Become a Patient                         Dr Hedaya’s Recent Publication


Your body breaks down the protein you eat into 23 amino acids. Eight of these are the so-called “essential” amino acids, which must come from the diet itself via protein-rich foods. Studies have repeatedly demonstrated that people on antidepressants who abstain from eating protein—even for as little as three days–will suffer a relapse of depression. When they add protein back into their diets, they again respond to the antidepressants, in about 3-5 days.

Your body breaks protein down into amino acids. Tryptophan, one of the essential amino acids, is the core building block of serotonin, one of the neurotransmitters necessary for mood control and appetite suppression. Your body also needs protein to produce the pleasure-inducing neurotransmitters, dopamine, and norepinephrine. If your body can’t manufacture sufficient levels of these three neurotransmitters, your antidepressants won’t provide you with their full benefits. My patients are frequently amazed at how much better their moods are once they begin to eat more protein.

It would be logical to wonder, after reading the above paragraphs, why not eat a diet of only protein? There are a multitude of reasons why this is unhealthy, but here are the three biggest ones: First of all, your body can only handle so much protein before it puts too much strain on your kidneys, which can cause them to malfunction. Second, your body is better able to absorb tryptophan in the presence of carbohydrates (and the absence of certain other amino acids)–an interesting example of how ‘nature loves balance’. Lastly, protein alone won’t give you sustained energy or keep your blood sugar levels on an even keel. You need to eat protein in combination with carbohydrates fats to get its full energy and mood-boosting benefits.

To understand why, let’s get into a little science: If you were to eat a burrito filled with vegetables, cheese and shredded beef, your body would use the various nutrients from your meal for blood sugar control in a specific order. Within a few minutes to an hour after eating, the tortilla and vegetables (which are mostly composed of carbohydrates) will be broken down into glucose (a simple sugar), which will then enter your blood stream causing your blood sugar levels to rise and then fall again about an hour later. At that point, the protein from the cheese and beef will have been converted to glucose and will again trigger a rise in your blood sugar. Just as your levels are about to fall once again, the fat from the cheese and beef will have finally been converted to glucose to trigger a third rise in your blood sugar. This total process takes about 5 hours—just in time for your next meal. So eating the right combination of carbohydrate, protein and fat can keep your blood sugar levels on an even keel to prevent energy lags and sugar cravings—which can help you lose weight.

The trick is to get the right ratio of carbohydrates to protein. Follow the two-thirds rule: Make sure the volume of protein is a little more than one-third of your meal, while carbohydrates should be a little less than two-thirds the volume of your meal. This should give you a ratio of roughly 7 grams of protein for 9 grams of carbohydrates. (Remember to count fruits and vegetables as carbohydrates in addition to starches, such as potatoes and grain-based foods.) So if you’re having chicken and vegetable stir-fry for dinner, just under one third of your plate should be whole-grain rice, just under one-third should be vegetables and just over one-third should be the chicken. I recommend you stick with low-fat protein sources such as: Wild Low Mercury Fish (salmon, haddock, cod, tilapia, trout, herring, sardines), organic skinless white meat turkey and organic chicken, organic extra lean select-grades of beef and pork (beef eye of round, top round, and top sirloin and pork tenderloin) and organic low-fat vegetable protein (beans, tofu) for reasons that I’ll describe in the fat section below.

If you’re trying to determine serving size, the best rule of thumb is to eat a portion of beef, chicken or fish that’s about the size of a deck of cards. The total carbohydrates can cover two decks of cards. You can increase your serving sizes to reach your level of satisfaction of real hunger, but make sure you increase the protein by the same proportion as the increase in carbohydrates.

Omega-3 fatty acids — the “Good” Fats:

Fat has become such a villain that I consider it the forgotten nutrient. But it’s worth remembering that the fat and protein content in a meal causes the release of a hormone called cholecystokinin (CCK) from the stomach. This hormone, among others, tells the brain you’re satisfied and to stop eating.

Of course, you need to be selective about the kinds of fats you eat. The fats we get too much of in our modern Western diet are arachidonic acid (the building block of “bad eicosanoids”) and saturated fats (those that harden at room temperature). These fats are found in shellfish, egg yolks, dairy products, organ meats (like liver and most deli meats) and fatty red meats. Saturated fats are difficult for the body to process, and help narrow arteries. I recommend you eat low-fat sources of animal protein.

Build your meals around the “good” fats. These are the monounsaturated fats and omega-3 essential fatty acids. Monounsaturated fats help reduce the risk of narrowed arteries, thereby improving your circulation, which can help keep your energy levels up, the flow of blood to your brain healthy, and your sexual organs functioning properly. These fats are found in fish, olive oil, canola oil, flaxseed oil, olives, macadamia nuts, and avocados.

Omega-3 essential fatty acids (EFA’s) can help make your nerve cells more responsive to chemical signals from serotonin, dopamine and norepinephrine. A clinical trial conducted at Harvard University and published in the May, 1999 edition of found that manic-depressive patients who took fish oil capsules high in Omega-3 fatty acids, in combination with antidepressants, showed dramatic improvement. Epidemiologists have found that people who live in countries with seafood-based diets rich in omega-3 EFA’s have a very significantly lower incidence of a number of psychiatric disorders, including depression and manic-depression, as well as other health conditions such as heart disease (which is also closely associated with depression), and certain cancers. Moreover, recent studies have shown that depressed patients have much lower levels of these EFA’s than the normal population. Omega-3 EFA’s are predominantly found in dark-fleshed fish including salmon, haddock, tilapia, mackerel, anchovies, caviar, herring, sardines, lake trout, and Atlantic sturgeon. Check out the environmental defense fund (www.edf.org/seafood) for more information on the best seafood choices with the least contaminants.

Eat at least one omega-3-rich fish meal a day—preferably two. Cook with olive oil instead of butter, margarine or vegetable oil. When making eggs with olive oil, instead of butter, heat the oil to a high temperature before putting the eggs in the pan. Use flaxseed oil (another source of Omega-3 essential fatty acids) to make a salad dressing and baste olive oil on chicken or fish. Limit your intake of the foods containing “bad” saturated fats and arachidonic acids, listed above.

Folic acid and Vitamin-B rich foods:

In the 1960’s, a noted psychiatrist noticed that after consuming a diet deficient in folic acid for a few months, he developed fatigue, irritability, sleep disturbances and memory problems. Since then, there has been increasing evidence showing that you’re more likely to feel depressed or remain in a state of clinical depression if your diet is deficient in folic acid, or vitamins B-6 and B-12. Your brain needs these B vitamins to initiate many essential chemical reactions which help prevent depression and heighten the effects of antidepressants. Studies have revealed that people who are depressed have significantly lower amounts of folic acid in their red blood cells. What’s more, you don’t need to be extremely deficient to suffer ill effects: It only takes a mild deficiency in these vitamins to fog your mind and reduce your concentration. (Abnormal gastrointestinal function, can easily affect the availability of B vitamins.)

Just two months ago, I began treating a 73-year-old man, Max, for low B12 levels. A successful businessman, he’d been feeling overwhelmed by life for two years — more and more depressed to the point of feeling he couldn’t go on. This despite being on Prozac which he had earlier responded to well. His blood tests for B12-realted abnormalities were on the borderline, so Max and I decided to give him a trial of B12 injections with folic acid — despite the disagreement of his internist. Max’s response was so dramatic — his depression lifted and his energy doubled — that within 3 weeks we began discussing cutting back on therapy sessions.

The good news is that correcting these deficiencies can help to dispel any lingering depression and improve your concentration and memory as well. You’ll be improving other factors of your health as well. Mothers who eat adequate amounts of this vitamin early in pregnancy are much less likely to have babies with spinal cord defects. Folic acid also plays a role in preventing heart disease (which is associated with depression) by reducing excessive levels of homocysteine, which is believed to contribute to the damage of blood vessel walls. There is a weaker, but still significant, link between a shortage of vitamin B-6 and B-12 and increased homocysteine levels. Vitamin B-6 also plays a role in easing the symptoms of PMS, which can involve moods swings, anxiety, sugar cravings and feelings of depression.

Are you beginning to see how huge an impact you can have on your mind-body through the foods you eat?

For folic acid and vitamins B-6 and B-12: Following my protein prescription for getting more meat, chicken or fish will enable you to get adequate amounts of vitamin B-12—unless you have the kind of absorption problem that prevents using the B12 (this occurs in people older than 50, people on antacids, and some people with autoimmune disease). Protein-rich foods also contain (though in smaller amounts) vitamin B-6. Other vitamin B-6 sources include bananas, avocados and watermelon. Folate-rich foods include all legumes, dark green leafy vegetables, Brussels sprouts, spinach, oranges, sunflower seeds, wheat germ and peanuts. Aim for at least three servings a day of folate-rich foods: For instance, eating 1 cup of steamed lentils, and 1 cup of spinach sprinkled with sunflower seeds will go a long way toward fulfilling your daily folate requirement. If you decide to supplement your diet with a particular B vitamin, always add in a complete B complex, so that you don’t create deficiencies in any of the others.

Carbohydrates intended by nature:

As I mentioned earlier, my nutrition plan is based on eating foods in their natural state. Unrefined carbohydrates (whole grains, fresh fruits and vegetables, legumes) offer major health benefits over processed carbohydrates. First of all, they are generally high in fiber, which improves digestion and controls the release of sugar into your bloodstream. Fiber may also help reduce cancer risk, improve your cholesterol levels, and stimulate the growth of healthy bacteria in your digestive system (those bacteria manufacture several of the B-vitamins you need for normal brain function.)

Another significant health benefit is that the unrefined carbohydrates contain significantly more natural vitamins (like folic acid, vitamins B-6 and B-12) as well as minerals. For instance, ginger root, nuts and whole wheat grains contain zinc, which plays a major role in memory and mood control and is necessary for testosterone production. Calcium, plentiful in kelp, collard leaves and turnip leaves, is necessary for the proper functioning of the dopamine pathways. Magnesium, found in dark greens, wheat bran, buckwheat, and rye, has numerous bodily functions including the generation of energy from food.

I’d estimate that 90% of my patients are deficient in one or more minerals, and chances are, you are as well, especially if you’re not eating a well balanced diet. One way to maximize your intake of minerals is to buy foods that are organically grown without chemicals, the way nature intended. Research suggests that organically grown foods have a higher content of minerals because the soil that they’re grown in is less likely to be depleted, since the farmers can’t rely on artificial fertilizers, pesticides and herbicides to make the plants grow well in the absence of good soil. A recent study by Consumers Union, publisher of Consumer Reports, found unsafe, although not illegal, levels of toxic chemical contamination (including some nerve agents which are actually directly toxic to nerve cells) in peaches, winter squash, apples, pears, spinach, grapes, lettuce, celery, green beans.

For carbohydrates intended by nature: Choose whole-grains, fruits and vegetables over refined, processed carbohydrates. Buy organically grown produce whenever possible.