Closing Out 2010

For many, like my beloved Texas Longhorns, 2010 was a difficult year. I started the year in a plateau, having gained and lost (and gained and lost) quite a few pounds during and after pregnancies for my two little girls. Nutrition was an interest of mine for many years, however. I had read Good Calories, Bad Calories and the works of Micheal Pollan, and for years had been avoiding too much fake processed food and vegetable oil. But it wasn't until I found the idea of a paleolithic-style diet that everything began to have focus, and made perfect sense. I started out with a nutritionist who had a paleolithic bent (but a distaste of fat and a fondness for brown rice and oatmeal nonetheless). I would describe his plan as Loren Cordain meets Body For Life. I followed his plan for 3 months, losing all the excess baby weight and then some, then discovered The Primal Blueprint, where paleo meets Good Calories, Bad Calories, and Food and Western Disease (paleo meets academia). I added back the fat, ditched the post-workout brown rice and oatmeal, and through a perusal of the forums found the wonderful resources of the paleo and traditional foods blogs, and the rest is history.

None of that had much to do with psychiatry. But with my biochemistry knowledge and front lines experience with mental illness, it seemed an obvious route to take with a blog. As a population, we are long-lived and expensive and sick. It didn't seem to me that hunter-gatherers could have been so afflicted and survive very long. And many of my patients (and myself) had the look - the extra pounds, the flushed skin, the thin hair - something was wrong. Very wrong.

It is not that hard to find inflammation. A new commenter on an older post noted that it seems to be in fashion to blame everything on inflammation. And to some extent I agree - when I was pregnant, all the little discomforts (loose joints, weight gain, bleeding gums) were blamed on "hormones." Inflammation is a big word, covering a vast landscape of biochemical processes. But it is a place to start, beyond psychology, beyond stress. Inflammation is where vegetable oil meets the modern stressful life. And that is where psychopathology lies as well.

There are a number of ways to attack psychopathology. Therapy, exercise, proper sleep and avoidance of addictive poisons. And here I focus on food, and parse the details. This is science so the definitive is less than we would like. But this is science, so we can question dogma.

Fortunately, I have all my friends to parse with me. And that is the greatest blessing from 2010. Not the skinny jeans, the clear skin, or the vibrant hair (though those are quite nice). The greatest blessing is the community. My old friend Dan from medical school, gorgeous Jamie and Julianne all the way in New Zealand. Stephan in the northwest US, Dr. BG and Aaron Blaisdell in southern California. Steve Parker in Arizona. Paul Jaminet a few miles away in Cambridge. Melissa in NYC.  Thanks to   Leslie Irish Evans and Robert Su for the podcast opportunities! Andrew on his boat. Enigmatic paleo rock star Kurt Harris in the midwest. Dr. Eades and Richard Nikoley. The commenters and facebook friends and twitter community who are all ready to look at a new angle and take apart a new or old idea.  Tear it apart.  That's what leads us forward.

Evolutionary medicine in the 21st century is a breathtaking enterprise. I can be a doctor and use my powers for good. My plans for the blog include (yes, at long last) the thyroid, delving more into phospholipids and the now-famous choline, and looking more into sleep. I'll endeavor along the way to keep up with the latest news and papers (though I still have a day job, a husband, and two adorable little girls). I'm looking forward to a gluten-free January, and more pairs of skinny jeans. Mostly I follow the winds, and my nose, and my gut, which I suppose is more or less what my ancestors did.

It is nice to be able to use one's powers for good. Happy New Year.