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Dr Ann Childers is a rare breed: an adult, adolescent and child psychiatrist with an integrated approach to mental health. In other words, she doesn’t just dish out the drugs to anyone who is ‘down in the dumps’. Childers has a passionate interest in helping patients improve their physical and mental health through optimum nutrition, weight control, metabolic management, and sleep. She was one of a stellar gathering of international speakers at the low-carb, high-fat (LCHF) summit in Cape Town in February, hosted by sports scientist Prof Tim Noakes, where she spoke on nutrition and mental health. Childers says a major problem affecting not just waistlines, but mental health and mood worldwide, is that we’ve strayed too far from traditional, healthy diets. We don’t eat enough fat, especially well-sourced, natural (and saturated) fats from pastured animals, virgin coconut oil, etc. We eat too many processed foods, and ‘highly fermentable carbohydrates’: sticky, sugary foods, dried fruits, refined grains, crackers, potato chips, and sugary soft drinks, that are cariogenic, promote malnutrition, impair metabolism, and affect cognition (thinking) and mood. Here, Childers talks to me about good and bad food for mood. – Marika Sboros
Dr Ann Childers is an adult and child psychiatrist from Oregon, who has a special interest in improving her patients’ health through diet and sleep. Dr Childers, you started your career as a dog trainer. That’s very different from psychiatry – or is it?
Well, it actually taught me a lot. One of the things that I noticed when I was training dogs is that the better nourished dogs were the ones that were more settled and more ready to learn. They also looked beautiful. They tended to have shiny coats that were not oily or full of dandruff.
What about the nose? Did they have a shiny, wet nose?
Yes, shiny wet nose – exactly – and the pads on the feet were not dry and cracked. They had very clear eyes – not a lot of matter around the eyes, so they just looked good and healthy.
In a way, your change from animal behaviour to psychiatry is almost as if you’ve changed from training animals to training humans.
Yes, pretty much. Although actually, when I was training animals I was training humans because there was a human attached to each dog.
What made you move from animal behaviour into medicine and not just medicine, but psychiatry?
At the time, I had several facilities and I had a radio show that had to do with training animals, and I thought that I had reached the cul-de-sac of my career – that I had done about as much as I could do in that field, at that time. I made the decision to follow through with going to medical school, which is what I had always wanted to do, and did an observership in child and adult psychiatry with Dr Herb Woodcock at the Oregon Health and Sciences University which I really enjoyed. As you mentioned, there is some crossover between dog training and working with human beings (especially children), and I really enjoyed seeing more expansion on what I already knew. It’s much greater expansion.
Dr Childers, you have a special interest as I mentioned earlier, in improving patients’ health through diet and sleep. Isn’t psychiatry premised on drug therapy, mostly? Aren’t you going against what you were trained to do?
This is my impression – at least, in my area. There is a trend toward using medication primarily, and my thought was that once we get the nutrition and sleep healthy and established, there should not be very much left to do with medication. I found that to be true over and over again. I would not be truthful if I said that all of my patients are off medication. Many people come here with severe illnesses, but what I found is that I can reduce the amount of medication used and I can often limit the number of medications used. I would say that the majority of my patients are maybe on one or two medications, but not more.
Right. Given that those medications often come with serious side effects, this is definitely a case where less is more.
Yes. I would say that less is more because sometimes we end up treating the side effect with another medicine.
I do know that you are a proponent of low carb/high fat diets. In fact, you were one of the speakers at the recent Low Carb/High Fat summit in Cape Town. Presumably, you don’t fear fat – in particular, saturated fat. Did you ever fear fat?
Did I personally fear fat? Yes, absolutely.
What changed the fear?
I got sick. I became very ill. I was probably on less than 10% total fat in my diet. I really thought thatI was going to spare my heart and keep me from having a stroke but ultimately, I did have a minor stroke. I had osteoporosis and a number of other ailments. I had to figure out if there was underlying cause. I firmly believe now that the underlying cause was poor nutrition.
Yet another interest of yours is food and mood. What did being on a low-fat diet do to your mood?
I would say I had a lot of mood fluctuations during the day. I’m generally an easy-going person, but it still caused me distress. The other thing that I noticed is that I would become severely hungry if I didn’t keep up with eating, so I’d eat many times per day – probably about every two to three hours.
Most dieticians I’ve spoken to say people need to eat carbs because they are good for mood – especially women. Some of them even go as far as to say women and people in general will get depressed on a low carb diet. What’s your view of that?
I think that the lower we go on carbohydrates, the less fat and protein that we have in the diet –and here, I’m not proposing a high protein diet, I just want to make that clear – but we do need at least maybe 16% to 18% and probably 23% of good quality protein in the diet. I think that the lower we go on fat and protein, the less satisfied we are and the more likely we’re going to have mood swings because along with extreme hunger, comes a mood swing. In fact, some people call it being “hangry” – being both hungry and angry at the same time.
“Hangry” – I like that. Well, I don’t really like it, but I get what you’re getting at. So a low-carb diet can stop people from being hangry?
Yes, this is what I found. Once people start stocking up the fats in their diets, they actually feel better. The mood seems to level out and they sleep better.
What about brain function? Dieticians often tell me that the brain has to have glucose, so that’s why you absolutely have to have carbs in the diet –and quite a lot of them. What’s your view on that?
The body’s very good at making and maintaining glucose as it needs. There are many ways to conserve on glucose and there are also ways of producing glucose from protein – it’s called gluconeogenesis – so the body has a way of working with a low carbohydrate or even a ketogenic diet. I don’t fear for lack of glucose. I don’t fear for lack of carbohydrate on a low carbohydrate diet, at all.
Do you think that humans really need carbs? Are carbs essential to the human diet – carbohydrate foods?
The United States Institute of Medicine says (and I’m paraphrasing here) the amount of carbohydrate needed to support human life is apparently zero, so long as there is enough protein and fat in the diet.
By fat, you also include saturated fat, which is a big change from the official dietary guidelines?
Yes. I am of the opinion that the polyunsaturated fats that come from factories are very damaging to the human body. They’re often highly oxidised by the time they leave the factory and many of them have traces of solvents used to process them. I do not think it’s a good idea. Cold pressed fats are better but even so, the Omega 6 fatty acids in the commercial diet often overwhelm the amount of Omega 3 fatty acids in the diet and these things must be balanced. If someone is to take some type of vegetable oil (let’s say avocado oil), it should be cold processed. Sesame seed oil is another one. Olive oil is another. However, I believe that the human body does need saturated fats. We certainly produce them if we don’t get them and in fact, we make saturated fats out of carbohydrates.
That’s interesting. Tell me; what about low-carb, high-fat diets for problems like ADD or ADHD in children?
That’s one of the best approaches for ADD and ADHD.
Really? Have you used LCHF diets for children with ADD and ADHD in your practice?
Yes. These were not ketogenic diets, but these were much lower carbohydrates and much higher fats than what the average American gets. The average American perhaps takes 55% to 65% percent of their diet in carbohydrates and I recommend that we reverse that trend and go back to about 40% to 43% carbohydrates and ensure that these carbohydrates are in a complex form, not in a simple form like sugar or starch.
Right, so unrefined carbohydrates?
Yes. I think that the industrialisation of carbohydrates has really damaged our food supply.
Can you give some examples of the kinds of foods that you think are good for mood?
Yes. Basically, what I do in my practice is that I recommend people change just one meal to start with, and that’s the breakfast. I recommend that they basically have a ketogenic breakfast – bacon and eggs, maybe some sautéed vegetable and whatever vegetable they use should be a low carbohydrate vegetable that grows above ground. This could be something like sautéed spinach and these vegetables should be loaded with a good quality butter from pasture-fed animals. This change often makes a difference, especially in the morning, in someone’s mood. It will actually smooth things out and people are often not hungry if they get adequate calories during that breakfast. They’re often not hungry until much later in the day. In fact, some people skip lunch.
Right. What kinds of foods do you think people should avoid like the plague, so that they don’t open themselves up to bad moods?
I would say the basic foods people should avoid like the plague would be highly processed starches and sugars. This would include grain flours and sugars, added sugars of any kind. I would definitely say that. I also say that if you’re going to indulge in any kind of fruit juice at all, it should be used in very small quantities. Maybe a tablespoon of orange juice in a full glass of club soda or soda water. It should be used in a very limited way as if it is sugar itself.
Interesting. Mothers have always thought that if they give their child a glass of fresh fruit juice, they’d be giving them something really nutritious and in fact, that’s not the case?
If only they could take the sugar out of it, they would be giving their child something very nutritious. Unfortunately, once the fruit is juiced, it becomes a very concentrated form of sugar. The fruit itself is safer to eat because it’s full of fibre and the fibre slows down the entry of that sugar into the bloodstream. In the old days, people used to cook their fruits (even berries that are considered very healthy) in heavy cream; that’s another way of slowing down the entry of the fruit sugars into the bloodstream. I think these old, traditional ways are very instructive. We need to go back to them.
Alright. One last question: what would be your message to the public about food and mood? There’s an increasing use of antidepressants and SSRI’s all over the world – a pill to make you happy. What’s your message?
My message would be to stop eating processed food. Start eating a whole food diet. A whole food diet is much safer than a processed food diet. Processed foods are loaded with starches, sugars, and many chemicals that can affect one’s mood. The other thing I would say is to turn back time to 1977. Back then, we were eating about 43% carbohydrate diet and those carbohydrates were (for the most part) complex. Our diet was higher in fat and had moderate protein. I think this was a much safer diet for us and this predates our obesity and diabetes epidemic.
It also predates the official Dietary Guidelines that came into practice in 1977 in the US, I think. Is that correct?
Yes. Thanks for mentioning that, Marika. Yes, that’s exactly when the first Dietary Guidelines came in. That was almost the moment at which, our obesity and illness epidemic began to rise.
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