The Fabulously Keto Podcast

Why Calories Don’t Tell the Full Story About Mental Health — And What Does

This post is adapted from my conversation on the Fabulously Keto Podcast with Jackie Fletcher, where we explored the connections among ultra-processed food, mental health, functional medicine, and why the calorie model falls short for brain health, and why calories don’t tell the full story.

The Personal Journey Behind the Work

Most people in the nutrition field have a personal story that informs their professional direction. For me, it started at 24 when I got serious about my health and began exercising for the first time. Within a few months, I had a rapid transformation — not just physically, but mentally. My anxiety dropped significantly, and it became obvious that nutrition, movement, sunlight, sleep, water, and supplements were all part of my recovery journey.

That experience eventually led me from nutrition for addiction recovery to functional medicine for mental health — a much wider net that includes lifestyle medicine, systems biology thinking, and specialty lab testing to identify root causes.

Why the Calorie Model Fails Mental Health

There have been significant efforts to make nutrition into a hard science, which makes sense for research purposes — you need to control variables, and calories are a perfect example. But in the context of mental health, not everyone’s brain works quantitatively. Some people need what I call a qualitative approach: focusing on food quality, processing levels, colors, packaging, and internal cues like hunger and fullness, particularly when there is disordered eating. 

When I made changes to my life, I didn’t use a calorie model. I just ate real food and did the opposite of what I used to do. That worked really well for me because at the time I had a tendency toward rigid, black-and-white thinking, and the calorie model can feed into that.

Here’s what I’ve observed over years of studying the food industry: when food companies came under fire for excessive additives, oils, sugars, and salts, their response was always to lean on the calorie model. They’d offer low-fat versions with fewer calories, or reduced-sugar versions with artificial sweeteners. While that might seem like a step in the right direction, it didn’t solve people’s issues — it just moved them onto ultra-processed diet foods filled with ingredients that don’t readily occur in nature.

A calorie-centric model will look at avocados and walnuts as “high-calorie foods.” That’s when I knew we needed to think about things differently. I’ve worked hard to promote alternative frameworks — not just because I believe it’s what people need, but because counting calories for my career didn’t feel meaningful enough. I wanted to talk to people and solve problems.

The Trauma-Addiction-Food Connection

There are scholars who argue that addiction doesn’t exist without some underlying stress, trauma, or adversity. I don’t like to speak in absolutes, but the data suggest that people with multiple adverse childhood experiences (ACEs) are four to five times — up to ten times — more likely to develop an addictive disorder. The original ACE study clearly mapped out these odds ratios.

I was savvy enough to recognize that people with substance use disorders tend to cross-addict into other addictive behaviors. If childhood adversity is a risk factor for substance use disorder, it has to be a risk factor for addiction-like eating. That’s been a focus of my research: the link between childhood trauma and ultra-processed food addiction.

An important distinction: ACEs and childhood trauma aren’t identical. They tend to coexist, but some people have a lot of childhood adversity without the same traumatic effects. It’s less about the event itself and more about the meaning that’s ascribed to it — plus the other complexities that unfold across a lifespan.

A Tailored Approach: No Single Path

In my private practice, I collect data upfront — ACE scores, PTSD symptoms, anxiety and depression measures, and a full timeline of someone’s life. I assess addictive tendencies and susceptibility to eating disorders and dietary restriction. All of that is driven by clinical experience and intuition. I’ve published my findings. 

I’ve maintained a safe and successful practice by not having a single protocol. I know that makes it harder — having one clear path is easier for providers. But I’ve always known that different people need different approaches, different speeds, and different levels of rigidity versus fluidity. Some people need harm reduction. Some need really soft messaging. Others want distinct guidelines.

In functional medicine, we co-create a plan and modify it. It needs to make sense not just biologically and psychologically but also in the context of someone’s life — their access to resources, family environment, and stress levels. Ultimately, the choice is the person’s. I’m not making the final decision about someone’s health.

Micronutrients, Gut Health, and the Brain

Early research in nutritional psychiatry identified cross-sectional associations between mental health conditions and nutrient deficiencies. Pretty much all of them — if insufficient or deficient — have implications for mental health. The concluding chapters in the early books on this topic basically said: take a multivitamin. And that’s fair, because you need all of them.

But that’s where specialty lab testing comes in. You can figure out specifically what each person needs. The superstars tend to be minerals like magnesium, zinc, and iron. B vitamins are critically important for brain health — sometimes we run genetic tests to determine what forms are best. Vitamin D has strong links with depressive symptoms. Vitamin C plays a role in dopamine production.

The part we’re still hung up on is this: if we know a certain vitamin or mineral is a cofactor in a converting pathway, does taking a lot of it actually help? If someone is deficient, it will probably help. But stacking more on top doesn’t necessarily provide additional benefits.

The bigger topic that’s emerged more recently goes beyond single nutrients. It’s about the actual gut environment — the presence of gut bacteria and the immune system’s role in communication between the gut and the brain. I’ve focused a lot more on reducing inflammation through the gut-brain axis rather than honing in on individual nutrients or just recommending a multivitamin.

Leaky Gut, Leaky Brain

Most people have heard of leaky gut — the official term is intestinal permeability — which describes a state in which substances that shouldn’t be getting through the gut lining are getting through. We’re talking about microscopic material like bacterial cell walls, not a piece of rice.

What’s less discussed is the concept of “leaky brain,” or permeability at the blood-brain barrier. This has received a lot of attention in neurodegenerative disease research, particularly Alzheimer’s and dementia. But I think it’s a significantly overlooked consideration for people with behavioral issues, impulsivity, a tendency for high-risk behaviors, and emotional reactivity.

There are immune cells at the blood-brain barrier. When inflammatory signals make contact there, microglia and astrocytes pick up on that and send signals throughout the brain that essentially say: something’s off. That can put the brain into more of a fight-or-flight mode, where it’s focused on solving immune-related problems rather than supporting higher executive functioning and consciousness.

This is the field of psychoneuroimmunology, and there’s a lot of emerging research with both familiar and breakthrough biomarkers.

Ultra-Processed Food: Beyond the Ingredients List

When I published a paper on ultra-processed foods and mental health, one of the key findings was that it’s not just about what’s in the food. The packaging and the processing steps themselves introduce compounds that aren’t captured on any nutrition label.

A big part of ultra-processing involves high heat exposure, which degrades nutrients but also introduces neoformed compounds from the machinery. These compounds can be inflammatory. The packaging — particularly plastics — adds another layer, with microplastics and endocrine-disrupting materials entering the food supply.

This is a perfect example of how the calorie model misses the bigger picture. If someone’s just focusing on calories but eating low-calorie food filled with microplastics, that can’t be good. And honestly, the environmental exposure to these compounds is somewhat inevitable at this point. That’s why I also emphasize our body’s ability to biotransform and eliminate — through sweating, detox pathways, and practices like sauna use.

Research shows that a 10% increase in ultra-processed food consumption is associated with an 11% increase in depression. That’s a striking number.

Using AI to Connect the Dots

The direction I’m heading is to leverage AI to simultaneously analyze multiple data points from functional medicine testing. Many lab testing companies are already integrating AI into their interpretation, but I’ve built my own models and trained AI systems to think in systems biology for mental health.

In practice, I pull together standard lab tests and stool tests, and enter someone’s medications, supplements, and mental health diagnoses. AI can identify blind spots that even the most savvy clinicians might miss. It provides protocols across multiple phases, which I then review with the patient to determine what makes sense.

I’m upfront about it: I tell patients I’m going to take their lab tests, run additional tests, gather a lot of input, and develop insights and protocols together. I’m obviously experienced enough to say “this doesn’t make sense” — I don’t trust anything blindly. And when the client confirms what has worked and what hasn’t in the past, we can develop highly personalized functional medicine protocols.

Three Principles I Live By

Find your own lane. Don’t take on someone else’s identity around nutrition or health. Find what resonates with you.

Run experiments and stay curious. Don’t come to overly firm conclusions, because things change over time. An approach that worked really well for me ten years ago doesn’t work the same way today. I like to keep a curious beginner’s mind.

Only do what’s sustainable. If something is too difficult, you can back off and get more social support. Think about nutrition and functional medicine as a lifetime approach rather than short-term crisis management.

Key Takeaways

The calorie model — while useful for research — misses critical context about food quality, processing, packaging, and mental health when applied to individual nutrition counseling. Calories don’t tell the full story.

Childhood adversity is a well-documented risk factor for addictive disorders, including addiction-like eating. The link is four to ten times higher risk in people with multiple ACEs.

Micronutrient deficiencies — particularly magnesium, zinc, B vitamins, and vitamin D — have clear implications for brain health, but the gut-brain axis and inflammation may matter even more than single-nutrient supplementation.

“Leaky brain”—permeability of the blood-brain barrier—is an overlooked factor in behavioral issues, emotional reactivity, and fight-or-flight states driven by neuroinflammation.

Ultra-processed food harms mental health through more than just ingredients: high-heat processing, packaging materials, and microplastics introduce inflammatory compounds that the calorie model completely ignores.

Functional medicine combined with AI-driven analysis can identify personalized root causes and treatment protocols that traditional approaches miss — but the work is always collaborative, individualized, and patient-led.