessed foods and giving your body the right nutrients and support it needs. It doesn’t mean you might no longer need meds to treat schizophrenia, but that there is an additional support that might cause fewer side effects or increased  overall well being. There’s a place for both kinds of medicine, utilizing both, seems optimal.

Well like I said, I am genuinely happy you have found something that works for you. All the best with your alternative health and naturopathic remedies.

I often wish I had the moral flexibility to be a homeopath. Very lucrative.

[Mrs. Healthywealth]

I know health can be a touchy subject, so first of all, I'd like to say that I'm glad you are feeling better.

I'll drop this link as something for you to consider.

https://sciencebasedmedicine.org/functional-medicine-the-ultimate-misnomer-in-the-world-of-integrative-medicine/

I actually read this guys website when I was first started the treatment. It scared the shit out of me, then realized he’s just a guy, and my lab results and how I felt were a lot more telling. When your read more, he seems a bit more questionable.  Functional medicine is looking at the whole body, not just one symptom. Also it can go by many different names, naturopathic medicine, alternative, integrative medicine, etc. Its being taught to Harvard Medical students now, as well as the residents that I work with. In the end, all it is about is eating healthy unprocessed foods and giving your body the right nutrients and support it needs. It doesn’t mean you might no longer need meds to treat schizophrenia, but that there is an additional support that might cause fewer side effects or increased  overall well being. There’s a place for both kinds of medicine, utilizing both, seems optimal.

Well like I said, I am genuinely happy you have found something that works for you. All the best with your alternative health and naturopathic remedies.

I often wish I had the moral flexibility to be a homeopath. Very lucrative.

Ignorance is unfortunate

[EscapeVelocity2020]

Paleo does not equal high protein or high meat. It mostly refers to what NOT to eat, such as grains, dairy, sugar, in other words all of the stuff that was not available to paleolithic people. In practice people all over the world ate vastly different diets and were very healthy, some were 95% or more carbohydrates in the form of yams/sweet potatoes, others were very high fat/protein, but none included significant amount of calories from grains, dairy, sugar.

Although you are technically correct, it gets even harder to go Paleo if you don't include meat.  Maybe Impossible Foods or Beyond Meat makes this more accessible in the future, but can you offer a near term solution other than tofu?

Please don’t hate me lol Impossible foods and Beyond Meat, in terms of what we are taking about, has stuff that for sure wouldn’t be paleo (due to all the chemicals/additives), and I can guarantee jacks up your gut. Tofu (waah) is also highly processed. What’s interesting is a lot of the folks who write about autoimmune disease, they have it, and were vegan—the soy, and tofu added to their inflammatory response. There are alternatives, and there is tons of info on what to eat if you’re a vegan or vegetarian, as well as what supplements are necessary. For folks with Hashimoto’s Izabella Wentz gives stats on the most reactive foods. I’m also working with someone who has helping me with the lifestyle change (I practice what I preach, so if I help others with this, I will get help as needed too). It’s been 10 months, after the first 6 months, it’s been easier. Plus, since I started the diet change a bunch of friends and family have gone to other integrative specialist and been told to make the same diet changes.

So are you looking for customers or are you going to voluntarily share your answer to my initial questions - Are you 100% and How can you make your version of Paleo easier, because it is a lifestyle overhaul for me.

[Mrs. Healthywealth]

Paleo does not equal high protein or high meat. It mostly refers to what NOT to eat, such as grains, dairy, sugar, in other words all of the stuff that was not available to paleolithic people. In practice people all over the world ate vastly different diets and were very healthy, some were 95% or more carbohydrates in the form of yams/sweet potatoes, others were very high fat/protein, but none included significant amount of calories from grains, dairy, sugar.

Although you are technically correct, it gets even harder to go Paleo if you don't include meat.  Maybe Impossible Foods or Beyond Meat makes this more accessible in the future, but can you offer a near term solution other than tofu?

Please don’t hate me lol Impossible foods and Beyond Meat, in terms of what we are taking about, has stuff that for sure wouldn’t be paleo (due to all the chemicals/additives), and I can guarantee jacks up your gut. Tofu (waah) is also highly processed. What’s interesting is a lot of the folks who write about autoimmune disease, they have it, and were vegan—the soy, and tofu added to their inflammatory response. There are alternatives, and there is tons of info on what to eat if you’re a vegan or vegetarian, as well as what supplements are necessary. For folks with Hashimoto’s Izabella Wentz gives stats on the most reactive foods. I’m also working with someone who has helping me with the lifestyle change (I practice what I preach, so if I help others with this, I will get help as needed too). It’s been 10 months, after the first 6 months, it’s been easier. Plus, since I started the diet change a bunch of friends and family have gone to other integrative specialist and been told to make the same diet changes.

So are you looking for customers or are you going to voluntarily share your answer to my initial questions - Are you 100% and How can you make your version of Paleo easier, because it is a lifestyle overhaul for me.

Definitely not looking for customers. I share cause I actually care and maybe it will help folks like it did me, and the folks I’ve referred :). My  doc is covered by medical insurance, so it’s always possible to go that route. He started me on 100% paleo or keto my choice.  I did Paleo. After I started feeling better he asked me to try grains, lentils, gluten, and dairy, to see how I respond to them individually because he doesn’t believe in being too restrictive. So the answer, from my experience is, initially it was 100%, and it still pretty much is, except for occasional grains (white rice) and lentils once every so often. For Hashimoto’s, Izabella Wentz’s book and website is going to answer all your questions (I don’t make any money doing this or giving the resources).

In her book and website she talks about the various diet options and success rates based on a few thousand clients. I got her book from the library-Hashimoto’s Protocol. I get the supplements from amazon—mostly stuff like digestive enzymes, vitamin B, minerals, N-AcetylCysteine, and probiotics. The minute I took probiotics, my brain calmed itself—which attests to how jacked my gut was. I’ve read a bunch of other stuff, but she was the most in line with my doctor, so trusted it more. Antibodies dropped a few months after starting the protocol.

https://thyroidpharmacist.com/articles/paleo-diet-resolve-hashimotos/

[Habilis]

Paleo does not equal high protein or high meat. It mostly refers to what NOT to eat, such as grains, dairy, sugar, in other words all of the stuff that was not available to paleolithic people. In practice people all over the world ate vastly different diets and were very healthy, some were 95% or more carbohydrates in the form of yams/sweet potatoes, others were very high fat/protein, but none included significant amount of calories from grains, dairy, sugar.

Although you are technically correct, it gets even harder to go Paleo if you don't include meat.  Maybe Impossible Foods or Beyond Meat makes this more accessible in the future, but can you offer a near term solution other than tofu?

This website has an example of paleo with a majority of foods from plants: http://www.humansarenotbroken.com/mostly-plant-diet/

[Ynari]

Functional medicine is a fascinating topic - I think most doctors would agree it's a great treatment option, but are constrained by either the nature of research, systemic concerns, and patient behavior. Keto was initially "discovered" as a treatment for epilepsy. It worked better than all other treatments at the time other than starvation (which isn't... really... a treatment.) But the only patients who performed the diet successfully were children, because their parents could control what they ate. Adults were awful at it.

Add that to the complexities of nutritional research (It wasn't understood why keto controlled epilepsy, people just knew it did), and medicines were researched that did more or less the same thing, and doctors stopped prescribing the hard-to-follow diet in favor of the easy-to-follow pills. As the diet became less popular, there were fewer dietitians who knew how to help patients implement it, so it became less and less "effective". So even in cases that weren't responsive to the medications, keto was no longer as viable because there was noone to help you through it. With the sharing of information we've had recently, parents (in particular, one film-making set of parents), have "re"discovered keto and shared their experience, making it easier for individuals to follow the diet (whether for epilepsy and otherwise). These kind of lifestyle changes can't happen in a vacuum, so doctors can't make their recommendations as if you have perfect information and willpower in a world that's fighting against you. Practical medicine usually includes some amount of medications even when lifestyle changes can make a huge difference. It's good to share your experiences here because then people who have the desire/willpower for lifestyle changes, they know to seek out doctors who will help them through the process. The biggest downside here is that while many lifestyle changes are studied in some amount, it varies drastically and some people who had one diet work for them become militant about it and/or avoids all "non-functional" medicine because of a bad experience. The best thing a doctor can say, IMO, is "If it's working, it's working." Even placebo is a powerful medicinal tool that can't be ignored because "it's all in your head". It still works, doesn't it?

Diet can be such a minefield given how the rest of your life interacts. My body and brain don't always agree on what I should eat! I want to cut out red meat for personal reasons, but I have high protein/iron needs. I'd like to eat eggs and beans instead but I can only consume in limited quantities given food sensitivities. I get nauseous when stressed or anxious or sleep deprived (I have GAD, set to a hair trigger by lack of sleep) and my body refuses to consider things that aren't highly palatable foods like pasta, which means when I'm most stressed I don't really eat vegetables. My approach to a healthy lifestyle has a lot more to do with limiting stress and increasing sleep (thanks to mustachianism, I'm "half time" at 30 hours per week) which makes following any new lifestyle plan much easier.

[use2betrix]

Wow - very interesting topic here.

I just googled Hashimoto disease and believe I may have the same thing. I have had issues with enlargement of my thyroid occasionally. To the point that my MD has requested I get ultra sounds every few years (I’ve had two over the last 3-4 years). They have always came back negative for alarming growths.

Sometimes my thyroid swells to the point it is uncomfortable to turn my head and is visible in the mirror. I notice it, however the average person would never notice it.

My dad had thyroid cancer when he was young and had his thyroid removed, so it is something I certainly do not take lightly.

Thank you for this thread, it has caused me to perform additional research.

FYI - you can eat very very healthy without having to put a label on your diet. Unless someone has a medical condition, I don’t find it reasonable to avoid 100% of a certain type of food. Any diet should be composed of a reasonable ratio of protein, carbs, and fats. This can vary by person, age, and genetics. What’s most important is eating health, Whole Foods. Fruit (within reason) low fat meats, complex carbs, and vegetables, should be a good staple of most peoples diets.

[StarBright]

PTF

We are super lucky to have run into doctors who seem to take a nutrition first line when dealing with our kids. My son's neurologist suggested pre/probiotics and magnesium for my child instead of jumping straight into psych meds for anxiety. We saw enough improvement that we haven't needed to start meds.

When we also thought that we might be looking at HF Autism, I read some fascinating stuff about the mind/gut connection and the Nemechek Protocol. There never seem to be studies when it comes to integrative medicine but that anecdata on that one is impressive.

I feel like gut biomes are where it is at right now when it comes to a lot of medical fields (but particularly auto immune, mental health, and non-neurotypical specialties).

[socalteacher]

I have not read everything in this thread but thought this website would be an interesting resource. My family switched to a plant based/vegan diet 3 years ago out of desperation for a health issue for my one year old. I’m definitely a believer in diet and health. I think diet needs to be looked at for long term health. Most diets are about changing the outside appearance with little thought about the inside health.

These videos talk about the current research and are at the bottom.

https://nutritionfacts.org/topics/paleolithic-diets/

[Abe]

I've never done the paleo diet, and to tell the truth it's not clear how hard that kind of diet is on your kidneys long-term. For example I helped run a study with people on very low carb diet and we had to take their labs every 8 week to monitor creatinine, to make sure they were not dehydrated, etc. The positive thing about the study, is that the low carb diet worked just as well as medications in controlling blood sugar for people with out of control diabetes, with less side effects. It is such a strict diet you do need supervision to do so.

The vast majority of Americans are overly sedentary, too much screen time and eat non-optimal diets. I would suggest to anyone who wants to improve health (which I need to do myself) start with physical activity most days for 20-60 minutes a day that includes both cardiovascular and some weight bearing exercise. Be outside more, and look at screens less. Cut out fast food and greatly reduce refined sugars, substitute in instead fruit and produce, legumes.

Once you get past that, people are individual in how they respond to diets.  I would personally hate being on a paleo diet (I just don't like meat, animal products that much).  I would not say there is a one size fits all diet.

I agree with all of the above. I advise my patients to get more physical activity, eat a reasonable diet low in processed meat or high-sugar food (if it comes from the center of the grocery store, don't eat it). All of that has pretty good evidence behind it. Specific diets do have specialized roles for certain diseases (i.e. gluten-free for celiac disease, ketogenic for certain neurologic conditions, low sodium for heart failure), but are generally not applicable to most reasonably healthy adults. The best part is none of this costs anything and requires pretty much no special knowledge to obtain. I don't know if this makes me a functional surgeon, but <shrug> it's common sense.

[Kyle Schuant]

The vast majority of Americans are overly sedentary, too much screen time and eat non-optimal diets. I would suggest to anyone who wants to improve health (which I need to do myself) start with physical activity most days for 20-60 minutes a day that includes both cardiovascular and some weight bearing exercise. Be outside more, and look at screens less. Cut out fast food and greatly reduce refined sugars, substitute in instead fruit and produce, legumes.

Australians, too.

For reference, most Western countries have settled on something like this as exercise and food guidelines:

• 150-300' of moderate, or 75-150' vigorous endurance activity weekly. Which would be a 30-60' walk or 15-30' jog 5 days a week; as a trainer, I would suggest that if you have previous injuries and/or are over BMI 30, don't jog, just walk.
• at least 2 "muscle strengthening" sessions weekly; they're vague on the details, I like barbells, myself, but for a base of health I don't think it's desperately important which tools you use
• Daily, 3 cups vegies
• Daily, 3 pieces fruit
• Daily, 3 cups cooked grain, mostly wholegrain
• Daily, 3 serves meat, fish or eggs (100g piece, or 2 eggs is a serve, or 1 cup cooked beans)
• Daily, 3 serves dairy (cup of milk, 4/5th cup yoghurt, or 40g hard cheese is a serve), mostly reduced fat
• Daily, 3 cups water (yes, you need more, but the rest of the diet supplies it, too)
• Weekly, women at least and men not more than 3 serves red meat
• Weekly, at least 3 cups beans, and 3 serves fish
• no tobacco or booze
• no junk food, lollies, etc; of course, these contribute to your mental health even if they don't help your physical health, so in this as in other things, balance is key

There are, of course, those who wish to make it more complicated. With the decline of organised religion in the West, many people have transplanted their Saviour Narrative to nutritional or exercise gurus, and ideas of "clean" and "unclean" food, etc.

[Sibley]

The vast majority of Americans are overly sedentary, too much screen time and eat non-optimal diets. I would suggest to anyone who wants to improve health (which I need to do myself) start with physical activity most days for 20-60 minutes a day that includes both cardiovascular and some weight bearing exercise. Be outside more, and look at screens less. Cut out fast food and greatly reduce refined sugars, substitute in instead fruit and produce, legumes.

Australians, too.

For reference, most Western countries have settled on something like this as exercise and food guidelines:

• 150-300' of moderate, or 75-150' vigorous endurance activity weekly. Which would be a 30-60' walk or 15-30' jog 5 days a week; as a trainer, I would suggest that if you have previous injuries and/or are over BMI 30, don't jog, just walk.
• at least 2 "muscle strengthening" sessions weekly; they're vague on the details, I like barbells, myself, but for a base of health I don't think it's desperately important which tools you use
• Daily, 3 cups vegies
• Daily, 3 pieces fruit
• Daily, 3 cups cooked grain, mostly wholegrain
• Daily, 3 serves meat, fish or eggs (100g piece, or 2 eggs is a serve, or 1 cup cooked beans)
• Daily, 3 serves dairy (cup of milk, 4/5th cup yoghurt, or 40g hard cheese is a serve), mostly reduced fat
• Daily, 3 cups water (yes, you need more, but the rest of the diet supplies it, too)
• Weekly, women at least and men not more than 3 serves red meat
• Weekly, at least 3 cups beans, and 3 serves fish
• no tobacco or booze
• no junk food, lollies, etc; of course, these contribute to your mental health even if they don't help your physical health, so in this as in other things, balance is key

There are, of course, those who wish to make it more complicated. With the decline of organised religion in the West, many people have transplanted their Saviour Narrative to nutritional or exercise gurus, and ideas of "clean" and "unclean" food, etc.

Do you know how much weight I'd gain eating that much food?!?

[FindingFI]

Incidentally, I have a co-worker that is going the ultra-paleo route (his diet had a three letter acronym that escapes my mind).  Talk about a tough lifestyle with a family!  He spends a majority of his day shopping and preparing his meals, restaurants and vacations are a minefield.  I'm interested to hear more details on your experience and any tips to make it easier.  Is this an all-or-nothing for you also?  I am about 75% into it, but that last 25% would really require a lifestyle overhaul.  I am also turned off by all the meat paleo typically includes.

The three letter acronym is likely AIP which stand for Autoimmune Protocol.  In addition to the restrictions of the standard paleo diet (grains, dairy, some oils, processed foods, legumes, etc.), several other food groups which are thought to contribute to inflammation associated with autoimmune diseases are also removed: nuts/seeds, all nightshades (tomatoes, potatoes, eggplant and peppers), eggs, caffeine, and I'm sure there are others that I'm forgetting. As others have mentioned the protocol is to avoid everything for a full 30 days, and then trial them all one by one to see what causes symptoms.  At the end add back in anything that your body tolerated well and that's your new diet.

Having done the 30 day elimination and reintroductions, it's a process and half and really hard to stick to.  What did help me was eliminating each food item one by one to give me time to adjust to eating and cooking without that ingredient.  It took way longer than 30 days, but I started from nothing and went to AIP so it was a shock to try to eliminate everything all at once.  The biggest thing that helped me was not trying to make paleo/AIP version of meals that just weren't (pizza, mac n cheese, etc.).  Instead I stuck to a protein and 2 vegetable sides as my meal template.

Lately I have been basically not following the diet at all. I struggle with a small cheat turning into a huge cheap because I had already eaten the inflammation causing food, so I may as well enjoy whatever else I want since the damage was already done.  It's not a helpful attitude. Maybe I'll try to get back into it again.  With Crohn's and Hashimoto's it can't hurt, though neither my primary nor GI see any value in it.

[wenchsenior]

Incidentally, I have a co-worker that is going the ultra-paleo route (his diet had a three letter acronym that escapes my mind).  Talk about a tough lifestyle with a family!  He spends a majority of his day shopping and preparing his meals, restaurants and vacations are a minefield.  I'm interested to hear more details on your experience and any tips to make it easier.  Is this an all-or-nothing for you also?  I am about 75% into it, but that last 25% would really require a lifestyle overhaul.  I am also turned off by all the meat paleo typically includes.

The three letter acronym is likely AIP which stand for Autoimmune Protocol.  In addition to the restrictions of the standard paleo diet (grains, dairy, some oils, processed foods, legumes, etc.), several other food groups which are thought to contribute to inflammation associated with autoimmune diseases are also removed: nuts/seeds, all nightshades (tomatoes, potatoes, eggplant and peppers), eggs, caffeine, and I'm sure there are others that I'm forgetting. As others have mentioned the protocol is to avoid everything for a full 30 days, and then trial them all one by one to see what causes symptoms.  At the end add back in anything that your body tolerated well and that's your new diet.

Having done the 30 day elimination and reintroductions, it's a process and half and really hard to stick to.  What did help me was eliminating each food item one by one to give me time to adjust to eating and cooking without that ingredient.  It took way longer than 30 days, but I started from nothing and went to AIP so it was a shock to try to eliminate everything all at once.  The biggest thing that helped me was not trying to make paleo/AIP version of meals that just weren't (pizza, mac n cheese, etc.).  Instead I stuck to a protein and 2 vegetable sides as my meal template.

Lately I have been basically not following the diet at all. I struggle with a small cheat turning into a huge cheap because I had already eaten the inflammation causing food, so I may as well enjoy whatever else I want since the damage was already done.  It's not a helpful attitude. Maybe I'll try to get back into it again.  With Crohn's and Hashimoto's it can't hurt, though neither my primary nor GI see any value in it.

One thing I'm always curious about: How are you/people on these diets that are supposed to reduce 'inflammation' defining inflammation? And how are you tracking and measuring it?  Do you get your CRP tested every month, or are there other lab markers, or what? Or are you tracking specific autoimmune markers like ANA, etc. as a proxy for inflammatory immune responses? 

[FindingFI]

SNIP

One thing I'm always curious about: How are you/people on these diets that are supposed to reduce 'inflammation' defining inflammation? And how are you tracking and measuring it?  Do you get your CRP tested every month, or are there other lab markers, or what? Or are you tracking specific autoimmune markers like ANA, etc. as a proxy for inflammatory immune responses?

For a while I was getting CRP tested every couple months, but mainly I paid attention to some rather obvious symptoms of Crohn's.  The Hashimoto's symptoms weren't quite as straightforward to monitor for me, but I could tell when my Crohn's was acting up very easily.  I cared more about reducing symptoms than improving an objective inflammation marker. Hell, if the whole thing turned about to be a result of the placebo effect, but I felt better then it was still with doing to improve my quality of life. These days I'm eating whatever I want and the symptoms are still minimal, so who knows.

[wenchsenior]

SNIP

One thing I'm always curious about: How are you/people on these diets that are supposed to reduce 'inflammation' defining inflammation? And how are you tracking and measuring it?  Do you get your CRP tested every month, or are there other lab markers, or what? Or are you tracking specific autoimmune markers like ANA, etc. as a proxy for inflammatory immune responses?

For a while I was getting CRP tested every couple months, but mainly I paid attention to some rather obvious symptoms of Crohn's.  The Hashimoto's symptoms weren't quite as straightforward to monitor for me, but I could tell when my Crohn's was acting up very easily.  I cared more about reducing symptoms than improving an objective inflammation marker. Hell, if the whole thing turned about to be a result of the placebo effect, but I felt better then it was still with doing to improve my quality of life. These days I'm eating whatever I want and the symptoms are still minimal, so who knows.

Thanks; that clarifies the context for me.

[Mrs. Healthywealth]

SNIP

One thing I'm always curious about: How are you/people on these diets that are supposed to reduce 'inflammation' defining inflammation? And how are you tracking and measuring it?  Do you get your CRP tested every month, or are there other lab markers, or what? Or are you tracking specific autoimmune markers like ANA, etc. as a proxy for inflammatory immune responses?

For a while I was getting CRP tested every couple months, but mainly I paid attention to some rather obvious symptoms of Crohn's.  The Hashimoto's symptoms weren't quite as straightforward to monitor for me, but I could tell when my Crohn's was acting up very easily.  I cared more about reducing symptoms than improving an objective inflammation marker. Hell, if the whole thing turned about to be a result of the placebo effect, but I felt better then it was still with doing to improve my quality of life. These days I'm eating whatever I want and the symptoms are still minimal, so who knows.

I get lab tests regularly, all covered by insurance. The labs have been the most helpful in identifying what vitamins/minerals/amino acids, and whatever else I’m deficient in. Then, I add the vitamin or whatever to my daily routine. After 2-3 months everything on my labs increased or decreased in a good way. With Hashimoto’s iron deficiency is common. Adding that in, plus B vitamins, Vitamin D, etc, there was a big difference in energy and mood. I’m a science freak, but also happily ok with placebo effect. However, in this case the labs showed there was overall improvement. He also takes labs to show inflammation in body and a bazillion other things.

[Mrs. Healthywealth]

FYI - you can eat very very healthy without having to put a label on your diet. Unless someone has a medical condition, I don’t find it reasonable to avoid 100% of a certain type of food. Any diet should be composed of a reasonable ratio of protein, carbs, and fats. This can vary by person, age, and genetics. What’s most important is eating health, Whole Foods. Fruit (within reason) low fat meats, complex carbs, and vegetables, should be a good staple of most peoples diets.

Agree. I’ve just found that a lot of docs, MD, NDs, DOs have been recommending what basically is a Keto or Paleo diet, with modifications. Every one has different needs and preferences, that’s where a good knowledgable doc can help out. An elimination diet seems to be the easiest way to find out what ur allergic to, and the info my doc told me, was once my gut was healed, to reintroduce dairy, soy, gluten and lentils to see how I respond.  As someone mentioned, the Elimination Diet is hard! Eating healthy all the time is super hard...tip make healthy junk food and desserts 😊

Random—when we were in Europe I had no reaction to gluten and dairy, but coming back to the US, I noticed allergic reactions...thought it was interesting.

[Kyle Schuant]

Do you know how much weight I'd gain eating that much food?!?

No, because I don't know your current age, height, weight, health issues if any, and current diet and physical activity. But speaking generally:

• It depends on which particular foods you choose. For example, the day's 3 serves of dairy could be 600g of full-fat yoghurt which is 1,307kCal, or 600g low-fat greek yoghurt which is 480kCal, or 3 cups skim milk which is about 250kCal. So you see that following the guidelines gives a huge range of calories - and other nutrients, for that matter.
• Recall that the nutritional advice is supposed to be taken with the exercise advice - 30-60' brisk walk each day, and 2 or more weightlifting sessions a week. You'd find that uses up more energy than you imagine, especially when you start.
• These are general recommendations. If you have health issues, including being under or overweight, then you consult a dietician. Typically, absent any funky health issues like diabetes, they start you on the general recommendations and then see how you go. Most people do not gain weight on the above (diet AND exercise) unless they are currently underweight.

[Mrs. Healthywealth]

Since some folks were following because they have Hashimoto’s, wanted to provide this link.
https://universityhealthnews.com/daily/energy/a-hashimotos-diet-can-help-manage-your-autoimmune-disease/

Also, it’s been a year since I went on this journey to heal my body. It was tough in the beginning and some days I just want lots of gluten and dairy, but I can’t b/c I see changes in my labs when I do. But, the huge motivator is that I’ve never in my adult life felt this good mentally and physically. My doc added the right supplements so anything that was deficient is now optimal. It might take 2-4 yrs to get my antibodies down, but feeling this good makes the continued journey well worth it. 

For those that don’t have access to this kind of care, there is a place called Parsley Health that will do visits by video chat, but first visit you have to visit their office. They, I believe, can work with your PCP.

[John Galt incarnate!]

I sometime read threads about folks experiencing depression, anxiety, autoimmune disorders, etc. I recently was diagnosed with Hashimoto’s...had gone to my regular doctor who said that my fatigue could never go away because I had a thyroid condition. She failed to mention it was Hashimoto’s. Gratefully, I went to a DO who specializes in functional medicine. I paid about $2000 for the supplements initially, had to go on a paleo low carb diet, and  begin fasting. I ate healthy, but this lifestyle kicked my ass. Within a few weeks though, from probiotics alone, I had less anxiety, no brain fog, didn’t get hangry, and had more energy. After a few months all my labs are showing major improvements.

Since then I’ve read a shit ton of books on functional medicine, paleo/keto diets, leaky brain, leaky gut, and the gut brain connection is very real. So many mental health symptoms, anxiety, depression, PTSD, OCD, ADHD, can be addressed or managed with fewer side effects. I know cause I also referred folks with MH conditions to them and they started feeling great within weeks too. It’s just challenging to change to a paleo diet, but that alone can make a difference. If ur saving up for FIRE, it’s worth spending money on good medical care. You can look into functional psychiatrists. It’s worth a shot at least. Kelly Brogan has a website and she does functional psychiatry. My doc is amazing, not all of them are, it’s worth shopping around.

I sorta wish I could scream this out to the world. Get 2nd opinions from folks that are NDs, OD, or MD that do functional or system’s medicine. Google this and learn, please. I work in this field, and we are really trying to get doctors onboard to focus on root cause vs just bandaids on symptoms.

Can’t imagine how many folks suffer from diabetes, arthritis, IBS, MS, and so many more ailments. Wish this shit was common knowledge, I didn’t know about it till more recently.

Wonder how many of u changed to a paleo/keto lifestyle and take supplements to improve your health. Yes, therapy helps a bunch too. Not saying medication isn’t needed, but treating root cause is also important to strive for. Hoping the best for all of you!

From your reading and research do you have any insight as to the physiological effects of anger, particularly long-standing, simmering anger?

[SimpleCycle]

I’m glad you’ve found something that works for you.  In your title and OP you mention mental health conditions, but provide no evidence that these dietary approaches work for those conditions.  And in fact we have some evidence that general healthy eating helps depression, but I have never heard of evidence for specific diets.  In fact, there was a book called “Potatoes not Prozac” in the 90s that suggested high carb eating for depression.  “No sugar” is common wisdom for ADHD but it’s not borne out by the evidence.

It just seems tremendously irresponsible to me to push unproven dietary approaches as the best treatment for diseases that have good evidence for other effective treatments.  We know that a combination of medication and therapy is the best first line treatment for most mental health disorders.  If you decide you don’t want the most effective treatment for yourself that is fine, but that’s not something I’d ever promote for other people.

[SimpleCycle]

Do you know how much weight I'd gain eating that much food?!?

No, because I don't know your current age, height, weight, health issues if any, and current diet and physical activity. But speaking generally:

• It depends on which particular foods you choose. For example, the day's 3 serves of dairy could be 600g of full-fat yoghurt which is 1,307kCal, or 600g low-fat greek yoghurt which is 480kCal, or 3 cups skim milk which is about 250kCal. So you see that following the guidelines gives a huge range of calories - and other nutrients, for that matter.
• Recall that the nutritional advice is supposed to be taken with the exercise advice - 30-60' brisk walk each day, and 2 or more weightlifting sessions a week. You'd find that uses up more energy than you imagine, especially when you start.
• These are general recommendations. If you have health issues, including being under or overweight, then you consult a dietician. Typically, absent any funky health issues like diabetes, they start you on the general recommendations and then see how you go. Most people do not gain weight on the above (diet AND exercise) unless they are currently underweight.

The above listed diet is about 1600 calories, which is less than is needed for a 5 foot 100 lb woman to maintain her weight at the recommended levels of exercise.  It seems unlikely this diet would result in weight gain for most active people.

[Kyle Schuant]

You wouldn't get 1,600kCal if you chose 3 serves of full-fat yoghurt, since that's 1,307kCal on its own, let alone all the other stuff.

Overall, the guidelines I posted, depending which foods you chose, could get you anything from 1,800-2,200kCal generally, or 1,700-2,300kCal if you really tried hard. I can't see it being 1,600kCal unless you were ridiculous and all your "vegetables" was just lettuce and your fruit watermelon, etc.

I should add that most dietary guidelines allow for 0-3 "discretionary" serves, by which they usually mean junk food and booze, but which can also be foods from other groups. For example, a runner could increase their grains, a lifter their meat/fish, and so on.

In either case, the exercise guidelines would be burning some energy, too. It does indeed seem a lot of food, because in the West we're used to energy-dense food like chips and chocolate, but of course 200g of chocolate and 200g of vegetables or meat are very different things.

For example, just now I had an afternoon snack with 300g fruit (orange, nectarine and strawberry) and 200g Chobani yoghurt. The yoghurt has 115kCal, and the fruit 120kCal, or 235kCal for 500g of food.

This is about the same calories as a 51g Mars bar. It is physically easier to eat a 51g Mars bar than 50g of fruit and yoghurt, but it will have less vitamins, minerals, and fibre. So if a person's used to eating highly-processed and packaged food, it'll take them a while to get used to eating fresh food - it's just physically a larger volume.

I'm in favour of gradual changes. With the people in my gym, I usually advise something like this,

Fortnight 1 - oats for breakfast, rest of the day the same
Fortnight 2 - alternate oats and eggs & toast
Fortnight 3 - continue oats/eggs, and have 2 pieces of fruit for morning tea
Fortnight 4- oats/eggs for breakfast, 2 pieces fruit for morning tea, now add lunch with a 200g piece of meat or fish
Fortnight 5 - oats/eggs for breakfast, 2 fruit morning tea, lunch of 200g meat/fish adding 2 cups vegies or salad
Fortnight 6 - add a cup of water to each meal

I don't find I have to say anything about dinner, if they get breakfast, morning tea and lunch right, the rest falls into place. Notice I haven't excluded anything, if they want to chug down a pint of beer with their oats, that's up to them. But they tend not to; good habits force out the bad without our saying anything.

[Maenad]

I’m glad you’ve found something that works for you.  In your title and OP you mention mental health conditions, but provide no evidence that these dietary approaches work for those conditions.  And in fact we have some evidence that general healthy eating helps depression, but I have never heard of evidence for specific diets.  In fact, there was a book called “Potatoes not Prozac” in the 90s that suggested high carb eating for depression.  “No sugar” is common wisdom for ADHD but it’s not borne out by the evidence.

It just seems tremendously irresponsible to me to push unproven dietary approaches as the best treatment for diseases that have good evidence for other effective treatments.  We know that a combination of medication and therapy is the best first line treatment for most mental health disorders.  If you decide you don’t want the most effective treatment for yourself that is fine, but that’s not something I’d ever promote for other people.

+1. Anecdotes are not a substitute for clinical studies, and a lack of clinical studies is an absolute dealbreaker for me. If there are clinical studies out there, I'd be glad to see them. (As an aside for those of you not in the medical fields, "clinical study" is a technical term that has very specific methodologies and regulations around it. If studies in the US aren't performed in compliance with regs like 21 CFR part 50, they aren't actually clinical studies.)

What I've seen of FM is identical to what my primary doc already does:
1. Recommends a diet high in fruits and veggies, lean meat, legumes, etc.
2. Recommends a good amount of exercise, sleep, sunlight (especially in winter)
3. Reviews my current lifestyle, diet, and family medical history for watch-outs, improvements, etc.

Additionally, the placebo effect is real. Hell, I use this tendency in myself every winter - I take a packet of Emergen-C every day to trick myself into thinking I won't get colds as easily, and it works. As long as the side effects and cost aren't causing other problems, we can absolutely use this to our advantage.

I get prickly when people talk about how "modern medicine" is all focused on treating symptoms and not root causes. My doctors have always talked about a healthy lifestyle, first and foremost. I just had a bout of unexplained back pain, and my physical therapist worked with me to both lessen the symptoms, determine the cause, and set up a set of core strengthening exercises as a long-term preventive. I haven't been prescribed painkillers without a parallel path of PT or other treatment in... ever, and I've had the pleasure of a herniated disk.

I admit, I have a personal grudge against any and all "alternative" medicine. My cousin died of cancer in her mid-50s because she had a bad opinion of doctors and chose treatments with no data behind them, no clinical studies, just a lot of anecdotes and faith. I'm sorry, I just can't support advocates or practitioners of that.

[Mrs. Healthywealth]

I’m glad you’ve found something that works for you.  In your title and OP you mention mental health conditions, but provide no evidence that these dietary approaches work for those conditions.  And in fact we have some evidence that general healthy eating helps depression, but I have never heard of evidence for specific diets.  In fact, there was a book called “Potatoes not Prozac” in the 90s that suggested high carb eating for depression.  “No sugar” is common wisdom for ADHD but it’s not borne out by the evidence.

It just seems tremendously irresponsible to me to push unproven dietary approaches as the best treatment for diseases that have good evidence for other effective treatments.  We know that a combination of medication and therapy is the best first line treatment for most mental health disorders.  If you decide you don’t want the most effective treatment for yourself that is fine, but that’s not something I’d ever promote for other people.

+1. Anecdotes are not a substitute for clinical studies, and a lack of clinical studies is an absolute dealbreaker for me. If there are clinical studies out there, I'd be glad to see them. (As an aside for those of you not in the medical fields, "clinical study" is a technical term that has very specific methodologies and regulations around it. If studies in the US aren't performed in compliance with regs like 21 CFR part 50, they aren't actually clinical studies.)

What I've seen of FM is identical to what my primary doc already does:
1. Recommends a diet high in fruits and veggies, lean meat, legumes, etc.
2. Recommends a good amount of exercise, sleep, sunlight (especially in winter)
3. Reviews my current lifestyle, diet, and family medical history for watch-outs, improvements, etc.

Additionally, the placebo effect is real. Hell, I use this tendency in myself every winter - I take a packet of Emergen-C every day to trick myself into thinking I won't get colds as easily, and it works. As long as the side effects and cost aren't causing other problems, we can absolutely use this to our advantage.

I get prickly when people talk about how "modern medicine" is all focused on treating symptoms and not root causes. My doctors have always talked about a healthy lifestyle, first and foremost. I just had a bout of unexplained back pain, and my physical therapist worked with me to both lessen the symptoms, determine the cause, and set up a set of core strengthening exercises as a long-term preventive. I haven't been prescribed painkillers without a parallel path of PT or other treatment in... ever, and I've had the pleasure of a herniated disk.

I admit, I have a personal grudge against any and all "alternative" medicine. My cousin died of cancer in her mid-50s because she had a bad opinion of doctors and chose treatments with no data behind them, no clinical studies, just a lot of anecdotes and faith. I'm sorry, I just can't support advocates or practitioners of that.

Very sorry to hear about your cousin. Don’t know the details of the situation, and usually only the individual has all the details of the recommended treatment, so it’s hard to say what “alternative” Tx it was.. Functional medicine is not far fetched, it just investigates more details. Many more informed medical docs do this as well, it just tends to be more common place in FM. For instance, went to a few docs at the top hospitals in the state, and they are on board with this sorta stuff-B12, Omega 3s, looking at iron, etc to address both health and mood.

It’s seriously fascinating, if you care to read about it. My coworker had thyroid cancer and went to an alternative medicine, and it went away. Depends on the treatment, your age, the doctor, etc.

[Mrs. Healthywealth]

I've never done the paleo diet, and to tell the truth it's not clear how hard that kind of diet is on your kidneys long-term. For example I helped run a study with people on very low carb diet and we had to take their labs every 8 week to monitor creatinine, to make sure they were not dehydrated, etc. The positive thing about the study, is that the low carb diet worked just as well as medications in controlling blood sugar for people with out of control diabetes, with less side effects. It is such a strict diet you do need supervision to do so.

The vast majority of Americans are overly sedentary, too much screen time and eat non-optimal diets. I would suggest to anyone who wants to improve health (which I need to do myself) start with physical activity most days for 20-60 minutes a day that includes both cardiovascular and some weight bearing exercise. Be outside more, and look at screens less. Cut out fast food and greatly reduce refined sugars, substitute in instead fruit and produce, legumes.

Once you get past that, people are individual in how they respond to diets.  I would personally hate being on a paleo diet (I just don't like meat, animal products that much).  I would not say there is a one size fits all diet.

I agree with all of the above. I advise my patients to get more physical activity, eat a reasonable diet low in processed meat or high-sugar food (if it comes from the center of the grocery store, don't eat it). All of that has pretty good evidence behind it. Specific diets do have specialized roles for certain diseases (i.e. gluten-free for celiac disease, ketogenic for certain neurologic conditions, low sodium for heart failure), but are generally not applicable to most reasonably healthy adults. The best part is none of this costs anything and requires pretty much no special knowledge to obtain. I don't know if this makes me a functional surgeon, but <shrug> it's common sense.

Haha, it makes you a surgeon who is a blessing for his patients.

Btw-folks tend to assume Paleo means a lot of meat, it doesn’t. Its just eating real food. I call it Paleo cause it’s easier to describe, but most folks don’t seem to know the details of it...my mistake on that.

Another major issue, is getting our patients to eat healthier, is a huge problem. It doesn’t help the mood component. It’s not the only thing by far, but a piece.

[Mrs. Healthywealth]

I’m glad you’ve found something that works for you.  In your title and OP you mention mental health conditions, but provide no evidence that these dietary approaches work for those conditions.  And in fact we have some evidence that general healthy eating helps depression, but I have never heard of evidence for specific diets.  In fact, there was a book called “Potatoes not Prozac” in the 90s that suggested high carb eating for depression.  “No sugar” is common wisdom for ADHD but it’s not borne out by the evidence.

It just seems tremendously irresponsible to me to push unproven dietary approaches as the best treatment for diseases that have good evidence for other effective treatments.  We know that a combination of medication and therapy is the best first line treatment for most mental health disorders.  If you decide you don’t want the most effective treatment for yourself that is fine, but that’s not something I’d ever promote for other people.

If folks are interested they can research for themselves like I did. There’s a ton of info. Meds and therapy are helpful, and there is a place for them for some people.  Diet, exercise, life style changes can help—therapy can help with addressing that.

Food actually has a huge impact on mood—that I’ll let you read—you can get CEUs for it if your a practitioner. Any practitioner in the mental health field is learning about the gut brain connection. If you work in the field, you will come across doctors who don’t give a fuck, so our goal is to empower the client on helping themselves, food is one component amongst many. Food in itself, along with exercise/meditation, etc, can make a tremendous impact. Guess what, mild to moderate depression/anxiety don’t need them if they addressed diet/exercise. 

This is a lengthy convo, one that I’ll actually be presenting, because I’m sorta being forced, to mental health practitioners and doctors. I bet if we talked about it, you would get what I’m talking about, it’s just a lot to type out. It’s about overall well being.

[fixie]

Considering Homo sapiens wasn't even around during the paleolithic era I find it curious why  modern humans would adopt a diet they think our ancestors ate.  They most certainly DID eat wild grains and pulses, natural sugars, carbohydrates, leaves, fruits etc.  Their diet was probably also full of foods we can no longer process.  They ate in season, they gathered wild foods and they were opportunists, no doubt.  Their diet was extremely varied. 

They also probably lived only 30 years or so.

IMO, the modern conception of how much meat they ate is overblown, also how much they actively hunted.  Natural abundance during prehistory is impossible to perceive, as we have lost so many species/food sources.
Not saying this is suggested here, but anyone eating only meat(which I DO hear suggested at times) will die a horrible death.  I invite you to read of the voyage/stranding of the Karluk in the Arctic to see how well that went.

Allopathic medicine is the reason most of us are alive today.  We all know what a healthy diet consists of, so just stick to some simple rules that work for you.
-fixie

[JGS1980]

Great Post Fixie!

"Allopathic medicine is the reason most of us are alive today.  We all know what a healthy diet consists of, so just stick to some simple rules that work for you."

This is the truth. Remember this, folks, and respect it!

Modern Allopathic Medicine (also known as Western Medicine) has been wildly successful over the last couple centuries. Life expectancy went from 40 years to 80 years.  We now routinely cure previously incurable diseases. Unfortunately, the modern American diet is at odds with long term good health.

Ironically, after starvation being the hardest thing to avoid over the last 10000 years, modern industrial food production has led to overfeeding (with cards, sugars, nitrates, various additives) to be our current scourge.

Oh well, at least we can avoid dying from Malaria, Cholera, Childhood Leukemia, Tertiary Syphilis, and Polio.

[sui generis]

Considering Homo sapiens wasn't even around during the paleolithic era I find it curious why  modern humans would adopt a diet they think our ancestors ate. 

Well...modern H. sapiens definitely lived during the last couple hundred thousand years of the paleolithic. Modern humans were around for quite a while before the move to agriculture.  Nevertheless, your point that we only know so much about the diet of paleolithic H. sapiens as well as other hominids that might be a good model is well-taken.

I also agree that people should not so easily dismiss the amazing progress in medicine in the last couple hundred years.  And also we know some doctors have difficulty having conversations with their patients about healthy diet and lifestyle and might lean too heavily on the easier conversation of handing out a pill.  And for sure, there are many patients (sorry for the anecdata, but my dad was definitely one) who fully believe in magic pills as the answer to everything and used it as a way sometimes to avoid making healthy lifestyle changes.  As long as my dad was taking his medicine religiously, he was home free, right?! 

There are no magic bullets for complicated health issues we deal with a lot more in this modern age.  But being open to learning about different approaches (not to the exclusion of standard protocols) always seems worth one's time.

[fixie]

Considering Homo sapiens wasn't even around during the paleolithic era I find it curious why  modern humans would adopt a diet they think our ancestors ate. 

Well...modern H. sapiens definitely lived during the last couple hundred thousand years of the paleolithic. Modern humans were around for quite a while before the move to agriculture.  Nevertheless, your point that we only know so much about the diet of paleolithic H. sapiens as well as other hominids that might be a good model is well-taken.

I also agree that people should not so easily dismiss the amazing progress in medicine in the last couple hundred years.  And also we know some doctors have difficulty having conversations with their patients about healthy diet and lifestyle and might lean too heavily on the easier conversation of handing out a pill.  And for sure, there are many patients (sorry for the anecdata, but my dad was definitely one) who fully believe in magic pills as the answer to everything and used it as a way sometimes to avoid making healthy lifestyle changes.  As long as my dad was taking his medicine religiously, he was home free, right?! 

There are no magic bullets for complicated health issues we deal with a lot more in this modern age.  But being open to learning about different approaches (not to the exclusion of standard protocols) always seems worth one's time.

Well taken friend.  You're right of course...I made sort of an artificial distinction there with paleolithic humans and modern humans.  You COULD probably pluck a paleo human out of her time and put her in the present and never know the difference. 

-fixie

[Dr. Pepper]

I’m glad you’ve found something that works for you.  In your title and OP you mention mental health conditions, but provide no evidence that these dietary approaches work for those conditions.  And in fact we have some evidence that general healthy eating helps depression, but I have never heard of evidence for specific diets.  In fact, there was a book called “Potatoes not Prozac” in the 90s that suggested high carb eating for depression.  “No sugar” is common wisdom for ADHD but it’s not borne out by the evidence.

It just seems tremendously irresponsible to me to push unproven dietary approaches as the best treatment for diseases that have good evidence for other effective treatments.  We know that a combination of medication and therapy is the best first line treatment for most mental health disorders.  If you decide you don’t want the most effective treatment for yourself that is fine, but that’s not something I’d ever promote for other people.

+1. Anecdotes are not a substitute for clinical studies, and a lack of clinical studies is an absolute dealbreaker for me. If there are clinical studies out there, I'd be glad to see them. (As an aside for those of you not in the medical fields, "clinical study" is a technical term that has very specific methodologies and regulations around it. If studies in the US aren't performed in compliance with regs like 21 CFR part 50, they aren't actually clinical studies.)

What I've seen of FM is identical to what my primary doc already does:
1. Recommends a diet high in fruits and veggies, lean meat, legumes, etc.
2. Recommends a good amount of exercise, sleep, sunlight (especially in winter)
3. Reviews my current lifestyle, diet, and family medical history for watch-outs, improvements, etc.

Additionally, the placebo effect is real. Hell, I use this tendency in myself every winter - I take a packet of Emergen-C every day to trick myself into thinking I won't get colds as easily, and it works. As long as the side effects and cost aren't causing other problems, we can absolutely use this to our advantage.

I get prickly when people talk about how "modern medicine" is all focused on treating symptoms and not root causes. My doctors have always talked about a healthy lifestyle, first and foremost. I just had a bout of unexplained back pain, and my physical therapist worked with me to both lessen the symptoms, determine the cause, and set up a set of core strengthening exercises as a long-term preventive. I haven't been prescribed painkillers without a parallel path of PT or other treatment in... ever, and I've had the pleasure of a herniated disk.

I admit, I have a personal grudge against any and all "alternative" medicine. My cousin died of cancer in her mid-50s because she had a bad opinion of doctors and chose treatments with no data behind them, no clinical studies, just a lot of anecdotes and faith. I'm sorry, I just can't support advocates or practitioners of that.

Very sorry to hear about your cousin. Don’t know the details of the situation, and usually only the individual has all the details of the recommended treatment, so it’s hard to say what “alternative” Tx it was.. Functional medicine is not far fetched, it just investigates more details. Many more informed medical docs do this as well, it just tends to be more common place in FM. For instance, went to a few docs at the top hospitals in the state, and they are on board with this sorta stuff-B12, Omega 3s, looking at iron, etc to address both health and mood.

It’s seriously fascinating, if you care to read about it. My coworker had thyroid cancer and went to an alternative medicine, and it went away. Depends on the treatment, your age, the doctor, etc.

I had a patient with esophageal adenocarcinoma who refused conventional therapy, demanded I place a PEG tube for him, because he could no longer swallow or even manage his own secretions and had collapsed at home. I restaged him and offered him consultation with the appropriate surgeon, since at the time he was still a candidate for resection. He refused, of course which was his right. I placed the PEG and he went back to continue his mistletoe infusions. I later looked up the practice that was doing that to him, and guess what they had him listed as a success story on the website, not by name of course, but I couldn't imagine they had a bunch of people with his condition in their practice. If he is a success I would hate to see a failure. A little more digging showed the practice had been sued by multiple patients for extracting teeth and fillings saying they were being poisoned by mercury. I could go on, but the whole experience left a very bad impression for me. It seemed at the time that these alternative providers were preying on the ill informed, scared, very sick patients, who will believe anyone who tells them there is a potential for cure, no matter how insane it seems.

[Anette]

I’m glad you’ve found something that works for you.  In your title and OP you mention mental health conditions, but provide no evidence that these dietary approaches work for those conditions.  And in fact we have some evidence that general healthy eating helps depression, but I have never heard of evidence for specific diets.  In fact, there was a book called “Potatoes not Prozac” in the 90s that suggested high carb eating for depression.  “No sugar” is common wisdom for ADHD but it’s not borne out by the evidence.

It just seems tremendously irresponsible to me to push unproven dietary approaches as the best treatment for diseases that have good evidence for other effective treatments.  We know that a combination of medication and therapy is the best first line treatment for most mental health disorders.  If you decide you don’t want the most effective treatment for yourself that is fine, but that’s not something I’d ever promote for other people.

+1. Anecdotes are not a substitute for clinical studies, and a lack of clinical studies is an absolute dealbreaker for me. If there are clinical studies out there, I'd be glad to see them. (As an aside for those of you not in the medical fields, "clinical study" is a technical term that has very specific methodologies and regulations around it. If studies in the US aren't performed in compliance with regs like 21 CFR part 50, they aren't actually clinical studies.)

What I've seen of FM is identical to what my primary doc already does:
1. Recommends a diet high in fruits and veggies, lean meat, legumes, etc.
2. Recommends a good amount of exercise, sleep, sunlight (especially in winter)
3. Reviews my current lifestyle, diet, and family medical history for watch-outs, improvements, etc.

Additionally, the placebo effect is real. Hell, I use this tendency in myself every winter - I take a packet of Emergen-C every day to trick myself into thinking I won't get colds as easily, and it works. As long as the side effects and cost aren't causing other problems, we can absolutely use this to our advantage.

I get prickly when people talk about how "modern medicine" is all focused on treating symptoms and not root causes. My doctors have always talked about a healthy lifestyle, first and foremost. I just had a bout of unexplained back pain, and my physical therapist worked with me to both lessen the symptoms, determine the cause, and set up a set of core strengthening exercises as a long-term preventive. I haven't been prescribed painkillers without a parallel path of PT or other treatment in... ever, and I've had the pleasure of a herniated disk.

I admit, I have a personal grudge against any and all "alternative" medicine. My cousin died of cancer in her mid-50s because she had a bad opinion of doctors and chose treatments with no data behind them, no clinical studies, just a lot of anecdotes and faith. I'm sorry, I just can't support advocates or practitioners of that.
[/
I am sorry you löst your Cousin to Cancer but have to say we don't have evidence that your cousin would have survived with conventional treatment. I am not saying that to be mean, as a nurse I have seen many patients die of complications from the conventional treatments. I am glad every patient has agency to research and decide what they want to do/have done. Obviously it is often hard for their family to live with these choices. And obviously a lot of people undergo treatment to please their family.

Anyway, on the mental health I wish it was as easy as described above. I have two daughters with mental health issues. Therapy is offered but the psychiatrist ... are very quick to explain to the parents why therapy doesn't work: The patient has to want to work with them...
The next thing is a prescription of drugs which in most cases don't solve problems but have tons of side effects.
So basically nothing new developer in the mental health industry, they haven't been able to find a way to motivate patients for chemotherapy but the whole industry is making tons of money.
There are books out there which give great information like " Optimum nutrition for the mind" which mostly consist of information on recent research.
Studies? Hard to get done without money which often is provided by the pharmaceutical industry when you are not trying to sell a drug.
Conventional medicine has its place in treatment but is way to limited in my opinion. In the book " The Emperor of all Maladies. A Biography of Cancer" you can read how processes in medics work. Mainly very slow and it is very hard to convince the medical community of new, even proven ways, just look at the story of lung cancer and the role the medical community played for sadly a very long time in denying any connection with smoking.

As I mentioned above, I have Hashimotos. When I was diagnosed the Professor ( Endocrinologist) I went to see prescribed LThyroxin said take one in the morning on an empty stomach and come in for yearly check up. That was all
Years later I now have a second autoimmune disease and realised I better start searching for the cause of these diseases as now I have a prescription of cortison as well and that is just to suppress but not to treat my condition.
Thanks again for starting this thread, it has been really helpful to me.

[SimpleCycle]

I’m glad you’ve found something that works for you.  In your title and OP you mention mental health conditions, but provide no evidence that these dietary approaches work for those conditions.  And in fact we have some evidence that general healthy eating helps depression, but I have never heard of evidence for specific diets.  In fact, there was a book called “Potatoes not Prozac” in the 90s that suggested high carb eating for depression.  “No sugar” is common wisdom for ADHD but it’s not borne out by the evidence.

It just seems tremendously irresponsible to me to push unproven dietary approaches as the best treatment for diseases that have good evidence for other effective treatments.  We know that a combination of medication and therapy is the best first line treatment for most mental health disorders.  If you decide you don’t want the most effective treatment for yourself that is fine, but that’s not something I’d ever promote for other people.

If folks are interested they can research for themselves like I did. There’s a ton of info. Meds and therapy are helpful, and there is a place for them for some people.  Diet, exercise, life style changes can help—therapy can help with addressing that.

Food actually has a huge impact on mood—that I’ll let you read—you can get CEUs for it if your a practitioner. Any practitioner in the mental health field is learning about the gut brain connection. If you work in the field, you will come across doctors who don’t give a fuck, so our goal is to empower the client on helping themselves, food is one component amongst many. Food in itself, along with exercise/meditation, etc, can make a tremendous impact. Guess what, mild to moderate depression/anxiety don’t need them if they addressed diet/exercise. 

This is a lengthy convo, one that I’ll actually be presenting, because I’m sorta being forced, to mental health practitioners and doctors. I bet if we talked about it, you would get what I’m talking about, it’s just a lot to type out. It’s about overall well being.

Actually, the evidence is far from conclusive on exercise as a treatment for depression, especially when you limit to a clinical diagnosis of major depressive disorder.

https://www.cochrane.org/CD004366/DEPRESSN_exercise-for-depression
https://bmjopen.bmj.com/content/7/9/e014820

And exercise for depression has had a lot of randomized controlled trials!  This is not an area where you can say big pharma is suppressing the evidence.  The big problem here is selection and bias in the trials we have.  Also, almost all of these exercise trials are referring people to structured exercise programs, not telling patients to "go home and exercise", and there's a big difference between those two treatments.

Which isn't to say depressed people shouldn't exercise.  Exercise is probably the single biggest thing you can do for your health overall, and there is evidence that if you can manage to exercise, you'll have reduced depressive symptomology.  The problem is that it's very hard to differentiate people who are able to exercise because they are less depressed from people who are less depressed because they exercise.

Dietary interventions are a whole other ball of wax - there's mixed evidence in depression, and no one can agree on what diet is the one we should be testing.  The best evidence we have is from a single trial of a Mediterranean diet, but again, it was not "go home and eat this diet", it was 7 sessions with a nutritionist and the subsequent changes in diet that resulted.  It seems like generally eating less junk and more whole foods has a positive effect on mood, which again, follows the common dietary advice provided by both traditional Western medicine and functional medicine.

For the most part there's no harm in functional medicine, but I choose to spend my money and time on things that have good evidence behind them, when such evidence is available.  So I exercise and I eat a balanced diet (but not paleo - it's going to take a lot to convince me that whole grains and legumes are the culprit behind my health problems), but I also take levothyroxine and psychiatric medications.  And I don't take supplements, even vitamin D, because the evidence is just not there.  And I do a lot of mindfulness and meditation, even if the Cochrane review says we need more high quality studies, because they work for me and make me feel good.

In the end, you are an N of 1, and it's your responsibility to do what is best for your health.  So of course you shouldn't just pop an antidepressant and call it a day, but you also shouldn't hold out hope that you can treat your clinical depression with diet and exercise alone when there's a good chance that won't be enough.