WEBVTT 00:00:00.470 --> 00:00:03.648 [music] 00:00:03.648 --> 00:00:05.138 (Speaker) So, I mean, it's the 00:00:05.138 --> 00:00:06.629 old adage you are what you eat. 00:00:07.140 --> 00:00:09.970 When I eat, like, sugary or caffeinated foods 00:00:09.970 --> 00:00:12.800 I often find myself, like, unable to focus. 00:00:13.394 --> 00:00:18.230 So, eating healthier foods has had a significant impact on 00:00:18.230 --> 00:00:23.410 how well I can focus, as well as how quick I can think. 00:00:23.950 --> 00:00:25.594 (Host) That's Angela Guo. 00:00:25.982 --> 00:00:28.978 She's a 17-year old senior at Adlai Stevenson High School 00:00:29.309 --> 00:00:31.070 in Lincolnshire, Illinois. 00:00:31.568 --> 00:00:34.954 And that adage she just cited, "You are what you eat," 00:00:35.398 --> 00:00:37.522 that's been around since the 1800's. 00:00:37.928 --> 00:00:42.218 People have known for a long time just how much food affects us. 00:00:42.818 --> 00:00:45.650 But it's not just in terms of long-term health, 00:00:45.966 --> 00:00:48.123 but also short-term mood. 00:00:48.663 --> 00:00:51.526 (Angela) Food really helps us maintain 00:00:51.526 --> 00:00:55.939 a state clarity. And, so, eating healthier foods 00:00:55.939 --> 00:00:58.691 has had a significant impact 00:00:58.691 --> 00:01:04.021 on how well I can focus, as well as how quick I can think. 00:01:05.008 --> 00:01:05.454 (Host) She may only be in high school, 00:01:05.901 --> 00:01:06.794 but Angela has 00:01:06.794 --> 00:01:10.494 already made the crucial connection between what she puts in her mouth 00:01:10.494 --> 00:01:12.950 and how quickly that affects her brain. 00:01:13.510 --> 00:01:15.729 She even believes that simple understanding 00:01:16.078 --> 00:01:18.259 gave her a real advantage when she competed 00:01:18.259 --> 00:01:21.277 in the National Science Olympiad tournament earlier this year. 00:01:22.006 --> 00:01:25.404 (Announcer) First place, national champions of the 00:01:25.404 --> 00:01:28.849 2023 Science Olympiad National Tournament, 00:01:28.849 --> 00:01:33.023 Adlai Stevenson High School of Illinois! Let's go! [audience cheering] 00:01:33.663 --> 00:01:35.951 (Host) Now, at this tournament earlier this year, 00:01:35.951 --> 00:01:38.957 Angela and her teammates went up against thousands of students 00:01:38.957 --> 00:01:40.179 from around the country. 00:01:40.179 --> 00:01:42.387 They were competing in events, highlighting 00:01:42.387 --> 00:01:44.595 chemistry and earth science and biology. 00:01:44.870 --> 00:01:48.006 But here's the thing: the entire time on Angela's team 00:01:48.244 --> 00:01:50.259 you really didn't see much sugar around. 00:01:50.430 --> 00:01:53.037 Instead, there were lots of healthy snacks. 00:01:54.310 --> 00:01:56.969 (Angela) So, even at school, I'd bring my own lunch 00:01:57.171 --> 00:02:00.687 and it's just that aspect of knowing what goes into your meals 00:02:00.911 --> 00:02:03.865 is like really important. It kind of gives you peace of mind. 00:02:04.093 --> 00:02:07.019 (Host) The team did really well, and now as they 00:02:07.019 --> 00:02:08.477 prepare for more tournaments, 00:02:08.477 --> 00:02:12.944 Angela, who's now a team captain, says, "Sure, they do study hard, 00:02:13.192 --> 00:02:17.791 but what they eat, how they eat, that's also top of mind. 00:02:18.312 --> 00:02:22.627 AG: When we do travel for Science Olympiad our coaches always makes sure that 00:02:22.629 --> 00:02:24.570 our, like, bus is well stocked with 00:02:24.570 --> 00:02:26.512 fruits and water. 00:02:26.852 --> 00:02:31.249 SG: So Angela, seems pretty convinced that food helps her focus 00:02:31.249 --> 00:02:33.447 and perform well academically. 00:02:33.866 --> 00:02:37.203 Of course, that makes sense but the question today, 00:02:37.409 --> 00:02:41.970 "What is the empirical evidence to support that and how does it work? 00:02:42.319 --> 00:02:44.659 How exactly does food impact the brain? 00:02:44.969 --> 00:02:48.330 And how do we really know when our brain is well nourished?" 00:02:48.330 --> 00:02:49.802 Uma Naidoo: Sugar is not good 00:02:49.802 --> 00:02:50.573 for our brain 00:02:50.573 --> 00:02:54.001 But I also want people to understand we need sugar for our bodies and our 00:02:54.001 --> 00:02:56.677 brain, so it's where you get the sugar that's important. 00:02:56.677 --> 00:03:00.389 SG: Look, a lot of people worry about how food influences the way we look, 00:03:00.389 --> 00:03:03.306 how much weight we may gain -- I get that -- 00:03:03.306 --> 00:03:06.394 or the likelihood we're going to be high risk for diseases, 00:03:06.394 --> 00:03:08.166 like diabetes and hypertension. 00:03:08.468 --> 00:03:12.848 But even though it is harder to measure, food is also deeply connected 00:03:12.848 --> 00:03:17.721 to how we feel in the moment and how well the brain functions. 00:03:17.793 --> 00:03:21.833 Even as you listen to this podcast, your experience, right now, 00:03:21.833 --> 00:03:25.042 is likely affected by what you ate earlier today. 00:03:25.646 --> 00:03:30.506 So in this episode, I'm going to find out what's the best fuel for the brain, 00:03:30.506 --> 00:03:34.077 what food we should avoid and what it really means 00:03:34.077 --> 00:03:36.068 to have a well-nourished brain. 00:03:36.571 --> 00:03:40.366 I'm Dr. Sanjay Gupta, CNN's Chief Medical Correspondent 00:03:40.442 --> 00:03:42.202 and this is Chasing Life. 00:03:47.934 --> 00:03:50.155 You know, I love hearing stories like Angela's. 00:03:50.155 --> 00:03:52.903 They're so personal. She's someone who's paying attention 00:03:52.903 --> 00:03:54.761 to her body and then she's figuring out 00:03:54.761 --> 00:03:58.790 what makes her feel good and what it takes to do the activities she loves. 00:03:59.299 --> 00:04:02.141 She's being really intentional with her nutrition 00:04:02.141 --> 00:04:05.335 and that may save her from having health problems later in life 00:04:05.393 --> 00:04:08.478 but, it could help optimize her function now. 00:04:08.972 --> 00:04:12.387 For me, food is an endless source of fascination. 00:04:12.933 --> 00:04:14.883 The way that I think about it is this: 00:04:15.206 --> 00:04:20.596 Food is one of the most significant ways we allow our outside world to influence 00:04:20.596 --> 00:04:26.189 and communicate with our inside world, the world inside of our body and our mind. 00:04:26.642 --> 00:04:29.394 That is an awesome task. Food does that. 00:04:29.802 --> 00:04:32.187 So, I thought today we would start with the basics. 00:04:32.187 --> 00:04:36.466 We know that all food items have calories and calories are by definition energy 00:04:36.843 --> 00:04:40.673 but, as you just heard, not all calories are created equal. 00:04:40.964 --> 00:04:43.580 Some have more nutrients and do more to promote 00:04:43.580 --> 00:04:45.714 overall health and well-being than others. 00:04:46.022 --> 00:04:48.993 And that is especially true when it comes to the brain. 00:04:49.396 --> 00:04:52.954 But the challenge again: That's hard to measure. 00:04:52.954 --> 00:04:57.460 There is no brain scan or blood test that indicates that a particular food 00:04:57.603 --> 00:04:59.340 promotes brain health. 00:04:59.340 --> 00:05:01.083 So how do we really know? 00:05:01.083 --> 00:05:03.679 How do you really know what works for you? 00:05:05.600 --> 00:05:08.930 To find out, I return to someone whose work I really respect 00:05:08.974 --> 00:05:13.204 both in the clinic and in the kitchen, someone who knows a lot 00:05:13.204 --> 00:05:17.537 about this really intricate connection between food and brain health. 00:05:18.040 --> 00:05:19.716 Uma Naidoo: If you want, you know, 00:05:19.716 --> 00:05:21.496 your brain to really be optimized, 00:05:21.658 --> 00:05:24.873 lean into the foods you like, but the healthy versions of that. 00:05:25.039 --> 00:05:29.904 SG: That's Dr Uma Naidoo; she's a nutritional psychiatrist. 00:05:30.136 --> 00:05:32.755 Such a cool field. She's at Harvard Medical School. 00:05:33.157 --> 00:05:35.863 What she does is that she works with patients to improve 00:05:35.863 --> 00:05:39.464 their mental health with the help of medication and food. 00:05:39.795 --> 00:05:42.809 She's also a professional chef. She's the author of the books 00:05:42.809 --> 00:05:46.362 "This is Your Brain on Food" and "Calm Your Mind with Food." 00:05:46.362 --> 00:05:48.756 That one's going to be released later this year. 00:05:48.756 --> 00:05:52.514 I should tell you, this is actually Dr Naidoo's second time on the show. 00:05:53.151 --> 00:05:57.269 We spoke a few years ago about the broader concept of food as medicine, 00:05:57.550 --> 00:06:00.960 and I was so fascinated by the conversation, so affected by it, 00:06:00.960 --> 00:06:05.191 I asked her to come back and discuss how food impacts brain health specifically 00:06:05.615 --> 00:06:07.029 and brain function. 00:06:07.188 --> 00:06:09.546 I have long said that I think food 00:06:09.546 --> 00:06:13.176 can be medicine, I also think just philosophically, 00:06:13.176 --> 00:06:16.999 we consciously decide what signals we're going to give to the inside 00:06:16.999 --> 00:06:18.408 of our body through food. 00:06:19.155 --> 00:06:22.734 What the discussion has primarily focused on has been calories and energy, 00:06:23.005 --> 00:06:24.986 and are you going overweight or not. 00:06:25.025 --> 00:06:27.506 UN: Correct SG: So what are those foods that are both 00:06:27.506 --> 00:06:30.038 good for the brain and can actually get to the brain? 00:06:30.038 --> 00:06:34.520 UN: What I think is good, and I think what is helpful for people, 00:06:34.520 --> 00:06:37.550 especially in the U.S., is that most people are consuming 00:06:37.550 --> 00:06:38.979 the standard American diet 00:06:38.979 --> 00:06:41.343 which, as you know, is called sad for a reason. 00:06:41.507 --> 00:06:45.923 So any time that we can add those lipid grains and those actual whole foods 00:06:46.023 --> 00:06:51.666 onto our plate, you know, and think about it that way and step away 00:06:51.666 --> 00:06:54.088 a little bit from those processed fast foods, 00:06:54.616 --> 00:06:58.205 the healthier we are going to become as a country and I think that that is 00:06:58.205 --> 00:07:02.331 because processed, ultra-processed foods are engineered, as you know, 00:07:02.331 --> 00:07:03.478 to trick our brain. 00:07:03.478 --> 00:07:06.843 So we eat more, we can't stop ourselves. 00:07:06.843 --> 00:07:12.179 SG: Yeah, maybe I'm being audacious here in doing a podcast about how to achieve 00:07:12.179 --> 00:07:15.596 a most optimally nourished brain. 00:07:15.596 --> 00:07:19.516 As you correctly point out, we have a lot of work to do as a country to just 00:07:19.516 --> 00:07:24.805 stop doing the bad things, maybe even before we can, uh, really, really focus 00:07:24.805 --> 00:07:25.902 on the good things. 00:07:25.902 --> 00:07:30.678 But the idea that food itself can be medicine and that can be quantified, 00:07:30.941 --> 00:07:36.087 maybe even to the point, for someone like you, prescribed. Are we to the point, 00:07:36.317 --> 00:07:40.230 with what we know, data-wise that food can be thought of prescriptive, 00:07:40.576 --> 00:07:41.858 like we think of medicine? 00:07:42.129 --> 00:07:46.798 UN: So I can't yet say to you, you need to eat ten blueberries over this amount 00:07:46.798 --> 00:07:48.357 of time to improve your mood. 00:07:48.357 --> 00:07:51.990 But what we do know from pretty large population-based studies that 00:07:51.990 --> 00:07:57.615 if you were consuming extra-dark natural chocolate, that it improved depression 00:07:57.615 --> 00:08:02.883 by 70% in over 12,000 participants. We know and it was in the candy bars 00:08:02.883 --> 00:08:06.903 it was extra dark natural chocolate, which contains serotonin, magnesium, 00:08:06.997 --> 00:08:11.944 um, some fiber. So, we're not at a point where I can say this number 00:08:11.944 --> 00:08:14.050 of blueberries in order to improve your mood, 00:08:14.050 --> 00:08:17.769 but we are definitely emerging and growing in the scientific evidence 00:08:17.769 --> 00:08:22.169 to be able to say you can construct a nutritional psychiatry plate 00:08:22.169 --> 00:08:23.461 for your mood. 00:08:23.461 --> 00:08:29.283 You can lean into those leafy green vegetable, 3-5 cups a day. Um, things like 00:08:29.283 --> 00:08:34.013 arugula, spinach all contain folate. A low folate is associated with low mood. 00:08:34.013 --> 00:08:38.880 So, we can give people guidance around it and really have them understanding that 00:08:38.880 --> 00:08:41.188 food is moving in that direction. 00:08:42.158 --> 00:08:45.983 SG: Now before we hear more food recommendations, I want to note something 00:08:45.983 --> 00:08:50.002 that's, I think, really important here. the term "brain food." 00:08:50.002 --> 00:08:54.195 That gets thrown around a lot. But, true brain food meaning any food that actually 99:59:59.999 --> 99:59:59.999 impacts the function of the brain has to do something really important. 99:59:59.999 --> 99:59:59.999 It's got to get past the blood-brain barrier. 99:59:59.999 --> 99:59:59.999 Now, I don't want to get to wonky or technical, but I think it's important 99:59:59.999 --> 99:59:59.999 for you to understand this point. Think of the blood-brain barrier as sort 99:59:59.999 --> 99:59:59.999 of a body guard for the brain. This barrier prevents the entry of toxins 99:59:59.999 --> 99:59:59.999 and pathogens and other molecules that could be harmful to the brain. 99:59:59.999 --> 99:59:59.999 What it looks like is a system of blood vessels around the brain and the central 99:59:59.999 --> 99:59:59.999 nervous system that sort of keep tight control over which molecules and which 99:59:59.999 --> 99:59:59.999 nutrients are allowed to get in. 99:59:59.999 --> 99:59:59.999 UN: We know this, for example a lot of serotonin that's manufactured 99:59:59.999 --> 99:59:59.999 in the gut and some in the brain but the more peripheral serotonin 99:59:59.999 --> 99:59:59.999 doesn't cross over the blood brain barrier, so why not look at the foods 99:59:59.999 --> 99:59:59.999 which are the precursors to the neurotransmitters, that then 99:59:59.999 --> 99:59:59.999 interact with the gut microbes, I'm fascinated by the gut microbes. 99:59:59.999 --> 99:59:59.999 The impact of the gut microbes and then they are able to cross over 99:59:59.999 --> 99:59:59.999 the blood brain barrier and then form the substances that we need 99:59:59.999 --> 99:59:59.999 in the brain. So I'm thinking about things we need like serotonin 99:59:59.999 --> 99:59:59.999 and dopamine. 99:59:59.999 --> 99:59:59.999 Let me hit pause here to explain a couple of things about 99:59:59.999 --> 99:59:59.999 the gut. You probably know this, but the gut contains trillions 99:59:59.999 --> 99:59:59.999 of micro organisms. Bacteria, viruses, fungi. Collectively 99:59:59.999 --> 99:59:59.999 they are referred to as the gut microbiome. Now, these micro organisms 99:59:59.999 --> 99:59:59.999 or microbes aren't just hanging out, they play an important role in 99:59:59.999 --> 99:59:59.999 our health and they are constantly interacting with each other and 99:59:59.999 --> 99:59:59.999 the rest of our body. While a few of those bacteria or pathogens are 99:59:59.999 --> 99:59:59.999 potentially harmful, many are helpful. For example, what they will do is 99:59:59.999 --> 99:59:59.999 they will break down food, they will then interact with our immune system, 99:59:59.999 --> 99:59:59.999 they will synthesize vitamins and amino acids. And then they communicate with 99:59:59.999 --> 99:59:59.999 other parts of the body. And that brings me to the second thing about the gut. 99:59:59.999 --> 99:59:59.999 It is sometimes called the second brain, and I think that is a good title. And 99:59:59.999 --> 99:59:59.999 that's because it uses many of the same chemicals and cells as the brain to do 99:59:59.999 --> 99:59:59.999 its job and to communicate. In fact, there is an extraordinary amount 99:59:59.999 --> 99:59:59.999 of cross talk between the gut and the brain. This makes the gut very 99:59:59.999 --> 99:59:59.999 sensitive to emotions. Anger, fear, anxiety. Those things can cause 99:59:59.999 --> 99:59:59.999 problems in the gut, vise versa. When the gut feels bad, it can 99:59:59.999 --> 99:59:59.999 cause anxiety and other emotional issues. Understanding that might 99:59:59.999 --> 99:59:59.999 give new meaning to phrases like, having "butterflies in your stomach" 99:59:59.999 --> 99:59:59.999 when you're nervous, or a quote, unquote "gut feeling" about a person or 99:59:59.999 --> 99:59:59.999 a situation. 99:59:59.999 --> 99:59:59.999 This is why Doctor Niudu's work is so important and intriguing. She says, 99:59:59.999 --> 99:59:59.999 "It is possible for food to impact how well our brain functions and how we 99:59:59.999 --> 99:59:59.999 feel mentally." For example, some ultra processed foods have been linked to 99:59:59.999 --> 99:59:59.999 disrupting the gut microbiome in a way that increases the risk for depression. 99:59:59.999 --> 99:59:59.999 In contrast, some whole foods such as bananas help trigger the production 99:59:59.999 --> 99:59:59.999 of important chemicals in the gut such as the molecule, serotonin. 99:59:59.999 --> 99:59:59.999 But again, remember this point. Much of the serotonin made 99:59:59.999 --> 99:59:59.999 in the gut cannot cross the blood brain barrier and that is why 99:59:59.999 --> 99:59:59.999 doctor Nidu says we need to focus on the precursors to 99:59:59.999 --> 99:59:59.999 serotonin, which can then cross more easily and be assembled 99:59:59.999 --> 99:59:59.999 in the brain. Think of it like this, there are certain foods, for example, 99:59:59.999 --> 99:59:59.999 ones that are rich in the amino acid tryptophan, that when eaten interact 99:59:59.999 --> 99:59:59.999 with the gut microbiome. You with me? 99:59:59.999 --> 99:59:59.999 And they become then the precursor or building blocks for serotonin. 99:59:59.999 --> 99:59:59.999 And then these building blocks cross into the brain, get converted to 99:59:59.999 --> 99:59:59.999 serotonin, and exert their influence. The reason that I'm repeating this 99:59:59.999 --> 99:59:59.999 so many times is because it is so important. What does 99:59:59.999 --> 99:59:59.999 this all mean? Eating foods like, salmon or pineapple, ones that 99:59:59.999 --> 99:59:59.999 are loaded with tryptophan, could help you feel happier and calmer. 99:59:59.999 --> 99:59:59.999 That is a better definition of brain food. 99:59:59.999 --> 99:59:59.999 UN: Another fascinating but odd research that is coming through is 99:59:59.999 --> 99:59:59.999 several microbiome companies testing the microbiome. So, they are looking 99:59:59.999 --> 99:59:59.999 more deeply into what's in the microbiome and what you may need 99:59:59.999 --> 99:59:59.999 to eat versus what I might need to eat because our microbiome is so 99:59:59.999 --> 99:59:59.999 sort of unique. Whether you take that substance as a supplement, or you 99:59:59.999 --> 99:59:59.999 take it as a guidance around food, it can really help us more finely tune 99:59:59.999 --> 99:59:59.999 the way that we can be eating. 99:59:59.999 --> 99:59:59.999 SG: What level of evidence to you rely on to make your recommendations 99:59:59.999 --> 99:59:59.999 when it comes to food? How do you collect that data and that evidence? 99:59:59.999 --> 99:59:59.999 UN: So, I try to keep current with whatever the new research is. For 99:59:59.999 --> 99:59:59.999 example, there was a fascinating study done recently and all of these years 99:59:59.999 --> 99:59:59.999 I've been encouraging my patients to eat foods that are rich in vitamin A. 99:59:59.999 --> 99:59:59.999 And this particular study show that actually vitamin A rich foods are not 99:59:59.999 --> 99:59:59.999 that helpful for mood or for your brain health. Another interesting 99:59:59.999 --> 99:59:59.999 study. 99:59:59.999 --> 99:59:59.999 SG: What are those foods? Not to cut you off, but what kinds of foods are we 99:59:59.999 --> 99:59:59.999 talking about? 99:59:59.999 --> 99:59:59.999 UN: So, you know, eggs, milk, fish oils beef liver, tomatoes, red bell pepper. 99:59:59.999 --> 99:59:59.999 Now, does it mean that those foods are foods I will tell my patients not 99:59:59.999 --> 99:59:59.999 to eat? Absolutely not. Uh, like, the new research about serotonin. It's 99:59:59.999 --> 99:59:59.999 more that I would have emphasized eating vitamin A rich foods along with 99:59:59.999 --> 99:59:59.999 that nutritional psychiatry plate. And I most importantly feel that 99:59:59.999 --> 99:59:59.999 what's been my secret sources has been integrating the actual literature 99:59:59.999 --> 99:59:59.999 the research and what I do clinically with seeing patients and 99:59:59.999 --> 99:59:59.999 being able to monitor them you know and see how they do. Because I think, 99:59:59.999 --> 99:59:59.999 please know that I come at this with great humility. I don't feel that 99:59:59.999 --> 99:59:59.999 because whatever I've studied that you know, that I have the way to make 99:59:59.999 --> 99:59:59.999 everyone feel better. But I have certainly seen my patients improve. 99:59:59.999 --> 99:59:59.999 SG: You know, when I was growing up, um, maybe you heard this as well 99:59:59.999 --> 99:59:59.999 when you were a child, but there were certain foods that were 99:59:59.999 --> 99:59:59.999 "brain foods." Fish for example was sort of considered a brain food. 99:59:59.999 --> 99:59:59.999 UN: Nuts, almonds. SG: Nuts, you know. And my 99:59:59.999 --> 99:59:59.999 mom would always, you know, "If you eat this, you'll be smart." 99:59:59.999 --> 99:59:59.999 You know, that was always the 99:59:59.999 --> 99:59:59.999 encouragement. But what of it, though? Are there foods that 99:59:59.999 --> 99:59:59.999 can reliably help our brains? What are they and why? 99:59:59.999 --> 99:59:59.999 UN: So, one of the groups I'll start with, because people are pretty familiar 99:59:59.999 --> 99:59:59.999 with this, that the foods rich in omega-3. So, things like fatty 99:59:59.999 --> 99:59:59.999 fish. There's a mnemonic for the fish that are top of the list, "SMASH". Salmon, 99:59:59.999 --> 99:59:59.999 Mackerel, Anchovies, Sardines, and Herring. Um, because they contain 99:59:59.999 --> 99:59:59.999 forms of uh EPAJHA that are actually helpful um for the brain and will 99:59:59.999 --> 99:59:59.999 actually make a difference. And they have anti Primatene and antioxidant 99:59:59.999 --> 99:59:59.999 properties. Then, you know people who don't consume seafood can rely on the 99:59:59.999 --> 99:59:59.999 plant based sources like chia seeds, flax seeds, almonds. Having a vegan 99:59:59.999 --> 99:59:59.999 supplement or an algal oil supplement made from sea algae is something that 99:59:59.999 --> 99:59:59.999 you can do to improve your brain performance if you feel you're not 99:59:59.999 --> 99:59:59.999 getting enough nutrition from food. So that's one very big group. Another 99:59:59.999 --> 99:59:59.999 group of foods that I think people tend to just think of only as a 99:59:59.999 --> 99:59:59.999 supplement, but is actually available in our everyday foods, are prebiotics 99:59:59.999 --> 99:59:59.999 and probiotics. 99:59:59.999 --> 99:59:59.999 SG: Ok, I want to pause here again to offer a crash course in pre and 99:59:59.999 --> 99:59:59.999 probiotics. Terms you've probably heard about. Probiotics are "live bacteria" that 99:59:59.999 --> 99:59:59.999 may offer health benefits when consumed in adequate numbers. 99:59:59.999 --> 99:59:59.999 You can find them in things like fermented foods. Yogurt, kimchee. 99:59:59.999 --> 99:59:59.999 You can buy them in pill form. Prebiotics on the other hand, are food for your 99:59:59.999 --> 99:59:59.999 microbiome. These are the organisms that are living in your gut and prebiotic 99:59:59.999 --> 99:59:59.999 foods are usually higher in certain types of fiber and include items like 99:59:59.999 --> 99:59:59.999 fruit and veggies and whole grains. Now, as Doctor Nidu said, it is hard 99:59:59.999 --> 99:59:59.999 to prescribe these foods to an exact timing or an exact dosage, but at the 99:59:59.999 --> 99:59:59.999 time, we have been making a lot of progress there as well. 99:59:59.999 --> 99:59:59.999 UN: So when we think about food groups, Omega 3, those probiotics and prebiotics, 99:59:59.999 --> 99:59:59.999 those fermented foods, all can actually be helpful in reducing things like anxiety 99:59:59.999 --> 99:59:59.999 and depression. 99:59:59.999 --> 99:59:59.999 SG: We'll be right back. 99:59:59.999 --> 99:59:59.999 SG: And now back to Chasing Life and my conversation with nutritional psychiatrist 99:59:59.999 --> 99:59:59.999 Dr. Uma Naidoo. Now that I have a better sense of which, and how, certain foods 99:59:59.999 --> 99:59:59.999 might impact my mood, what I wanted to know is how food might affect my 99:59:59.999 --> 99:59:59.999 general brain health. 99:59:59.999 --> 99:59:59.999 UN: So just, you know, having a dairy and non-dairy plain yogurt with live active 99:59:59.999 --> 99:59:59.999 cultures does help your gut. Probiotics were actually tested in the study and the 99:59:59.999 --> 99:59:59.999 use of probiotics were compared to a dose of an SSRI, and the probiotics showed 99:59:59.999 --> 99:59:59.999 a better effect. So, not to single out just one study, it has been shown again, 99:59:59.999 --> 99:59:59.999 but I think that's compelling information, that a person who is consuming something 99:59:59.999 --> 99:59:59.999 like yogurt, or say a fermented food is adding these probiotics and live cultures 99:59:59.999 --> 99:59:59.999 to their gut, could in fact be helping the gut microbes, helping the serotonin 99:59:59.999 --> 99:59:59.999 formation there. We don't know the exact mechanisms of everything, but we can tell 99:59:59.999 --> 99:59:59.999 by the improvements in symptoms. For example, if I am assessing someone in my 99:59:59.999 --> 99:59:59.999 clinic, I have to go by their report, which may or may not be 100% accurate 99:59:59.999 --> 99:59:59.999 sometimes, but that happens with all of us, but also to check the improvement of 99:59:59.999 --> 99:59:59.999 their mood. Improvement in anxiety. That is one way to assess how they're doing and 99:59:59.999 --> 99:59:59.999 if these foods are making a difference. 99:59:59.999 --> 99:59:59.999 SG: So, you're comparing yogurt to an antidepressant. 99:59:59.999 --> 99:59:59.999 UN: That's right. 99:59:59.999 --> 99:59:59.999 SG: I mean, that, I know it's almost comical to reflect on, but I mean look, we 99:59:59.999 --> 99:59:59.999 take too many pills, ya know? And these pills have side-effects, and so the idea 99:59:59.999 --> 99:59:59.999 that yogurt could, and I don't want to overstate this, Dr. Naidoo, so you tell 99:59:59.999 --> 99:59:59.999 me. What do they find when they compare yogurt to an antidepressant in a study? 99:59:59.999 --> 99:59:59.999 UN: So, they found that individuals who consumed yogurt along with, say, a 99:59:59.999 --> 99:59:59.999 selective serotonin re-uptake inhibitor had a better response and improvement in 99:59:59.999 --> 99:59:59.999 mood. So, it offered us a guidance in this area to basically think that, you know, we 99:59:59.999 --> 99:59:59.999 can use these inventions around the gut microbiome, and the use of things like 99:59:59.999 --> 99:59:59.999 probiotics. Which, you know, I think most of my patients would rather reach for 99:59:59.999 --> 99:59:59.999 a yogurt than, you know, an antidepressant. 99:59:59.999 --> 99:59:59.999 SG: If I was to describe to my three teenage girls a well nourished brain, 99:59:59.999 --> 99:59:59.999 like, I think we can describe a healthy body, right? We can say, "You don't have 99:59:59.999 --> 99:59:59.999 plaques in your blood vessels, you have good blood pressure, heart rate.." all 99:59:59.999 --> 99:59:59.999 that sort of stuff. How, Dr. Naidoo, would you describe a well nourished brain? 99:59:59.999 --> 99:59:59.999 What do you get in return? 99:59:59.999 --> 99:59:59.999 UN: For one thing, you focus, your energy, your ability to get through your day, not 99:59:59.999 --> 99:59:59.999 having that afternoon slump where you're not quite sure but you're sluggish and 99:59:59.999 --> 99:59:59.999 you need another cup of coffee or candy bar or something more. If you're athletic, 99:59:59.999 --> 99:59:59.999 if you're engaged in sports or other activities, if you're having fun with your 99:59:59.999 --> 99:59:59.999 friends and going out and doing things, you're going to have the energy to do 99:59:59.999 --> 99:59:59.999 that. Plus, you're going to be able to actually manage your schoolwork 99:59:59.999 --> 99:59:59.999 because your brain being optimized, eating in a healthy way will mean you can manage 99:59:59.999 --> 99:59:59.999 your schedule, you can multitask, you can engage in other activities and still get 99:59:59.999 --> 99:59:59.999 through school okay and do well. 99:59:59.999 --> 99:59:59.999 SG: 80% of people over the age of 60 put "fear of loss of memory" as one of their 99:59:59.999 --> 99:59:59.999 top concerns, fear of dementia of some sort. Are there foods that can help stave 99:59:59.999 --> 99:59:59.999 off diseases like dementia? 99:59:59.999 --> 99:59:59.999 UN: Yes. Certainly, there's some guidance around what food to eat and how to eat it, 99:59:59.999 --> 99:59:59.999 so foods that will help cognition, we actually go back to those Omega 3's. 99:59:59.999 --> 99:59:59.999 It's a group that's featured very frequently. Olive oil is also one that we 99:59:59.999 --> 99:59:59.999 lean into. The herbs and spices that showed up doing well for cognition, and 99:59:59.999 --> 99:59:59.999 for thinking, and for memory are turmeric with a pinch of black pepper, which makes 99:59:59.999 --> 99:59:59.999 it much more bioavailable. Cinnamon, saffron, rosemary, ginger, sage. Then 99:59:59.999 --> 99:59:59.999 some guidances around coffee was thought, if you keep your caffeine consumption and 99:59:59.999 --> 99:59:59.999 your coffee consumption under 400mg a day was thought to be healthy, but for me, 99:59:59.999 --> 99:59:59.999 this is some guidance, while I know that those foods have been identified as 99:59:59.999 --> 99:59:59.999 healthy, it's also part of an overall plate, right? It's not just eating the 99:59:59.999 --> 99:59:59.999 nuts or eating the olive oils, it's putting that together in a meal that's 99:59:59.999 --> 99:59:59.999 still tasty that makes a very big difference to balancing that out for 99:59:59.999 --> 99:59:59.999 people. 99:59:59.999 --> 99:59:59.999 SG: I'm very interested in trying to stay as mentally sharp as possible, as long as 99:59:59.999 --> 99:59:59.999 possible. My life, I'm in my early 50's now, I mean. You've talked about the 99:59:59.999 --> 99:59:59.999 specific food groups and things that are probably going to be the things that I 99:59:59.999 --> 99:59:59.999 should gravitate toward, but could you just, like, what's an ideal breakfast, an 99:59:59.999 --> 99:59:59.999 ideal lunch, and an ideal dinner? Should I be having all three meals, should I 99:59:59.999 --> 99:59:59.999 intermittently fast? Snacks? How would you put it together? 99:59:59.999 --> 99:59:59.999 UN: Right, so, with intermittent fasting or with fasting in general, for my 99:59:59.999 --> 99:59:59.999 patients, we usually really see what their body intelligence is. What I mean by that 99:59:59.999 --> 99:59:59.999 is how they respond to food. Do they wake up hungry? Do they need to take medication 99:59:59.999 --> 99:59:59.999 in the morning that require them to eat? Some people naturally get up and they're 99:59:59.999 --> 99:59:59.999 not hungry, and then we lean more into intuitive eating, lean into what your body 99:59:59.999 --> 99:59:59.999 pattern is. I like people to have snacks because I'd rather they have some healthy 99:59:59.999 --> 99:59:59.999 nuts or a little bit of berries that will nurture them through. Great breakfasts, 99:59:59.999 --> 99:59:59.999 things like a chia pudding rich in protein, fiber, easy to make, has Omega 99:59:59.999 --> 99:59:59.999 3's in it, and can be prepared ahead. Things like if you consume eggs with lots 99:59:59.999 --> 99:59:59.999 of veggies of veggies in them, or a vegetarian version of that would be a tofu 99:59:59.999 --> 99:59:59.999 scramble, again lean into the spices, your fresh herbs, because that's a great 99:59:59.999 --> 99:59:59.999 way to go. I'm a fan of avocado toast, I love sourdough bread, because it has a 99:59:59.999 --> 99:59:59.999 fermented starter, so the natural process of it is it has a slightly lower sugar 99:59:59.999 --> 99:59:59.999 content. I slice tomato on it. The lycopene from tomato are super healthy 99:59:59.999 --> 99:59:59.999 for the brain and it actually turns out that much of the lycopene is from the 99:59:59.999 --> 99:59:59.999 skin. So, you know, slice your tomatoes and leave the skin on. For lunch, I like 99:59:59.999 --> 99:59:59.999 to lean into a really big salad and then put my favorite proteins with that. So, 99:59:59.999 --> 99:59:59.999 lentils, legumes, and some tofu or other things which flavor it up, and make an 99:59:59.999 --> 99:59:59.999 interesting dressing that will make that enjoyable for you. Nuts and seeds are 99:59:59.999 --> 99:59:59.999 another great way to lean into it. Then, one of my other favorite afternoon snacks, 99:59:59.999 --> 99:59:59.999 and it's funny because I learned that chocolate and citrus, like clementines or 99:59:59.999 --> 99:59:59.999 oranges, pair well from a flavor profile in culinary school, but I recently, over 99:59:59.999 --> 99:59:59.999 the last few years, discovered there's actual science behind it. Extra dark 99:59:59.999 --> 99:59:59.999 chocolate is the highest source of plant- based iron. Cool reason to eat dark 99:59:59.999 --> 99:59:59.999 chocolate. 99:59:59.999 --> 99:59:59.999 SG: Look, I'm never going to eat dark chocolate the same way again! I will 99:59:59.999 --> 99:59:59.999 always have it with a little citrus. I love little tips like that, that's 99:59:59.999 --> 99:59:59.999 fantastic. 99:59:59.999 --> 99:59:59.999 UN: Exactly. Then, in the evening is when I'll usually end up having a bigger 99:59:59.999 --> 99:59:59.999 meal. Like, I'll do a cauliflower steak, but I'll use the spices from tikka 99:59:59.999 --> 99:59:59.999 masala. So, you know, someone else in my family may have the chicken version, but 99:59:59.999 --> 99:59:59.999 I'll have the cauliflower version. I can do it air fried or grilled, but I always 99:59:59.999 --> 99:59:59.999 add in veggies around that, so a salad. I find that to be satiating, I know it's 99:59:59.999 --> 99:59:59.999 helping my metabolism, but it's a green. So the green beans, or the brussel sprouts 99:59:59.999 --> 99:59:59.999 or whatever it is, I add spices to them so that they're more flavorful. 99:59:59.999 --> 99:59:59.999 SG: So, I didn't hear any meat? 99:59:59.999 --> 99:59:59.999 UN: So, I was born into a vegetarian family, so I'm vegetarian. 99:59:59.999 --> 99:59:59.999 SG: Should I be a vegetarian? 99:59:59.999 --> 99:59:59.999 UN: (Laughs) No, I think people should eat what they enjoy eating. I just think they 99:59:59.999 --> 99:59:59.999 should eat healthy versions. I happen to be in a family where everyone else eats 99:59:59.999 --> 99:59:59.999 meat, so I think that meat has a place on that diet, and I feel like the B vitamins 99:59:59.999 --> 99:59:59.999 from meat are something that as a vegetarian, I supplement. I think there is 99:59:59.999 --> 99:59:59.999 also a place for plant-based eaters. 99:59:59.999 --> 99:59:59.999 SG: What about carbs? 99:59:59.999 --> 99:59:59.999 UN: I think that carbs are important. They're really important for our brain, 99:59:59.999 --> 99:59:59.999 they're really important for our body, but it's where we obtain our carbs. 99:59:59.999 --> 99:59:59.999 SG: A lot of messaging seems to indicate that they're toxic because of the glycemic 99:59:59.999 --> 99:59:59.999 index, the sugar, these types of things, the calories. 99:59:59.999 --> 99:59:59.999 UN: Right. So, all of those, there's truth to many of those factors, but I think it's 99:59:59.999 --> 99:59:59.999 the messaging has also got to show people that you need carbs for your body and for 99:59:59.999 --> 99:59:59.999 your brain to function. It's where you obtain your carbs; if you're eating a 99:59:59.999 --> 99:59:59.999 sugary donut with a coffee laced with highly processed cream and eight sugars, 99:59:59.999 --> 99:59:59.999 that's very different from a avocado toast on sourdough bread, maybe with some smoked 99:59:59.999 --> 99:59:59.999 salmon or a tofu scramble with tons of spinach and vegetables in it. A totally 99:59:59.999 --> 99:59:59.999 different product. They break down differently in your body. 99:59:59.999 --> 99:59:59.999 SG: Yeah, the healthy carbs vs. the healthy proteins vs. the healthy fats, you 99:59:59.999 --> 99:59:59.999 know, these big categories of food. We know that myelin coats the nerves and it's 99:59:59.999 --> 99:59:59.999 kind of like the coating on a wire. A wire doesn't conduct as well unless it has the 99:59:59.999 --> 99:59:59.999 coating on it. Myelin is sort of like that coating on nerves, and that's made up 99:59:59.999 --> 99:59:59.999 primarily of fat, and there's been people that I have talked to that have said you 99:59:59.999 --> 99:59:59.999 really need to focus on eating those fats to get that myelin. I would put that at 99:59:59.999 --> 99:59:59.999 he top of my list in terms of brain foods. Maybe not the healthiest 99:59:59.999 --> 99:59:59.999 cardiovascular, although again, these are good fats, not the bad trans fats. If you 99:59:59.999 --> 99:59:59.999 look at healthy proteins, healthy fats, healthy carbs, how to you sort of think 99:59:59.999 --> 99:59:59.999 about it with regard to impact on the brain? 99:59:59.999 --> 99:59:59.999 UN: So I think that balance is really important. I ask people to lean into all 99:59:59.999 --> 99:59:59.999 the different vegetables, and I'm not leading with potatoes and sweet potatoes. 99:59:59.999 --> 99:59:59.999 I'm leading with cruciferous vegetables and leafy greens, and legumes, lentils, 99:59:59.999 --> 99:59:59.999 and beans. Then you want to think of your olive oil, your avocado, your salmon, and 99:59:59.999 --> 99:59:59.999 your other healthy fats. You want to think about, what I like to say, your "clean" 99:59:59.999 --> 99:59:59.999 source of protein, and all I mean by that is have, you know, stir-fry tofu in a 99:59:59.999 --> 99:59:59.999 healthy way, or air fry something instead of deep fried fish, for example. The fish 99:59:59.999 --> 99:59:59.999 itself may be healthy, but the method is not. Now, once in a while, of course, but 99:59:59.999 --> 99:59:59.999 not as your everyday meal. Then, I don't forget fruit. So, some berries, you know, 99:59:59.999 --> 99:59:59.999 a couple servings of fruit is super important to get those natural sugars into 99:59:59.999 --> 99:59:59.999 your body rather than reaching for the candy bar that we know is not the 99:59:59.999 --> 99:59:59.999 healthiest choice. 99:59:59.999 --> 99:59:59.999 SG: So what about sugar? And, let me preface it by saying this; I did a piece 99:59:59.999 --> 99:59:59.999 for 60 Minutes years ago called "The Toxic Truth", and we thought long and hard about 99:59:59.999 --> 99:59:59.999 what to title this, because I didn't want it to be unfairly or unnecessarily 99:59:59.999 --> 99:59:59.999 alarmist. But, when I talked to some of the nutritionists when we were 99:59:59.999 --> 99:59:59.999 interviewing them, they said this is an appropriate title. The way we humans 99:59:59.999 --> 99:59:59.999 consume sugar is toxic. We consume too much, our livers don't know what to do 99:59:59.999 --> 99:59:59.999 with it, it hits our bodies like a tsunami wave, and churns out these low-density 99:59:59.999 --> 99:59:59.999 lipoproteins, the bad kind of cholesterol, which I thought was really 99:59:59.999 --> 99:59:59.999 interesting. The brain, when it's exposed to too much sugar, the receptors will 99:59:59.999 --> 99:59:59.999 actually start to shut down. So, you could be in a situation, as they outlined it to 99:59:59.999 --> 99:59:59.999 me, where you're stuffing the body and starving the brain essentially at the 99:59:59.999 --> 99:59:59.999 same time, and that's because you're eating too much sugar. We know it's a 99:59:59.999 --> 99:59:59.999 problem, but how bad is sugar for our brain? 99:59:59.999 --> 99:59:59.999 UN: So, sugar is a problem, but I also want people to understand we need sugar 99:59:59.999 --> 99:59:59.999 or our bodies and our brains, so it's where you get the sugar that's important. 99:59:59.999 --> 99:59:59.999 Metabolic health, you know, with the rising in type 2 diabetes, insulin 99:59:59.999 --> 99:59:59.999 resistance in this country, the fact that we have common overweight and obesity in 99:59:59.999 --> 99:59:59.999 the country, there's a reason. I do think there's so much sugar in our everyday 99:59:59.999 --> 99:59:59.999 foods, including our savory foods, like our ketchup, pasta sauces, salad 99:59:59.999 --> 99:59:59.999 dressings. French fries at fast food restaurants are engineered to contain 99:59:59.999 --> 99:59:59.999 sugar. You don't taste it, but they are really engineered to tap into our 99:59:59.999 --> 99:59:59.999 cravings. 99:59:59.999 --> 99:59:59.999 SG: That sounds kind of sinister when you put it like that. I realize that this 99:59:59.999 --> 99:59:59.999 isn't opioids we're talking about, but the idea of tapping into our cravings.. 99:59:59.999 --> 99:59:59.999 UN: The research has shown that foods, ultra processed and processed, have a 99:59:59.999 --> 99:59:59.999 significant amount of brain science behind how they tap into cravings. I think 99:59:59.999 --> 99:59:59.999 that, the more that people should understand the amount of sugar in our 99:59:59.999 --> 99:59:59.999 food. So, I teach all my patients that 4 grams of sugar is 1 teaspoon, because our 99:59:59.999 --> 99:59:59.999 food labels are in grams and we cook and bake all our U.S. cookbooks in pounds and 99:59:59.999 --> 99:59:59.999 ounces. So, if a person goes to a yogurt, and it's 6oz or 4oz, it could have 24g of 99:59:59.999 --> 99:59:59.999 sugar in it. You'd think, "Oh, that's not bad." When actually, you wouldn't put that 99:59:59.999 --> 99:59:59.999 number of teaspoons into your plain yogurt. 99:59:59.999 --> 99:59:59.999 SG: So, if you see 4g of sugar on the food label, imagine you're seeing a full 99:59:59.999 --> 99:59:59.999 teaspoon of sugar in it. You see 12g, 3 teaspoons. So, it's a good visual. Let me 99:59:59.999 --> 99:59:59.999 ask you real quick, coffee/caffeine is something that seems to come on and off 99:59:59.999 --> 99:59:59.999 the favored list. Where do you land on that, when it comes to the brain? 99:59:59.999 --> 99:59:59.999 UN: I like coffee, and I think that coffee has a lot of health benefits in 99:59:59.999 --> 99:59:59.999 it. It's actually rich in plant polyphenols. The caffeine, my patients 99:59:59.999 --> 99:59:59.999 with anxiety can be sensitive to, so it depends on what their tolerance is. 99:59:59.999 --> 99:59:59.999 Interestingly, studies of ADHD in adults show that coffee can help focus, so it's a 99:59:59.999 --> 99:59:59.999 certain amount of coffee, not too much, so my patients who are struggling with 99:59:59.999 --> 99:59:59.999 ADHD or some issues around focus, I like to encourage them, if they can tolerate 99:59:59.999 --> 99:59:59.999 coffee and they don't become jittery or uncomfortable. You know, have it early in 99:59:59.999 --> 99:59:59.999 the day, don't go more than 2-3 cups, have them be small cups. Also, clean up 99:59:59.999 --> 99:59:59.999 the coffee, meaning, you know, have it the way that you'd like, but if you're putting 99:59:59.999 --> 99:59:59.999 1/2 cup of processed cream and 8 sugars, you're not helping your brain. 99:59:59.999 --> 99:59:59.999 SG: Can we manage anxiety with food? This is the topic of your new book coming out 99:59:59.999 --> 99:59:59.999 just in time for the holidays, right? 99:59:59.999 --> 99:59:59.999 UN: It is. My new book is "Calm Your Mind With Food" because during the pandemic, 99:59:59.999 --> 99:59:59.999 that's what I saw. People really struggling at all ages, all demographics, 99:59:59.999 --> 99:59:59.999 with anxiety and we know that even coming out of Covid, that numbers are increased. 99:59:59.999 --> 99:59:59.999 So, I feel that if we looked at an integrated approach to really using 99:59:59.999 --> 99:59:59.999 anxiety more as a strength and using food to harness how we can feel better, I think 99:59:59.999 --> 99:59:59.999 it'll help a lot of us. 99:59:59.999 --> 99:59:59.999 SG: I would like to imagine a world where we just wouldn't have to take many of the 99:59:59.999 --> 99:59:59.999 medications that we take. I mean, I'm a doctor, you're a doctor, there's a role, 99:59:59.999 --> 99:59:59.999 but we spend $4 trillion on health care, and an increasingly large amount of that 99:59:59.999 --> 99:59:59.999 is on prescription drugs. Food is the only signal we give the inside of our body from 99:59:59.999 --> 99:59:59.999 the outside world on a daily basis and it can be therapeutic. It can make us feel 99:59:59.999 --> 99:59:59.999 better, and I just really, really love the work that you do, Dr. Naidoo. I really 99:59:59.999 --> 99:59:59.999 admire it. 99:59:59.999 --> 99:59:59.999 UN: Thank you so much. Thank you for having me back, it's always great to talk 99:59:59.999 --> 99:59:59.999 to you. You always have fascinating questions, I love it. 99:59:59.999 --> 99:59:59.999 SG: We talked for a long time, Dr. Naidoo and I, and she goes into even more depth 99:59:59.999 --> 99:59:59.999 in this connection between diet and anxiety in her new book, which is coming 99:59:59.999 --> 99:59:59.999 out in December. As I've told her, it's an idea that I find really fascinating. 99:59:59.999 --> 99:59:59.999 It makes sense that food affects our bodies. It also affects our brains, and 99:59:59.999 --> 99:59:59.999 it does so quickly, so it makes total sense that it would affect our mental 99:59:59.999 --> 99:59:59.999 health as well. Food is more than just calories; it's a signal. It's a message. 99:59:59.999 --> 99:59:59.999 It affects more than your weight and whether you have a flat stomach or not. 99:59:59.999 --> 99:59:59.999 Food can be a medicine. It can help stave off disease, manage our moods, help us 99:59:59.999 --> 99:59:59.999 think more clearly. So, chew on that the next time you want to feel smarter, or 99:59:59.999 --> 99:59:59.999 calmer. Next time on Chasing Life, we have a very special episode for you. We're 99:59:59.999 --> 99:59:59.999 going to be talking about the frightened brain. What happens when we get scared, 99:59:59.999 --> 99:59:59.999 and why do some people like feeling that way? Who better to answer those questions 99:59:59.999 --> 99:59:59.999 than the king of horror himself: Stephen King. 99:59:59.999 --> 99:59:59.999 Stephen King: Everything is out to get you. You see, that's the dark side of the 99:59:59.999 --> 99:59:59.999 imagination. But, the good side of it is that you're able to take reasonable 99:59:59.999 --> 99:59:59.999 precautions and watch out for either Coronavirus, or Jason in the Friday the 99:59:59.999 --> 99:59:59.999 13th movies. They both go together. 99:59:59.999 --> 99:59:59.999 SG: Thanks for listening. 99:59:59.999 --> 99:59:59.999 Chasing life is a production of CNN Audio. Our podcast is produced by Eryn 99:59:59.999 --> 99:59:59.999 Mathewson, Madeleine Thompson, David Rind, and Grace Walker. Our senior producer and 99:59:59.999 --> 99:59:59.999 show runner is Felicia Patinkin. Andrea Kane is our medical writer, and Tommy 99:59:59.999 --> 99:59:59.999 Barbarian is our engineer. Dan Dzula is our technical director, and the executive 99:59:59.999 --> 99:59:59.999 producer of CNN audio is Steve Lickteig. Special thanks to Ben Tinker, Amanda Sealy 99:59:59.999 --> 99:59:59.999 and Nadia Kounang of CNN Health.