Metabolic Health, Metabolic Psychiatry and more | Rachel Frase RD

Benjamin Hopkins (0:06)

Welcome back, everyone.

We have a wonderful guest. We have Rachel Frase with us today. We're going to be talking about all things metabolic psychiatry. So Rachel, thank you so much for your time in advance. We did it.

Rachel Frase (0:15)

We did it. We made it.

Fingers crossed the connection stays good. But yeah, thank you so much for having me on. Happy.

Benjamin Hopkins (0:21)

Where do we start with your story? How did you get end up in the world of metabolic psychiatry in general?

Rachel Frase (0:25)

I started with my own gut health issues. That started when I was 19 They got pretty severe and it took me several years, like six to seven years to figure out the root causes of them, which of course were all related to gut microbiome and metabolic health. So that was my first eye-opening experience into it. Going on a very low carbohydrate diet was a huge part of my healing for my gut. And then in terms of my career, and about five years in, I realized I can definitely do more, right? I can do more in the world of prevention to help people change their lives now, get better quality of life, all those things.

And so that's when I started looking for different jobs and fortunately found one nearby. And I stayed in Connecticut here where medical practice was hiring dieticians to do just that, help people lose weight, reverse diabetes, blood pressure, all the metabolic health conditions with low carbohydrate and ketogenic diets. So I stayed there for a good five years. And then I learned about metabolic psychiatry. It was right around the time when Dr. Chris Palmer's book came out, Brain Energy.

And I was introduced to a psychiatrist also here that was looking to add a dietician to her practice to expand ketogenic metabolic therapy in her practice. And so that's how that started. She hired me and I stayed there for about three years just doing only metabolic psychiatry. So working with patients one-on-one that wanted to use ketogenic diets as either adjunctive to their care or sole treatment, depending on where they were, and we created personalized macros, so personalized ketogenic diet ratios, a little bit less than the classic epilepsy ratios of three to one, four to one, where that's three or four grams of fat for every one gram of protein plus carbohydrate. So these were a little bit lower between the one and two range. So 1.5 and two were very common. So 1.5 grams of fat or two grams of fat to one gram of carbohydrate and protein.

Benjamin Hopkins (2:18)

Wonderful. For someone who hasn't heard of metabolic psychiatry and is immediately dismissing it in their mind of like, oh, you can't, it's a ketogenic, conditions are so serious and we shouldn't approach something so serious and with something as mundane as a diet, right? I mean, it's the consensus view to someone who hasn't been around metabolic health. What would you say, what have you seen that has convinced you of the wonderful outcomes that can have, that can happen off the back of metabolic health in terms of metabolic psychiatry? What have you seen?

Rachel Frase (2:50)

Yeah. Oh man. So I've seen a wide range of things.

I think, well, you know, one that stands out is of course, when with someone young, a ketogenic diet can make a huge difference in the rest of their life, right? If something happens quickly, you have a first episode of psychosis or first, you know, something major mental health-wise intervening early on can really help someone's trajectory and not needing medications for the rest of their life because that is one of the things that can happen. It can be, oh, you're probably going to need this for the rest of your life, right? And we know that there's so many side effects with the anti-psychotics and the different psychiatric medications. That was definitely a powerful thing that stood out to me is being able to intervene early, but just intervene in general to reduce the amount of medications and side effects that someone needs.

Benjamin Hopkins (3:35)

Amazing. And what about when it comes to the depression? You've done a lot of research around people with depression. How effective can changing one's diet be for depression?

Rachel Frase (3:44)

Very effective. And it can. There's a whole, one of the questions I often get is, how long does it take? There's a whole length of time.

I've seen people respond quickly on the early side, which is a couple months, two to three months, which seems really quick. For others, it's a longer process, and it really depends on, I think there's a lot of factors. I think it's the state of their metabolic health at the time, right? How long they've been on medications, how long they've had these different conditions. So a lot of factors, but it can really help to increase their energy levels, reduce brain fog. So a lot of immediate effects to improve mental clarity that helps someone feel better when you're depressed, right? If you start to feel your energy level is getting better, you start to be able to think clearer, focus more, that helps in the short term. So that, I think, you see those changes quicker and it gives you inspiration and hope that it can keep progressing. And if you've had depression for many years, you can keep getting better gradually over time.