Methylation and mental health are intricately related. We take a deeper look into the association and why it is important.
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Methylation has been a buzzword in the integrative health sphere for some time now. This is unsurprising considering its importance to our overall health and wellbeing. You may have heard of it before – or even googled it… Were you then promptly turned off by it after just one glance at its complexity?
We don’t blame you, understanding methylation is not for the faint-hearted.
However, let us break it down for you into bite sized chunks. Hopefully you can finally make sense of it and apply this knowledge to your everyday life.
Methylation is a critical biochemical process that happens billions of times in every single cell of the human body. It’s responsible for a vast range of biological functions such as:
Whilst it can be complex in nature, the process of methylation simply entails the transfer of four atoms: one carbon atom and three hydrogen atoms. These are transferred from one substance to another.
Let’s say that methylation is a type of biological switch that turns on and off to help keep our health in check.
While we know that methylation plays an intrinsic role in many important body functions, for the purpose of this article, we will focus on its role in mental well-being and brain health.
Put simply, methylation helps us make neurotransmitters, such as serotonin, dopamine, adrenaline, norepinephrine and melatonin.
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Methylation does this in a number of ways. It helps:
So as you can see, it’s pretty vital to a balanced mood and overall brain health.
Unfortunately there are many things that can negatively impact methylation, such as our diet, exposure to environmental toxins, genetic factors and lifestyle habits.
Let’s look at this in a little more detail.
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Oxidative stress is a natural biological process that’s usually offset by our body’s own endogenous antioxidant production. But when there’s an imbalance between the two, and factors in our environment generating oxidative stress are tipping the scale in their favour, that’s when we can see prolonged inflammation and problems with methylation.
Our modern environment is plagued with reactive oxygen species ROS that generate oxidative stress in the body. Key examples are environmental endocrine disruptors, like PCBs, herbicides, pesticides and plastisizers, as well as air pollution.
Whilst we can’t necessarily fully control these aspects in our environment, we can control our defence against them, as well as making wise dietary choices that will have less of these substances in them.
But first, let’s talk about what else can impact methylation.
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If you want to dive deeper into Methylation then you can get instant access to this expert webinar here.
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What you eat can impact how well you methylate – especially intake of processed foods and sugars, which has been shown to play a negative role in methylation.
Perhaps unsurprisingly, research shows that eating a wholefood diet that includes wholemeal cereals, fish, legumes, fruits and vegetables can have a positive effect on methylation.
Aside from dietary factors, there are a few nutrients that play a critical role in methylation.
Perhaps the most important nutrient is folate or B9. Methylation is almost entirely dependent on the availability of folate in the diet. It uses this nutrient to create the methyl donors – SAMe and methionine – to spark enzymatic reactions that are required for neurotransmitter production and transport.
A large body of research confirms that folate deficiency – something that is incredibly common – is frequently seen in those with depression, and is remediated with the supplementation of this nutrient.
When we consider the role that optimal methylation plays in producing serotonin and other neurotransmitters, it’s easy to see why folate is so important.
Many are drawn to supplementing folate in the form of folic acid – the synthetic version of this nutrient. You can often find folic acid in fortified foods such as breakfast cereals and breads.
However, what people don’t realise is that this version of folate needs to be converted in the body to l-methylfolate and many people lack the ability to do this efficiently due to gene variations.
This means the body is unable to utilise the folic acid properly.
We go into gene variants in a little more depth further down, so hold on for more information.
Green leafy vegetables and legumes are perhaps the most rich sources of folate, so be sure to be getting these in your diet frequently.
Whereas folate is important to initiate the methylation cycle, B12 is required for the activation of folate from dietary folate to 5-methyltetrahydrofolate, so that it can go on to create the methyl groups – SAMe and methionine.
If there isn’t enough B12 in the diet, folate can get stuck in the cycle, which halts methylation.
Where can we get B12 in our diet?
B12 is a nutrient that’s found in animal foods, such as meats, fishes, eggs, poultry and dairy products. This means that if you’re vegan or vegetarian, you will likely need to supplement your B12 and consider eating fortified foods, such as plant milks.
Choline plays an important role in various junctions in the methylation cycle. It is widely known that when folate is low, the body uses choline as its back up methyl donor to help keep methylation ticking along.
Choline helps with activation of folate, as well as the recycling of homocysteine to methionine – a critical step in methylation.
Having high homocysteine is a key way of indicating whether your methylation is struggling and whether this recycling process isn’t functioning properly.
We don’t want accumulating levels of homocysteine as it is a neurotoxin that has been linked to psychiatric disorders such as depression, schizophrenia, bipolar and Alzheimer’s disease.
This is why if mental health is a concern, testing for homocysteine is a great way to find out whether you may have issues methylating.
Here’s a little more information on testing and further ways to check your methylation.
You can order and test your homocysteine level accurately from the comfort of your own home. Join our research and order your homocysteine test here.
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In addition to homocysteine, which is explained in further detail below, you can also take a DNA test to see whether you have any mutations on the MTHFR gene – the primary gene that is responsible for folate activation and homocysteine recycling – both of which are necessary for optimal methylation and therefore neurotransmitter production.
Variants or mutations on the MTHFR gene are inherited from your parents and can either be heterozygous (meaning you have one mutation) or homozygous (two mutations).
It’s well known that having a homozygous mutation is more likely to cause health problems and having a heterozygous mutation is unlikely to cause issues.
Common variants are:
Testing for these variants is done by a simple saliva test and is usually done privately. Here in the UK, there are various providers such as Lifecode GX, however, if you’re not based in the UK there are likely many more providers globally.
Testing homocysteine levels is a little more invasive, as it requires a blood draw.
Bear in mind that levels are not static and can change based on how well you’re methylating, as well as certain dietary factors, such as caffeine and alcohol consumption, which have been shown in some cases to tax methylation.
You can test your homocysteine here at Food for the Brain. Find details in our easy-to-order and simple pin-prick test here.
As well as eating a wholefood diet that is devoid of sugar and processed foods, if you suspect methylation may be an issue for you, it’s important to take the environmental factors listed above into consideration.
In order to avoid toxins and pollutants you can:
Supplementation might also be considered, you can find out more about supplementation and brain health here.
Working with a registered nutritionist is crucial for supporting the right supplementation programme in accordance with individual needs. You can find a practitioner at our Brain Bio Centre and via BANT.
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Eating a healthy, balanced diet, as well as engaging in healthy lifestyle practices as we outline in our COGNITION Program, is key. We cannot change our genes but we can create the right environment for them.
When you become a FRIEND and get access to your personalised 6-month COGNITION programme you will learn how to create the right environment in which your brain ‘upgrades’.
This is good news as it means that you are in control of your health and can start taking the right steps today to help support your methylation and overall brain health and mental wellbeing.
Enjoyed this article? Check out our blog for other deep dives into various aspects of nutrition, lifestyle and brain health.
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According to the charity Action on Addiction, one in three of us are addicted to something, whether it be a substance such as caffeine, cocaine or alcohol, or whether it is in the grips of a particular habit that is preventing someone from living their lives in the way in which they’d like. Addiction emcompasses a wide range of behaviours and dependencies and can range from substance misuse to an addiction to gambling, shopping or food.
In the US, research carried out over a 12 month period, demonstrated that it was quite plausible that 47% of the U.S. adult population suffers from maladaptive signs of an addictive disorder. Despite the variations of addictions and the behaviours that are entailed, it is increasingly recognised that common underlying neurochemical imbalances can be found amongst all of them.
The addicted brain has essentially become dependent on a substance or habit to produce feel-good chemicals; neurotransmitters that are associated with feelings of reward, pleasure, satisfaction and relief. When neurotransmitter balance in the brain is out of kilter due to either genetics, chronic stress or a poor diet, for example, we are more susceptible to turning to substances such as alcohol or caffeine. These substances bring us back to balance, as our brain instinctively craves what we are deficient in. In order to reach a more comfortable state, vulnerable individuals attempt to continuously manipulate their neurobiological circuitry by repeatedly using substances such as a drug or engaging in a behaviour such as gambling. The challenge with this is that these are often substances or habits that can leave us in a vicious cycle of needing more to produce the same effect.
A simple way of describing this is with caffeine, for example. A large majority of us struggle to start our day without our first cup of coffee in the morning. This is often related to having a poor circadian rhythm, whereby cortisol (a hormone that helps us wake up), which is normally supposed to peak in the morning, is abnormally low. Caffeine helps to stimulate the release of cortisol, adrenaline and the feel-good neurotransmitter dopamine. All together, the effect helps to enliven, motivate and stimulate us to get up and go. As our brain strives for balance after drinking a cup of coffee, or any other substance that’s mood-altering, the receptors to the neurotransmitters that have been stimulated, consequently dampen in order to avoid over-saturating our brain.
This means that we begin to build tolerance and therefore need increasing amounts of the chosen substance to produce the same rewarding effects. Eventually, this can lead us to what has been labelled as ‘reward deficient’, whereby our brain has become dependent on a substance or a habit to produce neurochemicals that lead to the ‘reward’ that it is seeking, which are in most cases feelings of pleasure, stimulation and satisfaction.
Giving up an addiction can be incredibly difficult, as the dependency is hardwired into the limbic system, an area of the brain that is only concerned with meeting our basic needs and survival. In addiction, obtaining the substance or engaging in a behaviour is a matter of survival to this part of the brain. The symptoms caused by abstinence, when the addictive substance or habit is removed, can be debilitating and can include anxiety, fatigue, hypersensitivity to stress or pain, problems sleeping and extreme mood swings. These symptoms can continue for long periods of time and can therefore be a negative influence in relapse.
Nutrition, alongside lifestyle changes such as exercise, improved sleep patterns and relieving stress, can play an essential role in helping to support the brain back to health. By supporting the optimal functioning of brain cells and neural networks, as well as helping to stimulate the brain’s intrinsic regenerative functions, we can help to attenuate cravings and therefore prevent the chance of relapse.
Eating a diet low in glycemic load can be an effective nutrition tool in reducing cravings and supporting brain and body health. This means eating foods that will have as little impact on blood sugar levels as possible, helping to keep them stabilised, which can have a positive impact on stress levels. This is due to the intimate relationship between blood sugar, cortisol and adrenaline – our stress hormones. When we eat foods high in glycemic load, sugar is released too quickly into our blood and insulin levels peak in order to rapidly remove the sugar from the blood into our cells. The result is that we are then left with lower than necessary blood sugar levels, which can lead to symptoms such as fatigue, mood swings, irritability, headaches and dizziness. Cortisol and adrenaline release are also stimulated, as they trigger the mobilisation of glucose from storage into the blood for use as quick energy. As you can see, these kinds of symptoms are not so different from abstinence symptoms, which can leave us vulnerable to relapse.
We also know that neurotransmitter production and transmission can only happen when there is a consistent supply of glucose to the brain, which is provided by the food that we eat. When blood sugar levels are rollercoastering due to a diet high in sugars, refined carbohydrates and processed foods, neurotransmitter transmission cannot happen optimally, leaving the brain deficient in inhibitory neurotransmitters that are essential for preventing anxiety, panic and irritability.
In order to eat a low glycemic load diet, it is important to eat foods that will release sugar slowly from food. Switching from refined grains such as white bread and white rice to wholemeal is important, as well as avoiding processed foods such as biscuits, cakes, fizzy drinks, confectionary and even seemingly healthy foods such as fruit juices. These do not provide the body with sustainable sources of energy, as blood sugar levels rise and fall rapidly, leaving us susceptible to cravings.
Instead, replacing these foods with good sources of protein, fat and fibre with every meal will stabilise blood sugar levels and therefore help to avoid the symptoms associated with blood sugar crashes. Lean meats, oily fish, pulses and nuts and seeds and avocados are all examples of healthy sources of protein and fat.
We’ve all heard about probiotics, but what about prebiotics? The gut contains approximately a trillion bacteria of varying strains, which thrive on the fibre from the food that you eat, or in other words prebiotics. This helps keep them nourished and continue performing all the wonderful things that they do, one of which is producing neurochemicals that literally ‘speak’ to our brain and help keep your brain healthy.
Foods that are rich in fibre, such as wholemeal grains, root vegetables, pulses, green leafy vegetables, nuts and seeds, are all examples of foods that we can increase on to help nourish our gut bacteria and therefore our brain. In addition to supporting gut bacteria, these foods also help to stabilise blood sugar levels, so it’s a win-win conclusion.
Latest research is showing just how important gut bacteria composition is for our mental health. In particular, it’s the metabolites that bacteria produce, such as short chain fatty acids, which can help regulate and prevent neuroinflammation, that are so interesting when looking through the lens of how diet can influence brain health. These short-chain fatty acids, such as butyrate, propionate and acetate help to leverage communication between the gut and the brain, having a direct impact on our neurotransmitters.
Research shows that the average adult is not getting 30g of daily fibre, which is the minimum we need to be consuming for optimal health. Ideally we need more. A quick way of hitting that target is making your meals as colourful as possible with a wide range of plant foods, such as vegetables, legumes, nuts and seeds. Dedicating half of your plate to these foods in variation and rotating them as much as possible, will help you exceed the target of 30g of fibre per day.
The essential fatty acid, omega 3, can be incredibly therapeutic in helping to optimise the function of our brain cells. Omega 3 is composed of two elements, EPA and DHA, which play an important role in regulating inflammatory responses, as well as nourishing the membrane of our cells. This is the part of our cells that is involved in receiving and transmitting neurotransmitter signals, as well as controlling nutrient intake and waste removal.
This is important when considering the process of recovery from an addiction, due to the long-term impact that habits such as alcoholism, smoking, food addictions etc. can have on the brain and its ability to maintain optimal neurotransmission. Quite often what can happen in the event of long-term addictions is both a lack of integrity in brain cells and upregulated inflammation, all of which can continue to perpetuate addictive habits and dependency on certain substances. Increasing omega 3 rich foods, will therefore help to provide the brain with the building blocks it needs to repair and thrive.
Both omega 3 and omega 6 are essential in the diet as we cannot manufacture them in our body. Our brain needs both for optimal functioning, however, they need to be in the right ratio.
Anthropological evidence of hunter-gatherer diets suggests that our ancestors evolved on a diet that was roughly 1:1, while the ratio today is actually 16:1 (omega 6 : omega 3). Our intake of omega 6 diets has increased by incredible amounts due to the industrialization of agriculture and the introduction of seed oils and grains in our diet.
Omega 6 is pro-inflammatory. Whilst we need inflammation – it’s necessary for tissue repair and for fighting against infections – too much of it can cause problems. Especially for the brain. Increased neuroinflammation is the hallmark of poor mental health and symptoms of low mood, brain fog and anxiety. This is why it’s key to support the brain by increasing omega 3 rich foods and avoiding seed oils such as rapeseed and sunflower oil.
The best sources of omega 3 are small oily fish such as sardines, anchovies, mackerel and herring. Enjoying these sources of omega 3 foods in your diet 3-4 times a week helps to provide the brain and body with optimal levels of omega 3.
If you’re vegetarian, plant-based sources include walnuts, flaxseeds, chia seeds and hemp seeds. However, we recommend eating these foods on a daily basis as levels of omega 3 are much lower and only contain the precursor form of omega 3, which then needs to be converted in the body through an enzymatic process.
Amino acids – the building blocks of protein – also provide the building blocks for neurotransmitters, as well as helping to support the cells in our brain and their energy-producing pathways. Depending on the substance or habit to which someone is addicted, supplementing with the right nutrients to address certain imbalances can be effective in improving abstinence symptoms, without causing side effects or dependency on medication.
Amino acid therapy, whereby specific amino acids are supplemented to help restore normal brain chemistry, has been shown to be an effective way of helping the brain to recover from its ‘reward deficiency’ and rebuild its own built in mechanism for producing a natural high. Every cell in our body is dependent on amino acids, which are the components that make up proteins, to ensure reproduction and growth. Amino acid therapy has shown to help increase receptor sensitivity to neurotransmitters such as GABA, serotonin and dopamine, as well as improve glucose metabolism, which also helps to support energy-production pathways in the cells.
However, the process of figuring out the right combination of amino acids is a complicated one. This is why it is important to work with a specialist in this area that is able to assess the symptoms and analyse test results to build the right personalised nutrition and supplement programme for an individual. If you’re interested in working with a professional practitioner in this area that can guide you through a tailor-made nutritional programme to suit your needs, you can search online via BANT (British Association for Applied Nutrition and Nutritional Therapy).
Estimated reading time: 4mins
Despite the festivities and joy that Christmas celebrations can bring for some, for many, it can be a particularly painful time with heightened feelings of loneliness and despair. This may be especially true for those who are isolated or disconnected from their loved ones. With the extra pressures that this year brings, it’s important to have some strategies in place to help us find a sense of connection.
An interesting recent study, offers some key information on how the brain is wired to seek social connection as if our survival depended on it, which helps us to understand why many of us feel such despair when we’re lonely. Neuroscientists at the University of Cambridge observed 40 participants in complete isolation for 10 hours, after which they were shown images of people socialising or playing sport. In response to these images, neurons in the midbrain – which is the part of the brain that is responsible for producing dopamine, our reward neurotransmitter – were stimulated. Interestingly, the same thing happened when these same participants – on a different day – were made to fast for 10 hours and then shown images of appetising food, like pizza and cake. This demonstrates how when we are lonely, we crave social connection in the same way that we crave food when we’re hungry.
Connection to others is just as much of a necessity to survive as it is to eat, and it’s not the first time that science is showing this. For example, we know that loneliness is a significant risk factor for poorer cognitive health, as well as depression and mortality. So, in light of this, and with the added pressures of the pandemic, how can we nurture our connection with
others to help us thrive throughout the festive season? Here are a few tips that can help to boost our sense of connectedness:
This may be a time to reflect on which relationships/social circles you value the most and which ones may be leaving you a little drained. It is possible to feel lonely or disconnected, even when you’re with friends or family. Once you’ve determined those that you value the most, find time to nurture those connections away from distractions, such as phones or TV. Getting out in nature by finding a new park or green space you’ve never been to before and arranging a walk with a friend, or cooking a new recipe with your loved one and having a romantic dinner. The list is endless, but the most important thing is that it works for you.
Science shows that altruistic behaviour, kindness and compassion, increase levels of endorphins and oxytocin, as well as creating new neural connections. Find a local food bank distribution venue or another cause that you resonate with where you can meet new people and help support others.
Getting involved in creative expression of any kind, from drawing and cooking, to gardening or dancing, can help to increase a sense of connection to ourselves and others. For example, making something creative with a friend or giving something creative as a gift, can be very therapeutic and rewarding, and has the added bonus of not requiring technology.
Final words…
It’s worth reiterating that loneliness can be a subjective experience, meaning that we can still be lonely despite having many loved ones around us. This highlights the need to take time to reflect and identify what makes each of us as individuals feel connected.
Since 2003, November has been coined ‘Movember’ by the Movember Foundation, originally a campaign that was launched to tackle issues related to prostate cancer and now raising awareness and funds for the biggest issues in men’s health, one of which is mental health and suicide. The statistics related to men’s mental health are alarming, according to the latest figures, 3 out of 4 suicides are men and it is the leading cause of death in England and Wales for men aged between 20 and 34 years. This may be of no surprise considering that men are less likely to access psychological therapies than women; only 36% of referrals to IAPT (Increasing Access to Psychological Therapies) are men. In addition, men have measurably lower access to the social support of friends, relatives and community. This indicates that there may be a serious epidemic of men that are going undiagnosed, in comparison to women.
Mental health is tough to talk about and many people don’t realise that a diagnosis does not mean you have to live with it for the rest of your life. Recovery is possible. When it comes to the male population, statistics show that they are more at risk of suffering from mental health issues caused by addiction to alcohol or drugs. Specifically, men are nearly three times more likely than women to become alcohol dependent, and are three times as likely to report frequent drug use than women, with more than two thirds of drug-related deaths occurring in men.
Taking this fact into consideration, and with the knowledge that dietary changes can support addiction recovery, optimise mental wellbeing and potentially reduce the risk of relapse, nutritional therapy may help play a very important role in reducing the risk of suicidality.
Targeted dietary changes can be highly effective in supporting mental wellbeing, by preventing cravings for substances such as alcohol and illicit drugs through optimising brain health. It is well-known that the brain uses up more energy than any other organ in our body, consuming about 20% of the body’s energy requirements. This means that it requires a consistent supply of fuel. Even when we may not appear to be using it, such as when we’re sleeping, there is still a high baseline consumption of glucose, which is our body’s main source of fuel. Two thirds of the brain’s energy is used to help neurons – our brain cells – send signals, with the remaining third used for basic housekeeping – or in scientific terms cell-health maintenance. When our brains are healthy, the rest of our body is healthy, plus we also feel great.
Those with mental health conditions and/or addictions often have issues with blood glucose dysregulation, meaning the brain is getting an inconsistent supply of energy. According to NICE, depression is the most common psychiatric disorder witnessed in the diabetes community and people with diabetes are 3 times more likely to have depression than those that don’t. This indicates that blood sugar control is important when treating depression and other mental health conditions.
A key way to prevent this is by eating foods that are low in glycemic load, meaning they have little impact on your blood sugar levels and are able to supply the brain and body with a consistent source of energy. Foods that are high in glycemic load include; refined grains such as white bread, pastries, baked goods, white rice, desserts, sweets, chocolates, fizzy drinks, alcohol and fruit juices. These are important to avoid and replace with a diet that is rich in vegetables, legumes, whole fruits, healthy fats like olive oil, avocado, nuts and seeds, whole grains such as wholemeal bread and brown rice, and finally good quality protein from eggs, poultry, fish and some red meat.
Another key area to look at is increasing intake of omega 3. This important nutrient is an essential fatty acid that we need to include in our diets as we cannot make it in our body. Omega 3 plays an important role in supporting brain cell structure, nerve conductivity and for regulating inflammation, all of which are important for supporting optimal mental wellbeing and cognitive function. Depression is now being considered by western medicine as a symptom of chronic and systemic inflammation, so much so that anti-inflammatory drugs commonly used for rheumatoid arthritis are now being used successfully in trials to treat depression. Oily fish such as sardines, mackerel, anchovies and herring are great sources of readily available Omega 3. However, it can also be found as alpha-linolenic fatty acid in some nuts and seeds such as flaxseeds, walnuts and chia seeds. These go on to be converted into the omega 3 found in fish and seafood, through enzymes in the body.
Something which is rarely touched upon in mainstream media is the importance of healthy cholesterol levels for mental health. Many believe that cholesterol needs to be kept as low as possible in the body, due to it’s ‘artery-clogging’ properties. However, there is a lot more than meets the eye when it comes to this highly important fat and its various roles in maintaining health in the body and brain. The brain actually stores the highest level of cholesterol in the body, containing approximately 20% of whole body cholesterol. And it’s no wonder that this is the case, since one of cholesterol’s most important functions in the brain is supporting the structure and function of neurons (brain cells), making up part of the outer protective layer of nerves and their cells to help optimise cell signalling and communication.
Studies have also shown that cholesterol plays a pivotal role in serotonin transmission due to cholesterol’s role in cell membrane structure. Considering this key fact, it makes sense why so many studies have persistently shown an association between low serum cholesterol and major depression/low mood. Aggressive statin medication has unsurprisingly led to reports of increased anxiety, depression and irritability. However, research is still unclear and it is important to highlight that not everyone that takes cholesterol-lowering medications will be predisposed to a mental health condition.
Well, the two points above on balancing blood sugar levels by eating a diet low in glycemic load, as well as increasing omega 3 intake are important steps, which will help raise HDL cholesterol (this is the cholesterol we want to be nice and high in comparison to the LDL).
However, another key dietary factor to take into consideration, is avoiding trans fats and industrial seed oils, which will have a negative impact on HDL levels, as well as raising LDL levels. This means avoiding seed oils like sunflower oil, rapeseed oil, refined vegetable oils and soy oil. Instead, choose avocado oil, ghee or coconut oil for high temperature cooking and olive oil for low temperature cooking.
Finally, optimising vitamin D3 levels and exercise have also been shown to have a positive impact on HDL cholesterol levels. As we are moving into the winter months, it may be worth considering vitamin D3 supplementation to help tie you over until April/May when the days become a lot brighter.
Estimated reading time: 5 mins
The gut microbiome, defined as the bacteria that colonises our digestive tract, seems to be a buzz word at the moment within the health industry, as a growing body of research is showing just how important quantity and quality of protective gut bacteria are for our health. But the most interesting recent discoveries concerning gut bacteria are how they interact with our brain, in a system that has been labelled the gut-brain axis. This axis represents a two-way relationship between the gut and the brain, whereby our bacteria help communicate messages to our brain and neurochemicals communicate from our brain to our gut. Not only have researchers found that gut bacteria are important for gut motility and nutrient absorption, but they are also finding that these 100 trillion microorganisms, that represent around 1000 different species, can actually modulate brain development and activity, as well as playing a role in conditions such as autism.
In the UK, there are over 700,000 people who are on the autism spectrum, which is a lifelong condition that can greatly impact the lives of those living with autism and their relatives. Research has continuously shown that those on the spectrum commonly have comorbidities related to digestive function, such as IBS. In a study of 255 (184 males/71 females) children with autism between two and 3.5 years of age and 129 (75 males/54 females) typically developing children in the same age group, it was found that preschool-aged children with autism were 2.7 times more likely to experience GI symptoms than their typically developing peers. Almost 50% of children with autism reported frequent GI symptoms — compared to 18% of children with typical development. It is not yet understood why this is the case, however the research on how our gut microbiome can influence brain activity is providing the grounds for new therapeutic measures for conditions like autism.
The composition of our gut bacteria and its diversity is often dependent on the food that we eat. Insoluble fibre such as cellulose, xylans and inulin found in foods such as vegetables and whole grains, provide fuel for our gut bacteria to flourish and ferment to create short-chain fatty acids (SCFAs). These fatty acids, produced by protective bacteria, can reduce the production of proinflammatory molecules called cytokines and can enhance anti-inflammatory processes. SCFAs produced by certain strains of bacteria have also been found to be capable of producing neurotransmitters such as GABA, which is an inhibitory neurotransmitter that helps to regulate anxiety. Bacteria can also produce a set of neurotransmitters called monoamines such as dopamine, which helps control the brain’s reward and pleasure centres, serotonin, our mood stabilizer, and noradrenaline, a neurotransmitter that’s involved in our fight or flight stress response. The vagus nerve, which travels from the intestine to the brain, enables neurochemicals produced by the gut bacteria to be signalled to the brain.
SCFAs produced by pathogenic bacteria, such as the Clostridial species, have on the other hand, been shown to be elevated in those with autism. Disrupted gut bacteria has been frequently associated to autism in studies showing unfavourable amounts of pathogenic bacteria in stool samples and in biopsies of children on the autism spectrum. A variety of drivers such as early weaning from breast milk to infant formula, which was related to increased fecal concentrations of SCFAs produced by pathogenic bacteria, and genetic alterations that can negatively impact how food is digested, have been shown to play a role in symptoms associated to autism.
Research has also shown how psychosocial stress can negatively impact our gut, by altering the composition of gut bacteria and thereby increasing inflammation. This is further evidence for the two-way relationship that exists between the brain and the gut, whereby externally-perceived stress can have a direct influence on the health of our digestive tract. A study measuring lactic acid bacteria (protective bacteria) in college students undergoing the stress of final examinations, found a significant decrease in this type of bacteria after the examination. In addition, studies observing the behaviour of bacteria-free mice, showed a wide range of deficits in brain and gut biochemistry, social behaviour and stress responses compared to mice inoculated with gut bacteria, again giving strong evidence for the role of gut bacteria in modulating brain activity.
In children with autism, the presence of dysfunction in the gastrointestinal tract is commonly associated with aggressive behaviour, tantrums, anxiety, irritability and sleep disturbances. Research on probiotics (supplements containing protective bacteria) and their beneficial effect on gastrointestinal conditions such as irritable bowel syndrome and diarrhea, is well-established. Considering this, it is not surprising that the use of probiotics as an integrative therapeutic approach to autism, is now being extensively investigated. Although the exact mechanism of how probiotics can modulate behaviour and mood in those with autism is not yet fully understood, researchers have posited that this may be due to how protective bacteria target circulating neurotransmitters and neuroimmune responses within the gut-brain axis. Probiotics have been found to reduce certain metabolites that have been associated to autism and gastrointestinal symptoms that are strongly correlated with the disorder.
Achieving optimal nutrient intake is additionally more difficult for those with autism. This is due to a higher rate of food allergies and/or intolerances to certain foods such as dairy, nuts and wheat, as well as a tendency to towards picky eating and food selectivity. There is no one-size-fits-all diet that is right for everyone, each person is biochemically unique, with a variety of genetic, environmental and lifestyle factors that can influence health, which is why it is important to work with a trained professional. However, there are certain key dietary factors that have shown to be beneficial for those on the autism spectrum, which you can begin integrating into your child’s or your everyday life now. If you’d like to see these steps, click here to go through to our Nutrition Solutions page on Autism.
The British Association of Applied Nutritional Therapists (BANT) has a register for qualified Nutritional Therapists in Britain. The Brain Bio Centre, our not for profit clinic, offers face to face in London and Skype appointments to enable consultations from across the UK and overseas.
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Estimated reading time: 9 mins
Chronic fatigue syndrome (CFS) is a debilitating condition that is otherwise known as myalgic encephalomyelitis (ME). Due to the diverse set of seemingly unrelated symptoms that people with this condition present with, it is commonly misdiagnosed and can often be confused with other conditions such as depression.
Typical symptoms of CFS can be:
CFS has long been stigmatised and ignored by many doctors due to its mysterious aetiology, often leaving many physicians baffled. This has commonly led to doctors concluding that it is purely a psychiatric illness, rather than a disease of some kind. Sadly, this means that many patients go through years of seeing various doctors before they get a proper diagnosis.
According to the National Institutes of Health, CFS impacts 15 million to 30 million people worldwide, and leaves 75% of those affected unable to work and 25% homebound or bedridden. Although the aetiology of CFS is unclear, the condition commonly arises following a viral illness, in particular Epstein-Barr virus, herpes and mononucleosis. Since the coronavirus outbreak, there has been a large number of reports of people suffering with long-term symptoms that are akin to those of CFS. This has led to a new line of research opening, to examine the biochemical mechanisms that are leading to symptoms, such as debilitating fatigue, low mood and brain fog, headaches and more in those who have been infected with COVID-19.
According to a report1 published by the Centers of Disease Control and Prevention, more than a third of those who have tested positive for COVID-19 and have symptoms don’t feel like they’re fully recovered, even weeks and months later. Why might this be occurring at such alarming rates? Some researchers, such as Mady Hornig, Immunologist at Colombia University, have proposed that this may be due to inflammation levels going haywire in the body. COVID-19 patients exhibit abnormally high levels of inflammatory molecules2, such as certain cytokines like interferon gamma, which are coincidentally the same inflammation driving molecules that are chronically present in CFS patients. This overactivation of the immune system, which has frequently been labelled the ‘cytokine storm’ in the acute phase of COVID-19, may be what is leading to long-term problems.
Neurovirologists such as Avindra Nath, at the National Institute of Neurological Disorders and Stroke, believe that there should be more attention placed on the long term risks of COVID-19. Nath purported, in an article published in The Scientist, that viruses can seek long-term refuge in organs to hide from the immune system, which can essentially cause a constant trickling of virus particles to escape into the bloodstream leading to a chronic trigger of inflammation. However, the most obvious mechanism by which viruses can cause symptoms related to CFS is autoimmunity. Nath explains how during the acute phase of a viral infection, the body’s immune system can mistake its own proteins with viral proteins, due to an overactivation of inflammation. This, over time, can lead to mitochondrial dysfunction
The mitochondria are the battery-like organelles of our cells, which play an important role in a wide range of physiological processes, such as creating APT (the energy currency of our body), as well as neurotransmitter synthesis, production of insulin, iron metabolism, heat production and many more. Damage to the mitochondria can therefore have a global effect on the body, and many chronic diseases such as diabetes, psychiatric conditions and heart disease, are related to poor mitochondrial function. A key example is in the lack of ATP production that can occur in mitochondrial dysfunction – without enough ATP, we begin to experience symptoms of overall malaise, exhaustion, muscle pain, brain fog and low mood. A chronic inflammatory response that can be triggered by acute viral infections, can literally wear down the mitochondria, altering the metabolism and functioning of cells. This can have a far-reaching impact on our body and even lead to problems in normal bodily functions such as sleep.
An example of this was seen in a case-controlled study3 carried out in 2011 and published in BMC Neurology, which looked at 22 healthcare workers who had been infected in 2003 with SARS-CoV-1 and were left with chronic exhaustion, musculoskeletal pain and sleep disturbances. After performing EEGs (electroencephalogram) on the study participants, they found elevated levels of alpha EEG anomaly and apnea. The alpha-EEG anomaly has been found to interrupt normal restorative aspects of sleep and many studies4 have identified this anomaly as a consistent feature in patients with fibromyalgia, a condition that leads to similar symptoms to CFS.
As the well-known adage goes, ‘the best offence is a good defence’ – the most important thing we can do to protect ourselves from the negative impact of viral infections like COVID-19, as well as prevent potential long term effects, is to optimise our health via nutrition and lifestyle approaches. A key trigger for mitochondrial impairment is oxidative stress5, caused by the following factors:
Oxidative stress is a term used to describe the impact that reactive oxygen species (ROS) can have on our health, which are chemically reactive unstable molecules that contain oxygen. These molecules scavenge electrons from other molecules, leaving a trail of disruption called free radical damage. It is well known that under normal conditions, our bodies maintain a healthy balance between ROS and antioxidants, which are molecules that can donate electrons without becoming ‘unstable’ themselves and are therefore able to halt free radical damage.
Having chronically high blood sugar levels, drinking too much alcohol, smoking, eating too many processed foods and chronic stress, are a recipe for free radical damage and therefore mitochondrial dysfunction. Here are some simple dietary changes to prevent this from happening:
Sugar can come in many forms, which is why it’s important to read ingredient labels. Food manufacturers often try to sneak sugar in by using other types of sweeteners such as dextrose, maltodextrin, syrups, fructose, sucrose, high-fructose corn syrup, agave, fruit concentrates and honey. Avoid products that contain any added sugars in them, as well as using sugar at home in foods and drinks.
To help avoid chronically high blood sugar levels, it’s important to base your diet on wholefoods rich in proteins, fibre and healthy fats. Protein can be found in meats, poultry, fish, eggs and pulses and healthy fats in oily fishes, nuts and seeds, coconut (and its oil), extra virgin olive oil and avocado (and its oil). Aiming for 50g of fibre a day is also incredibly important to help balance blood sugar levels. This means eating various types of vegetables throughout the day in your main meals. You can do this by aiming to dedicate half of your plate to a variety of vegetables at lunch and dinner.
Processed, ready-made meals, often contain ingredients that can be detrimental to our health if eaten too often. Hydrogenated oils, sugars and additives feature frequently in packaged foods, which can trigger oxidative stress and can have a negative impact on mitochondrial health. Focus on whole foods and cooking from scratch as much as possible, so that you have control over what’s going into your meals.
The pigments in plants that cause them to have vibrant colours, such as the red in tomatoes, orange in carrots and sweet potatoes and greens in spinach and kale, are rich in antioxidants like polyphenols and flavonoids. These molecules scavenge free radicals from the body’s cells and help mop up any damage left by them. Try to vary your vegetable intake so that you make sure you’re benefitting from a wide variety of antioxidants.
Aside from the above dietary changes, there are a few nutrients and enzymes that have been well researched in the context of supporting mitochondrial function.
CoQ10 is an important endogenous antioxidant and enzyme that is produced by the body, which plays an important role in something called the electron transport chain, an important process that occurs in the mitochondria, which triggers the production of ATP or energy in simpler terms. CoQ10 is something that is created inside the body, however, we can get small amounts directly from external sources such as our diet. Foods such as organ meats and oily fish have been shown to contain some CoQ10. In addition, deficiencies in cofactor nutrients such as B2, B3 and vitamin E have been shown to play a role in CoQ10 deficiency, as well as the use of statin medication6.
Carnitine is an amino acid that’s synthesised from dietary sources of lysine and methionine, also amino acids. It is responsible for the transport of long-chain fatty acids into the mitochondria to be oxidised and used to create ATP. In previous studies, patients with CFS have displayed significantly lower levels of acetyl-L-carnitine, total carnitine, and free carnitine; and those with the lowest levels have shown the worst functional capacity 7. Whilst carnitine deficiency is rare, those on long term restrictive diets, as well as those with poor liver function may have issues synthesising carnitine. Lysine and methionine are widely found in many foods such as meats, poultry, eggs, fish, as well as in nuts and seeds, wholegrains such as oats, brown rice, and finally, in pulses.
Alpha lipoic is an important antioxidant that plays an essential role in supporting mitochondrial enzymes involved in glucose metabolism and energy production. In particular, Alpha lipoic acid has been shown to prevent damage caused to the mitochondria by increased levels of a substance called nitrous oxide (NO) in the body. Whilst NO is essential for blood vessel health, too much of it can be detrimental to our cells. This often occurs in acute inflammation, such as during the initial stages of an infection. Alpha lipoic acid has been shown to effectively restore mitochondrial enzyme activities inhibited by excess NO, which has a consequent positive impact on ATP production8.
Supplementation with these nutrients has been explored in some studies9. However, it is important to work with a nutritional therapist or a nutritionist to make sure you’re taking the right dose and to investigate potential drug-nutrient interactions, for those taking medication. In the meantime, following the above dietary and lifestyle guidelines can have a profound impact on health and mitochondrial function.
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1. Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020. MMWR Morb Mortal Wkly Rep 2020;69:993-998. DOI: http://dx.doi.org/10.15585/mmwr.mm6930e1external icon
3. Moldofsky, H., Patcai, J. Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study. BMC Neurol 11, 37 (2011). https://doi.org/10.1186/1471-2377-11-37
4. A. M. Drewes, Pain and sleep disturbances with special reference to fibromyalgia and rheumatoid arthritis, Rheumatology, Volume 38, Issue 11, November 1999, Pages 1035–1038, https://doi.org/10.1093/rheumatology/38.11.1035
5. Guo, Chunyan et al. “Oxidative stress, mitochondrial damage and neurodegenerative diseases.” Neural regeneration research vol. 8,21 (2013): 2003-14. doi:10.3969/j.issn.1673-5374.2013.21.009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145906/
6. Kristin Filler, Debra Lyon, James Bennett et al, ‘Association of mitochondrial dysfunction and fatigue: A review of the literature’, BBA Clinical, Volume 1, June 2014, Pages 12-23. https://doi.org/10.1016/j.bbacli.2014.04.001
7. Sanford H. Levy MD, FACP, ABIHM, in Integrative Medicine (Fourth Edition), 2018. https://www.sciencedirect.com/topics/medicine-and-dentistry/carnitine
8. Sylvia Hiller, Robert De Kroon, Eric D.Hamlett et al, ‘Alpha-lipoic acid supplementation protects enzymes from damage by nitrosative and oxidative stress’, Biochimica et Biophysica Acta (BBA) – General Subjects, Volume 1860, Issue 1, Part A, January 2016, Pages 36-45. https://doi.org/10.1016/j.bbagen.2015.09.001 9. Kristin Filler, Debra Lyon, James Bennett et al, ‘Association of mitochondrial dysfunction and fatigue: A review of the literature’, BBA Clinical, Volume 1, June 2014, Pages 12-23. https://doi.org/10.1016/j.bbacli.2014.04.001
Estimated reading time: 7 mins
Periodontitis is another word for gum disease, caused by a specific bacteria called Porphyromonas gingivalis, that leads to infection of the tissue holding the teeth in place, and as a consequence, symptoms such as bleeding gums and loose teeth.
The association between chronic gum disease and cognitive impairment has long been established, with several studies showing a strong correlation between periodontitis and Alzheimer’s disease. In 2009, a cross sectional observational study on participants of 60 years and over, tested 2355 people for IgG antibodies to P. gingivalis. Those who had the highest levels of IgG antibodies, were more likely to have poor delayed verbal recall and impaired subtraction, compared to those with the lowest. This is significant, as we know that the presence of IgG antibodies demonstrates that the body has created an inflammatory response to the bacterium, which is strongly associated with the pathogenesis of Alzheimer’s disease.
We already know that patients with Alzheimer’s disease exhibit neuroinflammation that is akin to a reaction to an infectious agent, like bacteria, leading to the activation of the brain’s immune cells called the microglia, as well as a cascade of cytokine production – another hallmark of inflammation. For this reason, infectious agents have been robustly studied as a key contributing factor to the development of Alzheimer’s. However, a direct causal role is yet to be established.
Despite the lack of evidence for a causative role, associations between cognitive decline and bacterial infection have continued to be established. In another more recent study, published in Alzheimer’s Research & Therapy in August 2017, where more than 25,000 people aged 50 or older participated, researchers found that people who have suffered from gum disease for 10 years or longer are 70% more likely to develop Alzheimer’s disease. This study also highlighted that in those with chronic gum disease, there was a higher prevalence of depression, traumatic brain injury and hyperlipidaemia, which may all be contributors in the development of dementia. This research suggests that there may be various factors at play, rather than just gum disease on its own.
The bacteria responsible for the infection is not only found in those with gum disease, but has also been found at low levels in 25% of healthy individuals with no presence of oral disease. However, what more recent studies are showing is that it is the proteins called gingipains, that are released by the bacteria that are responsible for damage to nerve cells in the brain, rather than just the bacteria on its own. During experiments carried out in mice that were infected orally by P.gingivalis, scientists discovered that they later demonstrated signs of brain deterioration and infection, which are concurrent with humans showing symptoms of early-stage dementia.
In this same study, carried out by researchers from a variety of universities, brain tissue samples from approximately 100 people with and without Alzheimer’s were analysed and tested for two different types of gingipain proteins. They also tested for the presence of gingipain DNA in both the cerebrospinal fluid and the saliva of people that had been diagnosed with Alzheimer’s. What they found was that the level of gingipains in brain tissue of those with Alzheimer’s was between 91% and 96% (for the two different proteins), in comparison to 39% and 52% in those without Alzheimer’s. Furthermore, they found gingipain DNA in 7 out of 10 cerebrospinal fluid samples in those with Alzheimer’s and 10 out of 10 for the saliva samples.
P.gingivalis has, in addition, been shown to be extremely virulent – unlike other bacteria, studies demonstrate that broad-spectrum antibiotics rarely eradicate it and may lead to resistance to it. In addition, P.gingivalis depends on the secretion of gingipains to maintain its survival. They do this by supporting the bacteria’s colonization and the inactivation of the host’s immune defences. Whilst drugs have been developed to block the neuroinflammatory action of gingipains, trials have yet to be completed on humans to assess the efficacy of them.
Researchers from the University of Central Lancashire in the UK, report that bacteria like P.gingivalis can enter from oral cavities into the bloodstream through a variety of daily activities, such as eating, brushing teeth and chewing. However, they mention in a study published in the Journal of Alzheimer’s Disease, that the bacteria is more likely to enter the circulatory system after invasive dental treatment, which then goes on to trigger inflammation. Dr. Sim K. Singhrao, Senior Research Fellow at UCLan said: “we are working on the theory that when the brain is repeatedly exposed to bacteria and/or their debris from our gums, subsequent immune responses may lead to nerve cell death and possibly memory loss.”
Whilst we know that having dementia can lead to difficulties maintaining daily habits like brushing teeth properly, the findings of many studies suggest that gum infections precede the diagnosis of dementia. This means that, like other modifiable risk factors such as diet, smoking, obesity and diabetes, there are things that we can do to help reduce the chance of developing Alzheimer’s disease.
Besides from the obvious dental hygiene habits like brushing teeth and the tongue after every meal to remove food and plaque, flossing and using an antibacterial mouthwash, there are also dietary measures that can be put in place to offer extra support.
For example, research shows that there is a strong association between type 2 diabetes and periodontal disease. This may be due to the fact that increased levels of glucose in the blood, due to insulin resistance, can favour the growth of certain species of bacteria such as P.gingivalis. In addition, diabetes can lead to a malfunctioning of the immune system, which leads to a decrease in antibody function and therefore more opportunity for bacterial infection.
On that basis, it is therefore essential to avoid sugar, in all its forms, including the seemingly ‘natural’ alternatives to regular cane sugar, as well as focusing on a diet that helps to stabilise blood sugar levels.
Dextrose, Fructose, Galactose, Glucose, Lactose, Maltose, Sucrose, Beet sugar, Cane juice crystals, Coconut sugar, Corn syrup solids, Crystalline fructose, Date sugar, Dextrin, Diastatic malt, Ethyl maltol, Florida crystals, Glucose syrup solids, Grape concentrate, Maltodextrin, Agave Nectar/Syrup, Barley malt, Blackstrap molasses, Brown rice syrup, Buttered sugar/buttercream, Caramel, Carob syrup, Corn syrup, Evaporated cane juice, Fruit juice, Fruit juice concentrate, Golden syrup, High-Fructose Corn Syrup (HFCS), Honey, Invert sugar, Malt syrup, Maple syrup, Molasses, Rice syrup, Refiner’s syrup, Sorghum syrup, Treacle.
2. Avoid fruit juices and in particular shop-bought fruit juices, which often contain fruit concentrates. Whilst fruit is a natural form of sugar, fruit juices often contain the juice of the fruit without its pulp or fibre. This means that it is very quickly converted into glucose (sugar) in the body, which leads to blood sugar imbalances and eventually insulin resistance, if consumed too frequently.
3. Eat a diet that mainly consists of foods in their natural form, paying attention to meals that prioritise protein such as in pulses, eggs, poultry, meat and fish, along with a wide variety of vegetables and healthy fats found in nuts and seeds, avocado and extra virgin olive oil.
4. Switch refined carbohydrates for complex carbohydrates – these are foods that are naturally high in fibre such as whole grains like brown rice, wholemeal bread, quinoa and oats, as well as starchy vegetables like beetroot, sweet potatoes, carrots, pumpkin and butternut squash.
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Estimated reading time: 5mins
The ‘Brain-Gut Axis’ is a term used to describe the two-way communication system between our digestive tract and the brain. A growing body of research into this axis demonstrates how much influence the gut can have over the brain and vice versa. When we speak about reactions to foods, we most commonly understand them as immediate and often dangerous allergic responses, such as the constriction of the throat and trouble breathing, or dizziness and fainting. It is usually easy to pinpoint the food that causes these reactions because of the immediate immune system response, caused by a type of immune cell known as IgE antibody. In contrast to this, food intolerances are mediated by IgG antibodies and these reactions can take up to 48 hours to have an effect. Symptoms related to IgG reactions can often be manifested as chronic issues like joint ache, IBS and depression or anxiety, which are often overlooked and not associated with what we eat.
Communication between the gut and the brain is controlled via our immune system, our endocrine system (hormones) and our central nervous system, which are all under the influence of the bacteria in our gut. The types and amount of these bacteria, known as our gut microbiome, can be directly impacted by factors such as diet, stress, pollution and medications and the composition of the microbiome is also understood to affect one’s susceptibility to food sensitivities and intolerances.
To understand further about how food intolerances can impact our mental health, it is important to explain the relationship between our gut microbiome, the immune system and our brain in a little more detail. The walls of our digestive tract provide a barrier between what we eat and the rest of our body and an unhealthy gut microbiome can lead to increased levels of inflammation, leaving the walls vulnerable to structural damage. Our intestinal wall is composed of cell junctions that prevent bacteria and large food molecules from entering the bloodstream, however, if these become damaged, proteins from foods that should not be circulating in our bloodstream can enter and an immune response is mounted as a reaction. This response is mediated by IgG, an antibody, that helps to protect against bacterial and viral infections as well as food antigens and is the most abundant immune cell in the body. Whilst food antigens are usually quickly cleared by an intelligent system called the reticuloendothelial system, with structural damage and a poor gut microbiome, this immune response can keep reoccurring. It is suggested that a chronic immune response such as this can have a negative impact on the brain, damaging its own structural barrier, called the Blood Brain Barrier.
The Blood Brain Barrier (BBB) is similar in structure to the intestinal barrier and is usually highly selective, allowing certain required metabolic products, such as short chain fatty acids and amino acids to pass into the brain from our wider circulation but protecting the brain from potentially damaging components. When the BBB is compromised, unwanted translocation may occur such as allowing a bacterial invasion, which can alter the function of immune cells that are responsible for regulating inflammation. Chronic inflammation is associated with many mental and physical health problems, so it is therefore suggested that poor gut health can have a direct correlation to poor mental wellbeing. This is as a result of a compromised intestinal barrier and the negative impact this has on our brain’s own structural barrier (BBB), resulting in inflammation.
Large scale studies have shown the association between chronic low-grade inflammation and depression. For example, in a study that examined data from 14,275 people who were interviewed between 2007 and 2012, they found that people who had depression had 46% higher levels of C-reactive protein (CRP), a marker of inflammatory disease, in their blood samples. Studies like these are paving the way towards a new understanding of the pathology of mental health conditions and how diet and stress can alter bodily systems, such as digestive function and consequently impact mental wellbeing.
Measuring IgG antibodies in food intolerance tests has been implicated as a popular strategy to tackle symptoms related to sensitivities such as IBS, joint pain, fatigue, migraines, anxiety and depression. A recent survey on 708 people commissioned by Allergy UK, demonstrated how 81% of those with elevated IgG levels, as well as psychological symptoms, reported an improvement in their condition after following a food-specific IgG elimination diet. Taking this all into account, health professionals and those with poor mental health may want to consider the potential role of food intolerances in mental well-being and in managing common mood-related disorders, such as depression and anxiety.
Foods that are rich in collagen and its amino acids, like glycine and proline, are great for healing connective tissue, which is what the intestines are made up of. A traditional food, rich in these amino acids, that has made its way into our kitchens again after rediscovering its therapeutic properties is bone broth. Another example of a group of traditional foods that can be used therapeutically in building digestive health, are fermented foods such as kefir, sauerkraut and kimchi. These are abundant in probiotics, which are the ‘good’ bacteria our digestive system needs to help keep a good balance and protect the intestinal barrier from pathogens, toxins and parasites. Once these foods have been introduced on an everyday basis along with eating a healthy nutrient-dense diet and the possible use of supplements to help restore balance, it may be possible to reintroduce foods that were previously triggering an IgG response carefully, one at a time, whilst monitoring symptoms.
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Attention Deficit and Hyperactivity Disorder (ADHD) is a condition that relates to a collection of behavioural symptoms such as hyperactivity, impulsiveness and inattentiveness. It is most commonly diagnosed in childhood between the ages of 6 and 12 when disruptive behaviour begins to show, however, due to a growing awareness of the condition, it is also becoming common among adults. According to the thinktank Demos, the cost of undiagnosed ADHD in adults in the UK, who are unable to work or hold down a full-time job, are estimated to cost billions of pounds to the nation. They warn that too many may be going through life struggling, unable to access the support or diagnosis they need, which means there could be a huge amount of wasted talent.
The most common front-line of treatment for ADHD is medication and cognitive behavioural therapy (CBT). Prescriptions for ADHD drugs such as Ritalin, have doubled to 922,000 a year in the last decade, and whilst it offers symptom management for many, it has also been found to have significant negative side effects such as weight loss, liver toxicity, and suicidal thoughts, and in the short term may suppress pubertal growth. The aetiology of ADHD is multifactorial, meaning that there are varying influencing factors that drive the symptoms. This is perhaps why this condition has been hard to study and find effective treatment for.
A key area that has been widely researched is the link between the microbiome (bacteria) in the gut and the brain. The hypothesis is that alterations in bacteria due to changes in our environment such as increased hygiene, increased exposure to antibiotics, refined and processed foods and stress, have led to disturbances in short-chain fatty acids (SFCAs), which are byproducts of fermentation in the gut when bacteria come into contact with indigestible fibre found in food.
One SCFA in particular, called propionic acid, has been identified as a driver for abnormal behaviour that is related to both ADHD and the autism spectrum. This SCFA can alter metabolic and immune pathways, as well as gene expression, which can affect the functionality of the brain cells and their receptivity to neurotransmitters, as well as their ability to regenerate and regulate inflammatory responses. Certain strains of pathogenic bacteria, such as clostridia, have been implicated in producing large amounts of propionic acid. This strain of bacteria is naturally present in the gut, however, an overgrowth can occur when good bacteria levels are compromised and/or there is an acute infection. In addition, processed wheat and dairy products often contain propionic acid as a food preservative in the form of calcium propionate.
Other SCFAs such as butyrate, are well known for having health-promoting properties, such as producing anti-inflammatory effects by being able to regulate T-cells (immune cells) in the colon, as well as helping to maintain a healthy gut barrier function. In order to increase the favourable, health-promoting SCFAs, such as butyrate, it’s important to increase the intake of vegetables, fruits and good fats such as grass-fed butter, coconut oil, nuts and seeds, olive oil and avocado. These provide food for gut bacteria to feed on, also known as prebiotic fibres. Foods such as those listed above, contain the right nourishment for gut bacteria to produce SCFAs that support health. Eating traditional foods such as fermented cabbage and other vegetables, as well as bone broth, are also rich in prebiotics and nutrients that support a healthy microbiome and digestive system.
Exposure to toxins and heavy metals has also been implicated in the aetiology of ADHD. Research shows that significant childhood exposure to heavy metals and chemical compounds promotes neurodevelopmental toxicity and may be one of the underlying drivers of behavioural disorders among children.
For example, prenatal exposure to phthalates, which are chemical compounds that are commonly added to plastics to increase their durability and flexibility, have been linked to behavioural abnormalities, characterised by shortened attention span and impaired social interaction. Phthalates are an extensive group of chemicals, and whilst not all of them have been studied, several have shown to have negative health impacts. This class of chemicals is found abundantly and can find their way into food packaging, cosmetics and household cleaners – making them virtually impossible to avoid. However, a growing awareness about the potential negative impact on health has led to the production of phthalate-free cosmetic and personal care products, as well as cleaning products. It may, therefore, be a significant step to try to avoid these chemicals by choosing products wisely, as well as trying to buy vegetables, fruit etc that haven’t been wrapped in plastic.
Mercury exposure is among several other heavy metals, such as lead, aluminium and cadmium, that have been implicated in the aetiology of ADHD. Childhood exposure to mercury is predominantly through the consumption of seafood, dental amalgams and vaccines containing thimerosal. The reason why mercury can be so problematic, as well as other metals, is that it is capable of breaching the blood brain barrier. This is the brain’s ‘high fortress’, an intelligent gateway system that filters through molecules that are needed in the brain such as cells, nutrients and signalling molecules, and filters out pathogens and toxins.
Mercury, as well as other heavy metals such as lead, can accumulate in brain tissue, as well as in the spinal cord, as they are fat-soluble. This means that they can hide themselves in fat tissue, abundant in both the brain and the spine. Once there, they can induce an inflammatory process called oxidative stress, displace important nutrients for brain health, such as zinc and iron, which are essential for neurotransmitter production.
An important dietary step to avoid heavy metal toxicity is choosing seafood and fish that has reduced levels of exposure. The Seafood Watch web page is a fantastic resource that has an extensive list of fish, seafood and sushi products that are safe, as well as those that are best to stay away from. For example, choosing wild pacific caught salmon is safer than Atlantic caught salmon.
The body has its own inherent detoxification pathways that are responsible for packaging and removing heavy metals safely from the system. For example, glutathione is known as the body’s ‘master antioxidant’ and aside from playing an important role in preventing free radicals from causing damage to the body’s cells, it also helps to bind to heavy metals and remove them from the body. Research shows that glutathione levels are lower than normal in those on the autism spectrum, so enhancing levels through the diet may be an effective way to prevent the accumulation of heavy metals. Consuming sulfur-rich foods such as broccoli, cabbage, onions, garlic, kale and cauliflower can boost glutathione levels, as well as milk thistle, which has unique flavonoids that also support glutathione production.
Most water filters on the market only filter out bacteria, parasites and organic compounds. There is a different method to filter out heavy metals, so make sure it explicitly says it does. The reverse osmosis method seems to be the most effective and can be integrated into the kitchen tap.
As mentioned above, eating foods that are rich in indigestible fibre such as vegetables and fruits, as well as eating good fats that are found in grass-fed butter, nuts and seeds, olive oil, coconut oil and avocado, provide bacteria with prebiotics that help to produce the ‘friendly’ short-chain fatty acids, such as butyrate. Avoiding processed foods that contain calcium propionate, which lead to higher levels of propionic acid – the not so friendly short-chain fatty acid – is also another key strategy to support the gut-brain link.
There are many more steps to help support the optimal functioning of the brain and therefore encourage improved learning and development. However, another key strategy to support brain health is to increase intake of omega 3, an essential fatty acid, that is most abundantly found in oily fish such as salmon, mackerel and sardines. Be sure to choose salmon that has had less exposure to polluted water – visit the Seafood Watch web page to find the best sources. Omega 3 is vital for the brain’s function, particularly one of its components called DHA. This is a key building block for the brain and is what keeps neurons (brain cells) working well and supports proper signalling via neurotransmitters.
Lastly, this may seem like a no-brainer, however, avoiding refined sugar and processed foods at all costs is essential for managing ADHD symptoms. These foods have a negative impact on blood sugar levels, which consequently affect mood and concentration.
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The vagus nerve is a fundamental part of the autonomic nervous system, which is composed of two key branches; the parasympathetic – the branch that allows us to rest, relax, digest and recharge, and the sympathetic – the branch that is responsible for our stress response and survival by controlling functions such as the heart rate, blood sugar and cortisol, which help us get away from a threat quickly and efficiently. The vagus nerve is the parasympathetic nervous system’s primary nerve, which travels from our brain stem down into a large number of organs and tissues such as the gut, the lungs and the heart. This is why this nerve was coined ‘vagus’, which is latin for ‘wandering’, due to its far-reaching effects on so many parts of the body.
A healthy parasympathetic nerve response, which is governed by the vagus nerve, is essential for our mental wellbeing and physical health. This is because when we are functioning from a parasympathetic ‘point of view’, we are able to repair, digest and assimilate nutrients in our food properly and regenerate. We have evolved to be in this state the majority of the time, however, due to the pressures of modern life and chronic stress, many of us are continuously in a sympathetic state, where we are constantly in a physiological ‘fight or flight’ mode. Stress is a major risk factor for all health conditions and emerging research is showing that it is also a fundamental driver of many of today’s chronic diseases, such as heart disease, diabetes and irritable bowel disease.
Poor mental health such as depression, anxiety, panic attacks and insomnia, are symptoms of a dysregulated nervous system, where our response to environmental stressors have, in essence, become either excessive, causing panic, anxiety, hypervigilance and aggression, or downregulated to the point where we experience symptoms of apathy, depression and sometimes even catatonia. These are all symptoms of poor vagus nerve function, which are often a result of environmental factors such as stressful situations and trauma.
We know that the vagus nerve is connected to the gut and plays a crucial role in modulating the enteric nervous system, which is a complex network of nerves that are located in the wall of the upper intestinal tract. This is a nervous system that is able to function entirely on its own, away from the central nervous system, which is composed of the spinal cord and the brain. Scientists have labelled it the ‘second brain’ due to its independent nature and its ability to communicate with the brain, which is where the vagus nerve comes into play. The vagus nerve is essentially the ‘bridge’ between the brain and the gut, facilitating a bi-directional communication between the two organs.
ref: https://lifeverchanging.com/2018/01/25/is-ibs-a-gut-brain-microbiome-axis-disorder/
As you can see in the diagram above, this two-way communication has a variety of functions, which not only influences the emotional wellbeing of a person, but also key physical processes such as digestion and metabolism. A crucial part of facilitating this communication and maintaining a healthy vagus nerve is the microbiome – the bacteria that live in the digestive system. In the past decade, research has exploded in this area, where scientists have begun to unearth how microorganisms such as bacteria, yeast and fungi impact the production and functioning of neurotransmitters and inflammatory processes, which modulate brain activity.
Research shows that eighty percent of the information transmitted by the vagus nerve flows from the body to the brain (afferent nerve fibres). Whereas twenty percent of the vagus nerve is efferent, which means the signals are transmitted from the brain to the body. A clear example of this two-way communication is seen in animal studies, where researchers have found how stress inhibits the signals sent through the vagus nerve and causes gastrointestinal problems. Symptoms such as the suppression of stomach acid and digestive enzyme production, as well as increased gut permeability (leaky gut), slower bowel transit time and nutrient malabsorption are often experienced when under chronic stress. On the other hand, we also see how ‘gut instincts’ or visceral sensations, influenced by external factors such as stressful environments, alert the brain by triggering an emotional response such as fear and anxiety.
In order to support healthy vagus nerve function to optimise mental wellbeing, it is essential to not only practice lifestyle habits that stimulate vagus nerve tone, but also to take care of digestive function.
Here are a number of ways that have been shown to help stimulate the vagus nerve and parasympathetic nerve activity:
Healthy gut bacteria help to create signalling molecules, which are communicated via the vagus nerve to the brain and keep inflammation at bay. Bacteria are also capable of creating neurotransmitters such as serotonin and dopamine. Eating fermented foods such as sauerkraut and kimchi (both fermented vegetable mixes) that are rich in beneficial bacteria, help to maintain equilibrium in the gut. In addition, eating a wide variety of vegetables and fruits can help to provide prebiotic fibres for bacteria to break down, which provides them the essential fuel they need to maintain themselves and create the metabolites that positively influence brain function.
Whilst breathing is part of our autonomic nervous system (meaning that it is a process that happens automatically, without the need for us to think about it) it is also a process that we can control. Deep belly breathing, and in particular, the lengthening of the exhale, can have an immediate impact on the nervous system, stimulating the vagus nerve and therefore the parasympathetic response. One of the easiest and most accessible breathing techniques is the box breathing exercise, which can be followed below:
Both gargling and singing mechanically stimulate the vagus nerve by vibrating the muscle fibres at the back of the mouth in the throat area. Due to part of the vagus nerve being located in this area, activities such as gargling can directly stimulate and fire the nerve fibres in the vagus. Practicing these activities on a daily basis can help to improve vagus nerve tone, which may have been lost due to chronic stress and trauma.
Craniosacral therapy directly addresses the cranial nerves (the vagus nerve is the 10th cranial nerve) and helps to shift the body out of a fight or flight state. Over time this can help to ‘rewire’ the nervous system by increasing vagal tone and allowing the balance between sympathetic and parasympathetic to reach a healthy equilibrium.
We know that meditation and mindfulness can be great health tools, especially due to the positive effect they can have on the nervous system. However, loving kindness meditation goes a step further by encouraging visualisation that generates ‘warm and fuzzy’ feelings of compassion and gratitude. This type of meditation is rooted in Buddhist tradition and seeks to promote four key experiences of friendliness, compassion, gratitude and equanimity. Studies have shown that practicing this type of meditation not only improves vagus nerve tone, but also significantly reduces symptoms of depression in those with PTSD and helps to increase social connection.
Here is a great guided loving kindness meditation, which you can try out:
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