Eat Complete: The 21 Nutrients That Fuel Brainpower, Boost Weight Loss, and Transform Your Health

By Drew Ramsey

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

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

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

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

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

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

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

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

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

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

• Language: English
• Publisher: Open Road Integrated Media
• Release date: May 17, 2016
• ISBN: 9780062413444

Drew Ramsey

Drew Ramsey, MD @DrewRamseyMD is a psychiatrist, author, and farmer. His work focuses on clinical excellence, nutritional interventions and creative media. He is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and in active telemedicine clinical practice based in New York City. His work has been featured by The New York Times, The Wall Street Journal, Lancet Psychiatry, The Today Show, BBC, and NPR and he has given three TEDx talks. He is the co-author of the Antidepressant Food Scale and his e-courses on Nutritional Psychiatry education for the public and clinicians. His books Eat to Beat Depression and Anxiety (Harperwave 2021), Eat Complete, 50 Shades of Kale, and The Happiness Diet explore the connections between mental health and nutrition. He is on the Advisory Board at Men’s Health, the Editorial Board at Medscape Psychiatry, and is a member of the Well+Good Wellness Council. He splits his time between New York City and Crawford County, Indiana where he lives with his wife and children on their organic farm and forest.

Book preview

INTRODUCTION

A Doctor Learns to PRESCRIBE FOOD

Our health is being challenged like never before in history. You’ve seen the headlines: modern food and lifestyle have made us sick, a nation overfed and yet undernourished. Add to this the new stressors of ceaseless media, more work, and less sleep. The need for proper nourishment and self-care is pressing and unprecedented.

Thankfully, the foundation of good health is delicious. For the first time in centuries, doctors are prescribing food. As our focus on health, nutrition, and wellness has grown, so too has the role of food in medicine. My work as a psychiatrist is all about brain health, which means helping people care for and protect their biggest asset: the brain. And it turns out that brain health is directly influenced by the food we eat.

Nutritional psychiatry is the new forefront of the psychiatric field, a movement focused on the mental health impact of food. As the movement has grown, so too has my desire to bring the important lessons about the impact of food on the brain to a wider audience. The advice in these pages is a prescription for your brain health and wellness, intended to help you cut through the controversies and eat with confidence. And the best prescription is to feed your brain properly, as an undernourished brain has profound implications for all aspects of life.

I learned about food growing up on my family’s farm in southern Indiana, and I learned about brain health at Columbia University College of Physicians and Surgeons, the top department of psychiatry in the United States, where I trained and have taught for the last twelve years. I now teach brain nutrition to graduate students and psychiatry residents, and I’m also in active clinical practice doing my best to apply my training to the art of medicine. While I primarily treat patients with mood and anxiety disorders, this book is for the general public. Everyone with a brain should know how to feed it.

A few years back, I changed how I practice medicine. A new class of medications was causing a series of side effects for the patients in our clinic. While these medications were often necessary, patients began to gain weight at an alarming rate, and frequently developed diabetes and high blood pressure. As a physician bound to the maxim Do no harm, I am obligated to help mediate these side effects. Healthy eating and exercise were major interests in my personal life, and I’d been a vegetarian for about a decade, but I hadn’t been talking to my patients about food and lifestyle choices.

It started to gnaw at me. Not only were the medications I was prescribing adding to my patients’ health problems, but I realized I was totally untrained to counsel them about nutrition. Doctors don’t learn about nutrition in medical school, even though poor food choices are at the root of the majority of health concerns in our country. I remember sitting with a woman who was free of the symptoms of her mental illness for the first time in years, realizing that she had also gained thirty pounds. I knew then that food needed to be a fundamental part of our assessment and prescription as doctors.

Food became a focus of my work. Increasingly curious about what my patients ate, I was also determined to find out what I should advise them to eat based on scientific evidence. I started talking to patients about their food, and reading about the recent advances in the science of nutrition. I learned that my patients were just as confused as I was. I felt foolish as I realized that the standard advice I was offering—Don’t eat cholesterol or fat—was both scientifically wrong and woefully inadequate. I also learned that my vegetarian diet wasn’t likely the healthiest. It was time to figure out what constituted a healthy meal.

As my understanding of healthy foods captivated my work as a physician, it also took a prominent role in my personal life thanks to a new motivation: my wife was pregnant with our daughter. Every molecule in our daughter’s developing brain would come from the food choices we made over the next few years. I needed to establish a core set of foods that would best nourish our new family.

As a physician interested in brain health, I’ve been struck by how little we consider the impact of food. We think of our bodies, but we put minimal thought and focus into how food choices relate to our brains, or how the state of our brains can affect so many important aspects of our overall health and mood. Our brains are both our greatest asset and the home of the hungriest cells in our body. It’s crucial to feed these cells well—and that’s important across the board, whether or not you are a patient on my couch. Not matter your personal background, genetics, or situation, the core of your personal wellness is your food.

As the science continues to advance, it’s become easier to see the impact food has on our brain health. Our brains consume 20 percent of everything we eat; this nourishment provides the energy and nutrients to create and sustain the quadrillions of connections that construct the brain, and the electricity that courses between those connections. Your brain is the organ of connection, and you depend on these connections for all aspects of your life: Your work. Your relationships. Your memories. Your intentions. Your dreams. You have in your possession the most complex structure in the known universe, a human brain—but most of us, myself included, were never taught how to optimally fuel it.

In my practice, I was prescribing medications and doing talk therapy, but it seemed clear that food presented a unique opportunity to further help my patients. It would certainly be my most delicious prescription. Better food choices would ensure that my patients’ brains were optimally nourished with building block nutrients such as omega-3 fats, vitamin B12, and zinc. It would also make their brains more resilient by enhancing brain growth—the latest brain science tells us that human brains continue to grow through adulthood, creating new brain cells and also new connections. On top of that, eating better food would decrease my patients’ risk of obesity, diabetes, and heart disease, all diseases that wreak havoc on mental health.

Armed with this knowledge, I made food as medicine the primary focus of my clinical work. My colleagues and I started to serve the patients in our clinic more plants and other nutrient-rich foods for lunch. Many started to lose weight and reported an improvement in their mood and self-confidence. This became a key tool in their treatment. And in addition to better nourishment, they also engaged in the mindful art of self-care.

My goal today is to help people achieve proper nourishment with every bite—and it’s become clear from the results that food can be an excellent medicine. Recently, a patient with panic attacks was largely cured by eating more seafood and having eggs for breakfast. A woman in her thirties noticed a significant reduction in her severe anxiety and mood swings after introducing more seafood and lentils into her food plan. A teenager who was irritable and argumentative with his parents became more reasonable with them after starting his day with a fruit, yogurt, and nut smoothie.

After I saw significant positive results like these, my first line of defense for patients became their nutrition. I now complete a nutrition assessment during my initial evaluations of patients, along with a brain food prescription. Food remains part of my ongoing clinical conversation, and I consider nutrition to be a key aspect of my clinical work overall. Helping people fully fuel their brains and eat foods that promote stable moods, clear thinking, and a more resilent brain just makes sense.

And it makes sense for everyone, not just my patients. The building blocks of your brain—all the vitamins, minerals, fats, sugars, and proteins—start at the end of your fork. Your eating pattern dictates the health and function of your brain, as well as the rate of your brain’s growth. That is what inspired me to write this cookbook. Most people don’t think about nutrition, and certainly not about how nutrition affects the brain. But it’s time to end eating confusion—and, while we’re at it, boost the power of our brains.

CHAPTER ONE

What Does It Mean to EAT COMPLETE?

The key to a healthy brain and body—and therefore optimal health—is to eat complete. Eating complete means that you get all of the nutrients your brain and body need from the food you eat. But for many people, it’s challenging to focus on nutrition in a way that is feasible, convenient, and delicious. Instead, it’s easy to make poor choices, fall into bad food habits, and often leave out the very foods we need most in our diets.

As I began addressing food and nutrition with the patients in my clinical practice, I found myself running into three common barriers. The first is that it is complicated for people to eat in a way that optimizes nutrients. How do you know what to do, and who can you trust about food? Another barrier comes from concerns about time and money. Many people feel they lack the skills and time to cook every night, and healthy food can be expensive. Finally, in order to work around these other two barriers, people often put blind trust in a bad insurance policy: the daily multivitamin. The data on supplementation are mixed at best—but either way, there is no insurance policy for eating poorly.

The more I ran into these barriers, the more I focused on helping my patients overcome them. Over the years of assessing people’s food habits, a pattern of missing nutrients became apparent to me. In conjunction, there has been a surge in the scientific evidence about brain health and nutrition (more on this below). Recent studies have looked at dietary patterns and the risk of brain-based illnesses such as depression and dementia, and the results are showing strong correlations between those illnesses and what we eat. Coupled with the modern discovery that the human brain is growing even in adulthood, the conclusions are startling. The very nutrients many people are missing are those most important to human brain health. And without these nutrients, your brain and body will not operate as they should.

Take, for example, the brain chemical serotonin, which regulates critical physiology such as mood, weight, and sex drive. For your brain to produce this chemical, you must eat foods that contain the amino acid tryptophan (such as pumpkin seeds, cod, and beef) as well as foods high in iron, folate, and vitamin B12 (such as lentils, mussels, and kale). While many foods contain these nutrients, only a few contain enough to help you meet the required daily dose.

The more I learned about the nutritional needs of the body, and especially those of the brain, the more I began to wonder—was it even possible to obtain all of the nutrients you need from food? For example, human health depends on getting at least 400 milligrams of magnesium every day. Where do you find it? I didn’t know. Neither did my colleagues. And my patients certainly didn’t know either.

So back to the main question: Can you actually get the most important nutrients for your health, such as magnesium, just by eating food? The answer is yes—it just takes a little knowledge, a core set of foods, and 100 recipes to get you started. And that’s the goal of Eat Complete.

The 21 Nutrients of Transformation

The 21 nutrients (vitamins, minerals, fats, protein, plant-based phytonutrients, and health-promoting bacteria) that form the core of this book come from the rapidly evolving science of how food changes the brain. I’ve selected them based on this science, and on the reality that Americans are missing a number of key nutrients in their diets. The simple and scary truth is that the majority of Americans eat a diet that is lacking the most important nutrients for health. Recent data from the United States Department of Agriculture (USDA) found that most people are not meeting the Recommended Daily Allowance for many key nutrients. For example, 68 percent of people are not getting enough magnesium, 75 percent are not getting enough folate, and a whopping 86 percent are not getting enough vitamin E.

In the following pages, I’ll explain why these 21 nutrients are the core of living a healthy life. I’ll review each of the nutrients in detail, and I’ll also show you how to incorporate high concentrations of these nutrients into your diet with whole, natural foods and simple, delicious recipes. These tasty meals will fuel your brain, keep your body lean, and transform your health.

Focusing on the foods that maximize these 21 nutrients ensures your meals are rich in the compounds most important for your success. The foods you eat help build and fuel your brain, allowing it to make new connections and even signal the birth of new brain cells. When you feed your brain the most important nutrients with the minimal number of calories, your brain will function better and you will be your optimal weight. A healthy brain offers protection from low moods and anxiety, as well as better resilience during times of stress. And having a sharper, happier, and more resilient brain is ultimately what it takes to transform your overall health.

Additionally, when you eat the whole healthy foods that contain these nutrients, you will avoid a number of ingredients in modern food that are horrible for your health, such as trans fats, artificial food dyes, preservatives, pesticides, and persistent organic pollutants—all of which are tied to brain health problems and weight gain. One reason we are so undernourished and yet overfed is that we’re using the wrong foods as fuel.

There is a lot of hyperbole in the health and wellness scene, but it is not my intention to add to that. If I seem optimistic about your health, it is for a good reason. Over the last fifteen years as a physician, I’ve seen a lot of people radically change their lives. When intention is aligned with a commitment to self-care, the human spirit is an unstoppable force. Transformations happen when a brain is at full power and a person is at a healthy weight. These two factors—brain power and a healthy weight—are what these recipes are designed to deliver. Eat your way to a better brain and body, and transform your health by eating complete.

Building a Tool Kit: Arming Yourself with Knowledge

Over the last few decades, we have dissected our food and eating habits as never before in history. Such scrutiny has led to a number of trends. In my work, I come across eaters of every stripe: The Paleo tribe. Vegans. Pescatarians. Fasters. Juicers. Jenny Craigers. Weight Watchers. It’s clear that having a set of rules for eating helps people.

Eating complete doesn’t have to replace those rules. Part of the challenge of good nutritional advice is the art of guiding people to their goal, helping them find a place where they are content and satisfied. That’s a unique place for each of us, as we each have our own palate and our own set of values that guide our eating. To cater to as many eaters as possible, almost all of the recipes in this book have optional (and easy) modifications for everyone from vegans to Paleos. Almost all the recipes are naturally gluten-free, and the few that aren’t will surprise you by showing you how fermenting flour as sourdough greatly reduces the gluten.

My role here first and foremost is to be a resource for you. With so much debate about nutrition, people often have no idea that when it comes to your brain, eating a plant-based diet is great, but eating only plants equals malnutrition. After all, this is why strict vegans are obligated to take supplements. While there are plenty of plant-worshipping vegan dishes in this book, I have also consciously selected seafood and meat dishes that would serve as the best invitation to the vegan and vegetarian readers looking to expand their palates.

By asking you to make the idea of fueling your brain your primary goal as an eater, I’m asking you to take a step back and look at your food through a different lens. This means reconsidering how you think about food and nutrition. For example, fat, a perpetual enemy of healthy eating for decades, is actually at the top of the list of nutrients for a healthy brain and body. It’s also worth calling attention to the phrase plant-based diet. This means most of your plate is made up of vegetables, nuts, beans, fruits, and whole grains. But all diets on the planet are currently plant based, as photosynthesis in plants and in algae is at the base of the food supply. Without plants and photosynthesis, we’d have no food. But eating only plants is often portrayed as a healthy diet, when it actually leads to nutrient deficiencies of vitamin B12, long-chained omega-3 fats, and often iron and zinc. Furthermore, not all plants are created equal. After all, three plants—sugarcane, corn, and soybeans—are at the heart of our country’s nutrition problems thanks to their role as the primary ingredients in most processed foods.

It’s also imperative to understand that the real toxins in food are more than just sugar, refined carbs, or gluten. Not only are we often demonizing the wrong foods, but we’re ignoring the fact that modern food contains some strange new molecules that humans have never eaten. Research on the negative health effects of food dyes, brominated compounds, and fake fats is compelling enough that I’ve banned them from my family’s kitchen. The FDA plans to eliminate trans fats from the food supply by 2018, but you can eliminate them now by avoiding highly processed, packaged foods. Such a move would also largely help eliminate your exposure to toxins such as plasticizers, persistent organic pollutants, and synthetic estrogens, all of which throw our metabolism and health out of balance by acting as endocrine disrupters.

My hope is that this book will encourage you to confidently explore a new set of foundational foods that can get you started on this journey towards health and happiness. The following pages will arm you with a new set of moves in the kitchen, along with some facts and figures that will change the way you fill your refrigerator. For example, the top source of vitamin B12 is clams. Smaller fruits have more nutrients. Grass-fed beef has a healthier nutritional profile than chicken. The right choice in chocolate could enhance your mood and memory abilities.

To truly nourish yourself, and to obtain a clear, calm, and creative mind, you should aim to eat whole, real foods that have one ingredient—for example, apples, onions, mussels, almonds, and chicken. These foods contain more of the good stuff (vitamins, minerals, phytonutrients, and fiber) and less of the bad stuff (toxins). My goal in this book is to provide you with a practical and enticing tool: know what your body needs and why, and then fuel it via simple, efficient recipes.

Food on the Couch

When it comes to mental health, it’s important to keep in mind that this is a complex area and everyone’s situation is unique. But sometimes we make even the simplest elements too complex. Here is the straight truth: the human body and brain run on a core set of nutrients. The majority of people do not meet the daily requirement of many of these nutrients. If you become deficient in any of the key nutrients your brain and body need, you cannot function at your best. You may feel run-down, irritable, sluggish, and sad.

For many people, these are the long-term consequences of poor nutrition and lifestyle choices. Take Tommy, for example. Tommy never imagined he would see a psychiatrist. He had just graduated from college and was a hardworking, smart, and thoughtful young man. But he couldn’t find a job after college, and he ended up moving back in with his mom and dad. He abandoned his fitness routine, his friends got busy with work and new girlfriends, and the structure of his life evaporated.

He was depressed when we met and had even pondered suicide. He had no job, no apartment, no girlfriend, and no hope. He slept all day and played video games late into the night. He started to blow up at his parents. He was irritable, went through mood swings, and became isolated.

Embarrassed by his situation, Tommy asked me if he was bipolar. He wasn’t—he was malnourished. With each new patient comes a new food story, and Tommy’s story was particularly vivid. I asked him to take a picture of everything he ate for three days, and the collection of pictures told a story of empty carbohydrates, missing fats, and a tribute to the color beige: bagels, breakfast cereal, pasta, pizza, hot dogs. When I joked that he should eat more colors, he sent a picture of colorful gummy bears.

But Tommy knew enough about nutrition to see the problem, commenting that he ate like a twelve-year-old boy. As it turned out, he had always been interested in food, which helped facilitate his quest to feel better. First, he agreed to focus his schedule so that he was sleeping during the night and awake in time for breakfast every morning. One of the symptoms of depression is a lack of appetite, and lower food intake means fewer essential nutrients for the brain. Together we set some modest breakfast goals for him, and the first was to include more plants in his diet. With the help of a blender, Tommy started looking forward to his morning smoothie of fruits, greens, and nuts blended with yogurt and a bit of honey.

Pasta and carbs have a bad reputation, but together we were able to transform these dishes into something healthier. Tommy ate ravioli stuffed