Caesar Salad, Anyone? (Ides of March Edition!)
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The Mediterranean Diet: What Is It Good For?
More to the point: what isn’t it good for?
- It’s been found to reduce all-cause mortality, which is about the best thing one can say of any diet.
- It’s especially good for heart health and against cancer.
- It’s particularly recommended for the prevention or management of diabetes.
- It’s also been found, societally, to reduce general healthcare costs—basically, people get sick less and so have fewer healthcare costs.
What brought it to the attention of the world’s scientific community?
Back in the 1950s, physiologist Ancel Keys wondered why poor people in Italian villages were healthier than wealthy New Yorkers. Upon undertaking studies, he narrowed it down to the Mediterranean diet—something he’d then take on as a public health cause for the rest of his career.
Keys himself lived to the ripe old age of 100, by the way.
When we say “Mediterranean Diet”, what image comes to mind?
We’re willing to bet that tomatoes feature (great source of lycopene, by the way), but what else?
- Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
- Bread? Pasta? Prosciutto, salami? Cheese?
- Pizza but only if it’s Romana style, not Chicago?
- Pan-seared liver, with some fava beans and a nice Chianti?
In reality, the diet is based on what was historically eaten specifically by Italian peasants. If the word “peasants” conjures an image of medieval paupers in smocks and cowls, and that’s not necessarily wrong, further back historically… but the relevant part here is that they were people who lived and worked in the countryside.
They didn’t have money for meat, which was expensive, nor the industrial setting for refined grain products to be affordable. They didn’t have big monocrops either, which meant no canola oil, for example… Olives produce much more easily extractable oil per plant, so olive oil was easier to get. Nor, of course, did they have the money (or infrastructure) for much in the way of imports.
So what foods are part of “the” Mediterranean Diet?
- Fruits. These would be fruits grown locally, but no need to sweat that, dietwise. It’s hard to go wrong with fruit.
- Tomatoes yes. So many tomatoes. (Knowledge is knowing tomato is a fruit. Wisdom is not putting it in a fruit salad)
- Non-starchy vegetables (e.g. eggplant yes, potatoes no)
- Greens (spinach, kale, lettuce, all those sorts of things)
- Beans and other legumes (whatever was grown nearby)
- Whole grain products in moderation (wholegrain bread, wholewheat pasta)
- Olives and olive oil. Special category, single largest source of fat in the Mediterranean diet, but don’t overdo it.
- Dairy products in moderation (usually hard cheeses, as these keep well)
- Fish, in moderation. Typically grilled, baked, steamed even. Not fried.
- Other meats as a rarer luxury in considerable moderation. There’s more than one reason prosciutto is so thinly sliced!
Want to super-power this already super diet?
Try: A Pesco-Mediterranean Diet With Intermittent Fasting: JACC Review Topic of the Week
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California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.
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With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.
Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.
“We believe they’re going to have not just great impact, but wide impact across California, especially in places where maybe it’s not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom’s health secretary, Mark Ghaly, during the Jan. 16 announcement.
The apps represent one of the Democratic governor’s major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.
However, the rollout has been slow. Only about 15,000 of the state’s 12.6 million children and young adults have signed up for the apps, school counselors say they’ve never heard of them, and one of the companies isn’t making its app available on Android phones until summer.
Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies’ coaches won’t properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.
An App for That
Newsom’s administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It’s part of Newsom’s sweeping $4.7 billion master plan for kids’ mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.
“The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom’s Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”
The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.
But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.
“It’s fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children’s Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don’t see it as fundamental. And we don’t believe the youth mental health crisis will be solved by technology projects built by a professional class who don’t share the lived experience of marginalized communities.”
The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth’s Pennsylvania pilot, 6% of students who had access to the app signed up.
Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.
Although the service is intended to be free with no insurance requirement, Brightline’s app, BrightLife Kids, is folded into and only accessible through the company’s main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.
The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.
‘It’s Like Crickets’
Despite being months into the launch and having millions in marketing funds, the companies don’t have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”
“It’s a big state — 58 counties,” Bob McCullough of Kooth said. “It’ll take us a while to get to all of them.”
So far BrightLife Kids is available only on Apple phones. Brightline said it’s aiming to launch the Android version over the summer.
“Nobody’s really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We’re very much in the early innings. We’re already learning a lot.”
The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom’s virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.
The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.
KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.
“I’m not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s like crickets.”
Whitson said she doesn’t think the apps are on “anyone’s” radar in schools, and she doesn’t know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn’t reach out to plan the meeting; she did.
Concern Over Referrals
Whitson isn’t comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she’s concerned that the coaches, who aren’t all licensed therapists, won’t have the training to detect when users need more help and refer them to clinical care.
This sentiment was echoed by other school-based social workers, who also noted the apps’ duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.
While the state is also funneling money to the schools as part of Newsom’s master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.
Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they’d prefer in-person therapy.
“There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they’re on the waitlist,” Merchant said. “And, like, you’re seeing all these people struggle.”
Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.
Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.
“What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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12 Foods That Fight Depression & Anxiety
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Food impacts mental health, and while it won’t magically cure mental illness, dietary changes can do a lot to improve mood. Here’s how:
Nutraceuticals
We’ll not keep the 12 nutraceutical foods a mystery; here’s what they are and a few words on how they work (in many cases, we could write whole articles about them; in some cases, we already have! You can find many of them by using the search function in the top-right of each page).
- Walnuts are rich in omega-3s for brain health; arguably the best nut for depression relief.
- Fermented foods because probiotics in foods like yogurt and sauerkraut support the gut-brain connection as well as serotonin production there, enhancing mood.
- Cherry tomatoes are rich in lycopene, which helps combat both depression and mood swings.
- Leafy greens reduce brain inflammation linked to depression.
- Apples and other fruit are high in fiber and antioxidants that stabilize blood sugar and mood, reducing brain inflammation.
- Beans are high in B vitamins, crucial for neurotransmitter production and mood regulation (without also being high in brain-harmful things, as red meat is).
- Berries are super-high antioxidants and cortisol-lowering anthocyanidins, promoting calmness and reducing stress.
- Oats contain the healthiest kind of fiber, β-glucan, and additionally help stabilize blood sugar and mood; they’re also rich in selenium, which boosts mood.
- Mushrooms help regulate blood sugar and act as prebiotics, supporting serotonin production in the gut.
- Avocados are famously rich in healthy fats, including omega-3s and oleic acid, which support brain health and combat depression.
- Dark chocolate contains antioxidants, magnesium, and gut-healthy prebiotics that indirectly reduce mental stress and improve brain function. Also a famous comfort food for many, of course, and that factor’s not to be overlooked either.
- Pumpkin seeds are rich in tryptophan, which boosts serotonin production. As a bonus, they also help some kinds of antidepressant to work better—check with your doctor or pharmacist to be sure in your case, though.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The 6 Pillars Of Nutritional Psychiatry
Take care!
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Pumpkin Seeds vs Watermelon Seeds – Which is Healthier?
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Our Verdict
When comparing pumpkin seeds to watermelon seeds, we picked the watermelon.
Why?
Starting with the macros: pumpkin seeds have a lot more carbs, while watermelon seeds have a lot more protein, despite pumpkin seeds being famous for such. They’re about equal on fiber. In terms of fats, watermelon seeds are higher in fats, and yes, these are healthy fats, mostly polyunsaturated.
When it comes to vitamins, pumpkin seeds are marginally higher in vitamins A and C, while watermelon seeds are a lot higher in vitamins B1, B2, B3, B5, B6, and B9. An easy win for watermelon seeds here.
In the category of minerals, despite being famous for zinc, pumpkin seeds are higher only in potassium, while watermelon seeds are higher in iron, magnesium, manganese, and phosphorus; the two seeds are equal on calcium, copper, and zinc. Another win for watermelon seeds.
In short, enjoy both, but watermelon has more to offer. Of course, if buying just the seeds and not the whole fruit, it’s generally easier to find pumpkin seeds than watermelon seeds, so do bear in mind that pumpkin seeds’ second place isn’t that bad here—it’s just a case of a very nutritious food looking bad by standing next to an even better one.
Want to learn more?
You might like to read:
Seed Saving Secrets – by Alice Mirren
Take care!
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The Food For Life Cookbook – by Dr. Tim Spector
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We’ve previously reviewed Dr. Spector’s “Food For Life”, and while that was more of an “explanatory science” book, this one takes that science (reiterating it more briefly this time, by way of introduction) and makes a cookbook of it.
The nutritional emphasis in these recipes is on two things: maximizing fiber, and maximizing plant diversity. The recipes are not all vegan or even vegetarian, but they are plant-centric, and if the reader is vegetarian/vegan, then substitutions are easy to make.
The recipes themselves are simple without being boring, and are easy to follow, with full-page photos to accompany them. The science parts are very clear, accessible, and pop-science in style.
Bottom line: if you’d like to incorporate more fiber and more plants into your diet without it being a burden, this book is great for that.
Click here to check out the Food For Life Cookbook, and get cooking for life!
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The Immunostimulant Superfood
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Eat These Greens!
Chlorella vulgaris, henceforth “chlorella”, is a simple green algae that has a lot of health benefits.
Note: most of the studies here are for Chlorella vulgaris specifically. However, some are for other species of the Chlorella genus, of which Chlorella vulgaris is by far the most common, hence the name (vulgaris = common). The relevant phytochemical properties appear to be the same regardless.
Superfood
While people generally take it as a supplement rather than a food item in any kind of bulk, it is more than 50% protein and contains all 9 essential amino acids.
As you might expect of a green superfood, it’s also full of many antioxidants, most of them carotenoids, and these pack a punch, for example against cancer:
It also has a lot of vitamins and minerals, and even omega-3.
Which latter also means it helps improve lipids and is thus particularly…
Heart healthy
❝Daily consumption of Chlorella supplements provided the potential of health benefits reducing serum lipid risk factors, mainly triglycerides and total cholesterol❞
Its heart-healthy benefits don’t stop at lipids though, and include blood pressure management, as in this study that found…
❝GABA-rich Chlorella significantly decreased high-normal blood pressure and borderline hypertension, and is a beneficial dietary supplement for prevention of the development of hypertension. ❞
About that GABA, if you’re curious about that, check out:
GABA Against Stress, Anxiety, & More
May remove heavy metals
We’re going with “may” for this one as we could only find animal studies so far (probably because most humans don’t have megadoses of heavy metals in them, which makes testing harder).
Here’s an example animal study, though:
Enhanced elimination of tissue methyl mercury in [Chlorella]-fed mice
Immunostimulant
This one’s clearer, for example in this 8-week study (with humans) that found…
❝Serum concentrations of interferon-γ (p<0.05) and interleukin-1β (p<0.001) significantly increased and that of interleukin-12 (p<0.1) tended to increase in the Chlorella group.
The increments of these cytokines after the intervention were significantly bigger in the Chlorella group than those in the placebo group. In addition, NK cell activities (%) were significantly increased in Chlorella group, but not in Placebo group.
The increments of NK cell activities (%) were also significantly bigger in the Chlorella group than the placebo group.
Additionally, changed levels of NK cell activity were positively correlated with those of serum interleukin-1β (r=0.280, p=0.047) and interferon-γ (r=0.271, p<0.005).❞
tl;dr = it boosts numerous different kinds of immune cells
PS, if you click though to the study, you may be momentarily alarmed by the first paragraph of the abstract that says “However, there were no direct evidences for the effect of Chlorella supplementation on immune/inflammation response in healthy humans“
this is from the “Background” section of the abstract, so what they are saying is “before we did this study, nobody had done this yet”.
So, be assured that the results are worthwhile and compelling.
Is it safe?
Based on the studies, it has a good safety profile. However, as it boosts the immune system, you may want to check with your doctor if you have an autoimmune disorder, and/or you are on immunosuppressants.
And in general, of course always check with your doctor/pharmacist if unsure about any potential drug interactions.
Want some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Antidepressants: Personalization Is Key!
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Antidepressants: Personalization Is Key!
Yesterday, we asked you for your opinions on antidepressants, and got the above-depicted, below-described, set of responses:
- Just over half of respondents said “They clearly help people, but should not be undertaken lightly”
- Just over a fifth of respondents said “They may help some people, but the side effects are alarming”
- Just under a sixth of respondents said “They’re a great way to correct an imbalance of neurochemicals”
- Four respondents said “They are no better than placebo, and are more likely to harm”
- Two respondents said “They merely mask the problem, and thus don’t really help”
So what does the science say?
❝They are no better than placebo, and are more likely to harm? True or False?❞
True or False depending on who you are and what you’re taking. Different antidepressants can work on many different systems with different mechanisms of action. This means if and only if you’re not taking the “right” antidepressant for you, then yes, you will get only placebo benefits:
- Placebo Effect in the Treatment of Depression and Anxiety ← randomly assigned antidepressants are, shockingly, luck of the draw in usefulness
- Antidepressants versus placebo in major depression: an overview ← “wow this science is messy”
- Comparative efficacy and acceptability of 21 antidepressant drugs: a systematic review and network meta-analysis ← “oh look, it makes a difference which antidepressant we give to people”
Rather than dismissing antidepressants as worthless, therefore, it is a good idea to find out (by examination or trial and error) what kind of antidepressant you need, if you indeed do need such.
Otherwise it is like getting a flu shot and being surprised when you still catch a cold!
❝They merely mask the problem, and thus don’t really help: True or False?❞
False, categorically.
The problem in depressed people is the depressed mood. This may be influenced by other factors, and antidepressants indeed won’t help directly with those, but they can enable the person to better tackle them (more on this later).
❝They may help some people, but the side-effects are alarming: True or False?❞
True or False depending on more factors than we can cover here.
Side-effects vary from drug to drug and person to person, of course. As does tolerability and acceptability, since to some extent these things are subjective.
One person’s dealbreaker may be another person’s shrugworthy minor inconvenience at most.
❝They’re a great way to correct an imbalance of neurochemicals: True or False?❞
True! Contingently.
That is to say: they’re a great way to correct an imbalance of neurochemicals if and only if your problem is (at least partly) an imbalance of neurochemicals. If it’s not, then your brain can have all the neurotransmitters it needs, and you will still be depressed, because (for example) the other factors* influencing your depression have not changed.
*common examples include low self-esteem, poor physical health, socioeconomic adversity, and ostensibly bleak prospects for the future.
For those for whom the problem is/was partly a neurochemical imbalance and partly other factors, the greatest help the antidepressants give is getting the brain into sufficient working order to be able to tackle those other factors.
Want to know more about the different kinds?
Here’s a helpful side-by-side comparison of common antidepressants, what type they are, and other considerations:
Mind | Comparing Antidepressants
Want a drug-free approach?
You might like our previous main feature:
The Mental Health First-Aid That You’ll Hopefully Never Need
Take care!
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