So how are mitochondria and brain health linked?
Very intricately indeed! Neurons which are nerve cells which send messages all around our body, use a lot of energy to do so, and the mitochondria provide the energy for this. So if mitochondria become damaged or dysfunctional (not working properly), there can be slowing down or limited messages getting through.
In terms of what this might look like for a person, symptoms could include:
- brain fog
- reduced endurance for tasks that previously were easy
- lack of motivation
- lethargy or fatigue
- inability to concentrate
All of these symptoms are suggestive of mild to moderate neuroinflammation.
The brain can become inflamed (aka neuroinflammation) from many causes including:
- Traumatic brain injury
- Post-Traumatic Stress Disorder
- Ageing – yup we’re all at risk of it!
- Pro-inflammatory diet – think junk food
- Depleted antioxidant reserves – not enough colourful veg and fruits
- Inflammatory bowel disease
So what can be done for a brain on fire?
I would start with a general overview of:
- Maximise: Exercise – specific to the individual
- Minimise: Alcohol and Stress
- Prioritise: Sleep and good nutrition
Then tailor a program specific to an individual person and their contributing factors.
A few weeks ago, I went to Leura to attend a 3 hour seminar on obesity, held by Metagenics. It was a great turn out from practitioners from Sydney, Canberra as well as the Blue Mountains and Central West.
In Australia, it is estimated that by the year 2025, there will be more obese
(BMI >30) people than people in the healthy weight range (BMI 20-25). Currently 63% of Australians are overweight or obese.
Why is this so important? Obesity is a medical issue in terms of the potential health implications. The more fat mass a person carries the greater risk of chronic disease:
- Cardiovascular disease
- Sleep apnoea
- Mood disorders
- Neurological diseases
Even modest amounts of weight loss (5-10% reduction) leads to dramatic improvements in health. The Diabetes Prevention Program showed that losing 5.5% of body weight over 2.8 years, decreases the risk of getting diabetes (from a pre-diabetic situation) by 48%. (1)
Obesity relates to our brains – they drive what we eat. We are hardwired to seek out more calories and remain less active, so we have ample supplies for the lean times. But in 2018 with food available 24/7 the lean times don’t come.
Body weight regulation is under UNCONSCIOUS homeostatic control – similar to blood pressure, blood sugar and pH regulation. The body weight our body likes to maintain is called the “body weight set point”. There is a 2-6kg fluctuation around this point. (2)
Our body weight set point is developed around the age of 20y, around 24y in some males. This body weight set point goes up in our 50s and as we then get older, this starts to drop. If there is obesity in childhood, the body weight set point will be set higher at an earlier stage.
Our brains control the energy we use. For example, in a group of obese people who had 20% weight loss, they were inclined NOT to move MORE than obese people who had lost 10%.
So, the gut-brain connection rears up again – in animal studies, inflammation in the brain (in particular the hypothalamus) precedes obesity. What drives inflammation? A high fat and high sugar diet. Eating food triggers dopamine release, a neurotransmitter, which activates reward, motivation and learning centres in the brain. The more calorie dense a food is, the more dopamine is released. (3)
Studies show that obese people demonstrate higher reward centre activation in the brain compared with lean controls. (4)
What are some of the real causes of obesity in 2018?
- We are eating more than we have historically – calorie intake is 425 kcal/day higher
- The body weight set point is reset so there is a 20% increase in energy intake (2)
So, what can we do to lower the set-point?
- Have a diet with low to moderate palatability (tastiness)
- Eat adequate protein
- Restrict fat OR carbohydrate
- Have diet breaks (time off restricted eating, to prevent metabolic adaption and give a psychological boost)
- Ensure adequate good quality sleep
- Maintain good levels of physical activity
Having a buddy when focusing on weight loss has been shown to be very beneficial for accountability, psychological support and better outcomes.
Watch out with the upcoming holiday season….much of weight gained through the year happens during the smallest window. Research shows that annually 52% of weight gain occurs over the holiday season, which is only 12% of the year. Lots of hyper-palatable (very tasty) food is consumed/over-consumed, which has been found to drive up the set-point. (5)
- Diabetes Prevention Program Outcomes Study. Lancet. 2009 14;374:1677-86
- Obesity Pathogenesis: An Endocrine Society Scientific Statement. Endocrine Rev. 2017 1;38:267-296
- The gut-brain dopamine axis: a regulatory system for caloric intake. Physiol Behav 2012 6;106:394-9
- Widespread reward-system activation in obese women in response to pictures of high-calorie foods. Neuroimage 2008 41:636-47
- Defence of body weight depends on dietary composition and palatability in rats with diet-induced obesity. Am J Physiol Regul Integr Comp Physiol. 2002 282:R46-54
I am so keen to share with you the knowledge that Alzheimer’s disease can be reversed! This was not something ever taught to me during my medical school or specialist training. In my more recent studies I have learnt about the work of Dr Dale Bredesen who has developed the first programme to prevent and reverse the cognitive decline of dementia. He has written an excellent book “The End of Alzheimer’s” and presents many examples of reversing mild cognitive impairment.
We now know that there are changes happening in the brain 10-20 years before symptoms start. Often people feel absolutely fine, then start noticing difficulty recognising and remembering faces, or getting more tired later in the day to do mentally challenging tasks. Other changes an individual or loved one may notice could be a decreased interest in reading or an inability to follow or engage in complex conversation. Sometimes words can be mixed up using a completely wrong word in a sentence. Early physical signs include a change in walking/gait, where someone might make more noise when they are walking, shuffling their feet and taking shorter steps.
Optimising brain health is something dear to me as my wonderful father has Alzheimer’s disease with moderate cognitive impairment. I have seen him slowly decline in communication, energy and endurance, getting lost in new or familiar places, and a slowing and shuffling of his gait. Fortunately he has remained positive and warm-hearted during these challenging times. He is supported by my amazing mother and some additional home help. Mum encourages him to do the concise crossword with her, go for at least a daily walk with her and catch up with friends on a regular basis.
So some of the lifestyle areas to address when looking to reverse Alzheimer’s include:
- Avoid all sugars which cause inflammation in the body.
- Avoid gluten which is inflammatory to 80% of the population and can cause intestinal permeability.
- Eat a wide variety of colourful fruit and vegetables every day. Aim for a 1, 2, 3 plan: 1 veggie at brekkie, 2 with lunch, 3 at dinner.
- Ensure you have a 12h gap between meals overnight.
- Avoid fatty fried foods which have Advanced Glycation End products – these get stuck in the end of tiny capillaries (blood vessels) and can induce AD.
- Sleep: Aim for 7-8h sleep per night. This is essential for the brain to clear out any debris and be ready for the next day ahead. Lack of sleep = debris build up.
- Stress: address your stress is one of the most important areas to target. Low-grade chronic stress is terrible for our systems. We were designed to have short bursts of stress that stopped. Work on up-regulating your Rest-and-Digest system (Parasympathetic Nervous System):
- Sit down to eat
- Take 3 deep breaths before you start
- Chew your food well
- Chill out after a meal
- Hum, sing, laugh or gargle to stimulate your vagus nerve
- Dental health: Brush your teeth 3 times a day. Dental health is related to the risk of AD. Mid-life tooth loss and lack of brushing teeth increases risk of AD. See your dentist regularly to check on dental hygiene and conditions like periodontitis.
If you know of someone who would benefit from this information, please share it so they can improve their brain health. As always, if you have a question please email me directly or contact my rooms if you would like to book an appointment.
Have you ever thought what your “grey-stuff” does when you’re in a deep slumber?
There’s a lot that goes on when we are asleep….and guess what? It’s really important for good health!
I’m really passionate about empowering you to achieve good health and sleep is the number 1 medicine I recommend. Above what you eat, how you manage your stress and how much you exercise, sleep is top dog.
Numerous functions of the brain are restored by, and depend upon, sleep. We have different stages of sleep – NREM (light and deep) and REM – and they all offer different brain benefits at different times of night.
Memory: sleep has proven itself time and again as a memory aid: both before learning, to prepare for making new memories and after learning, to cement those memories and prevent forgetting.
In my brain-injury rehabilitation clinic, I am always checking in on sleep with my clients, who often are challenged with short term memory. Good sleep patterns (including daytime naps in the recovery phase) are very important for brain recovery.
Creativity: at nighttime your sleeping brain creates a theatre, making connections between vast stores of information. This all happens during REM sleep in our dreaming state. These connections would never occur during wakefulness.
Cellular cleaning: while we are sleeping, metabolic debris is removed by the exceptional support team of our neurons – the glymphatic system. It is important to remove unwanted metabolic products from the areas surrounding hard working neurons, so the brain can work better the next day. This may even link with the development of Alzheimer’s disease. Amyloid protein is a poisonous element associated with AD and is usually cleared out at night. In mouse experiments depriving mice of NREM sleep, there is an immediate increase in amyloid deposits within the brain. Another way of saying this is “wakefulness is low-level brain damage, while sleep is neurological sanitation”.
Quote from Why we sleep by Matthew Walker (a fantastic read!).
Getting too little sleep across the adult lifespan will significantly raise your risk of developing Alzheimer’s disease. This has been reported in numerous epidemiological studies, and two anecdotal cases include Ronald Reagan and Margaret Thatcher. Two heads of state who appeared proud and were certainly vocal about sleeping only 4-5 hours a night. They both went on to develop the ruthless disease.
So what can you do to help your brain while you’re sleeping?
- Prioritise sleep! Aim for 7-8 hours per night
- Develop an evening routine to wind down
- Turn off screens 1-2 hours before bed
- Keep your bedroom cool
- Remove any blue-light emitting devices from your bedroom:
- phone, alarm clock/radio, TV
We can often take our health, including that of our brain, for granted. In order to keep our body humming along, there are a huge number of body systems our brain oversees – hormones, digestion and muscles to name a few.
Sadly, conditions of the brain are rampant in society nowadays.
Why is this the case? There are often several underlying factors including inflammation, gut microbial imbalance and toxins. In functional medicine, we look for the root cause(s).
I have presented webinars on the gut-brain connection before, and now research is finding a leaky gut can be associated with a leaky brain, or the protective blood-brain barrier (BBB).
Dr Alessio Fasano [MD, chief of pediatric gastroenterology and nutrition at MassGeneral Hospital for Children, Boston, Massachusetts], has worked extensively on the role of gluten and intestinal permeability. His research has shown how gluten stimulates the production of zonulin, and zonulin makes the bowel hyperpermeable, which allows proteins access to the bloodstream, where they might normally have been excluded. More importantly, what Dr. Fasano’s research has revealed is that the same mechanism is involved—gluten-stimulating zonulin—in increasing the permeability of the blood–brain barrier. While clinicians may be concerned about patients having leaky bowels, I can promise that having a leaky brain is certainly of much more concern. A compelling finding in his work is that 100% of humans have this gluten-zonulin signalling cascade to some degree.
So when we have leaky blood-brain barrier, larger molecules fit through the membrane than should usually get through. This leads to brain inflammation (cytokine model of cognitive function), and can be associated with depression, anxiety, brain fog and auto-immune brain conditions. Medications for example anti-depressants are often ineffective where there is brain inflammation because the underlying reason for brain inflammation has not been addressed.
So if you think you have brain inflammation, what can you do?
- Avoid brain zappers – sugar, highly processed foods, preservatives, artificial sweeteners. High blood sugar increases the risk of cognitive dysfunction (thinking problems) as well as shrinkage of the brain. Trial 2-4 weeks off gluten and see if you experience any difference in brain fog or mental energy.
- Manage stress – mindfulness, yoga, tai chi can all mitigate the effects of stress. Acute stress can increase leakiness of the blood-brain barrier.
- Exercise – aerobic exercise increases Brain Derived Neurotrophic Factor (BDNF) which promotes the health of the brain and nerve cells.
- Consider a functional medicine approach to brain health. Comprehensive testing for brain health includes markers such as homocysteine, a marker of detoxification, and HbA1C. This is a marker of sugar attaching to a protein over the past three months. If this marker is raised, it is likely other proteins are also becoming glycated. This in turn increases free radical production and oxidative stress in the body. This marker is well researched in monitoring the risk of Alzheimer’s Disease. The empowering part is that you have control on your HbA1C level – it depends on the foods you choose to eat.
- Look into the health of your microbiome. In clinic I often test the gut-brain axis through a stool test as an unhealthy gut can lead to an unhealthy brain. In particular bacterial imbalance or yeast overgrowth can have neurological implications. A good diversity of gut bacteria including Lactobacillus and Bifidobacterium species is important for good mental health.
Perlmutter D. Rethinking Dietary Approaches for Brain Health. Alt Comp Therap 2014;20:2.
Fasano A. Zonulin and its regulation of intestinal barrier function: The biological door to inflammation, autoimmunity, and cancer. Physiol Rev 2011;91:151–175.
Enzinger C, Fazekas F, Matthews PM, et al. Risk factors for progression of brain atrophy in aging: Six-year follow-up of normal subjects. Neurology 2005;64:1704–1711.