I often think that I see the world somewhat differently than most people. That’s because I tend to see things through what I call my “nutritional glasses”. When I look at human behavior I try to pick out those behaviors that might be strongly influenced by nutritional factors. It has been long accepted that a diet high in processed foods can lead to a long list of metabolic problems like insulin resistance, obesity and type II diabetes. The idea that your diet can adversely affect your brain function and behavior is relatively new concept. It’s not just “you are what you eat”—the new mantra is “you behave how you eat”.

Processed Food Fries Your Brain
For decades I have been promoting the idea that dietary factors can lead to brain dysfunction. In my opinion a diet high in processed foods can lead to a condition called Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. People with CARB syndrome develop metabolic problems and up to 22 brain dysfunction symptoms that can interfere with their ability to function. I often look for these symptoms in my patients or in people that I interact with on a daily basis. When I see behaviors and symptoms that fit the CARB syndrome pattern, it helps me to understand why some people behave in ways that don’t make a lot of sense. They have an untreated disease that is driving their counterproductive behavior. Of course when I do so I am speculating, because the CARB syndrome model is a new and unproven concept. What I find interesting is that when people improve their diet, their behavior often seems to become more aligned with their own self-interests, the same behavior I see in people with normal brain function.

I recently read David Perlmutter’s excellent book “Grain Brain” and he also promotes the idea that various nutritional factors can have a profound affect on brain function. My CARB syndrome concept and his Grain Brain concept seem to be describing the same condition. It’s nice to have a little company and I am hopeful that his book will broaden the conversation when it comes to diet and brain health.

What’s Next in Wacko Washington
Like everyone else, my attention has been riveted on the dysfunction in Washington DC over the past few weeks. Our government is shut down, our politicians are fighting like cats and dogs and the city has been subjected to several tragic shootings. The first event that caught my attention was the shooting of a dozen people at the Naval Yard by Aaron Alexis. There is very little available information about his private life, so any thoughts on his motives must be viewed as pure speculation. We do know he loved violent video games and he was treated at a VA clinic for insomnia and perhaps other mental issues. He was apparently prescribed the drug trazedone to help him sleep.

He left a message that suggested that he might have been experiencing some degree of psychosis. In my experience drugs like trazedone can sometimes trigger increased levels of hunger and cravings for sweet and starchy foods. If a person follows their cravings, they end up eating the very type of food that can lead to CARB syndrome. Several of his friends commented that they often had to bring him food when he was engrossed in playing video games and one friend commented that Aaron often took her food, suggesting increased hunger and cravings. I suspect that a single male like Aaron was likely consuming a lot of processed food. In my opinion it is clear that Alexis clearly had a serious mental illness. He may also have had some degree of CARB syndrome triggered by the medication he was taking and his dietary choices. Combining a mental disorder with CARB syndrome is often the straw that breaks the camel’s back when it comes to dysfunctional behavior. Of course we will never know for sure what triggered this truly tragic event.

A True Tragedy
The next event out of Washington that caught my attention was the tragic case of Miriam Carey, the 34-year old mother who was shot dead after trying to drive her car through some barriers protecting the White House. I watched this unfold on television and noted that she was driving very erratically in trying to bash through the barriers. At one point policemen on foot with drawn guns surrounded her. She apparently ran into one of the officers as she tried to drive away. At this point it was reported that the driver was a woman and she had a child in the car. As a trained healthcare professional, I immediately assumed that we were dealing with a mental health issue, not a terrorist. She likely wasn’t armed, so the goal should have been to disable her vehicle so she couldn’t use it as a weapon.

She then led police on a high-speed chase and at some point she was shot and killed by police officers. Her daughter fortunately survived. In my mind the question arises as to why the police decided to shoot her rather than disable her vehicle. I certainly understand that the city was on pins and needles after the Navy Yard shooting, yet the only weapon she had was her car. Apparently multiple shots were fired at the vehicle, increasing the chances of injuring bystanders or her daughter. It is my understanding that the police have been trained to stop vehicles without actually shooting the driver. Why didn’t they do so in this case? This is especially relevant when it seemed clear that the driver was a woman with likely mental health issues. Perhaps we will never know the answer to this question, but again I viewed this incident through my nutritional glasses.

Porky Police Hit the Streets
As I watched hundreds of law enforcement officers arrive at the scene, I also noticed that many of them were obviously overweight or obese. Studies have documented that police officers have a higher incidence of obesity and metabolic syndrome than the general public. As Robert Lustig points out in his book “Fat Chance”, about 20% of people with obesity are metabolically healthy. That suggests that 80% of obese police officers do have some degree of insulin resistance and we now know that insulin resistance can have a profound adverse affect on brain function. If you are thrown into a tense life or death situation with hundreds of people running around with loaded guns, you want those people to have optimal brain function. Remember that we are dealing with professionals who are expected to make good decisions under the most intense pressure. In this case I’m not so sure they did so. Could nutrition have played a role? I am only speculating, but I think that it’s possible that food induced brain dysfunction was in play. People with CARB syndrome tend to make impulsive decisions without considering all the consequences of their decisions. This is true for anyone with food-induced brain dysfunction, including law enforcement officials.

Post-Partum Depression is Often Driven by Diet
It was also reported the Miriam Carey was diagnosed with post-partum depression after the birth of her child. She apparently was prescribed Lexapro and Risperdal, but it isn’t clear if she was still taking them. Studies have shown a clear association between metabolic problems and depression, including post-partum depression. In my experience many women who are diagnosed with post-partum depression actually have CARB syndrome, not classical depression.

Throughout history true depression has always been associated with a loss of appetite and weight loss and pictures of Miriam show her to be on the plump side. In my experience SSRI medications like Lexapro and anti-psychotic medications like Risperdal are common secondary triggers of CARB syndrome because they can increase cravings for sweet and starchy foods, pushing them to eat more of the very food that is frying their brain.  Blacks seem to more prone to developing CARB syndrome, likely because their race has been eating processed foods for a shorter period of time than whites. The incidence of CARB syndrome in a given race seems to be inversely associated with the length of time that a race has been consuming processed foods.

She clearly had some form of serious mental illness with psychotic features and I think this was obvious to just about everyone at the beginning of the episode. I am certainly thankful that no police officers were killed in the incident, but I also believe that this incident could have ended without Miriam losing her life. Did dietary factors play a role in this tragic incident? Of course we will never know for certain, but I suspect nutritional factors did come into play on some level. Unless you put on my nutritional glasses it’s easy to miss this sort of connection.

Porky Politicians
Shortly after she was shot, congress gave two standing ovations in support of the capitol police. I found this to be rather bizarre, because at this point we knew that a mentally ill woman with her baby in the car was gunned down in a hale of bullets. Yes, we should be thankful that no police officers or citizens were killed, but for the reasons mentioned above, I’m not sure a standing ovation was in order. In panning the applauding politicians I noticed that many of them were also obese. They can’t seem to keep our government running, yet they enthusiastically applaud when a mentally ill mother is gunned down. Enough said.

The Messy Politics of Healthcare Reform
The last Washington event that I viewed through my nutritional glasses is the fracas over the Affordable Care Act or ObamaCare. Regardless of the merits or problems with this new healthcare law, I know one thing for sure. It is based on the traditional approach to chronic health problems and it will make it possible for everyone to have access to this type of care. I’m not sure that’s an entirely good thing.

Our current healthcare system is based on the idea of “managing” chronic diseases like metabolic syndrome, obesity and type II diabetes. We now have the science that shows us how to prevent these conditions by consuming a diet of whole foods and avoiding processed foods. It works virtually every time. If you do develop these conditions, the system is geared to managing them, not reversing or preventing them. In your seven-minute appointment with your primary care provider you most likely be given a handful of prescriptions and given advice to eat less and exercise more. This approach will certainly “manage” your disease, but it won’t protect your metabolic health or brain function.

Every day I admit patients to the hospital with these conditions and they are usually taking a long list of medications. Their health and brain function is almost always less than optimal. It doesn’t help that the food they are given in the hospital is loaded with sugar, high glycemic carbohydrates and vegetable oils, the primary triggers of CARB syndrome. Those with diabetes are told to count carbohydrates so they can give themselves more medication or insulin when they consume more carbohydrates. To me this is like a dog chasing its tail. These folks need to transition to a low carbohydrate, high fat diet that will actually turn round their metabolic problems, but the healthcare profession is still under the spell of the low-fat mantra promoted by the experts for decades.

ObamaCare—A New Money Pit
Until we fully accept that role that our national diet is playing in our collective health and brain problems, any healthcare program that focuses on simply “managing” these illness will end up becoming a bottomless pit that will consume more and more of our national resources. I agree with Robert Lustig that we are truly facing a massive public health problem that eventually must be attacked in a top down manner. Until that day comes, I’m afraid that I won’t be able to put down my nutritional glasses. Let me know if you want to borrow them. You’ll see the world in a very different and sometimes disturbing way.

Even when I use my nutritional glasses, I know that I am a spectator with no real influence over the events I am watching. To me it simply reinforces the importance of protecting my own brain function by following a healthy diet. It’s like those gory movies they showed us in high school, where teenagers who had been drinking ended up in dying in horrible crashes. If you use my nutritional glasses it might also stimulate you to be more careful about your diet. In my experience things almost always work out better when your brain is running on all cylinders without any CARB syndrome to mess things up. It’s a simple formula:

Processed foods + Brain = Brain Dysfunction + Bad decisions

You and I cannot control what others do, but we do have control over our own decisions. I don’t know about you, but I don’t want to a part of “wacky” anything. I just want to enjoy healthy metabolism and good brain health. Go Paleo, ketogenic or whatever. Just don’t go Standard American Diet. It’s not rocket science, but it is science.