Neurodietetics: The dietary science of human flourishing
Is it a paradox to suggest we need science to achieve a natural state of health? That appears to be precisely our situation – the current trend toward dietary deficiencies amongst abundance is swiftly veering away from our evolutionary survivalist trajectory with dire health consequences – not only involving physical health but mental health as well.
The brain is the most sensitive organ in our body and manifests its pathology cognitively, emotionally, and behaviorally, often insidiously. Diet has a profound influence on our minds. With some understanding of these effects, we can relieve suffering and possibly help reverse neuropsychiatric pathology.
Even without overt clinical signs of physical, cognitive, or emotional decline, we can achieve a profound state of mind-body wellness, eudaimonia – human flourishing – with proper lifestyle choices. This book is about mind-body flourishing through dietary choices that the author calls “neurodietetics.”
The New Ancestral Diet
We as primates have struggled mightily during the past 85 million years to find and eat enough food for survival. Fortunately, every one of your ancestors was successful so that you might succeed in that same endeavor. However, today that survival is in jeopardy. Recently and suddenly, from an evolutionary standpoint, the problem of subsistence in “civilized” countries has inverted: we have plenty of food but are not making selections that lead to long-term survival. Our plant-based ancestral diets for which we have become genetically adapted have become animal-based. For thousands of millennia, primate nutrition happened while seeking a wide variety fruits and vegetables sufficiently energy-dense to supply our needed daily calories. Today we still seek energy-dense foods, but in the form of high fat animal products or sweet processed foods. Nutrient-dense foods, formerly our staples, are tolerated as side-dishes. Taste, the most primitive of our senses, over the eons existed for our survival (as all the other senses), that is, to deselect plants sufficiently bitter as likely toxic or non-digestible. With the expansion of our brain capacity, taste was joined by higher brain regions’ appreciation of flavor. The result is a demand for flavorful energy-dense foods. Every meal experience must “taste good”. Dietary patterns based on such flavorful energy-dense foods has lead to chronic inflammatory states with high morbidly and mortality in the Western world. This book suggests a return to our true ancestral dietary patterns, supplemented by what is known from the latest scientific research concerning nutritional health. It is clear that we have evolved to be quite versatile eaters and while we can eat a variety of foods, a whole-food varied plant-based diet is best for our long-term survival as healthy and happy primates. Following the high nutrient density to energy density ratio, we recommend a dietary emphasis on green vegetables, particularly leaves, followed by all colors of vegetables, beans/legumes, then underground storage organs followed by a modicum of grains, nuts, and seeds. Personal opinions have been kept to a minimum. Most of the information presented herein is from recent peer reviewed scientific sources. For improved readability, these have been collected at the end of the book for each chapter section and subsection.
The Cognitive Milieu
This book was written for a most important but unsung group of therapists – those professionals who work all day with adolescents in a residential treatment setting. These therapists are often not titled as therapists per se, being assigned names such as “technician” or “direct care staff.” We shall call them properly “Milieu Therapists,” or even more formally “Cognitive Milieu Therapists.” While the Individual Therapist may meet individually with the resident once a week for an hour, perhaps with the resident and family for another hour, and with a group of residents once or twice a week, the other 165 hours are primarily the treatment domain of the Milieu Therapists. The Individual Therapist introduces therapeutic concepts but these are practiced in the milieu. Therefore, a critical element for therapeutic progress is communication between the Individual Therapist and the rest of the Treatment Team, including the Milieu Therapist. This can be accomplished during staffings and through documentation such as the Master Treatment Plan with regular updates. Or through personal one-on-one contacts. Given the importance of the Milieu Therapists, it is curious that there is no degree program or licensing for this individual. Typically, there is great responsibility and expectations with little training and support. That was the main impetus for this book, a basic manual for the Milieu Therapist. This need became particularly apparent with our residential program in which Cognitive Behavioral Therapy (CBT) is used comprehensively, across all treatment modalities including in the milieu. Over the more than dozen years since its implementation, we have found this approach to be highly effective, providing the Milieu Therapist with an excellent tool to assist residents to advance in their treatment within a therapeutic cognitive milieu. The idea of a “cognitive milieu” could apply to any setting, not just residential treatment. For example, we have applied it successfully in modified form to acute hospitalization. However, the basic principles could be utilized also in group homes, schools, even family settings. The main ingredients are knowledge of CBT and the presence of a facilitator to help the participant recognize triggers and respond to them with reality-based logic rather than distorted conditioned responses. Life is difficult. As Mark Twain once said: “It’s mind over matter, if you don’t mind, it doesn’t matter.” Some situations, even faced with realistic true understanding are still difficult. If we can understand that and accept that fact as an integral part of the human condition, it is not so difficult. It’s just life. What we as therapists try to do is facilitate removal of self-made difficulties, those that exist because of negative unrealistic processing of our environment. Typically, these distortions are based on unpleasant memories of the past or fears of the future – not so much on what is happening now. Now can be difficult but manageable. The past, a potentially useful concept that we can learn from, cannot be altered now – that’s impossible; the future, also a useful concept that we can prepare for, cannot be dealt with now – that’s impossible. The milieu therapist helps the resident deal with the reality of now.
We are delighted to offer this workbook as a simple effective approach to alleviating emotional challenges faced by many adolescents and young adults. The technique employed is that of Cognitive Behavioral Therapy (CBT), generally accepted as a best therapeutic practice for children, adolescents, and adults experiencing a variety of life distresses. As we discovered, there was a lack of available suitable instruments to utilize this technique for adolescents in group or individual therapy, therefore “Think Again” was created. Briefly, CBT recognizes that the human condition is influenced by a series of triggers that through conditioned responses, leads to emotions, some of which may be unpleasant and may result in undesirable behavior. However, if we think again after such triggers until our emotions are more acceptable, this can result in more acceptable behavior. We have utilized this workbook in various revised versions over the past dozen or so years in both in-patient and residential settings on thousands of adolescents with great success and, therefore, wish to offer it to therapists, parents, and adolescents in all settings. There are five Chapters. Each may be used in one session, for example one each weekday for five settings. It is important for the participant to internalize the content of each Chapter before moving on to the next. Once the workbook is completed, the real work begins: applying these concepts to everyday life. The Appendix contains some additional “Think Again” concept workbook sheets. Eventually the idea is to not require this formal written procedure but instead process mentally. After considerable practice, this should become second nature. We also offer a Think Again manual intended primarily for the adult facilitating therapy titled “Think Again: Therapist Instruction Manual”. A related text also available to the general public after more than a decade of development, is the application of these techniques in the day-to-day, hour-by-hour setting at home or in any structured setting, titled “The Cognitive Milieu”. It is our sincere intent that this tried-and-true product will relieve some suffering and, indeed, elevate emotional wellness in our adolescents well into adulthood