Dr. Jaca thank you so much for joining me on this podcast. I'm really excited to be speaking with you. Your work is so exciting and let's just you know before we get into the science. Let's just start at the beginning. How did you get into this line of research. Oh well that's another story so. I came into psychology as my second degree why I was originally an artist and then when my eldest daughter was born I decided to go back and study psychology you know I suggested in well. I guess how people worked and as I was going through my psychology degree very slowly as I had my children and did all of that. I started to realize that I wasn't interested in being a psychologist but I was pretty interested in the bits of psychology that touched on the brain and how it worked and was also in statistics which is a big part of psychology so when I was about halfway through my undergraduate degree I asked to go and do some interning in a research unit because I wanted to get my hands on some real data so that means that I started to hang around with researchers and psychiatrists and I quickly came to realize that there was this no research and nothing in psychiatry that looked at nutrition and mental health and the brain and it was a really interesting time because this is in 2002 2003 and when some fascinating research coming out of UCLA which focused on modulating nerve cells in the brain using Dietary Approaches so these are animal studies and they looked at the impact of say high-fat and refined sugar diet so I sort of like junk food diets for some ice on these very important proteins in the brain that we know help to grow new nerve cells in the brain near neurons. So there's two bits of the brain where you actually grow new brain cells over your life and the really important bit for us anyway is the hippocampus through neural structures. It's right in the middle of your brain and they play a very important role in learning and memory. Turn your brain power but they also seem to be important in mood regulation and I seem to be the target of antidepressant drugs so when you take antidepressant the way in which they work have a lot to do with making more of these proteins and making more brain cells in the hippocampus and this group of UCLA was showing that you could really up and down.

Regulate the amount of these neurotrophins these proteins by altering diet towards a healthier and unhealthy components. So that was saying okay. Foods have a direct impact on this really key part of the brain. That's important for mental health and brain power and then around the same time have started this hypothesis. That depression was very much to function of the immune system. So in the way that a dysregulated immune system or what they call systemic inflammation contributes to heart disease and to cancer and to other chronic diseases. They were starting to be pretty good evidence that this was also the case with depression. You know clinical depression and of course the things that influence this immune dysfunction is low level inflammation are all the things that we know are not great for us so you know not getting enough sleep not having enough vitamin D not exercising being fat being overweight. Because there's the fat tissue actually releases these pro-inflammatory little you know molecules but died of course is a major influence on the immune system. I'd always had a really strong interest in diet. I love food so old you know I've also very much always felt that nutrition was really the foundation. It's like the petrol you put in your engine and if you you put you know rubbish in the engine you're going to get rubbish out but I couldn't quite believe when I started hanging around all these researchers and psychiatrists that no one was looking at diet in relation to mental health and into being depression in particular and to put in context you know depression is one of the leading contributors to the global burden of disease cement disorders and substance sort of in general account for the leading global burden of disability.

Something you live not to their fullest. Because you are not able to fully engage with the community or workplace those sorts of things like if it has a major major impact. And we're also now knowing and this was true back you know 10 12 years ago then that our diets globally have changed really for the worst like really really profoundly and obviously we see that reflected in the obesity epidemic but it's also reflected in the huge tsunami of chronic disease type 2 diabetes obesity metabolic syndrome cancer. All of these sorts of diseases related to unhealthy diets so I wanted to put the two together and I wanted to do a PhD and I knew that the place that I was doing some working had really good data on diet and also mental health and when I first suggested it there was a general truth like really you know. So you know he'd be trippin flaky you know you're one of those naturopath -. I think that's actually really good reasons that we should be looking at this more seriously. And they said well sure if that's what you'd want to do and I really think that part of what propelled me to work so hard over the last seven years or so to show that I was like no I thought I well one of what amazing for sites who have had you know such a progressive hypothesis because I mean and correct me if I'm wrong. Couldn't it be said that for a long time. The brain was thought was considered immunological. II privileged communits in terms of its association with what was going on down below in the rest of the body. You know the separation via the blood-brain barrier and thinking like that you know now we know how intricately connected the you know the brain and you know these signals of inflammation is pro-inflammatory cytokines. What have you are onto the brain but I mean that was a pretty when you had this idea. That was something that was pretty ahead of the curve. It was it wasn't and you know there was a bit of sort of patronizing head painting going on here so like if silly woman wanting to look at diet diet doesn't have to do with the way you feel that you silly and so.

I went on and I did the first study to look at this relationship between overall diet quality and whether or not this large sample of women who are represented you as the Australian population did or didn't have at the time or in a history of major depressive disorder anxiety disorders so these are clinical disorders that we assessed and of course you take into account things like their socioeconomic status education age those sorts of things when you're looking at this and what we found was really pretty clear relationships and because it was the first study it was published on the front cover of the American Journal of Psychiatry so I had a pretty big impact you know it was um I think nominated the top - research paper in psychiatry in 2010. You know it had had a substantial impact and on the basis of that I was been able to go and propose working with many many groups from around the world who had data from these large cohort studies these large observational studies. So they're not interventions but I'm try and change anything they just collect data on people's diets people's mental health and a whole lot of other things and I was able to go and build collaboration and interrogate data. You know in in London in adolescents in East London we did a lot of work in Norway in the very large mode of study in Norway that looked at maternal diet and children's mental health and from that then I was able to very rapidly. Develop the evidence base to say that the quality of people's diet is most definitely related to the presence of all the risks for depression in particular. It doesn't seem to be explained by things like education socioeconomic status income it doesn't seem to be explained by reverse causality so that you know your mental health leading to you eating differently even though we know that that happens to me and this is my long-term patterns of eating that predisposed to depression or otherwise interested them but it became really robust so we did the first study in adults.

We did the first studies in adolescence. And they were really important because half of all mental disorders start before the age of 14. If you want to think about prevention you need to go back and then really importantly we did the first study and this is in 23,000 mothers in their children in Norway to show that mothers diets during pregnancy we're related to the children's emotional health over the first years of their life and the children start were also really important so there were separate contributions then in 2015 we showed for the first time in humans that diet quality was indeed related to the size of people if it's Kampai so this is this key region of the brain and very obviously so it like it wasn't a tiny relationship it was a big relationship the healthier people diets were thee for all the people the bigger than hippocampus and the opposite was true so that was really important but of course the final piece of the puzzle is the intervention study. This is when you actually take people who are depressed. You help them to change their diet. It excellent allow us to break people's eyes worse the fear that made them worse than well but we could help them to change it to make it better to see whether it would actually help their depression and this is what we've just done. This is the study we've just published. It's gone ballistic all over the world last time. I looked yesterday on the BMC medicine website where it's been published. It's been accessed nearly thirteen and a half thousand times in the two weeks since it's been published so it's really obviously having an impact which is wonderful and now we can really that to say okay. Diet is important. We already knew that exercise is really helpful to treat depression. And there's good evidence that it helps prevent it now.

We think we can say the same about - so fascinating you must be a very busy woman so I'm you know all the more honored - right - I can't even sleep it would make my life a lot easier. Wow but just to underscore I mean how important this research this trial it just published is it's being called the world's first you know trial and demise control. Toronto to show that a dietary intervention can actually significantly improve symptoms of depression to the point. Where um you know you actually had people go into remission so that you know in terms of the depression scale that you were using they were actually no longer able to qualify as being as suffering from major. Depression is that is that accurate Iran. Yeah well and you know we were even surprised even me who really. I do believe my hypothesis is which I shouldn't as a scientist but I do have been to. Nutrition is important for mental and brain health. I wasn't even surprised by the size of the effect. Well you know it was pretty profound at the same time. Of course you know you have to replicate these sorts of studies. It would be great to have a larger sample size next time. So you can maybe look at subgroup analysis. You know if there's a lot of work still to be done but I think it's a really really important study to just say. Yes we really need to consider diet when we're looking at people with mental health problems not just their physical health problem but of course the beauty of it is if you go to the doctor and you're depressed which certainly in Australia most people with depression end up in their GP. You know the general practice surgery not with a psychiatrist or a psychologist first are they should be able to say now. Well you know we can write you a referral to a dietitian so as well as or instead of depending on the patient's preference and the doctors view on how severe feel they are how about you go see a dietitian. And if they do that and they do improve their diet under the guidance of an expert and doesn't really need to be an expert for some people.

That's very helpful you know. It also can have a wonderful benefit for the obesity metabolic syndrome. Type two diabetes heart disease all of the other chronic illnesses that we know that depression increases the risk for and that also increase the risk for depression. Wow well I mean and especially in light of the latest reviews of efficacy when it comes to pharmacological antidepressant treatment that you know they you know for people with mild to moderate. Depression are no more effective than a placebo. And yet they're not like safety belts you know they cut they have side effects that are significant so I mean I think that this is for people that were really waiting for that kind of data. I mean people in the functional medicine community have been talking about this stuff but I mean what's so important was to now have data on paper is so useful ICT evidence if we had to change policy and practice and that was what my mother was just say look I'm right there's Anatomy amazing so can you talk to me a little bit about the dietary intervention I mean what were these people eating before and what were the you know enter. What would the intervention what did that look like so they their diets were pretty. Blair they had you know it's probably important to contextualize this because we the same mistakes according to our national surveys only about less than 5 percent of Australian adults are getting the vegetables and legumes that are recommended as part of their strand dietary guidelines were further under the broader community is eating really badly even though we have an abundance of wonderful fresh fantastic food in Australia because of the influence of the food industry and the fact that these food products. They're addictive be ubiquitous. They're heavily man sheep they're socially normalized that means that people are eating crack instead of good stuff and if you look at the data for children it's even worse something like half a percent of Australian children are any according to the Dietary Guidelines particularly around their vegetables and plant foods.

Which is the really key issue so these people who are coming into the depression trial were no different. They had not very high levels of good food intake and here. We're talking about vegetables fruits whole grains legumes so that you've been you know many chickpeas lentils that sort of thing raw nuts really important. We think fish. Lean red meat. This is the other thing. It wasn't a traditional Mediterranean diet which doesn't have a lot of red meat we've previously shown that people who have the recommended intake according to the dietary guidelines which is about three or four more serves a week like not not huge. But you know just palm-sized days a week. They were half as likely to have a clinical medical disorder mental disorder so we thought that was pretty interesting that is that what can I just underscore that for a second so I'm aware of your previous research. You found that people that were eating less red meat were more at risk for depression with the caveat being that you know the red meat consumed in Australia which is where you are is primarily grass fed would not and but what we found was a u-shaped relationship so it wasn't just they were eating not enough it was also those who were eating too much so it was a u-shaped relationship and the people in the recommended category were half as likely as either of those two categories people in either of those two categories to have a clinical depressive disorder a clinical anxiety disorder or even a live polar disorder bipolar disorder and weren't published in that paper. But that's because we only had a small sample but we that's what we found and then we we adjusted for overall diet quality. Because of course if you're eating a lot of red meat you might also be having a lot of vegetables and a lot of good stuff you just might give me a lot general or you might also be eating a whole lot of processed meats and unhealthy foods so we had to take that into account and we still saw this very clear relationship and what was notable was it so consistent across the three different sorts of disorders mood disorders anxiety disorders but also psychological symptoms.

We saw a relationship as well a bit more. J shaped and the other key thing about this study was that we took out the 20 or so actual vegetarians because there are quite a few studies saying that people who are vegetarians have worse mental Health's and people who are not vegetarian but of course it's a bit of a chicken and egg question with vegetarianism because people who have you know maybe different diets strict diet sometimes I can be higher on what we call neuroticism we could. I related to risk for depression. So it's never been clear what come first one or the other. I was just talking to captain. Joe headland yesterday who's a big wingding in the omega-3 fatty acids seafood grain health in the NIH and it was telling me about some very very interesting findings that they had in the elf pack study which is a big British cohort. Study looking at young people if you terian. ISM and mental health so there are more data coming out that suggests that there is a causal relationship because they publish it but I think that there's certainly going to be some new insights into this relationship published pretty soon I would look and learn more. Love it yeah. Yeah me too. I'm really really stressing the study when it comes out but the casing without dietary intervention was basically we had dieticians who are used to working with people and motivating them and finding ways that they can manage just to make those Rachel's tweaks and improvements to their diet helping them to increase their intake of the platitudes that we know a good olive oil fish and then the nuts legumes vegetables fruits the Lena and meet but one of the biggest changes of course was actually.

It was the reduction in the junk food that was probably a bigger change than anything was that they came in having something like thirty percent of their diet is what we call extra foods which is junk food and that went right down so this diet recommendation was really just about improving their overall diet quality because all the research we've done has shown that both things not getting enough of the good stuff and getting too much of the bad stuff both independently related to an increased risk or problem for psychiatric disorders depression in particular. So that's what we did and think - what that's amazing. Can you talk a little bit about um you know there were obviously a lot of things have changed in terms of your subjects diets. I mean some of the some of the mechanisms you mentioned. Obviously you know an increase in the consumption of omega-3 fats which grass-fed beef is particularly rich in. So it's fish things like that. Um you know was was olive oil a big staple in a diet that you recommended. I'm just curious about the various components and like how you would quantify the contribution of each in terms of the effect that you saw you can't you can't and I think that's that's sort of what we call a reductionist approach where you try and press it break it down to particular foods and particular nutrients we don't think at this point that it has a lot of utility because whenever you eat you eat includes and becomes very complex combinations and the way they interact in the body is so complex that we cannot even matter you know because all the many many differences for example there's you know obviously data to suggest that omega-3 fatty acids which are found in seafood helpful if you for mental health but and so is fish itself but there's data to show that fish itself is protective way over and above will be omega-3 fatty acids. There are other things in fish that we don't even know about that's be helpful you know it's the same with things like red meat you know.

I always eat at the zinc is at the iron. If it the business of that it's probably all of those things they're probably all working on genetic pathways gene expression pathways they're working on the gut microbiota and ways that we can typically begin to understand so breaking it down into individual food. It's just an exercise in futility essentially. Yeah well at this point. I do and this is something. I'm putting in a big grant application for at the moment there's a very interesting study last year from a group in Israel where they looked at people's postprandial glucose response to expanded meal and so basically what they found. Was that if you get a bunch of people and you feed them exactly the same meal their response to it in terms of the way their glucose goes up or down. It's completely different for each person so saying that food doesn't act in the same way and every person not even close but they did was they took all these medical data they had for these people and then added in the data from microbiome analyses that they've taken from stool samples and then they use these really cool statistical techniques machine learning that's called so that they were able to develop an algorithm that they believed could predict for each individual person what would be the ideal dinner or meal to keep the postprandial glucose response as low as possible they using that algorithm they contested that in an intervention and they show that it was true so these are the steps towards this personalized nutrition. That we're very interested in you. Know like what what foods what true combinations what types of foods are more useful for whom under work and this is same for nutrients you know supplementation roles as well not a hugely robust evidence space to supplement. What is apart from immediate area fatty. Acids seem to be helpful for people who have high levels of inflammation and that's not surprising because inflammation basically depletes your omega-3 fatty acid from your cell membranes.

Through oxidation processes varnishing is a good idea right now but we need to understand. What are the background factors. The way everybody metabolizes nutrients is going to vary enormous ly based on their genetics and their microbiome so if we can figure out tests that are relatively simple to work out who would benefit from. What sort of an intervention. That's we're going to be able to go in the next few years. It's very exciting. I often I mean I I completely agree that you know that everybody is different. There's no such thing as a one-size-fits-all dietary approach but there are still some salient. You know guidelines that. I think everybody can benefit from. I mean you know because the alternative waiting for such granular data to come out could take decades. Yeah when you when you take genetics into account when you take microbiomes and gene sequencing and things like that you know. I mean so what so what based on your findings do you think could be broadly applicable. I mean even more you know dark leafy greens which we know are rich in prebiotics fiber you know hormones. Michael Pollan which I love like I love liver and we actually were running the first international meeting of the International Society for nutritional proprietary research that I founded losing oxygen in the middle of the year and we want to get him as a you know gift opening plenary speaker because I use these quite on time which is eat whole food he just as eat food but we take that to mean eat whole food like not processed food not too much mostly plant you know is that it. I mean it's that simple and by the way if he's not available. I will you know wholeheartedly volunteer to open to open your show. Oh you're very welcome to come. It's going to be alright yeah. I would love to. I would love to um and I think that I think that's a great message to send especially for people that are really lost when it comes to nutrition but then like you know I think a lot of the people that are going to watch this video and are listening will be in.

My podcast are interested in like what's the next what's the next step from that you know how they can better tweak their diet. I am a paper coming out very soon and it's called nutritional psychiatry where to next and it sort of basically says okay. Well this is what we know so far. This is what we've still got to find out. We're really just starting. There's a lot that we have to do. We're trying to get funding to the food news center so we can do all sorts of other research there is deep research funding at the moment which is true everywhere but. I also think you know we're doing a lot of studies focused on the microbiome and you know whilst there's fantastic excuse me fantastic scientists all over the world that are drilling down and trying to understand what particular bacterial strain does not beings where and hey my manipulated and all of those sorts of things. I think that's great really glad you're doing that. We'll do a bit of that ourselves. But in the meantime we already know that dietary fiber is he healthy gut and not having a high-fat diet also seems to be very important so it would be reducing dietary fat. That doesn't mean we use them to almost nothing if you're made dietary fats. So that this means focus on the healthy ones and not have enormous quantities of them but increase plant fiber so vegetables fruits whole grains legumes nuts. It's those ones they're the ones that your body needs all different sorts to you know vegetables doesn't mean just potatoes. Sorry not something vegetables it's all in vegetables and red ones and green ones them you know just diversity and I would also say make your own fermented food at home I make butcher and kaffir at home isn't super easy it's super cheap and it means that I can control the quality in a way like I can choose the milk that I want I use an A two milks.

You know there's things you can do super easier to do at home and they're starting to really show that fermented foods have a wonderful impact on the gut and we don't need to measure all the millions and millions of bugs that are in the fermented foods although I'm sure people aren't doing that you just need to make the fermented foods and you can drink them. I agree I mean there's no culture that you know is without its own form of fermented food I used to brew my own kombucha too so yeah. It's so much fun. I just want to go back for a second to you. Know the recommendation to eat low in fat. You know the diet that that you used in your trial. I think I forget what you called it the Medi medic Mahdi. Med yes you reference in your paper. You know your reasoning for picking the pattern that you picked was in part. I think referencing the pretty med. Study where you know they used the compared a low-fat diet to two versions of an already higher fat. Mediterranean diet one of them was supplemented with you know extra fats from nuts and the other from a liter an extra liter a week of extra-virgin olive oil so I'm just curious you know that's not a obviously it's not a low-fat diet what what kinds of fats do we need to avoid do you think and is everybody different in that sense. I'm assuming your answer to them yeah. This is a completely unanswered question. But we really don't know the first issue is that most of the research has been done in animals and you know like mice or rats and we have very different nutritional needs that got microbiome different. We cannot necessarily extrapolate from those studies to us. In all of the animal studies. We see that high-fat diets in a controlled animal experiment induce leaking us. You know when you have opening the tight junction of the intestinal wall. You have contents of the guts spilling into the bloodstream that causes an immune response and this chronic inflammation which predisposes to disease so leaky gut.

You really want to avoid and in animal studies. We know that a high-fat diet induced leaky gut. We know that dietary emulsifiers that are in processed foods they really have a noxious impact. They're like detergent. They strip all the mucus off the side of person we've got all these are multipliers. Yeah so we're saying to t2 artificial sugars. As well you noxious things to the gut microbiome that actually make you fat. So they do. The opposite looks terrific. So there's elements of foods that we know have a noxious impact on the gut and that we should avoid when it comes to actual fats though there's so much different information and I think it's going to come down to different people with different microbiome profiles because for some people a keep that diet that promotes ketosis you know so low carbohydrate high fat seems to be helpful. We know that in epilepsy. It's helpful there's emerging information that suggests it may be helpful for people with psychosis and we're actually hoping to catch that this year and some other people swear by a very high fat low carb diet that focuses on you know. Whole Foods obviously good quality fat but we. We just don't know at this point. I've just finished an animal study in my first animal. Study where we actually looked at it. We looked at several groups of rats. Mice one group has the control normal. Mouse diet the other four had a diet that comprised about 30% fat so of anna i fat diet which is often sixty percent about thirty percent which is more or less what people would eat you know and one group had that coming from d which is clarified butter so the saturated fat one from olive oil one from coconut oil and one from soybean which is in commercial food products in great amounts and whilst we're still looking at the dancer and this is very very early preliminary it look like the soybean oils seem to be occasionally problematic when it came to anxiety and oppressive like behaviors well also.

I think weight gain as well but still more work to do on that but this is our question what type of fact you know. Yeah of course so what are. So what do you see with the monounsaturated fat you know olive oil versus the coconut oil or ghee if you seem to see the same degree of dysbiosis or what you know. I mean now we can you share what you've observed so forth. We haven't done the the microbiota analysis yet what we know so far is that there are differences between the groups. But we don't know what they mean yet. We need to go into more details but olive oil seem to make the - better can Liana but we don't know whether that's just a measurement issue you know. Maybe some ice paid more of the rocks would taste here. Maybe they're like the olive oil. There's some of that methodological things that we need to teach the past but hopefully we'll have them an integrated publication in the next couple months now and yeah we can have a look at that so really. There's a lot that we don't know if there really is and I suspect that again it's going to come back to this personalized nutrition if we look at your microbiome and other aspects of your your human DNA as well as your microbots from microbial DNA can we predict what sorts of diets are going to be best for your health to lower inflammation and I think that's the key that's what we want to do. Yeah very excite a ways until we have that kind of data so in terms of you know people listening like you know. Take away actionable steps that they can if they're not you know going back to the results of your trial. They're you know suffering from some kind of reduced mood and low-grade generalize anxiety. I mean it's easy to sort of have anxiety in today's climate uh-huh you know there's a lot there's a lot going on that people might be feeling a little bit heated about but um what are some takeaway things that you think people. Can you know put into practice in their own lives and diets too. I guess check the boxes to make sure that it's perhaps not diet.

That's driving their malaise as people who have a pretty bad diet to start with and so for and it's for instance in the States we now know that nearly 60% of the energy intake of average American diet is coming from junk and processes so that's nearly 60 percent of all the energy come from food is coming from these food products from jug from junk and that's why they have low nutritional value and they have a direct detrimental impact on the brain on the gut and therefore in every aspect of your health. So the first thing would be to just stop having stuff that comes in packets and cans like seriously that is the best thing you can do to start with but then you also need to start to increase your intake of fiber so that means having more veggies and you diet you know our new. Australian nutrition pyramid is a beauty because it just is the bottom layer. The main thing you should be eating is vegetables and protein legumes really you know. That's the bottom layer yes. Iver is and then you have good quality protein so you know fish and a good quality lean red meat. And then you've got you know eggs and nuts as well as other forms of and tofu and vegetarian options and then good quality oils up near the top of the pyramid. So that's your olive oil. I think coconut oil and butter are all fine and we just stay away from the margarines yeah I just and then the junk food at the top seriously like once a week make your own. If you want to have a piece of cake make your own you know. Yeah so butter. I heard you mention butter butter is something that would would be endorsed because I have you know for many decades butter was something that was considered very healthy. Yeah look at. I think the evidence is stacking up that this saturated fats are the terrible awful things that we were told and in fact I've said it the columns that your own fats or seed oils that they were replaced we. They're actually more problematic because of course they oxidize right.

Oxidized products are actually really largest in the body. So you know in terms of fats. I mean what do we have. At home. We have good quality of olive oil that stays in a dark tin or exact jar so it's not meat exposed to the light we have lots of over kados we have lots of nuts and we have really really nice butter not huge slabs of it but just you know if we're going to cook up some mushrooms they will use a spoonful of butter rather than certainly wouldn't use my dream or nothing like that right would completely agree well. I think that's about you know all of the questions that I have for you. Your work is so incredibly exciting um what is I mean I guess my last question would be what's next for you. Are you trying to replicate your findings. You just published in it with a larger sample size or what. What's what are the next about you target a lot of projects that are starting this year. Korea small is just finished up which is great and I've got a PhD student who's looking at some of the biochemistry and some aspects of the diet with that and that you're published in this year those papers. We're doing a very. I think very important intervention based at the big Royal Children's Hospital in Melbourne with Murdoch Children's Research you just Institute which is one of the leading institutes in the world in pediatric research. And we're recruiting women who are pregnant and we're because we know that only 10% of pregnant women in Australia eat according to the dietary guidelines so we're trying to improve their diets with a focus on the gut which has taking their gut microbiome samples and then a month after their baby spawn. We're checking them and their babies microbiome samples because we know that the gut microbiome of a newborn is absolutely integral to the development of the brain and the development of the immune system. So you can get a baby to have a healthy gut microbiota profile which we still not entirely sure like that is yes we need to turn at the month.

Because that's where they get the bugs from so that's a study that's underway. We hope to start looking in psychosis this year. What is the possible role of food sensitivities or allergies for some people with psychosis due exclusion diet. Help do the kit. Does the ketogenic diet help. We have a colleague who's a neuroscience scientist in. Queensland who's shown in an animal model schizophrenia that a ketogenic diet seems to be really beneficial well so that's another one we're wanting to take your smiles trial and put it online so that we can make an online program that people can access wherever they are to help them move through a structured program to help them improve their diet and hopefully improve their mood and we'll evaluate that and then we're also going to be doing a randomized control trial looking at a2 milk versus standard milk. Because we think that there's good reasons why they zero so there's a lot of stuff that we're doing. We're trying to get funding for nutraceutical trials for chronic fatigue syndrome. We're doing a very interesting study. Looking at the microbiome in people are coming in to colonoscopies and looking to see what changes are the bowel. Prep looking to see what influence diet exercise. All of those sorts of things have people's microbiome and their mental health. So there's so much work to be done but we really need funding and that's an ongoing issue so we've sort of one of the reasons is setting up a food move center was to try and get some tropic funding which is not really a big being in Australia for research but because our research budgets have gone down the toilet. We're hoping that people who are really interested in this and think it's important will actually contribute some dollars so that we can extend what studies that we're doing because we're really the only Institute in the world who doing yeah I mean. It's it's super exciting. I've given the talk at the Center for nutrition learning memory they have one in Chicago at the University of Illinois urbana-champaign but yeah that I know of no other Center doing work on diet and mood the way that you can see kind of nutritional psychiatry well I love it um real quick you mentioned you know milk a one versus a 2.

This is an area that. I've done very sort of cursory dive into I don't personally consume dairy but I was wondering if you could perhaps kind of just touch on the differences between the two um yeah. I'm certainly not an expert yet because I've only just started to look at this and I've got a PhD student coming out in March to start looking at this properly. But they're very very good data now. I think to suggest that the there is a difference between the a to only cows and the ones that have a one and A two together in Europe sometime back. I don't know hundred years ago or so. It's thought that there was a genetic mutation that happens that turned this the proteins that are in the milk changed based on this genetic mutation. And that it's been this. A one has read badly exponent of seven properly but it looks like that sort of milk in the. European cows is very strongly related to autoimmune disease and a whole lot of other diseases that we think relate to problems where the immune system an oxidative stress probably mediated through the gut microbiota possibly yes but also genetic polymorphisms related to a protein called B C m7 or gene C C m7. I don't know I've got that. I've got the literature in my soul folder though but just being sent to me. I haven't read it yet but I could send it to you but it looks like for some people with a particular polymorphism you the DES protein. The b c m7 in the a one type milk it blocks the uptake of cysteine and she seems the key to create glue. Sion which is your body's natural antioxidant system and it protects the brain and it protects the body whereas eight who doesn't do this in eight who doesn't seem to be associated with these problematic health outcomes so we're actually going to do a randomized control trial.

We're going to look at mental health. We're going to look at bone osteoporosis. Endpoints we're going to look at body weight we're going to look at a whole range of outcomes including the microbiome and do metagenomics on the microbiome and the a tube milk company will provide us with the milk so the AC milk and I think you can get yogurt and cheese and stuff and then just stand this stuff and of course it's perfect as far as a placebo control. Trial goes because is that's no way to tighten the difference between them. You will actually put people on these milk products and give it to them through a period of six months and then measure all these things before during and after and see what we find because clearly it has a lot of public health implications. We've already published the paper to show that people women who drink milk regularly are more likely to develop a major depressive episode interesting. It's an interesting start anyway yeah. I mean I know that milk causes at least you know. The a1 milk causes an increase in the expression of a certain type of mucus in the gut. I think is nuke5 or something like that. It's typically associated only with inflammation or you know inflammatory bowel disease and things like that. Oh hi okay because as I said this is all really new to me um we didn't get to you all sort of dive into it in a lot more detail but I personally drink a to milk I make my kaffir out of it that's what I do think from just based on the lectures that I've seen that there's a good reason to think that because something we need to consider well very exciting well thank you so much for your time I really appreciate it. I don't know more. I can go to the food and mood center because the website we've set it up so that people can get good evidence-based information they can click on the link and go to the scientific paper that backs up what we said in there.

So it's not getting it's not. We think that we have answer to this nutritional problem at slides because what the research says hopefully presented in a way that's accessible to everyone and you can also then see the other studies that we're doing as well can viewers join your trials. I certainly when we do the online smiles online which will probably start. Recruitment of probably in 12 months so 2018 yes if we've met a pregnant and in Melbourne in the structure I can join our randomized control trial for pregnancy other than that. You probably a bit far away where you are. I'm going to be in the u.s. three times this year the first time will be for the Big FM PR conference in Washington which is really exciting. We're going to have some fantastic because we're also going to run a full day of workshops. You've got turnaround. Ramsay with you in new friend oven. I like him. Okay yeah well here at Harvard. They're running or workshops with clinicians and there will be another two workshops they focus on nutraceuticals but also focus on Dietetics and people's mental disorders and lots of great speakers so Jon Cryer. You know world leading expert and gut brain access research. You know we've got some great speakers so that can be really fun when I'm coming to New York and the end of April for another conference. I looking forward to that all right. We'll have to grab a coffee or something. Oh yeah that would be awesome. Lastly you know. I think a lot of people that are actually like stuck in me. I keep having that one last question but it's just an it's such an interesting shot um if people are out there and sort of stuck in the throes of depression and feeling like there's no hope and you know wherever they happen to be in their small town they go to their you know local health care practitioner and they're not so privy on this new research. I mean what do you what do you suggest they do. Print out your paper and bring it in and be like look.

I mean here's hard data that diet could be affecting life. I don't I don't need the SSRI I don't need the drug necessarily oh okay. I think that's a very very good idea. There's also another paper we published in 2015 in Lancet psychiatry and it's called nutritional medicine as mainstream in psychiatry and it summarizes the literature it gives a really good context it's in Lancet psychiatry so one of the top journals in the world and it's another great one that people can take to their practitioner to say look. I'm not just you know making yourself this is this is a real field that has enormous implications for my mental health. I believe yeah and of course I mean you know. Pharmaceutical intervention is not you know is useful for some cases. We're not saying that like that. It's that's not ever warranted but you know this is. This is an alternative that is safe that is clearly effective and that is definitely worth trying and it can go alongside it. I mean most of the people in our study we're on you know their antidepressants or had psychotherapy you know. They're receiving standard treatment and that's as well as and I suspect that that's going to be really really fundamental that people take a multi-pronged approach to their mental health. Well there you go all right dr. Joe Cole thank you so much for chatting. It's such a pleasure max.