Nutritional Psychiatry: The Future of Brain Health Part 1 - Drew Ramsey MD

What is nutritional psychiatry? 

If you’ve read about how omega-3 fats can benefit brain health or how the gut microbiome impacts depression, you are reading about nutritional psychiatry. This emerging area of attention in mental health seeks to understand how our food impacts our brain health and how this research can be translated to clinical care, both for prevention and treatment. 

Today we are beginning to understand the power of food with exciting new research and near daily headlines about mental health and nutrition. I wrote my first Brainfood Prescription in 2007, a simple list of five foods on a small piece of paper. A young man with depression asked me what he could eat to help with his mood.


Little did I know that the way I practiced psychiatry was about to change.

In 2012, I was on a conference call with the top international researchers in nutrition and brain health. We were discussing the formation of a new organization called the International Society of Nutrition and Psychiatry Research. 

I was thrilled to have that conversation because I felt a bit alone as a psychiatrist speaking with patients about nutrition. We weren’t taught to talk with patients about what they eat, so as mental health professionals we don’t ask. I wondered why not. After all, nutrients play a vital but often-overlook role in mental health, yet at that point we had more or less neglected the key aspects of nutritional psychiatry.

Recently, I’ve been asked a lot of questions about Nutritional Psychiatry and our work. It’s been exciting to be quoted in the New York Times as a pioneer in this field, it has also given me a sense of responsibility in clarifying the appropriate use of nutrition to help people with mental health concerns.

As research helps us better understand the biological underpinnings of depression, there are new factors that we think drive depression. Things like inflammation, brain plasticity and function, the biology of psychological stress, and the nuances of the brain-gut connection. All of these processes are deeply biologically interwoven with our food.  

Yet, we lacked any evidence-based primary prevention and treatment strategies based on dietary modifications to alleviate depression. And the studies that did look at the connection between diet and depression mostly focused on individual nutrients or food groups like folate or omega-3 fats. It is important science but provided an incomplete picture. After all, we don’t eat foods or nutrients in isolation we eat a “dietary pattern” ideally of diverse foods. Focusing on a single factor, be that vitamin B12 or cholesterol, neglected the complex interactions among nutrients in our daily diet. 

Putting Nutritional Psychiatry on the Map

A 2010 study changed that perspective. Pioneering Nutritional Psychiatry researcher Felice Jacka, Ph.D and her colleagues looked at diet quality and mental disorders among Australian women and in the American Journal of Psychiatry concluded that “a better diet quality would be associated with a lower likelihood of depressive and anxiety disorders and with fewer psychological symptoms.”

After adjusting for other variables, participants showed a 35% reduced risk for major depression and a 32% reduced risk for anxiety disorders with a healthy diet consisting of vegetables, fruit, beef, lamb, fish, and whole-grain foods. 

A western diet, on the other hand, increased their odds for major depression. 

This was the first study in the premiere academic journal of psychiatry to show the significant impact of diet quality on mental health. Unlike many other risk factors for depression and other mental disorders, your diet is entirely modifiable. This was a cross-sectional study, a far cry from the randomized trials needed to change how we practice clinically, but it was significant for me. 

My Shift into Nutritional Psychiatry

In my practice during that time, I was prescribing medications and doing talk therapy.

In many ways I am a classic Columbia-trained Psychiatrist, I do a lot of psychotherapy and I am handy with medications. I care about evidence and excellent patient-based care. For my own mental health, I was riding my bike all over New York City and eating a plant-based diet. The incongruence struck me. We had not been taught as physicians and psychiatrists to focus on these factors much with patients. It seemed something was missing to help my patients, who were struggling with anxiety, depression, and other mental disorders. I talked a lot about symptoms, but not very much about lifestyle factors like nutrition, exercise, and spirituality. 

As I researched my first book The Happiness Diet, I read everything I could about brain nutrition. For the first time, I learned the history of how our food has changed, as we wrote, “more in the last 100 years than in the last 100,000.” So many of my patients were eating low-fat diets and fearing cholesterol. In fact I had been a low-fat vegetarian for almost a decade myself. As I learned more about the flawed science and policy that was guiding how the medical system was interacting with the food system, I reached a clear conclusion. Modern food puts our mental health at risk. T

And increasingly, that’s what the data was showing. A prospective study in 2009 showed that in 10,094 university students those who adhered most closely to a Mediterranean dietary pattern had a 52% reduced risk of depression. 

Evidence like this encouraged me to continue evaluating the eating habits of my patients and to learn as much as possible about what I should recommend that they consume based on the evidence. 

I began incorporating brain-nourishing food choices with “building-block” nutrients such as long-chained omega-3 fats, vitamin B12, and zinc. More new science was suggesting that these same foods would help my patients’ brains be more resilient by enhancing brain growth. (The latest brain research tells us that human brains continue to grow through adulthood, creating new brain cells and new connections via a hormone called BDNF.) 

On top of that, eating more of these brainfoods would decrease my patients’ risk of obesity, diabetes, and heart disease; all diseases that wreak havoc on mental health. 

Armed with this knowledge, I made “food as medicine” the main focus of my clinical work and writing.

People ask me all the time how my colleagues in mental health react to the idea of using food as a tool in clinical practice. I’ll tell you all about it in my next post.

Eat Complete

Winner of a 2017 IACP Cookbook Award  •  Finalist for a Books for a Better Life Award

Named one of the top health and wellness books for 2016 by Well + Good and MindBodyGreen


From leading psychiatrist and author of Fifty Shades of Kale comes a collection of 100 simple, delicious, and affordable recipes to help you get the core nutrients your brain and body need to stay happy and healthy.

What does food have to do with brain health? Everything.

Your brain burns more of the food you eat than any other organ. It determines if you gain or lose weight, if you’re feeling energetic or fatigued, if you’re upbeat or depressed. In this essential guide and cookbook, Drew Ramsey, MD, explores the role the human brain plays in every part of your life, including mood, health, focus, memory, and appetite, and reveals what foods you need to eat to keep your brain—and by extension your body—properly fueled.

Drawing upon cutting-edge scientific research, Dr. Ramsey identifies the twenty-one nutrients most important to brain health and overall well-being—the very nutrients that are often lacking in most people’s diets. Without these nutrients, he emphasizes, our brains and bodies don’t run the way they should.

Eat Complete includes 100 appetizing, easy, gluten-free recipes engineered for optimal nourishment. It also teaches readers how to use food to correct the nutrient deficiencies causing brain drain and poor health for millions. For example:

• Start the day with an Orange Pecan Waffle or a Turmeric Raspberry Almond Smoothie, and the Vitamin E found in the nuts will work to protect vulnerable brain fat (plus the fiber keeps you satisfied until lunch).

• Enjoy Garlic Butter Shrimp over Zucchini Noodles and Mussels with Garlicky Kale Ribbons and Artichokes, and the zinc and magnesium from the seafood will help stimulate the growth of new brain cells.

• Want to slow down your brain’s aging process? Indulge with a cup of Turmeric Cinnamon Hot Chocolate, and the flavanols found in chocolate both increase blood flow to the brain and help fight age-related memory decline.

Featuring fifty stunning, full-color photographs, Eat Complete helps you pinpoint the nutrients missing from your diet and gives you tasty recipes to transform your health—and ultimately your life.


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The Happiness Diet

For the first time in history, too much food is making us sick. It's all too apparent that the Modern American Diet (MAD) is expanding our waistlines; what's less obvious is that it's starving and shrinking our brains. Rates of obesity and depression have recently doubled, and while these epidemics are closely linked, few experts are connecting the dots for the average American.

Using the latest data from the rapidly changing fields of neuroscience and nutrition, The Happiness Dietshows that over the past several generations small, seemingly insignificant changes to our diet have stripped it of nutrients--like magnesium, vitamin B12, iron, and vitamin D, as well as some very special fats--that are essential for happy, well-balanced brains. These shifts also explain the overabundance of mood-destroying foods in the average American's diet and why they predispose most of us to excessive weight gain.

After a clear explanation of how we've all been led so far astray, The Happiness Diet empowers the reader with simple, straightforward solutions. Graham and Ramsey show you how to steer clear of this MAD way of life with foods to swear off, shopping tips, brain-building recipes, and other practical advice, and then remake your diet by doubling down on feel-good foods--even the all-American burger.


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Fifty Shades of Kale

Kale gets sexy in Fifty Shades of Kale by Drew Ramsey, M.D., and Jennifer Iserloh, with 50 recipes that are mouth-wateringly delicious and do a body good.
Release yourself from the bondage of guilt and start cooking meals with the ingredients you love: meat, cheese, and yes—even butter. Nutrient-rich kale provides essential vitamins and minerals to keep you healthy, happy, and lean—so you can indulge in your most delicious desires. Whether you’re a cooking novice or a real kale submissive, you will undoubtedly succumb to Kale’s charms.

From Mushroom and Kale Risotto to Kale Kiwi Gazpacho, Fifty Shade of Kale offers simple ways to have your kale and eat it, too, as well as nutritional information, cooking tips, and a tutorial on kale in all her glorious shades.
Indulge your culinary passions with Fifty Shades of Kale: 50 Fresh and Satisfying Recipes That Are Bound to Please.


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