Going on everyone Sam here with late sports cards with 10 boxes of 23 Bowman Cromant University football hobby for Mr. Jeremy B So good luck Jeremy see if we can get any Penn State and maybe Lions here for you Sean who maybe so much easier open than our tribes are Same deal is what we do with our guys, but these are significantly easier Ripping everything and stacking them so much easier It's not even They're not even comparable. All right, Jeremy. Good luck here, buddy John Reese Plumlee first refractor nice and mech egg buca for the rivals Penn State rivals, but Very nice one there to 499 very solid player, of course Checker our X-fractor of Corey Foreman, that is Roman henby first refractor green shimmer AJ swan to 99 And jacquavious marks to 499 first refractor on Shimmer first Alan Hayden Devin Neil first refractor Green Cooper Lagasse to 99 X-fractor first Josh Williams There is well, there's Hunter and should or Sanders first Brilliant Trice to 99 green shimmer was swan Surprise no take G underscore 08 It's so funny like, you know, he's laying in bed dying right now That's a warm milk Vaughn you miss some absolutely crazy names and archives this morning or this afternoon You miss you miss a lot of Vaughn cards Brady Cook first refractor Brian Wilson auto Hunter Pence auto Chili Davis auto Drake night first Jason Worth auto I said that already Cameron Ward X-fractor Donovan Jackson first refractor That is a Michael Pratt to 150 on the aqua Somehow missed every archives break Johnny Wilson nice to 499 for Florida State Fractor first auto. I was gonna say I haven't seen you here. I've only ripped. I've ripped Three cases three of the four cases we've done. Yeah, I haven't seen you for any of them Marvin Harrison Should or Sanders early risers or two of the four jahad Campbell to All here for some more fact. It was number to ten to his fire dude Jeremiah Hunter Got leaf ultimate hockey coming up next to everybody my first time ripping that this year Jason Marshall first refractor I'm excited love ripping hockey Dean key first base auto for Kentucky should or first Or in shimmer I'm at more head to 25 nice one there First shimmer Taj Brooks first refractor Oscar Delt looks really good and Marvin Harrison in Place of Bowers the injured Brock Bowers Drake may first Mitch labor first refractor Whoa Right Caleb Williams unexpected lights more mutual insurance.  I just drove to the casino Parked my car outside. I came out and was destroyed. Thanks, dude. I appreciate that man Braylon Allen to 299. I was like dude Why Frank or junior first base auto? Look, I don't think I've ever just for no reason blown somebody somebody's car car up.  I had this great play on some kid There's Quinn shot Judkins nice one there to 99 Ole Miss. I Just great. I clipped it to first will shepherd refractor shimmer. I Yeah Some kids started chasing me and was like shooting at me and I was in my I was in like some car He was on a motorcycle a little goss to what 399 and He was throwing sticky bombs at me Raheem Sanders, and they kept missing luckily So Marvin Harrison, obviously most motorcycles are faster. Yeah Obviously Harrison yellow Antonio Gates the 75 junior Travis Hunter X-Fractor to Cory Brooks and base so I He was catching up to me so I saw it like I was looking my rear view mirror as I was going down the highway and He was getting closer and he had the sticky bomb in his hand So I slammed on my brakes and he threw the sticky bomb over me and then he crashed into my back Of my car. I went flying over me and died I just I love you're just going to get a hydro or some jet. Yeah, I know and some clown is annoying man a freaking oppressor That's why whenever I join a lobby, and I'm trying to like export vehicles I always like always do a standard range one first because it's the cheapest and test out the lobby and see if anybody's being A jerk if somebody's blowing me up, then I'll just if someone blows my car up I'll leave.  I respect that guy. Oh, yeah, and not even thought twice about it I know that's the worst part about it dude. It's so overpowered. It's so it's the most unfair vehicle in that freaking game, dude I can't stand it.  I guess that makes sense I mean if that if you could just spam rockets nice Malik neighbors to 99 there we go Grats on that one. There you go Jeremy. Yeah, because if you could that would be so overpowered Tyler new But it'd be more overpowered than it is Drake may because everybody would have one and just blow each other up Jason McClellan first refractor green shimmer Keon Coleman. I just won there to 99 Drew pine first base auto for the Arizona State Sun Sun Devils Bruins just can't see what you mean to me. They lost today. Did they really? Yeah, I had them tonight, and they lost tonight. Geez We're about them. I've been Harrison purple shimmer Carson Beck I swung there Jayden Dolora first refractor Caleb Williams unexpected the lights purple mini diamonds Jalen Daniels to 399 Habs one today. They beat the Bruins in OT Phil Maffa. Really? That's kind of shocking the Habs one. No offense Audra guesstimate to 299 railing Allen and Bass Yeah, that's what I figured you wouldn't take offense to that I feel like you'd be the first one to admit it so I haven't I bought you know these they put the auto body shop update in I have one of those and it's so much fun Yeah, cuz you could you I'm assuming you Really yeah, the nightclub's huge cuz a kaioper Really They all do it themselves that's nice Yeah, I don't have the nightclub. It's definitely worth it. No, it sounds like it Yeah, that's a big one Well, what's cool about the auto body is you have to do one mission Which is super annoying. It's so obnoxious Marvin Harrison Grant Wells first refractor Roman doon say to 75. There we go. It's been a solid break Jeremy. I swung there buddy for Washington eight of 75 It's had a neighbor's green the last one Drake may first now a Rome Nate Wiggins first ex-fractor Winston Wright Hunter Deckers to 399 Mario Williams first base auto I swung there for USC as well journey Jordan Travis Purple shimmered Ryan O'Keefe Roydale Williams first refractor Drake may unexpected delights Will Rogers to 150 Ex-fractor first short Franklin Cooper to John Purple Devon Mockaby to 399 Ronde gas than the second first refractor and base so with the Autobody shop you get discounts on on vehicle modifications. So for me, it's worth it because I have and how much I like to customize them all the time, but Basically what have that the two big perks you get is one is you get The exotic export lists and it changes every day There's like 20 that randomly spawn around the map and then all you have to do is get into it and drive it to the docs And you get 20 grand and it only notifies it only notifies other people in the session that also have an auto body workshop So you're not gonna get chased by it's not gonna be like a normal business And then the other one is like once every hour or so of game time It'll you'll get a tax and they'll say that somebody has dropped off their car to modify So yeah, you have to pay 35,000 up front to modify it and then it gives you like specs that you have to follow So they'll say oh, I want this color.   That's crashed into something. Oh, yeah, dude. It's so hard to drive in that game I'm getting a lot better at racing because of the The car meet challenges, okay with the prize ride like you have to it's always the challenges always you have to do You have to go into the street race and finish in the tops blah blah blah two days in a row No, it's fun for sure. It's not super difficult now So I've got a lot better at that but All I care about is getting Drew macabre at the end of the day Anything else Rebel shimmer Christopher Vizina for Clemson a bokeh Drake may unexpected lights up the fire up Kyle Perica She knocked the 150 nice one there Green shimmer JV on Cohen for the you to 99 I say a Williams X factor first Kj. Jefferson refractor Damian Martinez to 499 Shop get our 2d2 cake for Dylan where's birthday? Hell, yeah, we should About 3.4 mil Carson back to 399 no, not really I'm good on money X factor Carson steel but the next thing funny enough it's stupid But the next thing I'm gonna buy is the next big purchase Devon mockabees to add in a garage in my CEO The 199 camp camper Yeah, oh yeah, I love the car. I love the car meet dude Don't bond. I do the prize ride challenges every week now. I just got it I just did the prize right challenge today as a matter of fact. I just got the rapid GT classic today. Oh so far And then you get they have they always have three vehicles every week not updates every Thursday like Casino update and everything the new certain missions will be 2x RP and all that to cash whatever It's always They change the prize ride every week on Thursday So it's Saturday He's dude. Yeah Um, but yeah, I mean I have I'm trying to think how many so I have my apartment And then I have so I have apartment 10 car garage. That's full then I have five other garages All full and then I have my motorcycle Workshop, which I'm just I just have bikes in and only has two bikes right now And then I have my auto body which has one car That's the next one to fill up and then I'm gonna get the then I'm gonna get the 60 car garage for my CO office I have obsessed with cars in that game. I freaking love it my crew the crew I'm in is a car meet crew. Really? So I've done a few with like private sessions with people What's up, Greg? Yes, sir, Greg Yes, sir Welcome in Good morning Well, Greg blue smell modern jr. 199 Georgia jade not first refractor Travis hunter Ricky white first X factor That's Marvin Harrison first Montrell Johnson first refractor Winston, right? Uh, I don't know we have uh like a 10 boxer after this You know, we have a 10 we have a one boxer than a 10 boxer than another one boxer I would probably assume not tonight, Greg bonus Robbie asford to 399 Malik Benson first X factor If you wanted to if you want to do something quick, we could prop we might be able to get it in It just depends how long the next one takes Or the the 10 boxer orange jay garcia to 25 nice one there on the auto But I think forest is doing them after group breaks tomorrow if you do want to get if you have something in mind Richard Reese to 99 Uh, justice ellison first base auto for wake forest first shimmer of jacquabious marks kubernetes Three cases of bone in you. Yeah, that'll go tomorrow That sounds like forest got you forest got you All right, three to go here jeremy pretty solid break so far overall Yeah, some of the auto has been really good Yeah, I'll see you tomorrow, Greg. Hey, have a good one, Greg. Have a good day, man. Absolutely. Absolutely. I'll see you on Monday morning. I'm sure as well What do you mean like um Do you have a bunker? No There's like a armory thing. I think it's in the bunker It's like a it's a gunwork shop where you can get like mark two weapons. Wow. That's pretty cool actually So like my shotgun has it seems like flaming Jesus, son you do this That sounds pretty cool. Yeah, I know the bunker would be the next one that I would think about getting Because the nightclub is just it nightclub is too much hatch up fun. That's the only thing for the nightclub for right now at least And what do you have? You have one of the two devices right now? Uh Two technically because I have well technically one That's on securo serve As I mean, I don't know because I have a cocaine lockup That counts it counts as a business, but it counts as a motorcycle club an mc president instead of a ceo But it's technically a business. Yeah, I would get the bunker and then get the nightclub Get the bunker than the nightclub. Yeah, I know the bunker is very worth it because then you could get like the the war stop cars Right. Yeah, you can get like the ramp buggy and the compressor probably yeah Okay, you can get a garage and something i'm there, man You get a garage and something i'm there and it's um It's the casino ice for the bunker. Oh, okay. That's pretty solid done. Yeah because that's uh We're talking we're talking about gta grand theft auto Anthony There's brendon solvent. Yeah, I guess if you just tune in you say here we say I have a cocaine lock up that makes That doesn't sound great in the game in grand theft auto in grand theft auto Harold Perkins Drew aller did I remember when I was first because I was first was starting to try to get money to to get the the ceo office chaelen McMillan and uh Blake fischer to 150 To get the ceo office to get the Vehicle workshop or the vehicle uh cargo very yeah vehicle workshop. There's um Coby prentice first refractor auto And travis hunter And I remember being so frustrated with the cocaine lock up because it took so goddamn long Malachi Starks unless you upgraded it, but I wasn't interested in spending more money on it To try to upgrade it. It is worth it now jarcas hunter But it kind of sucks that you can't be an mc president and a ceo at the same time Jason mclellan first base auto for alabama That's why I do like I don't even go to the Carson Beck businesses anymore. Once you have the night club Yeah, that's that would help a little bit the nightclub I think I've sold up to like three four million just from doing the nightclub one nightclub sale Michael williams do 299 especially if you have all the all the mc businesses to manual henderson first refractor bonix early risers 2 399 nicks singleton. There's some penn state mojo pc love there jeremy Zoom left. Good luck. Jeremy two boxes remaining nightclub Oh, you just grabbed that. Yeah, I've seen that I've seen that on youtube That's pretty awesome. It's so cool. Have you seen the terabyte? That's like the mobile one you can use right like the mobile nightclub kinds of Yeah That's nice.   Donald's that'd be pretty cool sports card heist in the game that'd be dope Travis hunter first refractor and dinky Yeah, late in height fire the mecha ebuca It's we can all go do a high so should door sanders Uh brock powers pink mini diamonds nice one there. Damn. You're up late cam.  What's up cam? angel macabre should door sanders drake may first javante barns first refractor and jared verse green shimmer mayan williams to 99 Jackson arnold first refractor auto go into the Oklahoma Sooners will go into jeremy, but on Oklahoma. Oh hell. Yeah. Juan said he's in let's go We got any of it something funny like the lsc box or something That's what it should be I'm gonna be The leader of it. I'm a spearhead that I can tell you that right now Been watching the killer on netflix Oh nice There you go cam So in on that In Korea now for league hell. Yeah, dude. Oh, that's My league legend. Yeah. Yeah You bet on it. I already had a couple. It's like at 3 a.m. I think yeah He said cam said he's waiting for the semi finals to start fact imagine. Yeah Well, it's usually over Yeah Well, I was like rocket league all the time too like if you were every now and then I get like randomly like 7 a.m. Uh twitch that rocket Like really yeah all these e-sports players weird time. Yeah, I guess it all depends on where it is Drake may mario williams first refractor Olufashanu lt. Overton first refractor Purple drew pine to 399 Piccahuna travis hunter auto to 150 what a last box there we go, uh, jeremy congrats buddy That's awesome. Hell yeah, dude neat wiggins mag that one, of course Richard Reese to 75 kj jefferson x fractor Tray Benson first refractor green donovan edwards nice one there to 99 Shadoor sanders first shimmer of paris jones green smell modem jr. To 99 Marvin Harrison first First of Nate wiggins refractor and base. I'll do a quick recap of your autos here, jeremy. I think there's only No, did you get the other one? Nice Don't ever it's perfect. Thanks, sir We had jackson arnold jace mclellan justice ellison mario williams drew pine Frank or jr. Dane key johnny wilson mech egg buca quavius marks coby prentiss Damian martinez jade not quinchon judkins mleek neighbors donovan edwards uh, jason marshal roman dunze Uh, jake garcia and then a big kahuna travis hunter auto that will do it for the break everybody. Thanks again for the fill Or thanks again for the fill. Thanks again, jeremy. That's gonna do it for your break. I felt like a group break to be fair Um, thank you again. Jeremy appreciate it is always buddy. We'll get him right out to my friends


Welcome to the six-yard sprint. This technique will help you become sharper on the pitch. Bend both knees and lean forward.  Pump your arms and legs. Now go and practice to get ready to the challenge.


Hi, you mentioned a sick boost, so I thought I would bring that up What do you think about the allegations against bitmain and jihun new and if true what? Implications will that have if any on the breaking the impasse between core and Bitcoin unlimited? I Don't know if the allegations are true However, we do know that Bitmain's mining chips have on board FPGAs and multi-core CPUs that would be the necessary thing to put on a chip in order to do a sick boost Their CEO said that they put the chips on their a sick Board in order to do a sick boost, but then didn't do it for the good of the network And so they spent all of this money putting these chips on the only purpose of these chips would be to do a sick boost But they only did a sick boost on testnet and Have never done it on mainnet, so you can believe that or you can't right? It depends on your perspective, but if you do believe it I have a simple answer to that which is well in that case If you didn't use it, and you won't use it then you don't mind if the entire network disables it because No matter who uses it it creates a tremendous impediment to protocol enhancements by making the header itself Immutable in its architecture.  It doesn't matter if the motives of running it are simply profit-driven, and that's fine That's the free market. You should do optimizations. It's not an attack. It's an optimization great So what we're going to do to fix it is not a counter attack. It's a counter optimization And since nobody's using it, it's okay, right, right, right? There's not a hundred million dollars on the table here. Nobody's using it. It's okay. Turn it off You're not using it turn it off because it is Sitting there, and it's a time bomb if nobody's using it right now if somebody starts using it in six months They're going to derail pocket protocol development for exactly the reasons that we suspect or some people suspect that protocol development might be derailed and so I Would say turn it off That way everybody's happy you can still do overt a sick boost by using the front part of the header In fact, there are some proposals to make it more efficient anyone can run that Some people object to this idea by saying but the free market is optimizing the chips and The free market includes you and I and all of the protocol developers saying We don't want that optimization. So that's also part of the free market and In another way you've got to think about It's not really a free market It's a free market Secured by a patent That provides an exclusive economic right over an invention Backed by the threat of state force. That's not a free market, right a patent is a Monopoly by definition. That's what a patent does It secures the exclusive right to the patent owner to use a technology and not let anybody else use it Under threat of state force therefore not a free market. So If it's not being used we should turn it off if it is being used we should turn it off and I don't know if that's gonna change the debate It might not change the debate at all because at this point the debate is not just about profits and technology. It's also about Bruce the egos and hurt feelings and you called me this name and I called you that name and six months ago You said and all of that. It's a bit like a divorce, right? You have this couple and they're now six months into the divorce and they've spent a quarter of a million dollars fighting over who gets custody of Moo Moo the mini dog Right and anybody who's met Moo Moo Says Why why do you who wants to know take that little dog away from me? Nobody really wants the dog. It's not about the dog It's about Someone's feelings have been hurt and they want to spend a quarter of a million dollars Hurting the other person's feelings in revenge, right? And if you focus on trying to think okay, how about we get you both cats Like you know, these are the compromise proposals we see coming out of the Bitcoin community How about we get you both cats? I wanted a dog. You promised me that I could have Moo Moo three years ago. Here's the email Right and it's not about the dog and you can't fix it with a compromise because there's hurt feelings So this is the problem with a lot of the scaling debate and especially a sick boost because now we have another Ingredient and that's ingredient is the possibility of completely undetectable covert action that confers an Advantage by the way How many of you have heard of all of this? Okay, great. So quite a few people do you understand what it means to have a 20% advantage in energy consumption So first of all most data centers that run mining are not constrained by how many mining Rigs they can buy or rack. They're constrained by how much power they can feed into the building That's always the constraint and as soon as they have more power They can easily buy all of the chips and rack them etc. And immediately get to a hundred percent of all of the power I'd say it's the gating factor the limiting factor is always the electricity that's going in if you reduce consumption by 20% That means you can install 20% more miners, which means 20% more hashing power But it gets better That doesn't mean a 20% increase in profits Oh, no because profit margins are less than 1% What happens when your profit margins are less than 1% you spend a million dollars on electricity, right? So you spend a sorry you get a million dollars in rewards from mining and you spend 990 thousand dollars on Electricity and you make a $10,000 profit if you reduce the cost of electricity by 20% You earn a million dollars in mining and now you spend $750,000 on electricity and your profit just went from 10,000 to a hundred and ninety thousand a factor of 19 or 20 This is a huge advantage This is an enormous advantage and a basic boost is really happening. It will allow one miner Which one the one that has the monopoly control over the technology backed by the state's force To completely dominate the market and knock all of their competitors out of business that is unacceptable If you're gonna do it do it with the overt version Everyone can see you're doing it and adjust their business plan accordingly the covert version damages the market It damages the protocol development and since nobody's using it. Let's turn it off That's what I think about a suppose. Thank you


It's time to surrender everything. No more games. No more compromises. Sometimes what we do is we place ourselves on the altar. We say, Lord, you can have me. And then moments later, we step right off. The hour is calling for people who will be fully committed, not just fully committed, but completely crucified.


All right, thank you very much. So glad to be back here at Ancestral Health Society. I was at the very first one down in Los Angeles and met a lot of you there. So this talk is something that I present a variation to actual psychiatrists, mental health workers, other clinicians trying to help people out in the real world. So it's focused on the scientific data and real world applications. It's not gonna be as drilled down into some of the things that some of you all are interested in, but it's a way to approach people and talk to people about food and mental health in a way that pretty much everybody can understand, no matter where they come from, from a vegetarian perspective, sort of a standard American diet perspective, from a perspective that food doesn't matter to mental health, which was the perspective for a long time. So here we go. I do have a couple of blogs. I'm also on the editorial board of MedSkate, and a couple of other things I've been added since then, but none of them pay me, except the Psychology Today blog by Views. So we're gonna talk about evidence-based food and mechanisms. We're gonna skip the food assessment and then we're gonna go to a question and answer, because I only have 30 minutes. So what is the evidence that food affects the mood? Believe it or not, this is kind of a hard sell for people. And finally, in the Lancet psychiatry, not a couple of years ago, this was kind of groundbreaking. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition is a crucial factor in the high prevalence and incidence of mental disorders, suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterologist. I mean, can you imagine going up to a gastroenterologist and saying, I'm sorry, what you eat has nothing to do with how your gut feels, and you would be laughed out of the room. Sometimes it's actually independent, but people had that belief about psychiatry that somehow the brain is isolated from the rest of the body. And it's really hit the mainstream scientific American mind had a whole issue dedicated to food and mood.   It has the highest concentrations of pufas of any organ and of any primate. It is also the largest deposit of cholesterol in the body. And they used to think, oh, it's mostly static cholesterol. So that's why they thought that statins and other cholesterol lowering medications didn't really affect the brain because it was a lot of myelin, which is it's kind of building blocks rather than stuff going in and out. But now we know that cholesterol is very important in signaling and the lipid rafts that are part of serotonin receptors and other things like that. So here we have dietary guidelines again for endocrinology, cardiology, cancer treatment. They all have their own little diet booklet and kind of mainstream ideas about how to treat these. We may or may not agree with these. Psychiatry, the American Psychiatric Association, nothing. There's no consensus document by any psychiatric organization about what you should eat or what you should even steer toward. So it wasn't, mental health is not mentioned at all in the dietary guidelines for Americans. This is shifting. They are no longer focused on the food groups. Cholesterol is no longer a nutrient of concern. There's no mention of mental health. Oops, sorry, I got lost somehow. All right, so these are the lenses that we look through when we're looking at what food. How do you build a better brain? First, nutrients and mechanisms. Second, epidemiology, the evidence that we do have in brain health. And last, sustainability and feasibility. It doesn't do any good to tell, if I'm working with a population in downtown Atlanta, to tell them to go kill and eat their own wild boars. And so let's look at the evidence. We're gonna start with the observational trials, which believe it or not, just really started rolling in in 2009. It's not even 10 years ago. All of the evidence, all of the good evidence that we have for food and mood is not even 10 years old. This was the very first study Sanchez Viegas published in one of the big psychiatry journals, archives. 10,094 people, healthy, followed for 4.4 years. If they followed a Mediterranean dietary pattern, they had a 42% decreased risk of developing depression at the end of the 4.4 years. And so this, it's kind of small, but you can see the hazard ratios at the end here. And these are the two sex tiles that are closest adhering to the Mediterranean diet. And you see the hazard ratios are between 0.6 and 0.32. So about having your risk of developing depression after four years. Just observational data, obviously. This was a study by Felice Jacka, who's one of my very favorite food and mood researchers. She's the one who did the very first study of a diet to treat major depressive disorder. We'll see that later. She did this back in 2009, right when she was first getting her PhD dissertation. And she found that teens who followed a healthy dietary pattern, again, were much less likely to develop depression. In fact, the ones with the lowest quality diet were 79% more likely to get depressed than their peers. And you saw the linear correlation there. So instead of going through all of the sort of tedious observational trials, they've did a meta-analysis of all of them. There was another new one. You guys might have seen in the news, came out in March with a big splash. It was just another observational trial. People who followed the DASH diet more closely were more likely to be less depressed. But as you can see, all of these trials, mostly Mediterranean, whole foods, more home cooking, less processed food. And there's a signal that it does decrease the risk of depression. With the little diamond at the bottom is like the combination score for all of those trials. But these are just observational, healthy people, happy people, are more likely to eat well and cook their own food and feel motivated to do that. So that may be all the signal we're seeing there, but let's try some randomized control trials to see this. So believe it or not, up until just last year or the end of, yeah, the end of 2016, the only randomized controlled trials of diets and depression used depression as a secondary endpoint or is it like a diet for a control group treating depression. So all of these studies that I'm gonna talk about right now they were usually cardiology studies because you need a lot of money for those and a lot of people wanna go on a different diet to treat their heart disease, but they happened to measure validated measures of depression or sometimes anxiety along the way. And this one was a Prety Med which also news has shown recently that they didn't carefully randomize some of their control group, but the interesting thing about it, their control group was actually like an AHA-approved low fat diet group and their research group was a Mediterranean diet and they had one where they encouraged more olive oil and one where they encouraged more nuts, all right? And what's interesting about that is you find a signal here, especially among people who, because I don't know how that's like, but especially among people who had diabetes, if they follow the Mediterranean diet, much less likely to get depression as opposed to the American Heart Association diet. And this was a randomized controlled trial where they put randomized people on two different tracks for several years. So this is actually a meta-analysis of the impact of whole food, whole of diet interventions on depression. And again, all of these were secondary endpoints for depression. They were really measuring something else, usually cardiovascular disease. And what they found, I'm trying to roll this up because I don't know the exact numbers. And I can't see on my, is there anyone, does anyone AV up here in here? Well, the exact, it shows you about what we did before and I apologize if I get the number exactly wrong, but it generally halves maybe 60%. You improve your symptoms of depression, you decrease your risk of developing depression. So this is my favorite randomized controlled trial for depression. It's not Dr. Jack as it was by Sarah Stahl. And what she did was she had elderly people at high risk for developing depression. So they did a sort of a scale for them. They found that they were all mildly depressed. Among the elderly if you're mildly depressed, you're very high risk for developing a clinical severe depression in a couple of years. And so they thought, how do we treat this in primary care? There's not enough mental health care. How do we get people to be able to do interventions?  So it was like a low training. It was where people, sort of with just regular wisdom and not a whole lot of training could basically render supportive mental health care. So the other arm that they thought was the control was it where they taught people to cook and encouraged them to cook more at home. So more whole real foods at home. So and the arms were actually equal. They both prevented these people from developing depression in the next several years. But I thought that was kind of humorous that they thought they were so out of tune with even the research that was already out that they thought that a healthy dietary intervention would be a control group for depression. And this is a Dr. Jack's study. And this was a very first dietary trial to look specifically at dietary treatment of a major depressive disorder. And what they did, they had a control group that was kind of like it was a group and they were just there sort of supporting each other and talking about things. They were all had diagnosis and were being treated for major depressive disorder. Some of them were on meds, some were not, some were in therapy, some were not, but they all were randomized to the two groups. The other group was nine fairly intensive interventions. They were given a basket of food. They were encouraged to eat a Mediterranean style diet which is whole grains. But whole grains rather than processed food, less processed food, cooking your own food, lots of vegetables. And this is the difference what they did in this trial. Their Mediterranean diet did not restrict red meat because in all the observational trials, any diet that restricted red meat they failed at improving depression symptoms. And so at the end of this trial, you can see a powerful signal there. The number needed to treat, they significantly decreased depression in the diet intervention compared to the social support group. The number needed to treat for this was 4.1 which means you needed to put 4.1 people in a diet for people to have a remission in their depression. And that's about the same or less than many chemical antidepressants that we have. It's statins the number needed to treat and it's a different endpoint for to reduce death as something like one in 100 or two in 100 depending on the population. So this is just something I throw in there. Another diet and behavior intervention.  These Gorillaz were picking at themselves and ruminating.  And so they decided to put these Gorillaz on an ancestral diet. Gorillaz eat 11 hours of the day. They have huge long guts. And so they give them a lot of Romaine lettuce and took away their Gorilla biscuits. And these behaviors, it was actually to help their heart disease. Same, because one of the Gorillaz had died of a heart attack. But these Gorillaz got a lot better and they're all, they're ruminating and they're picking behaviors went away. So they were no longer anxious. And so this is just a little trial I'll mention, I think from Belgium, Inca study. And they put, it's a weird diet. They put them on an elimination diet as they thought ADHD might be caused by food allergies. But it was rice, turkey, lamb, vegetable fruits. Sorry, margarine and vegetable oil. Tea, pear juice and water. It was a crossover trial. And 78% of the children showed improvement as opposed to sort of a processed food diet. Again, I wouldn't have chosen this diet, but that's what they picked. So what are the mechanisms? There's nutrient deficiency, insufficiency, neuroplasticity in BDNF.  And it tends to drop in depression. And all of our chemical interventions in depression, yoga, therapy, those things tend to be associated with increases in BDNF in the plasma and in the brain. So basically what our treatments for depression do is increase brain fertilizer to help you recover and repair from stress. That's the way out view. So what is neuroinflammation? It's a very hot area of mental health and research. And how do we kind of go back there? Here is sort of a complicated slide about different ways that you influence neuroinflammation. And so you get stress leading to cortisol being produced, kind of over-activates the brain and the sympathetic nervous system. The fight or flight nervous system gets overactive. And then the rest and digest nervous system is underactive. So all of our interventions are about getting the more imbalanced. And gut dysbiosis is actually a big part of this. I'll go into that later. And this was back to that prety med intervention. Oh, nevermind, this is a different one. So this one, they showed that this inflammatory diet, you had much higher measures of inflammation in the blood. That was the inflammatory part. I know they had meat over there. And then I'm gonna talk more about meat versus meat later on. And these were the elements of the anti-inflammatory pieces of the diet. And this was just interesting. It's a kind of a complicated slide, but it showed that people who followed people over time in their inflammatory markers, and if they ate a healthy diet, it not only protected them from depression, but it affected, if they were under tremendous stress, their inflammatory markers didn't go as high if they were on a healthy diet. This is another Felice Jacka study. She measured the hippocampus of people, I think 62 to 69 over a period of, again, like five to seven years. And as you can see, everybody's hippocampus shrinks over time as we get older. It's a part of the brain that affects memory and stuff like that. But the people on a healthy dietary pattern, their hippocampus shrinks less. And you start out much smaller if you have a poor diet. And so now at the microbiome, there was Anton von Leewenhoek, who first scraped his tooth and looked under his microscope and saw little living antimicules, very prettily and moving. And you guys all know all this stuff, but there's an intersection between a bi-director communication between the gut and the brain. So if you take a mouse away from its mother, the gut flora is altered. Stress and sleep will affect the human gut flora. There's increased translocation of gram-negative bacteria, talk to bacteria, and increased LPS, which is a measure of bacterial contamination of your blood in patients with major depressive disorder. And these are all the different bacteria. They actually produce our own neurotransmitters. And through mouse studies, we know that the bacteria can affect your behavior, kind of creepy. So they're talking to you through the vagus nerve. And so different bacteria can make you have a different mood or response to things or change your resiliency. So if you're thinking about a fecal transplant, there's a lot we don't know. I'm not really a DIY fecal transplant advocate myself, but you wanna make sure it's from a pretty serene person, okay? And this is just how the gut bacteria affect the brain. Again, it latches on to that sympathetic versus parasympathetic, fight or flight versus arrest and digest nervous system. And pathogenic bacteria in your gut will activate that fight or flight nervous system. It's another stressor that your body has to deal with. And things like probiotics can intervene in that cascade. The things that we have, if you look at this cascade, if any of you are psychiatrists or family doctors or OBGYNs, whoever uses stuff like an SSRI, we're affecting serotonin up there on the brain side, sometimes more successfully than others. But probiotics actually affect the same process and increase healthy signaling of serotonin on the gut side with a lot fewer side effects. Not as strong of a signal as SSRI signal, but that is the future of what they call psychobiotics, which I also think would make a good band name. And this is just studying the microbiome. This is from a study where they took African American men and they put them on a traditional South African diet. This is by O'Keeffe, who is well known for his hatred of red meat and TMAO. But this is an interesting study. This is just to show the kind of data that you get from a microbiome study. So you kind of need a supercomputer to figure it out. So tell me, after switching African Americans to a traditional South African diet for two weeks, the healthy butyrate producing microbial species in the gut increased by... So butyrate is the short fatty acids in butter. And so if you have the right bacteria, when you eat fiber, they change it into not exactly butter, but close enough. So we all think that's good, right? You make your high fiber diet into a high fat diet. So it's 250%, two weeks. All right, and so there's a bunch of other kind of studies linking just changes in the microbiome to different mental health. There was a recent one with schizophrenia. There was another one that showed mania. It was really just two weeks ago. I'm gonna blog about it, but I haven't yet. And this is how, in more detail, if you wanna write all that down, exactly how you get from the microbiota up to the brain and all the different intervening things. This is from a, yeah, it's from Wang et al in brain behavior and immunity in 2014. It's actually open access and it's awesome. It's kind of a really good primer for this kind of thing. Wang et al in brain behavior and immunity 2014. So when you ask people as a clinician, do you eat a healthy diet? Oh, sure. What they mean is they count calories, they avoid cholesterol, they avoid fat, and they don't eat red meat. But they drink a lot of red wine, right? This was in 2009. I know I've heard recently, we don't need vitamins because most of us get our vitamins. Well, this is the percentage of the U.S. population not meeting the RDA. And look at these really important brain minerals. Zinc, magnesium, B vitamins, vitamin B12, 30%.  And this is one of the reasons why. So in 12 to 19-year-old boys, they get 273 of their daily calories from soda. I'm just gonna skip through that because you already know that. So inadequate intake of vitamins and minerals is most common among. Sorry, I should have stopped and asked you. So, oops. These are the most important minerals for the brain. Long chain omega-3s, folates, fiber, that's again to build happy, healthy microbiota that's associated with happy, healthier things. But I think we have some different ideas about that. In this group, vitamin B12, vitamin D, thiamine, magnesium, calcium, vitamin E, choline, iron and zinc. And a lot of these, B12, iron, zinc, choline, long chain omega-3s, the best sources are animal foods.  So these are sources of these good brain foods. If you wanna eat well for your brain, over there are oysters, kind of, or clams. Iron, so iron is the most common mineral deficiency in the world, especially among women. I know a lot of men worry about iron overload, but from a public health perspective, iron deficiency is more common. So you can get it from clams, you can get it from up at the top. Anybody know what that one is? Yes, liver, yummy, delicious liver. The bottom one, you know what that one is? Cashews, yeah, so a 6.1 milligram serving will give you 34% of your iron you need daily. And then pumpkin seeds over there. And y'all know what this is? Yeah, dark chocolate, 17 milligrams will give you 97% of your iron, did you know that? So this is what psychiatrists do a lot of the time. We block all the receptors and we try to get things much normal, but I like the pharmacy. At least to augment my pharmacy, I have a lot of pretty sick people who need medications, but I try to limit those medications as much as possible and get them back to functioning and eating well. And this is my friend Drew Ramsey's brain food prescription. Really focuses on more, you know, seafood and vegetables. He used to be a vegetarian, so he's not as pro red meat as I am, but he has some helpful swaps for people, like a salmon burger for a fried fish sandwich, dark chocolate almonds for white chocolate pretzels, that kind of stuff.  So you're zinc, you're long chain. Omega-3 is your B12 and your iron. It's all there. This is some more stuff on Omega-3. It's good for your brain. It's good in pregnancy. He loves kale. He wrote a book called 50 Shades of Kale. It's a recipe book. It's really funny. It's good. And then he also eat a lot of rainbow of foods. And this is sort of my, I like vegetables. I'm not really a carnivore myself, but I think Michael Pollan in his very first book made a good point that humans used to eat hundreds of different species of vegetables all the time, and we kind of were down to lettuce and broccoli and peas. And so eating the different rainbow of foods can help you get a smattering of the different phytochemicals for hormesis, right?  And so this was the interesting, this was the prety med Mediterranean diet plus nuts. It increased your plasma BDNF. So you're at much less risk of having low plasma BDNF, which is that brain derived neurotrophic factor. So I thought that was interesting. And look at the Mediterranean diet plus olive oil, no protection. It was the nuts. Isn't that interesting? Again, it's observational, but fascinating. All right, beans and legumes and then grains. So if you're talking public health, a lot of people, again, they're pro Mediterranean diet, but I have this slide in here to say there's more to grains than wheat and all sorts of different things that you can try. But I just wanna put this in. What about gluten and mental health? There's some very interesting signals. The biggest trial of the treatment of schizophrenia in the United States was called the KD trial. They happened to measure along the way markers for celiac disease, which I thought was very sensible of them. 23% of the patients with schizophrenia had the IGA marker for celiac disease versus 2.3% of the general population. That's a pretty wild signal, right? And if you have celiac, you're more likely to have schizophrenia. If you have schizophrenia, you're more likely to have celiac. And I think it's a sort of an inflammatory autoimmune marker. And this is just how celiac works. It bursts those tight junctions open. So then you have your poo in your blood, as Rob Wolf would say, which is not good. This is actually a patient of mine who made the New England Journal of Medicine. She's a 37-year-old woman with no previous psychiatric history, no family history, and suddenly became completely delusional and psychotic. She told me that the ravens or birds fighting outside her doorway were actually computer robots built to spy on her and to make her upset because she was a vegetarian and she didn't like birds hurting each other. Nothing worked, no medicines worked. She had celiac disease. When she first showed up, they finally were able to hospitalize her because she was so delusional and she weighed like 95 pounds. She was very low in B12. It took them a little while and Hashimoto's thyroiditis for them to figure out that she also had celiac disease. When they treat her celiac disease, her delusions went away entirely. She relapsed a couple of years ago and when I checked her, she cheated on her diet. She'd eaten some Chinese food. And after that, she was again psychotic for about a year before we got her back in line. Finally figured out in medication that worked with her but in which she stays on at a low dose but she's also very much careful to be gluten-free now. And then meat and eggs, lots of nutrition there. This is a Kefo. This is not the meat that we like. This is my family farm. This is the kind of meat that we like. We just raised cows there in the summertime to fatten up on the nice green grass there. And then meat and vegetables. And again, this is the kind of meat I'm not talking about so much, especially that stuff on the right there, kind of gross. Eggs are fantastic for you. Very interesting study about choline and risk of brain aberrations that predispose you to schizophrenia later in life. Give a pregnant mom enough choline. Their babies don't have the problem. So can you eat to build a better brain? I say yes, you do. Colors, fats, flavor and fun. Don't be scared of fish. Remember clams, you can sneak that into a pizza and other things. Whole foods or Mediterranean diet pattern are scientifically shown to be productive for depression but also dementia, anxiety, bipolar and ADHD. And learn from history, put the genie back in the bottle. Processed foods just aren't very good for you. They'll keep you alive. They'll give you 500 kids but they're not that good for you. So this says, of course you feel great, these things are loaded with anti-depressants. All right, any questions? Thank you. Hi, that was a great talk. I'm just curious, based on this research that's coming out or any of the mental hospitals or places like that latching onto this and trying to change what they're actually feeding the patients there. It really depends on the hospital. I know when I was at the Physicians for Ancestral Health Conference a while back, there was a psychiatrist working in kind of the inner city. I'm gonna say down in Tennessee, Nashville maybe. And he was able to have some influence to take away some of the processed food. But institutional food, weirdly you think it would be the easiest stuff to change because you have absolute control over what they're eating. But it's some of the hardest because it's not cheap. One thing though about the Mediterranean diet, Felice Jacka's study where she put people on a diet, she calculated economically and asked them what they were spending on their weekly food before they started the diet and then after. It actually went from $138 a week, that's Australian dollars, down to $112 a week on their fresh food diet. So they were saving money. I think more analysis like that would really help this go forward. And economic analysis is part of these, any of these interventions for cardiology, for mental health, anything.  Hi, Emily, thank you. How has depression quantified? What if people have legitimate reasons to be depressed and then, oh, we're going to change the diet and you're less depressed, but doesn't that bring about like a false sense of reality, like how do you do it in your field? Am I really talking just a clinical depression? There's absolutely nothing wrong by, let's say, I tried out for the orchestra and I failed, I didn't make it, for me to be down after that. That's totally normal, that's not pathologic at night. If you're not down after that, there's something wrong with you. So I'm talking about a clinical depression which is defined as multiple issues, suicidality, inability to function, foggy brain, lack of energy, lack of motivation, you know, sad most of the time and it has to last for at least two weeks for a major depressive disorder. It's significantly debilitating and about 6.2% of us meet that criteria at any given time. It's also distinguished from bereavement which is probably the most likely reason you're gonna feel super depressed and there tends to, again, to be lots of feelings of guilt and suicidality. So wanting to end your life. And so it's that, that is very different from feeling down, there's nothing, we need to feel down. We need to feel bereaved when we lose our loved ones. There's nothing wrong with feeling sad, but if you're sad for too long or you're overstressed, that's because that hypothalamic pituitary adrenal system is overloaded with stress and cortisol on your brain and it's associated with inflammatory cytokines and inflammation. Your immune system in your brain is overactive and it actually causes the cells not to work, not to regenerate the communication to break down. So it's an actual pathologic condition. And that can be measured? Yes, well they usually measure it, sometimes they measure it with cytokines and often they measure it with the rating scales and most of your rating scales will specify at least two weeks and they will have all of those different, some of their pain aspects, so people who are depressed feel pain more and those different rating scales have all that. You have to meet the established criteria because we don't wanna overdiagnose people with depression. That's just as bad as not treating it.


Coming out of last year's annual conference, the planning team asked for your feedback about what you liked about the event and what could be done better. A theme that emerged in your responses was how we address and handle legislative items, like resolutions. Letting surprise any of us, but hearing your specific concerns and ideas helped us evaluate our process, research what's working in other annual conferences, and imagine a new way of doing things for annual conference 2023. We heard you asking for more time dedicated to resolutions, for more information as you're asked to vote on resolutions, and for the opportunity to ask questions and hear thoughtful answers. We know that resolutions considered at our annual conference can be a powerful means to further God's work in North Texas. Ensuring that we have ample time and information to do this work well is critically important. We also heard a cry for more efficiency in the way we use our time together. For good collaboration and refinement to happen before a resolution is brought to the floor whenever possible. Our time together annual conference is precious and we want to ensure that the resolutions you're reviewing are strong and have already received input from impacted groups and stakeholders. When we sat down to brainstorm adjustments for 2023, our discussions were initially around tweaks to the process, how we could change the schedule or communication tools to incrementally improve the way we do this work. But as we kept coming back to the real challenge, how to increase the amount of dedicated time, the amount of information available, and the efficiency that we bring to this process, we understood that to make the changes our conference needs, we would have to completely reimagine our legislative process. When we stepped away from how we've always done things to consider something truly new, we landed on legislative committees as a new model to try in 2023. Under this new process, we will dedicate time on Monday afternoon to these small legislative committees. Each committee will include a convener, a parliamentarian, the author or authors of the resolution, as well as a mix of clergy and laity that we hope will represent diversity in thought and in voice. Together they will discuss and refine the resolution, possibly suggesting amendments. Following these sessions, each of the authors will still present their resolution to the floor, as they've done in the past. But following this presentation, the convener of the particular legislative committee that worked with that item will have a chance to make a brief report. This report could be a neutral statement, or it could be a statement for or against the resolution, depending on the conversation and consensus of the committee. Any member of the annual conference can participate in a legislative committee. If you'd like to participate, you'll be able to indicate your interest when you register for annual conference starting the week of April 24th. You won't be able to choose exactly which resolution you'll work on, but you will have an opportunity to rank your interests a few weeks before annual conference. From there, the legislative committee team will review the pool of interested attendees and your ranked interests and build out balanced legislative committees to set the stage for good conversation and collaboration. It's our intention that anyone with a passion for this work will be able to participate and contribute on a legislative committee, but we will have to operate within real space limitations. We can't overfill a room or crowd out voices at the table. We know this won't be a first come first serve situation. It's a bit more art than science as each committee should reflect a diversity of thought, but we're going to do our best to find a place for everyone. As a planning team, we like that legislative committees have the potential to address all three issues we were trying to solve when handling resolutions this year. They'll give us more time for work on resolutions at annual conference. They'll allow for more substantive two-way conversation around resolutions, and they'll bring informed efficiency to the work of the gathered body. We know that this solution isn't a perfect one. No process is. But we also know that this model is working for annual conferences across the country, and it resembles the way legislation is handled at general conference. More importantly, we have confidence that this change will be a step in the right direction. We're looking forward to seeing how this change plays out and continuing to incorporate your feedback as we learn together how best to engage in holy conferencing at our annual conference. Blessings, and we look forward to seeing you in June.