13 Sep Clinic of The Future Part V: Metabolic Health Is Mental Health

This this post was originally posted here

In 1992, Democratic strategist James Carville famously coined the phrase “It’s the economy, stupid!” as the guiding principle for Bill Clinton’s first presidential campaign. The pithy phrase conveyed the importance voters placed on economic issues in light of the recession under President George H. W. Bush.

Despite the many issues that appeal to voters, the phrase captured the singular issue that would give Clinton the win.

Similarly, when considering the multitude of factors contributing to an individual’s psychological, emotional, and physical health and well-being, a singular input—that has become disastrous—has an overwhelmingly outsized impact on the health of the whole organism.

It’s the food, stupid!

Share

In Part V of this series on The Clinic of the Future, we’ll examine the critical role of metabolic function in mental health, emphasizing the somehow overlooked aspect of food in the modern healthcare system.

As a refresher, I posit that future treatment paradigms will include four domains: Relational, Experiential, Energetic, and Metabolic.

Today, we’re looking at the Metabolic.

The emerging evidence that the most common constituents of the modern diet are actively pathological is too great to ignore. It will soon be apparent that any treatment approach to mental health and wellbeing that does not include a nutritional plan will be insufficient.

It’s The Food Stupid!

Here’s where we’re heading;

• Evolution shaped our biology in response to intermittent access to nutrient-dense foods.   

• The modern diet, the Standard American Diet (SAD), is riddled with nutrient-poor, calorie-rich, processed sugars, carbs and fats.   

• The SAD leads to inflammation, oxidative stress, and insulin resistance—pathological states that involve the mitochondria and are the root causes of nearly all chronic diseases, including mental illnesses.   

• Metabolic psychiatry aims to address mental illness at its origin: food.

The Evolutionary Lens

Any rigorous analysis of modern health and disease patterns must consider an evolutionary lens. 

One way to do this is to examine how different our modern lifestyle is from the environment in which our species evolved.

Humans evolved in small, close-knit, nomadic tribes where food access was uncertain and demanded constant effort. This formative period of about 300,000 years shaped our biology, which remains essentially unchanged today.

However, our current environment differs dramatically from that ancestral one. Two fundamental changes are particularly significant: the composition of our food and the ease with which we can access it.

Our ancestors’ diet consisted solely of plants and animals they had to hunt, gather, and forage. They expended energy to acquire energy. This resulted in a metabolism that evolved to use specific food components—primarily fiber, protein, and fat—for energy, tissue building, and maintenance.

Additionally, our ancestors faced regular periods of food scarcity, likely even experiencing prolonged fasting more often than not. This shaped our metabolic flexibility and ability to cope with limited food availability.

Now, compare this food environment of natural scarcity to our current food environment of synthetic hyperabundance, built on readily available, highly processed, nutrient-poor, additive-laden refined sugars, simple carbohydrates, and inflammatory fats. 

Comparing the stark differences between our ancestral food environment and our modern one offers a powerful insight: the food we eat today may play a significant role in our current health state, as depicted in the graph.

Share

SAD in America

While the Neolithic Revolution—also known as the Agricultural Revolution, which began in the Middle East 10,000 to 12,000 years ago—marked the beginning of our dietary shift, it was the Industrial Revolution that truly accelerated the evolution of our food system.

The introduction of petroleum-based fertilizers and pesticides, farm mechanization, and industrial food processing led to a dramatic departure from our evolutionary diet.

Throughout the 19th and 20th centuries, the refinement of scalable and profitable food production techniques led the Western diet to diverge from its evolutionary roots significantly.

While the Industrial Revolution began in England, the impact on the American food system was more pronounced. This can be attributed to two primary factors: 

• Government subsidies, meant to ensure a stable food supply, incentivized the production of corn, wheat, soybeans, and rice over fruit and vegetables, and

• The adoption of aggressive marketing strategies by food companies, mirroring tactics previously used by the tobacco industry.

The industrialization of our food system has led to a troubling reality: over 60% of the food consumed in America today is calorie-rich but nutrient-poor, consisting of industrially processed artificial sugars, carbs, and fats.

This shift towards processed foods is driven by their longer shelf life and higher profit margins, prioritizing commercial interests over nutritional value.

The consequences of this dietary landscape are dire, manifesting primarily in three ways:

• Chronic inflammation

• Oxidative stress

• Insulin resistance. 

Specifically, this phenotype overwhelms our mitochondria, an oft-overlooked cellular organelle that emerging research implicates in nearly all chronic diseases, including diabetes, obesity, heart disease, cancers, and mental illnesses.

Share

Metabolic Health Is Mitochondrial Health; Mitochondrial Health Is Mental Health

Mitochondria are far more than just energy producers.

They are vital communication hubs that orchestrate cellular function, including gene expression in response to various stressors.

This influence extends beyond energy metabolism, affecting cellular health, stress responses, and disease development.

In This is Your Mitochondria on Psychedelics, we noted:

Perhaps, the most interesting and “paradigmy” is the research that shows how mitochondria serve as a crucial interface between the genome and the environment and orchestrating gene expression in response to stress, external stimuli and internal demands.

We might even say that, in addition to the “powerhouse of the cell,” mitochondria are also the “central processing units of the cell.”

As regulators of gene expression, mitochondria influence not only the cellular response to stress and injury but also the maintenance of cellular health and the development of disease. 

Through complex signaling pathways, mitochondria communicate with the nucleus to regulate the activity of genes, effectively serving as conductors in the symphony of cellular life.

This orchestration ensures that the cell adapts efficiently to changes, protects against stress, and mediates repair mechanisms.

With regards to the mitochondria’s role in mental illness, in a paper titled Stress and Psychiatric Disorders: The Role of Mitochondria, the authors  note: 

“The mitochondrion, well-known for its role in cellular energy production, represents a critical nexus of biological, psychological, and social factors that underlie the mechanisms and consequences of the stress response. Psychosocial factors impact biological processes through physiological systems that are highly integrated with mitochondrial functioning.”

While the emerging field of metabolic psychiatry is often equated with low-carb or ketogenic diets, their true value lies in altering the fundamental environment of mitochondria.

By changing their energy source and surrounding conditions, these dietary interventions can profoundly influence cellular function and health.

The modern food environment, dominated by industrially processed sugar, carbs, and unhealthy fats, is far from the food we evolved with. 

This has led to a surge in metabolic dysfunction, which in turn fuels a multitude of chronic diseases, including mental health disorders. 

The emerging field of metabolic psychiatry highlights the critical connection between food, metabolism, and mental well-being, offering hope for a more comprehensive approach to healthcare in the future. 

By addressing the root causes of metabolic dysfunction, we can potentially not only improve physical health but also alleviate the burden of mental illness. 

The message is clear: it’s the food, stupid!