172. Ultra-Processed Minds: Trauma, Addiction & the Food We Eat | David Wiss, PhD

Welcome to Medicine Redefined, a podcast focusing on helping you reclaim ownership of your health. I'm Dr. Darsha, and I'm Dr. Altamasharaja, where you're host, here to challenge conventional practices and uncover the stories behind pioneers shaping the future of medicine. Our conversations not only focus on the individual level to dissect common practices for health optimization, but also zoom out to enhance systemic change. Join us as we look to break the status quo, move the needle forward, and put the help back in healthcare. Our guest today is Dr. David Whiss, a registered dietician with a PhD in Public Health from UCLA in a minor in health psychology. David is the founder of Nutrition in Recovery and the creator of the Wise Mind Nutrition App, which blends nutritional psychology, behavioral change, and trauma informed care. His work sits at the cutting edge of nutritional psychiatry, functional medicine, and public health, and today's conversation will leave you thinking deeply about how food shapes not just our bodies, but our minds, behaviors, and even our societal structures. So in this episode we discuss the difference between disordered eating and eating disorders, being an insightful dive into arphid, which stands for avoidant restrictive food intake disorder. We'll also touch on how ultra-process foods may contribute to addictive-like behaviors and how this overlaps and diverges from eating disorder pathology. We'll touch on the concept of nutritional criminology and how food systems may reinforce systemic injustice, as well as the emerging science around gut brain immune interactions and the role of inflammation in mental health. We'll also touch on David's personal journey through addiction, recovery, and what ultimately inspired his career in nutritional mental health. Enjoy this episode. Welcome to the podcast, Dr. David Whiss. How are you? Excellent today. How are you? We are doing well. We're doing really well. Man, I have been all too much as well. We've really been looking forward to this podcast. We're just talking a little bit offline about how much on this podcast now that we've been over four years. We've talked about mental health. We've talked about nutrition. We've brought on experts in both of those fields, and now you're here to really integrate the two and go down the rabbit hole with us so that we can all learn. And I know our guest or our listeners are really going to benefit from this episode. Let's dive right into it then. What is disordered eating? Great question. There is a distinction between disordered eating and eating disorders. And sometimes they're used interchangeably. Eating disorders are very clear, diagnostic categories. The more common ones are anorexia nervosa, bulimia nervosa, and binge eating disorder. There is a growing eating disorder called arfid, avoidant and restrictive food intake disorder, which is becoming more and more common and happy to touch on that if it's of interest. Disordered eating captures the broader scope of dysfunctional eating patterns could be subclinical or subthreshold, could be atypical in some ways, could be related to other issues. For example, a substance use disorder or a history of trauma, or it could just be a relic of a lot of diet culture that's in society that really promotes ideas about how one should eat, how one should look that people internalize. So it is a catch all term that describes eating patterns that might not be in the best interest of the eater. Gotcha. Yeah. Definitely a spectrum of things then, right, from not taking into many calories to maybe over excess with calories, different foods that you mentioned. Yeah. Take us through a little bit of that arfid. That is definitely new to me. Yeah. I think that historically, the term that people have heard or probably have used is picky eater, and this is an effort to understand this more clinically, to not see it as someone's choice of being picky and see it as more of a experience that has some biological, as well as psychological, probably some environmental contributors. There's a sensory component too, where the person, usually the child, becomes very averse to a lot of different foods and can be predictably satisfied with a very small range of foods, not to generalize, but there's a pattern, right? You could see the chicken nugget, the pizza, the burger. It's usually like the wheat, meat, and cheese and the ultra processed foods, right? They tend to condition the brain on what food should taste like, and unfortunately the cost is the very difficult time incorporating other foods. It could be the dopamine response, it could also be the texture, it could also be the possibility that certain foods are linked to traumatic experiences growing up, emotional difficulties, maybe parents pressuring, but I think there is a very much sensory component on the spectrum and continuum of neurodivergence. I'm sure there's some stuff we haven't discovered yet with the trigeminal nerve and the way the different parts of the brain register, the food, the insula, like I said, the reward system. There's a lot of research happening there because there are more and more youth having this problem, and it's very distressing to parents when they can't get their kid to eat anything other than six foods. But as an addiction researcher and specialist, I do think that the neurochemical response from ultra processed foods is a major contributor because it makes other foods less rewarding and there's less motivation to consume them. I think that's a part of the puzzle, but not the whole puzzle. You mentioned children, so is this one of the ones that is, like for instance, I think about, if I remember correctly, the conduct disorder is one of them, before the age of 16, it's called something else and when you become an adult, it's called conduct disorder. What's the predecessor to that? Do you remember? Darshan. I think it's conduct. It ties your soul. Maybe I have it the other way around it. Yeah, so is this like arphid is earlier on and then down the road when you become an adult, it turns, we characterize it as something different, like maybe you might have bulimia or anorexia or a combination of two. Or is it something that carries on to adulthood, like from a DSM diagnostic criteria? I think most people conceptualize them as pretty distinct from the classic eating disorder, so the category in the DSM-5 is eating and feeding disorders and it falls more under the realm of a feeding disorder rather than a classic eating disorder where there might be body image disturbance, very clear emotion dysregulation related to food, restrained eating, etc. So it's more of a feeding disorder and I think that parents that raise kids understand that during development, there's going to be periods where the relationship with food changes and certainly when someone is for and has strong preferences for certain foods, it's not to be quickly pathologized, but once they reach closer to 10 and puberty is on the horizon, it does become a concern for growth and for overall nutrition and me as someone interested in nutrition for brain health and mental health, I think the consequence of it is noteworthy in terms of mental development and there's ways to intervene. Some people do grow out of certain preferences and it doesn't turn into other clinically significant eating disorders, but it's a very difficult thing to treat and it requires creativity and a lot of support and a lot of encouragement and a lot of rewiring. Yeah, but it's interesting, we're not that far out of medical dorsal and I don't, this was not mentioned at all in any of the texts that I learned and I find it interesting, I think that the one point that you made with the body image issues with the other eating disorders that notoriously people learn about, they hear about, it is a strong component of it. Whereas, again, as you mentioned, children in most four-year-olds, that's not on their radar, but the sensory component, I got a three-year-old now and so a lot of it you're talking about some days, it's just going to be, some days you fight the fight to try to put good nutrition in other days, you're just like, okay, let's just get something in that belly and make sure you're not getting up in the middle of the night and so this is interesting to me, I gotta look more into it. You didn't mention, though, you're interested, again, mental health, the intersection between nutrition and how they may be transforming or even hurting our current landscape of just health in general, talk a little bit about how you see the intersection of nutrition and mental health. You did your whole doctorate in this, transforming the way we address what plagues are mental health challenges our society today. Yeah, when I think about the connection between nutrition and mental health, I usually try to think about three buckets. The first is the biology, the nutrients for brain health, right? Very clear scientific basis to understand the omega-3s and the B vitamins and the magnesiums, just the connection between nutrients and brain function could be directly, like, for example, the omega-3 is getting into the brain or could be indirectly, right? The different vitamins and minerals that are a part of pathways that are related to brain health, and then, of course, I think about gut health, right? The second brain, very clear connection between, if you think about the connection between food and the brain, right? The mediator is the gut, right? So that is the very clear science that has highlighted the role of nutrition and mental health and made it clear that there are multiple pathways, multiple mechanisms. And then the area that I've had particular interest in, and this goes back to the eating disorder conversation, is how we think about food, the language, and the messaging that we have internalized. This is the growing field of nutritional psychology in which I'm deeply interested in. Because mental health, obviously, we know, is not just biology, right? There's biology, psychology, social and environmental factors, context, and as someone who has studied public health, I like thinking about the larger contextual factors, whether it be diet, culture that's in society, or the role of weight stigma, or the impact of influencers, or the need for group identities that people have. Most humans crave being a part of a tribe, and sometimes nutrition can be a gateway toward building a social identity. And so there's a lot when it comes to nutrition and mental health, and I try to touch on all of them and bring them together using a biopsychosocial model. A lot to cover there. And my initial thought was that I wanted to segue into the gut brain stuff, because you said that is at the center connecting, but I actually defer to you on this. What do you think it makes sense to start touching on a little bit of all that, and I'm here to learn. So you tell me if gut brain access, if starting there makes more sense, or is it, do we separate them apart so we can digest a little bit better, nobody intended? I think there's so much to say about the bi-directional pathway between the gut and the brain. There are so many ways to conceptualize the relationship, bottom up, top down, vagus nerve, which I think we only know a little bit about in the context of where some of the research might be heading. And of course, there are the more biomedical explanations when you think about precursors for neurotransmitters amino acids. You think about fibers being converted into short-chain fatty acids. There's a lot of activity that is charged by our inner ecosystem. And I think that area of research has exploded and will continue to. But the one that I have taken the most interest in is the immune system. There's an emerging field called psycho-neuroimmunology, and I find it to be very fascinating. Of course, we're looking at nutrients that are in the blood circulating, et cetera. But the inflammatory cascades to me seem to be a very important link between the gut and the brain. And one of the reasons why nutrition matters so much, we know that certain types of foods, like ultra-processed foods are pro-inflammatory, and we know that there are foods that are anti-inflammatory. And the benefits of those foods for mental health isn't just what fibers are in there, what fats are in there, what nutrients are in there. I think there's a growing understanding that inflammation, a lot of it starts in the gut, and can travel throughout the periphery. And most people are familiar with the term leaky gut, which is better known as, should say, or maybe more intelligently known as intestinal permeability. But I've taken great interest, and I'm not going to say that I am a neuroscience expert, but this emerging concept of the leaky brain. Permiability at the level of the blood brain barrier suggests that there is a lot of communication happening with the microglia and the astrocytesy immune cells at the blood brain barrier, which are basically signaling the brain about what's going on throughout the body. A lot of it generates in the gut. But I don't have all the data in the world to support what I'm about to say, but I have a hunch that inflammatory cascades are one of the primary links between the gut and the brain, and particularly in the context of mental health, anxiety, depression, cravings, negative affect. This is the growing topic of neuroinflammation, which I will say is just a difficult thing to study. This is expensive research, and I think there's some really important work going on in this area. But that's where I've put my eyeballs to really start to understand how pro-inflammatory diets can lead to adverse mental health conditions by way of low grade systemic inflammation that builds up over time and influences brain function. I was just about to ask you if we can get a little nerdy on exactly what those outcomes are for mental health. So we're talking about pro-inflammation. Is this a direct impact on neurotransmitters and serotonin dopamine that is then going to lead to a depressed mood? I wish I could really unpack all the mechanisms, but like I said, it's pretty difficult to study neuroinflammation. I know there is some indication that, for example, a amygdala can be a site for neuroinflammation. One of the ways that I've come to understand the brain is that it's not just always site-specific, but we think about how different regions of the brain communicate with each other. The functional connectivity. So if I'm going to assume that if one part of the brain is having some difficulties, it's going to have a hard time communicating with other parts of the brain. It's going to lead to certain parts of the brain being more dominant, and that would, I think, explain why some people are less able to recruit their prefrontal cortex and bring just logic and rational processes into scenarios and be more dominated by emotional reactivity and in the context of trauma, a lot of the work that I've done looks at what we call threat vigilance. Moving through life, just hyper-vigilant to threats, feeling unsafe a lot. It's almost there's a hidden antenna that's moving through the world and detecting unsafety, and that makes it very difficult to have inner peace, and that is definitely one of the more well-established consequences of PTSD and early life adversity, which is one of the biggest predictors of most mental health conditions, and where I've taken interest also in dysfunctional, or as we said earlier, disordered eating behavior. So yeah, early life trauma changes in the brain, changes in eating. It all starts to accumulate over time and create risks that are sometimes difficult to turn the ship around. You mentioned trauma early life, and then also early adversity. Did you mean adversity in the sense of trauma, or do you think, because when I think about adversity, a lot of things, it helps create resilient, and started to just talk about this yesterday, right? Diversity is good. In many sense, it's good. Stress can be good. It helps harden you. It helps prepare you for being able to handle the challenges of life and life throws at you. But are we talking about just adversity that has manifested into something negative, something traumatic in that nature, or are we just talking about adversity period? Yeah. I sometimes lump stress trauma and adversity together as just known risk factors, but I try not to be a lumper. I try to be a splitter, as we say. And usually when myself and other people use the term adversity, at least in the context of research, often points to the body of literature on adverse childhood experiences. So those are 10 aces that are in the household. And then the community level, aces that are perhaps at school in the neighborhood. And yeah, I think the body of evidence on aces is so large that when I think about childhood adversity, obviously it's more than just aces, but that instrument has really brought that word to the forefront. I'm also deeply interested in the context of resilience. And do believe that certain stressors can have a, what we call a stealing effect, make someone more able to face life. But that definitely is more of an exception than the rule, at least in most research. Awesome. I definitely want to return back to trauma. I'm sure we'll have a more of a discussion on that in regards to trauma and mental health and diet. But sticking on the gut, I did want to ask, there's a lot of companies now coming out with certain tests that you can do to check out food sensitivities and your gut microbiome. And if you want foods, you can include what foods you should avoid. What is your opinion on these companies and the new boom that we're seeing with a lot of these just startup health startups that really tell you your quote unquote, what your diet should be? Yeah. Obviously, we live in a world of capitalism and opportunism. And I think when there is a demand, people will come with supply and certainly is the case in the conversation we're having. I've seen some stool testing companies really attempt to be market friendly and be able to say things like from a stool analysis, we know that you should be eating these foods and not eating these foods. And I'm always curious, I'm like, where's the studies that this came from? I haven't actually seen the literature base. And so I do think that a lot of it is designed to be commercial and market friendly. But yeah, I think if some people spend a few hundred bucks on a test and get some results that tell them they should be eating more blueberries and they should be eating walnuts and they should be eating real foods and they do that, there will be some benefits. There are some other tests that have different types of technology that might be a little bit more advanced or I should even say diverse in their approach. My view as someone who practices functional medicine is that in the situation where we can get a couple different tests, whether it be a stool test, a food sensitivity test, I use an MRT test there and perhaps some nutrition related evaluation or saliva, hair to be able to bring them all together and see where the data converges, a genetic test, right? That gives me a level of confidence that I might not have with a single test. Reality is a lot of these tests aren't covered by insurance and in order to do this type of workup, it becomes a very expensive endeavor. When someone is able to do multiple tests and see where the stories are telling something consistently, it's a pretty clear signal to me that is a lever for intervention. Are most of these tests trying to make you restrict certain items or are they trying to tell you to answer an item so that you can solve high cholesterol or whatever ethyl gene you might have? Yeah, great question. It's one of the bigger debates in gut health as a whole. We know that there's an issue, should we focus on removing, starving off opportunistic bacteria or should we try to feed the beneficial microbes? We do live in a world as someone that's done nutrition counseling for 13 years. I do know that consumers are interested in knowing what not to eat because they like that level of guardrails, but a good food sensitivity test, for example, won't just give you a list of things to avoid, it'll also indicate foods that are minimally reactive and I will often use that test, particularly if there's any sort of disordered eating or cognitive rigidity or black and white thinking, I will use this test as a clear indicator of, here's a bunch of foods that we know aren't pro-inflammatory in your body. We have this incredible opportunity to add these six fruits, these eight vegetables and to focus on bringing food in and that's a perfect example of nutrition for mental health, nutritional psychology. One could easily interpret a food sensitivity test as, here's the bad news, the big bummer, you've got to just now spend the rest of your time avoiding these foods versus we have this amazing data that we can celebrate because we know that there's a bunch of health-promoting foods that are great for you. Question is, how do we integrate them into your life? David, I want to kind of challenge this conversation that we're having. I want to get as excited as that you are and maybe in Darsher, Darsher had a passion for GI at some point. The interesting thing about gut health is, as you mentioned, we're still learning so much about this and it's this mystery for a lot of people, we have learned a lot in the last 10 years, but at the same time, when I see, so you're coming up from this lens of psychology, your immunology and that kind of stuff, but I talk to people when they're talking about pain, something that we see, a musculoskeletal health, and you're talking about cardiovascular disease. A lot of these people say it all starts with the gut man, it all starts with the gut, the gut will solve their problems, and I just wonder, will it really solve everything? It's very rare and the body is so complex, it's like, how can we, in one sense, be like, hey man, we don't know much about this and we're linked so much, and then at the same time have this incredible confidence, or at least some people do, is that when you fix your gut health, you will fix A, B, C, D, E, F, and that gives me a little pause. I'm so with you, I've heard that phrase quite a bit, it all starts in the gut and conceptually it makes sense and I think I understand that it's creating the impetus to focus more on nutrition and lifestyle rather than other things, but from my work with people and some of my dives into the literature and just a deeper understanding about health, I've concluded that a lot of challenges in the inner ecosystem in the gut are relics of early life stuff, and we all know antibiotic use in the first thousand days, but this concept that perhaps emotional or other traumatic experiences could have some sort of space to live in some of that region is of interest to me, and I think the only support I have for that other than just conceptually understanding generational legacies of trauma, the biological embedding of adversity, how trauma gets under the skin, where it's stored and theory, is that a lot of people have GI complaints and our Western medicine model usually can't pinpoint it. It's usually someone leaving a gastroenterologist with they said everything's fine, right? And so it points to this idea of wait, there's way more going on here than we know, question is what can we do? And it always points to like eat real food, manage your stress, sleep well, right? All the things that I think are probably effective interventions for most people. So I think that's that. For most things. Yeah. Yeah. So on that note, let's talk about doing nutrition assessments, and you advocate for this, which I love, of course, has the lines with my biases, why not? And you talk about doing nutrition assessments before delivering psychiatric diagnosis or administering or using medications as a treatment option. Tell us you've highlighted the case about how it's all interconnected, but tell us a little bit more about what that looks like for you practically, and some of the clinicians that you work with, and why do you have gays so strongly for that? I think that view, and I've held that view for quite a while, really comes from my extensive work with people in substance use disorder recovery. I think most people would agree or understand that addictions, whether it be alcohol or substances elicit or elicit, they affect nutrition in a very real way, whether from displacing food, direct effects on the gut, in the case of alcohol, rapid utilization of V vitamins like thiamine, most people that come into treatment and recovery for substance use disorders have some nutrient imbalances, right? And I think that in our insurance-based model, if you want to get someone into a program, you need a diagnosis pretty quick, and you're going to start a treatment pretty quick, right? So my statement, my little hilltop statement screaming from the rooftop, it's idealistic, but it's not supported by our current system. And so we know that if people have nutrient deficiencies, whether it be folate, B12, vitamin D, zinc, magnesium, iron, omega-3, that some of the symptoms of those deficiencies can mimic symptoms of psychiatric diagnoses. So repleting nutrient status is not necessarily an overnight matter unless you're in a hospital with the banana bag, but I think that if we could say, let's do some lifestyle medicine, let's refeed, let's replete, for example, someone in a detox, and then revisit any new psychiatric diagnoses. I don't know, even if it was just a three-day delay, I think there could be more emphasis on the lifestyle medicine part and less on relying on the medication management. Yeah, do you think so though with nutritional deficiencies or the gaps we'll call it? Do you think it makes people more susceptible to substance abuse as well, or does it also make people it harder for people to break out of that substance use pattern? Yeah, I think it's such a great question and points to structural injustices and the context of public health and social disadvantage. If people are raised eating ultra-processed foods, is that inherently a risk factor for substance use disorder? And we know that there's some studies, some great work from the Middle East, actually, where we know adolescents eating more ultra-processed foods, highly palatable foods. Some people like the term junk foods. I put it in air quotes because I am generally a food-positive person. It does actually associate with antisocial and aggressive tendencies. And so I've been deeply interested in a growing field called nutritional criminology, which thinks about how exposure to poor diet and associated nutrient deficiencies, pro-inflammatory cascades could actually be an upstream driver of mental health conduct disorders, as we discussed, and a risk factor for violence, other impulsive behaviors, and then, of course, thinking about the criminal justice system and some of the food that is in the institutional settings, right? And how nutrition can be a major unspoken tool of oppression to keep people institutionalized, et cetera? It's a big picture or public health field that brings together a lot of different disciplines. But to answer your question simply, yes, I do think that poor nutrition can be a driver of certain types of substance-seeking behavior, as well as other behavioral issues. Do we have any data that you familiar with that has happened studied? There's been definitely studies linking, like I said, nutrition, poor nutrition to the behavioral issues. There are studies in the prison system that show people who have their blood vitamin and mineral levels corrected through supplementation have less violent offenses. They have better behavior on the yard. This is usually like some sort of multivitamin omega-3 and vitamin D. A lot of this research came from the UK showing very clearly, and of course, all research has its limitations, right? It's a very difficult population to study, but they were trials that show where people did get repeated nutritionally. They had fewer offenses and violations over time, and the one study that looked at recidivism over three years came. It was a positive finding very close to statistically significant, and yeah, I was deeply interested in this work maybe 10 years ago when I started with nutrition for addiction, and only in the last year or two has a couple of new papers popped up, and some of this scholarship comes from an international think tank called the NOVA Institute, which I'm very grateful to be a part of. It's a group of scholars, and there's a recent paper called nutritional criminology in NDPI that might be worth checking out. Speaking of nutritional assessment, so aside from the, let's say, inpatient wards and getting blood work done for those aspects, when you go to a functional medicine practice, for example, oftentimes the practitioner will say, hey, give me your week-long diet that you've just been on so that I can take a look at and see how you're eating and how much protein you're getting. Look at the macros, maybe a sense of the microbes. When you do an assessment for that, what is the most objective best way to obtain reliable data? Because oftentimes, you're going to find, hey, the next week, I'm going to keep it healthy so that I don't look bad for the doctor, but then also you have to leave it for bias if you're looking backwards. Yeah. It's a challenge, and there's obviously a lot of tools and technology to support better assessments. I think there's a bias toward apps that count calories and look at macros, and a lot of people will invariably rely on some of that, feels like hard data. In my app, I built it so that people take pictures of their food and indicate what food group was present, food vegetable grain, dairy or dairy alternative proteins from animals, and then beans, nuts and seeds is my own little food group. I am able to, at least on an intake process, give someone a good idea about things that we might work on together, set a few intentions, and I usually don't start with a drastic nutrition intervention because I do want that baseline data. Having looked at people's food logs now for 13 years, when I look at someone's, let's say that first week, right? I'm obviously looking at the photos and looking for real food versus packaged food, which I think is an obvious thing for most people, but I'm also looking for colors. I like to see vibrant colors in someone's food, and then really looking at the food group distribution, right? So at the end of the day, it'll tell very clearly if they've indicated how many times they ate fruit that day, how many times they ate vegetable, grain, dairy, protein, bean, nut and seed, and that's not mathematically precise data, right? It's not saying how much of it did you eat, just basically saying how many times did you eat it in that day? It tells me something important, which food groups are overrepresented and which food groups are underrepresented, and the standard American diet, predictably, has grains, dairy, and protein, and not enough fruits, vegetables, and beans, nuts and seeds, right? I sometimes work with eating disorder clients who are very restrictive and under-eating, and they have the opposite pattern. They eat a lot of fruits, vegetables, and beans, nuts and seeds, and stay away from some of those other foods. So by combining food group distribution data and being able to look at the vibrancy and the colors of foods, I can get a pretty good idea of someone's eating patterns and be able to see what might be some next indicated actions. Sometimes people eat just single food groups. They just have a food group by itself, maybe making sure they get multiple food groups when they eat. When I combine that data with some of the mental health screening information that I have and talking to someone, I can usually get a pretty good picture of where we might be able to pull levers, intervene, make some changes. Some people want to change everything really fast, and other people need baby steps. Let's just focus on beverages in the first week. Let's just do beverages and then talk about food in a week. I love that. Baby steps is a good place to start. I want to come back to advocating for nutrition assessments. I think you mentioned earlier on the model that we practice in, the insurance-based model, you need to make the diagnosis and you to pretty quickly make some changes. If you figure out the billing strategies, there's ways around that, and I've done that fortunately. The challenge that I still have, believe it or not, insurance companies aren't the bigger challenge. The challenge is actually the patients. When you were talking about the substance abuse, that's a patient population that we sometimes see. When you're dealing with the chronic pain population, sometimes you can hear and care people who have been using opiates for a long time. Oftentimes, they have a background where they might have been misusing, and so now they fall into that addiction substance youth category where you have to use analogs like buprenorphine, etc. The understanding of opiates in this disruption with a gut, that's pretty well recognized. If somebody's coming in with pain and they know that something works reliably, whether or not they're in the substance abuse category, even if they're appropriately quote-unquote using the opiate medications, being able to tell them, hey, before we adjust your medications to control your pain, we're going to do this quote-unquote holistic approach. We're going to take a big step back. We'll look at a food log. We'll do this. We'll get some minerals lab work, that kind of stuff. That's a hard sell, man. So what strategies can you give me selfishly that I can make this case to some of my patients and put into play tomorrow? Yeah, getting buy-in for nutrition and other lifestyle interventions can be difficult because some people just outright don't believe that it's that impactful. I've come across quite a few people who really want to change, but have a hard time understanding that small changes can make humanively a big difference. I think changes also hard, so there's a natural resistance to change and the mind can build a case against certain things pretty easily. A lot of times, and this goes back to trauma and adversity, a lot of people in our world, and I would say that I am also not exempt from this, sometimes are moving through life in crises management and just want things fast. Our brain is hyper attuned to ultra convenience, quick results, immediate rewards, and the reality of nutrition is that it's slow. It is. There are nutrition interventions that people can notice in days and weeks, and I always have to tell people, you're going to be an eater for the rest of your life. Nutrition is a question of life course. It is a life course intervention, and what doesn't happen in days and weeks, it happens in months and years, and it happens in decades, and if we can start to make small changes today, it increases the likelihood that we can make some additional changes tomorrow. So it might not be that the little things we do today are going to make any noticeable difference, but they will be clear predictors of our ability to keep making some changes. And over time, with other factors involved, whether that be other health interventions or medications, et cetera, we can humanively make some serious changes, and it might happen just slow enough that you don't really notice it as much as you would like to. I also like to add, and I tell this to some of my clients and patients that nutrition probably has higher impact on some people than it does others, because everyone's biology is unique. There are people who respond rapidly to nutrition interventions in terms of their bowel movements, in terms of their mental health. I don't know how quickly you can move the lever on certain types of labs, but there's other people that just don't have the same experience, and obviously there's going to be other pathophysiology or other barriers, whether it be psychological, et cetera. So I like to talk things through with my clients and patients, to paint the big picture, give people a wide range of possibilities, and never try to oversell something, right, and say there are just a wide range of possibilities here, and our job is to run some experiments and figure some things out, and I invite you to take the journey with me. Yeah, I love that. I think that's a key word, right? We're going to take this journey together, and we're going to have to figure out what's going on, because as you highlighted multiple times, it's physiology is very complex, pathophysiology is even more complex. So just even understand physiology, and then the pathology and the disruptions from that, and yeah, telling patients that they need to be active partspinths, they need to have faith in you, trust you, and I think the thing that I found to be more successful when I'm having these difficult conversations is to let the patients know that they're not being abandoned or dismissed. Hey, I hear your concerns, I promise you, I am not dismissing that, but there is a method to the madness in terms of why I'm not doing what you think you need, and that report building takes some time, and it's really important not to oversell, as somebody wants to tell me, you want to underpromise and overdeliver the best your ability. I want to come back to ultra-processed foods, we talked about that, it seems to be all the rage nowadays, and for better or for worse, I shouldn't say that, nutrition is always front and center, for anything, right, much like religion and politics, and I want to get a sense from you about this disordered eating, we won't call eating disorders necessarily, disordered eating, and ultra-processed foods that were just inundated as we go through our environment, especially around the holiday time, and then also if we can call that food addiction, if that term is even appropriate to be able to use, what can you say about that? Yeah, so this is definitely my area, I have committed to intersectional work at ultra-processed food addiction and eating disorders, and you can look at it as an individual clinical question, right, in terms of like, where does someone lie on this continuum? You can also look at it as a more public health picture, and I'll start with the individual. The most pushback on the concept of food addiction, ultra-processed food addiction does come from the mainstream eating disorder community. The message about food being addictive conflicts with a lot of the well-accepted ideology in the eating disorder space, and what I mean by that is a lot of the restrictive eating disorders basically see the underlying driver of this dysfunctional eating as restriction. A lot of folks who work in eating disorder treatment say food addiction doesn't exist because they see eating disorder patients who have a long history of dieting, a long history of counting calories trying to lose weight, and when someone is underfed, undernourished, restricted either biologically or psychologically, if they have a lot of rules, they're very rigid with food. It does create what feels like food addiction symptoms, right? So it's very hard to know if someone actually has a ultra-processed food addiction if they're caught in a cycle of dieting, if you get what I'm saying, because the under-eating and the overeating, right, the soonest someone decides to cut something out, the brain upregulates the value that it assigns to that food. That's not necessarily my view, I just wanted to share the bigger context, and so eating disorder informed views says most of the symptoms of food addiction come from restriction, okay? And the alternative narrative is that a lot of people start dieting and start restricting because of food addiction, right? So it's a different directionality pathway. So instead of seeing restriction as the driver of loss of control eating, loss of control eating as the driver of restriction. So this is thinking about how ultra-processed foods prime the brain early in life for more hedonic eating. I like to use the term reward-based eating. People don't love the term addiction, so we have some other ways of messaging. Sometimes I use the phrase addiction-like eating. It's just basically neuroscience, understanding how the brain assigns reward to certain foods, especially during distress, right? If someone eats highly palatable foods during times of emotional turmoil or negative affect, it's going to assign that food more value and remember that it has a certain important role for that individual. When thinking about it clinically, I do think it's wise to take a really good look at someone's timeline and try to unpack the temporal sequence. If it seems like addiction and addiction-like neurochemistry exists and you can sometimes ascertain by looking at someone's genetic legacy, other cross-addictions, if it seems like addiction is underlying the restriction that's associated with eating disorders, I believe it to be potentially a different symptom picture than if someone is grew up dieting and then now they've dieted so many times, they've wait-cycled so many times and now they have food addiction symptoms. So that would be the individual view is trying to figure out which one is more of the driver. Sometimes it points to different interventions in terms of nutritionally and then the broader view is to think about how constructs like ultra-processed food addiction and disordered eating exist in society, almost like a dark cloud underpinning all of it. So I like to think about ultra-processed food addiction as a public health problem, not so much an individual problem, right? This person is a food addict and this person isn't, but to just think about the food supply as being increasingly rewarding, the human brain is being increasingly susceptible to reward-based eating and then of course the role of commercial actors in manufacturing and marketing these foods to be more addictive, convenient, etc. Ultra-processed food as a public health issue that exists in society is also a driver of dieting and diet culture and disordered eating, but the alternative view is that there's diet culture everywhere too. There's disordered eating. We've normalized the pursuit of weight loss and discussions about appearance and I think that's changing a bit. People are becoming a lot more sensitive to issues around weight stigma and have learned to be real mindful of other people's journeys and not to make assumptions, but you could also look at diet culture and disordered eating as the backdrop that is contributing to more loss of control eating and I hope it makes sense that the connection between under-eating and overeating, restriction and addiction, these are the seemingly opposing ends of a spectrum that creates polarization and there is a lot of polarization in the field, a lot of debate about these constructs and which one is more important clinically, which one's a bigger contributor and the last thing I'll say is there is a study from a year or two ago that looked at adolescence and examined if dietary restraint predicted food addiction or if food addiction predicted dietary restraint. So it was a longitudinal study that looked at the bi-directional pathways and not surprisingly to me, but the findings suggested that food addiction was a bigger predictor of dieting than dieting was of food addiction. I'm just not taking my time here to just reframe and think about this. Wow, I really appreciate the nuance. These are things that I think are also much an eye or the first time we're hearing about these pathways and this polarization, this discussion that's happening. I definitely want to get into the current culture, but I know you have this Instagram video talking about the rabbit hole that people can get into when we talk about food corruption and we talk about ultra-processed food as this public health issue and that we zoom out. I've heard episodes, other podcast episodes on this about the polarization even socioeconomically, how we use the poor and the impoverished as essentially subjects to when it comes to the food industry and what we try to allow, even if we think about narcotic substances, what can you tell us? You talk about this polarization even within the researchers about chicken, the egg, which pathway and what's effective. What can you tell us maybe just to start out about food corruption and what the public might not know? Yeah, I'm deeply interested in what I like to call the commercial determinants of health. Most people are attuned to the social determinants of health. This has really been at the forefront of social sciences and really affected medicine and the way people think as a whole, commercial determinants are a lot more hidden. They're a very difficult to understand because we're talking about capitalism and economic incentives and the way that commercial actors are able to influence and shape policy as well as influence norms and I think that's the part that I find to be the most fascinating is how big food, big egg, big pharma have the kind of resources where they can see a need for a narrative and have the patience and the money to be able to do what's necessary to make that narrative go mainstream. And this is done through obviously PR and media, mainstream media, social media. They could hire some PR firm, these hired guns for corporations who can change the question around and really stimulate a lot of culture wars. And the thing that I've noticed about it, which is deeply fascinating and I mean, I'm impressed by the intelligence is that hidden commercial actors that have agendas to make money to increase their shares, right? We call it putting private profits ahead of public health. They have a fiduciary responsibility to their shareholder so it's not technically illegal. It's actually supported and promoted by the law. One of the patterns that I've seen, which is just worth saying is that I think, I don't know if you guys like the term elites, I don't love using it but that's what we're talking about right now, really wealthy folks that have power and money. There is a knowledge that people are polarized by design. It's almost in our genes, right? To survive, we need to indicate the in group versus the out group. And when people are under a lot of distress in life, we're more likely to form groups and to look for social identities. What I've learned in my deep dives in the last few years on this topic is that commercial actors actually intentionally fuel social division and create infighting on topics as a way of distracting the people from seeing the bigger picture. So as long as we're fighting each other, we won't band together and look at the real structural injustices. So I'll just give you one example. Coming back to nutrition and ultra processed foods, a social determinants of health view would say that if low income people don't have access to real food, right? How dare you talk about ultra processed foods? That's so insensitive, right? Because there are people that are food insecure that just need to eat whatever they can. A social determinants of health informed view would say that people with limited access to food should be provided with whatever food is available at whatever price that they can afford. That shouldn't matter what the food is as long as they get food. And it's a valid perspective. A commercial determinants of health view informed view would say if it is true that there is a big percentage of the population that has food insecurity below federal poverty level is institutionalized. If socially disadvantaged groups don't have great access to food, this newer view would say that commercial actors and the government would have even more responsibility to make sure that this food is not poisonous, toxic and addictive in order to truly promote health equity. So commercial determinants of health is interested in holding corporations accountable. And it's a very difficult conversation. Again, very idealistic in nature, not something that is easily done, tackling, I call it going up against a tank with a shank. You know what I mean? It's like good luck. But fortunately, there's some political momentum and these conversations are happening at a much larger level. And I'm super excited to see what we can do to make some of these, I'm going to call them ultra macro public health views, right? So social determinants of health are upstream. I think commercial determinants of health are even further upstream that will have bigger influence on our health. And it might take a while. But I think it's, I think things are going to happen. I guess how do we get people to have this conversation, right? You talk about how these companies try to polarize us already, right? Which is what we see with probably die culture today where you have carnivore versus vegan, we're seeing silly debates. I think silly debates, at least on podcasts that have to go through these just to let people know, hey, there is not one way or the other, right? Which is exactly what we've been talking about. But if we want to go a little bit more upstream, what type of shifts do we need with our mindset with the way we engage with social media, the way we look at experts? What are those things that we need to start doing? Yeah, so I talked about corporate norm shaping and we didn't get into it much, but that's the more clever and insidious part of this conversation. But the more obvious part is just clear conflicts of interest at the level of policy. We're talking about higher guns, PhDs that work for corporations. I want to say that I don't believe all people that work for corporations have malintentions. But there is a known strategy where they're able to make donations and make sure that people are on boards, very important discussions. They always have a seat at the table. And I do believe that the bigger issues that we need to change before we can expect real noticeable differences is to remove people and organizations that have very clear conflicts of interest from policy discussions and to also think about the role of corporations in the use and production of science. I think there's probably some papers that need to be reconsidered or even retracted. I've had the experience trying to publish some work on ultra-processed foods where I was sensing a really strong pushback from a reviewer. And I think we all know that when you publish a manuscript, you have to disclose your conflicts. But it turns out that you don't have to disclose them to be a peer reviewer. And I just had this strange feeling that my reviewer was industry friendly. And I asked the journal editor if they had any conflicts of interest to disclose. And it was just me thinking about how much influence can be done with deep pockets and the will to really control the narrative. And that's the goal to control the narrative, to make sure that people believe that the products are safe. There's nothing wrong. That's the usual goal to really perpetuate what we call the status quo. Nothing's wrong. Everything's fine. It's business as usual. And the real strategy, I think that commercial entities use is to really try to shift the focus back to personal responsibility, right? To really get people to remember that this is your choice. If you want to change, you can do it. Count your calories. Do something about it. And people love personal responsibility. I like the concept. People that have it love it a lot. People that really want it love it a lot. And it's something that we celebrate. But a sociology and public health perspective would consider that there are social structural and commercial determinants of health that are very important sort of predictors. And so when we fight amongst ourselves, when we endlessly promote the idea of personal responsibility, we miss all the behind the scenes, influences and practices. And I'll say last thing about it, it is a rabbit hole. And it's not for everyone. It's definitely something that can really challenge your people's worldview. And it's deeply difficult, particularly like doctors, medical professionals, right? When you start thinking about big pharma and their tentacles, right? It's very disruptive to the human soul and psyche, especially if you're trusted in society with a position where you get to make decisions and be a part of the system, right? This idea that the system is misleading and all that. It's hard. It's a hard conversation for people. And it's not for everyone. And sometimes I know that it's not the right person to talk to about these things. But some people like to be, I guess in society, we call them conspiracy theorists. Yeah, we all like control at least to some degree, right? Some more than others. And I love you're talking about personal responsibility. I think it really does come down to that. And I made this point earlier. I was making with my trainees today about patients need to be active participants of their care. And I think we're seeing that to some degree, right? There is this paradigm shift. Patients, people are becoming more, have this more of a consumer mindset when it comes to healthcare and not just adjunct and allied professions, but just even things that in the past, you needed to go through your insurance company, see a physician for. And now you can go outside the bounds for that and to be able to do that. And this is particularly at the forefront with what's been happening recently with the Blue Cross, Blue Shield that we've talked about with United Health Care lately and the insurance companies and people are really just fed up with it. And for better or for worse. And I think for a side the way that one situation was handled, I think this is going to be something that is going to be better. But David, you, you're fascinating, man. You're a person with so many different interests. You mentioned nutritional criminology, something I've never heard before. You're talking about nutritional psychology, something you take a deep interest in. We're talking about psycho neuro immunology. That fortunately has been mentioned on here before. So that's something we were familiar with. But I'd like to take a side word here and just give the listeners a bit of background about what even made you such a passionate person about this. Talk a little bit about your journey, your personal recovery and stuff that shaped your philosophy and approach to have this deep interest in so many facets of nutrition, mental health and all that stuff. Thank you. And I love sharing bits about my personal story and I'll keep it brief. But I do want to just say one more thing about personal responsibility because again, I agree with it as a concept. And I think we all do, right? We have to take agency in our lives and it comes down to being able to do the thing. But the way that it's been weaponized is I think the main point that I wanted to make just to exemplify the term litter bug was coined by the plastic industry. So there was scrutiny about plastics being environmental hazards. And the very clever plastic industry thought about how can we control this question and they introduced through PR the term litter bug so that people would see the problem of plastics as an individual problem and it led to don't be a litter bug. You get it? So they were able to frame that to get people to think about how these are issues that each person needs to solve rather than be solved systemically. And I wanted to add that because I found it fascinating. I am also someone who comes from a family of personal responsibility values that you should be able to do what you say you're going to do, achieve your goals, my father's successful in some ways, retired orthopedic surgeon. And yeah, I remember having mental health challenges as a teenager and in my early 20s and it being baffling to me, I did believe that as soon as I wanted to change that I would be able to as soon as I wanted it bad enough, right? I struggled with different addictions and I really did internalize this message that once once things got dire and once things got severe that I would finally make the decision to turn my life around. And one of the reasons that I'm deeply interested in addiction recovery, spirituality and some of these deeper questions is because I want to share as a socially advantaged person as someone with a high IQ, right? With resources available to me, I did get myself to a place in my early 20s when I was not able to just take responsibility for my life and turn it around. I had my brain was hijacked in many ways and I was operating out of survival. A lot of logic had gone out the window. I didn't have the ability to weigh the pros and cons and to see the bigger picture to see what was needed. And I hit some really low spots in age 24. I had to live in some places that I didn't want to live. If you understand what I mean, some of them safer than others. And yeah, it was real adversity. I definitely have a background of violence and it was a really difficult time and I was in school doing an undergrad. I couldn't really pull it off. But yeah, I had a chance to hit a pretty hard reset. And believe it or not, I ended up at a nonprofit rehab facility in my own neighborhood that's Culver City, California. It was walking distance from where I went to high school in my own neck of the woods and was in a pretty, pretty low spot spiritually. And I didn't know what I wanted to do with my life. I just knew that I wanted to turn things around. And no one told me that nutrition was important for mental health. I didn't have a dietitian. There wasn't any support for that. But I had a strong sense that if I stopped doing a lot of things that I was doing previously and started doing a bunch of new things, that it would just change my biology and change my temperament. And I was one of those people that had very profound results from lifestyle change. I think I had the kind of results that people are looking for. You just go in, just started eating as many fruits and vegetables as possible, high protein, started training, drinking water. I'll never forget being out in the sunlight after having had very little sunlight and feeling my heart beat and feeling like changes in my body happening. And yeah, I think within a course of a few months, my entire skin changed. My eyes started glowing. I started interfacing with the world differently and everyone noticed it. And it was very clear that I had leveraged nutrition, exercise, and lifestyle medicine to create a pretty significant pivot in terms of mental health and recovery. And it set the foundation for my career. I became a trainer. I finished my undergrad. I went to graduate school and I studied nutrition. My master's thesis was called nutrition and substance abuse. So I got very interested in off the beaten path topics early on. Again, we talked about the link between opioids and nutrition and alcohol, etc. That led to food addiction, eating disorders, basically behavioral health nutrition. I did my PhD from UCLA in public health with a minor in health psychology and did mental health research early life adversity. And I've been just bringing all the different things together with functional medicine. I still do mental health research to this day. And I feel very blessed to have had such a wide range of experiences in life and to have such a diverse educational background from social scientists to biological sciences to individual health to population health. And I feel uniquely positioned to be able to contribute and to see things that a lot of people don't see. And I probably most importantly have the courage to dive in to topics that are uncomfortable. Absolutely, man. Absolutely. That's an incredible journey. Thank you for sharing. And probably for better in some way, it's major and excellent bot leader. And you can at least be on camera and be that person who knows of research and has an expertise, but also be that person who's I've done there. I've been there. I am teaching what you've lived. So it's really incredible to hear and see. One of the things that I was thinking about as you were sharing your story and journey is the motivation piece. You talked about a little bit in the beginning and we're talking about gut brain and the different aspects of mental health. How did you reconcile internal motivation versus external motivation and making that change? And how do we talk about it with that with your patients? I think where does that motivation need to come from in order to see the best version of yourself? Yeah, I think that if we could figure out how to activate intrinsic motivation, we'd all crack the code, right? Some people assume that it comes from desperation. Some people assume that it comes from opportunity. I've seen so many patients in the last 12 years and people that they're there and they just need someone to ignite the fire and they're ready to go and other people, it's a lot of work to recruit some of those kind of internal motivators. But I believe external motivation, whether it be changing the lab value or changing a facet of appearance, et cetera, can all be super helpful. But the counseling piece where you can help someone trying to harness their own internal motivation and check in with someone and find out their values and try to leverage the values that they already have. I think this is a really important paradigm. I've been calling it value-based eating to really figure out what values someone holds, whether that be about the environment or about their mood or some people value convenience. And if that's the case, let's harness the values that you already have. But being able to help people see, this is one way to change eating patterns. If someone is social justice oriented and doesn't like the fact that there's greedy corporations that engineer food to be addictive and market it to young children and disadvantaged communities, that can create a motivation to no longer want to eat those foods. I don't want to support these companies, you know what I mean? It could be very charged, but there's a lot of ways to tap into motivation and it's a really fun thing to explore with people. Awesome, I love that man. Let's come back to your clinical experience. You've been doing this, you mentioned 10 years, right? Is that how long you've been working with patients and clients for or is that cutting a journey throughout that? Okay. No, that's not long I've been in a dietician. Love it. If you can, distill it down, I know we talked about every single person, there's a tremendous amount of nuance. And if you've taken the individualized approach, different things were kind of matter in terms of what lever you need to pull for a different person. But in the time that you've been working, treating over a thousand patients, what's maybe two or three of the most significant lessons you've learned? And how does it continue to influence the work that you're doing today? Yeah, I'm a huge believer in multiple paths. In my practice, we do talk about recovery. My my private practice is nutrition and recovery. And while I have great personal experience, I try not to rely on it as the thing. I really believe in empowering people to ask questions. I know that as a healthcare provider, people do come for answers. And there are times when I have them, but I've learned, especially in doing what we call trauma informed work, to be very sensitive, just to a wide range of possibilities and just ask questions and help people discover things on their own. I find that to be more work, more challenging and not what everyone's looking for. But when someone can come to conclusions on their own through feedback interactions, me asking questions, it tends to be a little bit more sticky. There is a situation where people have chronic health issues, whether it be mental health or other and bounce from guru to guru. They went through, they went and saw this person and they really liked their program and they followed this person. And I don't know, especially when it comes to nutrition, because we don't have really clear evidence-based guidelines, the way certain other fields do, trying to help people become their own guru. Some people are always going to be challenging their own thinking or have lack of self-confidence. But to really help someone see that they got this and they don't need me and to get them discharged on their own and just come back to celebrate your wins is really meaningful work that I feel very privileged to do. Yeah, I love that. I think my friend here talked about how every single person's an expert, not necessarily us, but your an expert in yourself. So when you talk about becoming your own guru within for yourself, your own body, your own life, that's what that reminds me of. I want to talk about your nutrition app, the wise man nutrition app. Now, is this the wise mind come from the DBT concept wise mind? The same thing? Talk about that, please. I think this is super cool. Yeah, truly, as I shared my interest in eating disorder and food addiction is pointing to polarities in terms of professionals and also the orientation of it. Wise mind nutrition is an effort to bridge the gap between seemingly opposing ideas and operate from the wise mind. In that DBT context, it's pulling in the logical mind and the emotional line and just being able to see the intersection space. It could be the intersection between physical health and mental health, but it's a way of thinking in the both and rather than the either or. So I built a mental health app that uses nutrition to help people recover without it being a very clearly defined roadmap. It's a choose your own adventure. You come into the app, you set some intentions, you can always revisit them, change them, and you aren't told what to do as much as you are told how to think and how to ask questions and how to explore checking with your hunger and your fullness. So it's a non-conventional dietary app. It's meant to be very different from my fitness pal or other programs out there. It's qualitative in nature, which means I don't use calories and I don't use macronutrients. I look at the food groups and think about food quality and help people connect to food in some new ways, hopefully through cooking, through celebrating their bodies. It has recovery messaging in there and there's a lot of personalized messaging for people that have different mental health conditions. So I screened for anxiety and depression and trauma and if someone screens positive, they might start getting some specific support in that area. There might be some supplement recommendations based on some of those screening tools and basically someone can use all of the features or less. In other words, food logging, nightly reviews, and then educational modules with meditations, cooking classes, recipes. I basically put the equivalent of working with me for six months into a mobile app so someone could come in and just get access to all the resources, work through a program at their own pace, connect to other people. If you have someone's username, you could share your food log and your journaling. So I built it for practitioners to use with their clients so that a mental health therapist or a physician would be able to say, hey, listen, I know this tool. It's super friendly because it's not pass fail. You're not going to feel like you've failed the diet. It's just a place to learn how to eat anti-inflammatory and to check in with your body a little bit more. I want you to take this journey and I'll follow you. You can support them and just let them know. I looked at your logs, be able to send them a thing. Hey, looks good. When people are doing it with someone else there to support them, they're way more motivated. So I follow all my clients on the app. I get to look at their stuff almost daily. Sometimes analyze it much more before our sessions. I get a really good sense of what they've been eating, what their food group distribution looks like and some of their journaling. So it creates a rich session because we have content in between our meetings and I do make myself available to chat with my clients through the app as well. So it's practitioner friendly. It's in really good shape. There's a few more AI features that we're in the process of adding that I'm really excited about. I love that. It's awesome. I'm actually going to download it after we talk here. It's funny. In the beginning of this conversation, my notebook I wrote, I was going to ask you, how do we separate emotion from the active eating and you want to hand an answer to that about how we don't bring it together. Love it. That's awesome. I know we've been talking now. We covered a lot of topics. Is there anything that you feel like we'd miss that we should cover? I think we did great. The only piece that I often like to emphasize is that nutrition can also be thought about symbolically and sometimes people that have a thirst for spirituality can think about using nutrition as a way to connect to plants, to connect to nature, to feel a sense of oneness with their environment. I've also helped a lot of people make those connections that you can use nutrition as a way to connect to source, to feel more a part of our natural environment. I think with mental health, a big part of it is that lack of connection. When you start to see nutrition as a way to connect, it becomes much more deeper than a vitamin or a mineral, doesn't it? Absolutely. I love that. It's a goal of my wife and mine to, in the next in the new year, to start planting our own. We live in Tampa, right? This is a place where you can grow things on the balcony and show for you in LA as well. Sometimes I come home two, three, six p.m. I'm just ravishing. I'm just starving. Anything I'll grab. Hopefully seeing these plants out, cucumbers, tomatoes, herbs will be a good reminder for that connection that we aren't one with the earth. We have everything around us to support us and nourish us. I do like that. I do that approach. Awesome. David, where can our listeners find you? You've got a lot of great content on social meetings. Definitely want to like that. I have three distinct websites. Nutrition in recovery.com is my clinical practice. That's more focused on nutrition for eating and substance use disorders. Why is my nutrition.com is the app? I have about 90 plus blogs at the intersection of nutrition and mental health. So more focused there on the depression, anxiety, trauma, addiction, etc. My homepage on the internet is drdavidwis.com. That's where I put all of my research papers, my blogs and podcasts. I just uploaded a video on the commercial determinant to help, which is about an hour long and I dive deep into all the corporate norm shaping stuff and highly recommend if you're professional to sign up for that newsletter because I put out a lot of content. Of course, Instagram, drdavidwis and I have TikTok and YouTube for wise my nutrition. So we will put all that in the show notes for the listeners. Awesome. David, the last question we ask everyone, how do we put the health back in healthcare? Let's just join forces hug and try to leave that one out. Maybe I guess what I'm trying to say is maybe it's community. Maybe we just need more connection. We need to recruit more social support and support others. I think that's a big part of the health equation that is often overlooked. Ladies and gentlemen, dr. David Wiss. Thanks so much for coming on. Right on. Thanks for listening to the other episode of medicine redefine. 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