Dr. Uma Naidoo on Meals-Temper Connections

We all know that humans need daily nourishment to survive. But to thrive? That’s a bit more complicated than vitamin and mineral counts. We’re social creatures, too, meaning we crave—require, actually—connection on a regular basis. So much so that social isolation has been found to be as detrimental to our health as smoking 15 cigarettes per day¹. Yet one oft-forgotten opportunity remains key to satisfying both of these innate human needs: mealtime.

“Eating is a powerful tool that supports one’s physical and mental well-being, and nurtures our relationships with others,” says Uma Naidoo, MD, a first-of-her-kind triple threat in the intersecting worlds of food and mood. A Harvard–trained psychiatrist, professional chef, and nutritional specialist, Dr. Naidoo is a pioneer in nutritional psychiatry. Unfamiliar with the term? You’re not alone, as the field is in its relative infancy. 

Massachusetts General Hospital’s department of Nutritional & Metabolic Psychiatry is the first hospital-based nutritional psychiatry service in the United States, with Dr. Naidoo at the helm for nearly a decade. Given the fact that medical schools have long been found to lack adequate nutrition training², finding new ways to weave education on food and dietetics into medical education was (and remains to be) crucial.

Per a systematic review of nearly 66 studies published in The Lancet, nutrition is insufficiently incorporated into medical education—regardless of country, setting, or year of medical education. “Deficits in nutrition education affect students’ knowledge, skills, and confidence to implement nutrition care into patient care,” the report concludes. “Despite wanting to receive nutrition education to develop knowledge, skills, and confidence to counsel patients, graduating medical students are not adequately supported to provide high-quality, effective nutrition care to patients.” 

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What we eat is often reflective of our social and cultural selves, which are some of the most meaningful and emotional parts of our identity.

— Uma Naidoo, MD

As the director of the hospital’s Nutritional & Metabolic Psychiatry department, Dr. Naidoo works with patients who wish to complement traditional modes of psychiatric care, such as medications and psychotherapy, with nutritional and lifestyle recommendations. Her clinical assessments cover everything from blood work and gut-microbiome testing to habit tracking and comprehensive mental-status exams—all in an effort to help patients connect the dots between their favorite foods and their mental well-being.

Making science-backed connections between dietary routine and mental health is hugely complex. As such, Dr. Naidoo is happy to repeat to her patients as many times as needed: “There’s no one-size-fits-all approach to mindful nutrition.” Instead of chasing a number on a chart or attempting to make unappealing meals work for you, she affirms that the eating habits linked to reduced stress, decreased inflammation, and lower rates of chronic illness³ are deeply individualized. 

“What we eat is often reflective of our social and cultural selves, which are some of the most meaningful and emotional parts of our identity,” says Dr. Naidoo. As with longevity, your mood and mental state are inextricably linked to a vast web of lifestyle factors, she says, “including what you eat and how you carry out your days from one to the next.” To that end, Dr. Naidoo encourages her patients to take a proactive role in connecting to themselves and others through food—culinary arts included. 

A nutrition gap that needed minding

Dr. Naidoo’s interest in the food-mood connection began in earnest during her residency. “I came to medical school and training and realized that there was a big gap in never asking patients what they ate,” she explains. “I was learning to prescribe these very strong medications in a vacuum, without an assessment of the patient’s diet and lifestyle.” Until we address these gaps, however, no amount of medication or psychotherapy can correct the wave of mental-health issues in our society, as Dr. Naidoo explains in her national bestseller, This Is Your Brain on Food. “While many medications are life-saving for my patients, people want and need more options in their toolkit,” she says.

The more Dr. Naidoo worked with patients, the more she understood how their choice in food could bolster or dampen their mood. “Consumption of inflammatory foods—like alcohol, red meat, and added sugar—can trigger inflammation in the gut and brain,” she says. “These foods have also been shown to increase your risk of developing, or worsening symptoms of, depression and anxiety.”

Sure, in 2024, many of us have a slightly better understanding of the foods that do or don’t have a positive effect on your general mood or overall well-being. But science has only recently begun to catch up with the fact that diet and metabolic health can significantly impact mental health. It’s also worth remembering that the science of the gut microbiome is also incredibly new to the medical community, having only emerged in the past few decades (and only taken seriously in recent years).

Dr. Naidoo fashions her patient evaluations in a way that covers the standard check-ups and check-ins and integrates dietary and lifestyle components—all while staying on schedule within limited timeframes. “I consider these factors to be equally important as checking someone’s blood levels,” she says. “It was abundantly clear [from an early stage in my career] that lifestyle and nutrition were going to affect my patients’ lives.” Fortunately, her supervisors backed up this integrative approach, with the hospital chair eventually signing off on starting the clinic she leads to this very day.

Mastering the art of mindful cooking

Dr. Naidoo’s love of food began at first bite. “I came into the world with passion for delicious but healthy meals and a background of science in my family,” she says. “There was a natural way in which I learned about healthy eating; it was part of my DNA growing up.” Raised in Durban, South Africa, Dr. Naidoo skipped pre-school and instead spent her early years alongside her maternal grandmother (to whom This Is Your Brain on Food was dedicated), who picked vegetables in her garden and prepared fresh lunches for her in between teaching meditation and yoga. There was no shortage of cooks in her extended family, with aunts and older cousins taking the reins in the kitchen for hearty family meals.

Despite Dr. Naidoo’s warm memories around family and food, her own flair for cooking didn’t kick in until her residency. (Barring one exception: She became an avid baker at a young age, which her mother credited to her daughter’s penchant for science and measuring.) “Cooking became my quiet, calm space and a way to ease into my evening,” she explains. “I grew to enjoy and love it; it wasn’t a chore or something ‘extra.’” Her biggest inspiration to tap into the soothing, sensorial pleasures of food—versus the hard science of nutrition—came courtesy of Julia Child, whom Dr. Naidoo would watch on TV during her limited leisure time. “She encouraged me as a young cook to explore more and learn more, to accept that mistakes would be made,” she says. 

Once she discovered that Child established her cooking career as a second act only later in life, Dr. Naidoo’s lightbulb moment came: She could do the same. Driven by passion, she hacked her work schedule to be able to attend the Cambridge School of Culinary Arts, eventually graduating with the school’s top award. “When that worked out, I realized it was meant to be,” she recalls. “I worked an excessive number of hours, but it didn’t feel like work because I just loved it.”

Eating is naturally nuanced and deeply emotional

From the professional to the personal and the scientific to the sensory, Dr. Naidoo knows that “healthy” eating looks different for everyone, and that one’s relationship with food can range from beautiful to complicated. Misinformed (or downright toxic) messages about eating—whether from family, friends, social media, or elsewhere—come a dime a dozen no matter where you turn. They can chip away at the delicious delights of eating, leaving restriction, shame, and guilt in their wake. 

The idea of “emotional eating” typically bears a negative connotation. But if you ask Dr. Naidoo, it’s time we reframe that narrative. Instead of our cultural collective falling prey to a fear-based approach to food, imagine how game-changing it could be—for physical, mental, and emotional health, of course, but also for our relationships with ourselves and others—to view food and our choices around it as safe, joyous, and flat-out empowering? Emotional eating can include a nostalgic trip down memory lane, a source of comfort on a tough day, a sense of thrill from flavors, and a feeling of belonging with camaraderie and festivities. Depending on how you use it and view it, food has the ability to connect us to our past, inform our present, and shape our future—often for the better.

While adopting a positive spin on “emotional eating” might be challenging for some, it’s far from impossible. In this vein, Dr. Naidoo talks the talk and walks the walk. A bout with cancer, during which she complemented standard Western medical treatments with dietary and lifestyle adjustments, proved the healing prowess of the plate firshand. As she brewed a cup of calming turmeric tea before her first day of chemotherapy, she internalized a mantra to silence worry and fear, replacing it with courage and conviction: I know how to cook, I know about my body, and I can help myself with how I eat. No matter the battle we’re facing, each one of us can take her lead and do the same.

Food has the ability to connect us to our past, inform our present, and shape our future—often for the better.

To start, Dr. Naidoo recommends leaning on two foundational premises of nutritional psychiatry. First is body intelligence, which entails investigating how certain foods make you feel. For example, if you routinely grab a coffee and a doughnut for breakfast only to fall groggy and foggy in two hours’ time, recognize that they may not be doing your body any good. But instead of feeling like a failure or caving into negative self-talk, give yourself grace and adopt these learnings for tomorrow’s breakfast and the one thereafter. 

Similarly, step away from shame spirals and the concept of “bad foods” by aiming to eat whole, nutrient-dense foods most of the time—while also dissolving shame around eating foods that simply make your taste buds happy. (Emphasis on the word “happy.”) Eating with purpose goes a long way, as Dr. Naidoo writes in her book: “Acknowledge that you are eating to nourish your body and brain to defeat anxiety. Be mindful about your food. Chew thoughtfully. Pay attention to flavor. Don’t feel guilt or regret about the food you eat. Enjoy every bite from the first to the last.”

Many of our most meaningful social connections happen at mealtime

Complexities around eating go beyond guilt over so-called indulgences, however. The social aspects of dining—including the comfort of ritual and the fact that food is part and parcel of nearly all family, cultural, and celebratory gatherings—might also leave some people feeling like they’re left in the dust. Being single, living alone, and/or not having loved ones to break bread with can trigger its own sense of isolation and potential discomfort around dining. 

COVID, too, took a clear toll on IRL social opportunities (work lunches, family dinners, and celebratory milestones among them). It all contributes to the loneliness epidemic that plagues close to a quarter of people globally over the age of 15, per a 2023 Meta-Gallup survey⁴ conducted in 142 countries. Neuroscience research⁵ even suggests that acute isolation can result in social cravings akin to legitimate hunger. “Social connection is a fundamental human need, as essential to survival as food, water, and shelter,” explains Surgeon General (and 2024 Changemaker) Vivek Murthy, MD, in his 2023 advisory. “A culture of connection is vital to creating the changes needed in society. While formal programs and policies can be impactful, the informal practices of everyday life—the norms and culture of how we engage one another—significantly influence social connection.” 

Dr. Naidoo agrees that having a sense of community is crucial—and there are countless ways to leverage food as a means to foster or find your own tribe. Sure, you can make a one-off reservation at your favorite restaurant with a friend, but you can also schedule dog-walking dates, go to Trader Joe’s together, or co-work over toast and tea. “These experiences can be fun and integrated into how we live,” says Dr. Naidoo. “They become part of our lifestyle versus just something we do as an activity, [which can build] a sense of community.” 

If your loved ones aren’t nearby, you can schedule a dinner date, possibly even cooking the same meal over video chat. Don’t have a thriving social life? Make an effort to eat lunch with your work colleagues to see if you have mutual interests. When you’re feeling lonely, sharing food can be a ticket to nourishing your mind and body, fulfill our innate needs as social creatures, as well as boost happiness and life satisfaction⁶.

The righteous act of (re)discovering delight around food

Though Dr. Naidoo is a world leader in nutritional psychiatry, much of what she knows about food has been gleaned outside of her life as a physician. Without intimate memories of food and family, the passion for cooking instilled in her from a culinary icon, and eventual training as a chef, “I wouldn’t have learned from textbooks, research, and clinical work that food is so powerful,” she says. “Food feeds the body and the brain and helps you keep mentally fit, but it’s also centered around joy, a sense of community, and nurturance.”

In the coming years, Dr. Naidoo hopes that mood-food evaluations will be common practice for all primary care physicians and psychiatrists. She’d also like to witness a paradigm shift in which everyone accepts and embodies the idea that eating is inherently functional and emotional. To foster awareness and initiate change on a wider scale, she’s kept busy by penning her two books that brought nutritional psychiatry to the public domain. Until the publication of the first, Dr. Naidoo’s reach remained at the hospital level. The release however, “almost became a movement around healthy eating, and made me realize the book was really helping people,” she says.

This year, Dr. Naidoo is finalizing a nutritional psychiatry curriculum for fourth-year residents at her hospital, as well as evolving online learning resources for the Massachusetts General Hospital Psychiatry Academy, which educates mental-health professionals and clinical practitioners across the globe. “We’re trying our best to bring this area of psychiatry forward, but also build resources for patients to have and clinicians to learn,” she says.

In addition, she’s developing a podcast called Food Mood Chats with Dr. Uma Naidoo, slated for release later in 2024, that’ll reach even more eyes and ears (and, in a sense, mouths) around the globe. Expect digestible intel on how to hack your diet and eating patterns for harmony, happiness, and fortitude. But for now, we can all take small but meaningful steps to tap into the healing powers of the plate for our mental and social well-being alike, perhaps honing or rediscovering our own sense of delight and agency around food along the way.