Great article, Dr. Deans. Such an interesting set of ideas! Yet in this field as in others, I'm struck by the things we have yet to learn, but may learn someday soon.

Glad to see my image in the mix....Robert

There is a striking overlapping between substances / behaviors known to help with insulin resistance: omega 3, magnesium, chromium, b6, exercise and substance / behaviors known to help with mental health not to think that we are fundamentally talking about the same thing from two different perspectives. Moreover if you consider that too much insulin blocks the pathway from homocysteine to glutathione you can both explain hyperhomocysteinemia and the effectiveness of NAC and why vitamin b supplementation can help reduce homocysteine but just to some extent if it does not end in more glutathione production. If you push the mechanism from below with selenium you paradoxically get more insulin resistance because the demand for homocysteine drops. Add cortisol competition with vitamin d for cholesterol, vitamin d receptor polymorphisms and the different capacity most of us have to syntethize choline from veggies and you start to see a first broad coherent picture of some of the key mechanisms at stake in mental health (call it adhd in kids or depression in adults). If you push this line of reasoning even further you jump to the conclusion that the benefits of a ketogenic diet maybe are not linked to ketones at all, or indirectly through feedback signalling to stop producing the damned hormone.

I find the comment about Niacin worrying, as vitamins including Niacin are added by default to a lot of breads and cereal products here in Australia, and Vegemite is a popular default spread for many children.

What level of intake of Niacin would start to become problematic, do you think? I wonder if it is something we should be supplementing at all.

I like this image thank you