Courtney Snyder, MD
We’re not necessarily the same animal we once were. And, in many respects, especially when it comes to food, we’re increasingly different from one another. Describing a particular food (or nutrient) as “good” for you, depends on who “you” are. Due to our varied experiences, exposures (ie. to antibiotics, toxins, etc.) and genetics, we’re not all the same. The latest superfood may benefit some, but it may make others ill. Our complicated relationship with food can’t be discussed without considering inflammation, oxidative stress and epigenetics - the three exploding areas of medical research.
The Microbiome, Inflammation & Food:
Inflammation is what happens when our bodies mount a protective response against an invader or trauma - ie. like when you get an infection or cut your finger. It’s all good, unless of course the immune system starts attacking things that aren’t necessarily dangerous. The result is damage to the body and brain, which we think of as autoimmunity.
You can’t consider this type of inflammation without considering the microbiome - the trillions of microbes, viruses and fungi that live in and on us. When the microbiome is thrown out of balance (i.e. by antibiotics, stress, diets high in sugar and carbohydrates) inflammation ensues. Without a diversity of beneficial microbes lining our gastrointestinal tract, it can become porous or “leaky” and allow into our bodies food particles the immune system doesn’t recognize. The result is an inflammatory response that can persists and lead to chronic health problems.
The part of the body hit the hardest is usually impacted by our genetic (and epigenetic) vulnerabilities. For you it might be the joints (rheumatoid arthritis), for me maybe the protective covering on the nerves (multiple sclerosis), for someone else the lining of the gastrointestinal tract (Crohn's or ulcerative colitis). Though rheumatologists, neurologists and gastroenterologists address these separately, many, if not most people with autoimmune disorders have inflammation damaging more than one area of their body. Often that part of the body is the brain. The psychiatric field to date has not seriously addressed autoimmunity. Many with autoimmune conditions struggle with depression, anxiety, fatigue and “brain fog.” Likewise, many people diagnosed with a mood, anxiety or attention disorders, like ADHD, are unknowingly struggling with inflammation of the brain.
So, what do you eat if you want to minimize inflammation in your brain and elsewhere? You basically want to eat for your microbiome which means, eat foods that promote a diversity of microbes. A diverse microbiome is a measure of health and a marker for longevity. You want to eat a diet that promotes beneficial microbes and prevents the overgrowth of problematic ones. Such foods are high in fiber (giving those microbes something to do) and are “whole” meaning that little or nothing as been done to them. Consider processed food as partially digestedand more readily absorbed. If you're a microbe you’d choose an apple over apple juice any day. Foods high in refined carbohydrates (ie. the white stuff - bread, pasta, etc.) and sugar tend to feed and increase more problematic microbial populations that limit diversity and thus contribute to inflammation. If you’re spending much time in the aisles as opposed to the periphery of your grocery, you’re probably getting a highly processed diet.
We know the Western diet is low in fiber, highly processed, and high in refined carbohydrates and sugar. We also know the typical Western microbiome has low microbial diversity. If we have a “collective consciousness,” it is undoubtedly being impacted by the fact that we’re collectively inflamed.
When you hear about other specific foods that are considered highly inflammatory, imagine foods whose particles are more likely to cause an inflammatory response when there is “leaky gut.” Think gluten, casein (in dairy), nuts, eggs, corn nightshades (potatoes, tomatoes, eggplant), etc. Many people with autoimmune symptoms or other symptoms of inflammation benefit from withholding these foods while they heal their gut and gradually reintroduce them to see which they tolerate and which they don’t. For some, eliminating grains (as in the Paleo Diet) and minimizing the amount of natural sugars (ie. even from fruit) can also be necessary to bring down inflammation.
Food & Oxidative Stress:
If you’re eating whole food, especially organic whole food, the issue of toxinssomewhat takes care of itself. Oxidative stress occurs when there’s an imbalance between free radicals (molecules that can destroy cells or impair biochemical processes) and our bodies ability to detoxify them or to repair the resulting damage. If you read aloud the list of ingredients on the side of a box of processed food, you can be sure your ancient microbiome doesn’t know what you’re talking about either. Our bodies were never intended to deal with pesticides, additives, preservatives, dyes, etc. Even if toxins didn’t harm the microbes, many will make their way into the body and add to oxidative stress - more so if the gastrointestinal lining has lost it’s integrity due to antibiotics or other insults.
There’s no way to completely avoid toxins in our air, water, food, and through our skin. The best we can do, aside from staying calm and carrying on, is to limit those exposures. Eating whole foods with the least amount of pesticides, antibiotics, and hormones can have a big impact. Preservatives, additives and dyes and the like won’t need to be avoided if you’re eating whole food. Sugar and highly processed oils (ie. vegetable oil, corn oil) are the most extensively studied foods that have been shown to negatively impact the brain by increasing oxidative stress.
Just as we don’t all have the same integrity of our microbiome, we don’t have the same protective systems (ie. antioxidants) to defend against oxidative stress. You and I can be exposed to the same toxins in the environment. You may have normal development through your toddler years and I may regress into autism. You may thrive in your adult years. I may get cancer. Because of our genetic differences, to say a chemical, metal, etc. in our water, our food, our air or in our vaccines is safe is a bit ridiculous when you realize how different we are.
Most people with brain related symptoms have high oxidative stress. A “psychiatric” symptom can be the first indicator of problems emerging elsewhere in the body - problems that may not become evident for years. Psychiatric medications do not address root cause. If a child is truly hyperactive, impulsive and can’t focus, there’s something wrong - the child isn’t well. You can decrease a child’s symptoms with medications, but that doesn’t mean you’ve made the child well.
Food and Epigenetics:
We’re all amazingly similar in terms of our genetic makeup except for somewhere around one thousand plus single nucleotide polymorphisms, many of which can determine how vulnerable we are to certain diseases. While we’re all walking around with our own collection of these, most will never be expressed. The “expression of our genes” refers to epigenetics. While our DNA can take centuries to change, an epigenetic event (ie. the turning on or off of a gene) usually happens in an instant as the result of an environmental insult such as trauma, a toxic environmental exposure or even a significant change in the microbiome.
Most forms of cancer, cardiovascular disease and psychiatric conditions are epigenetic. The biochemical process that drives epigenetic expression is called methylation. To oversimplify, methylation relates to how much methyl we have. This can impact how tightly or loosely DNA is coiled. This degree of uncoiling (which is impacted by nutrients) impact the expression of our genes.
Dr. William Walsh, PhD of the Walsh Research Institute discovered that 70% of individuals with psychiatric conditions have a methylation imbalance - ie. too much methyl (overmethylation) or too little (undermethylation). While we can impact such imbalances with nutrients, diet is important as well. Those who are undermethylated benefit from more protein (a source of methyl) and less folate as in leafy greens, while those who are overmethylated (and folate deficient) benefit from more of a plant based diet that is higher in folate and lower in methyl. When Shakespeare said, “One man’s meat is another man’s poison,” he could have said, “One undermethylated person’s meat (with all it’s methyl) is an overmethylated person’s poison.
Food Intolerance & Other Food Challenges
We’re all aware that some people will have full blown allergic reactions to certain foods, such as nuts, shellfish and eggs. And, as I mentioned , if someone has “leaky gut’ they may have inflammatory reactions to a number of foods. Still, challenges around certain foods can get much more complicated.
I commonly see people with copper overload or toxicity which can cause an array of psychiatric symptoms. Trace metals like copper or zinc are occur naturally in our bodies and food. Copper can be high because of excessive exposure. More often, however, it seems to be due to high oxidative stress and/or genetic factors. An antioxidant in the body which regulates trace metals can be overwhelmed by oxidative stress or simply not be working up to speed because of a genetic vulnerability. Foods especially high in copper include chocolate and shellfish.
Some individuals can struggle with an overgrowth of candida - a fungus that occurs normally in the gastrointestinal tract which can over grow after antibiotics. This may cause reactions to a number of foods, including those that are the products of fermentation (ie. alcohol, coffee, aged cheese, soy sauce, etc.), malt, as well as sweets or other foods high in carbohydrates.
Others may have problems with foods that are high in histamine (again foods that are products of fermentation, but also avocado, lentils, strawberries, to name a few).
One food issue that (for those susceptible) can significantly be made worse by “healthy” foods and juicing relates to foods high in oxalates. There are a number of people struggling with fibromyalgia, chronic fatigue, vulvodynia (chronic pain or irritation of the vulva) or autism who unknowingly have problems with oxalates which combine with calcium to form crystals. Though oxalates are associated with kidney stones, they seem also to store up and wreak havoc in other parts of the body for many who will never have a stone. The cause in most cases seems to relate to the loss of a particular microbe (due to antibiotics) that would normally break down oxalates. Foods high in oxalates are some of the notoriously healthy ones like spinach, raw carrots, raw celery, kale, sweet potatoes, quinoa, blackberries, and nuts to name a few.
So whether it’s methyl, folate, copper, candida, histamine, oxalates or whether it’s food allergies or sensitivities or any of the food related issues I didn’t mention, know that we’re not all the same. As you can see, our genetics, oxidative stress and an alteration in the microbiome can create complicated and overlapping food issues. If you've never had such problems, be grateful, and be compassionate with those who do. Don't take it personally when someone won't eat that amazing dessert you created. And, if you're that someone who's starting to recognize the relationship between what you eat and how you feel, know that usually with careful investigation many of these issues can be figured out. Thanks to the evolving research and greater access to information, there are growing numbers of people finding symptom relief, improved functioning and even restored health. First, however, they had to let go of the idea that there is one way to be. They had to let go of the idea of super foods, super diets and super anything else. We're more complicated than that.
I'm a conventionally trained child, adolescent and adult psychiatrist. My current approach to health is both holistic (pertaining to the whole person) and functional (addressing the root causes of illness). I write this blog to share what I've learned.