Dr Matthew Bambling (2014) approaches the question of why (how?) nutrition might affect our brains by noting that nutrients serve numerous functions, such as energy metabolism, maintenance of healthy mood, protection and growth of neural structures, and the up- or down-regulation of genes involved in healthy brain metabolism. Most importantly, however, nutrients are involved with neurotransmitters. In fact, nutrients help make neurotransmitters. The old saying that we are what we eat is especially true for brains, so looking after them means ingesting optimal nutrition. Bambling sadly observes that many people begin to show cognitive changes that are related to decline by the time they enter their thirties (!). The quality of t he food we take in might significantly reduce our risk of age-related, negative neurological changes. Even with conditions such as Alzheimer’s Disease – the pre-disposition for which is carried genetically – genes only account for 30 percent of our risk for the disease. The other 70 percent of risk can be explained by lifestyle, health behaviour, and living environment.

As our brains burn energy (preferably glucose), they generate a large amount of toxic by-products which the body must get rid of. This metabolic activity causes wear and tear on our neural systems over time, causing two demons of brain cell decline: oxidation and inflammation. A third devil is that of excitosis, where neurons fire uncontrollably until they die (related to toxic chemicals in our food). Our brains don’t get access to all the protective nutrients against these processes that other parts of the body receive, because the tightly-packed cells of the blood brain barrier restrict many nutrients from getting in (though this obtains the positive result of protecting our brains from certain chemicals and pathogens in our blood). There are, however, some classes of nutrients, chemicals, and hormones which can cross the blood-brain barrier and serve important protect ive functions for us.

Keeping brains healthy

Sugar

It’s been getting bad press for years, and now we’ve got the goods on it, neurobiologically speaking: carbohydrate (sugar) is the preferred fuel for our brains, but we only need enough; more is not better. Our brains are highly sensitive to blood glucose levels, and low blood sugar (hypoglycaemia) affects us almost immediately, manifesting in drowsiness, slurred speech, inability to concentrate, and even unconsciousness leading to death. On the other hand, too much blood sugar (hyperglycaemia) can indicate diabetes, meaning that our neurons and other cells are not getting adequate glucose uptake. The results are glucose fusing with protein cells and excess glucose being converted to blood fat, leading to weight gain and other problems (Bambling, 2014).

Proteins

Our brains also need a constant supply of amino acids, as these are used directly as neurotransmitters, and indirectly as building blocks for other neurotransmitters. Many processed foods lack these essential nutrients. Keeping our brains healthy means getting enough protein in our diet (we can be assertive about helping clients understand how to do this) via plant, nut, animal, or dairy sources. Bambling points out that oxygen is required for the cells to burn glucose, and this process generates free radicals (the unbalanced reaction between atoms which causes damage to the machinery of our cells). Our bodies make abundant anti-oxidant (that is: anti-free-radical) chemicals when we are young, but the natural levels of these produced within the body decline rapidly as we get older, so the role of solid nutrition becomes correspondingly greater.

Small meals

Some hapless “greedy-guts” don’t know when to stop! Huge meals cause rapid increases in blood fats and blood sugar, and can create excessive rise in blood fats (triglyceride-rich lipoproteins) after eating: a risk factor for cardiovascular disease and also diabetes. The narrowed arteries caused by high levels of triglycerides can also mean less blood for our brains (Bambling, 2014).

Dietary and supplement neuroprotection

So what are the “super-foods” and supplements which help to reverse damage to our precious brains? Bambling puts the following at the head of the (brain-saving) class:

• Blueberries are a potent antioxidant (as are most other berries), protecting the brain through their compounds called polyphenols (which are found, in smaller amounts, in other fruits and in vegetables and nuts). Blueberries are also anti-inflammatory and inhibit the proteins which would otherwise try to kill off the neurons. Moreover, they up-regulate neuron function and health, improving neurogenesis.
• Grape seed extract is a neuroantioxidant, improving blood vessel function and tone in the brain.
• Gingko Biloba supports healthy blood flow in the brain.
• Curcumin (found in turmeric) is an antioxidant and powerful down-regulator of genes involved with inflammation; only ¼ teaspoon per day is needed to start giving results!
• Uridine-5’-monosphosphate is a building block of DNA, supporting brain growth and neuroplasticity.
• Vinpocetine is an herb which improves neural electrical conductivity and protects against excitotoxicity.
• CoQ10 (pyrroloquinoline quinone – PQQ), a potent antioxidant, protects against neurological disorders and dementia and enhances memory by stimulating growth factors.
• Vitamin-hormone D3 is now seen as essential for health. Low levels predict Parkinson’s disease and are linked to cognitive decline.
• B5, B12, and folic acid slow brain atrophy in adults with mild cognitive impairment.
• Long-term antioxidant supplementation improves arterial health and insulin sensitivity (source: Bambling, 2014).

The special cases of depression and anxiety

For those who are already healthy, the above list of supplements might be a helpful addition for the brain, keeping it healthy throughout life. As a mental health helper, however, you are likely to see many who are trying to get to that place of wellbeing, and are sitting in front of you because their depression or anxiety is keeping them from that state. While the supplements already named may markedly improve the mood of some clients, others will need more specialised help. As depression and anxiety are probably the two most common mental health issues (with anxiety being three times more common than depression in the Western world: Bambling, 2014), we look at developments old and new for these.

SAMe (S-Anenosyl-Methionine) is a natural compound whose levels are lower in depressed people. It is quickly earning its stripes as a brain antioxidant and mood improver, showing itself to be as effective as prescribed medication. It may be particularly helpful for treatment-resistant depression. An Australian study demonstrated that 800mg a day of SAMe over a six-week period more than doubled the remission rate compared to those on SSRI medication alone (Bambling, 2014). Made from natural amino acids, SAMe seems to regulate growth factors and neurotransmitters such as serotonin and dopamine, which are involved with mood. As low levels of this may be implicated in Alzheimer’s and also Parkinson’s disease, this may be a huge boon in more ways than one for those who are depressed. It should be taken with the B-group vitamins.

Saffron extract has strong anti-depressive effects on par with pharmaceutical solutions. It supports mood, increasing motivation and a sense of positive energy. It also has a powerful impact on the desire to eat and on hunger, so it may be used to assist weight loss where emotional eating is occurring. L-tryptophan, a precursor to serotonin and melatonin, may improve mood and quality of sleep. Omega-3 supplements (such as fish oils, which are abundant in this) have helped some people with depression and also learning problems and hyperactivity. St John’s Wort works like the SSRI family of depression drugs, being a weak reuptake inhibitor of serotonin, dopamine, and noradrenaline. It also influences GABA and L-glutamate: all neurotransmitters involved with brain and mood issues. It shouldn’t be used with anti-depressants.

Anxiety can be a stand-alone disorder or co-morbid with other conditions. It is also a factor in how severe other mental health problems are. Most medications are a temporary fix, and clients often have problems with tolerance and other side effects.

SSRIs (Sustained Serotonin Reuptake Inhibitor drugs) have become popular as a front line in anxiety medication; these increase serotonin in the synapses of the brain. Benzodiazepines stimulate GABA receptors. Glutamate and GABA neurotransmitters work together, accounting for over 80 percent of brain activity; in harmony, they keep things optimal, with glutamate accelerating and GABA inhibiting activity. Anxiety problems suggest an imbalance between these two very powerful mediators of brain activity. Too much glutamate can cause excitotoxic reactions and might be linked to the development of neurodegenerative disorders. Norepinephrine increases alertness and arousal – which is helpful in sports competitions, but probably not at social functions – and is involved with panic attacks.

Dopamine, more complex, can increase anxiety when levels are too high, but it helps with anxiety in the right amounts, increasing motivation and pleasure. This neurotransmitter often needs boosting, especially if the anxious person has had symptoms of negativity, apathy, fatigue, lack of pleasure, low sex drive, and/or the inability to lose weight. Serotonin is a neurotransmitter with many functions, from sleep, appetite, and impulse control to sexual desire. It can calm people and protect against the effects of cortisol. Serotonin levels may be low if the person’s anxiety is co-occurring with low mood, insomnia, carbohydrate cravings, muscle aches and pains, impulsiveness, insecurity and/or poor stress tolerance. Note that not everyone feels good with high levels of serotonin.

Cortisol is an important part of our stress response, as without this neurotransmitter, our physiology wouldn’t work. Chronically elevated cortisol, however, creates numerous health and neurological problems. L-Theanine is a derivative of Glutamic Acid, one of the neurotransmitters found in the brain. It is a natural amino acid highly concentrated in green tea, which has been shown to be as effective as medication in doses above 200 mg per day (without the effects of tranquilisers). It enhances concentration and memory and increases levels of serotonin and dopamine, promoting an alert but relaxed mental state (Alpha brain waves). Lemon balm can help improve the quality of people’s sleep with no sedative effect the next day. It may also improve concentration and can be used to help smokers quit (Bambling, 2014).

Three aids for OCD and panic

N-acetyle cysteine (NAC) is a recent treatment which modulates the glutamate/GABA balance and has been shown to be helpful for most compulsive behaviours, including such things as gambling, trichotillomania (hair pulling), and other obsessions. Inositol reduces anxiety, panic, and OCD-like symptoms, and has been found to be as effective as SSRIs for panic attack without the sometimes huge side effects. Taurine calms brain activity, although it can cause drowsiness and lower blood pressure, so it should be taken before bed. It is involved with a number of physiological processes.

Psychosis: Defective genes?

One theory of psychosis is that defective genes result in oxidised adrenaline hormone, so one natural treatment has been to try…

• High-dose niacin and Vitamin. This combination reduces adrenaline production and oxidisation. Although liver function needs to be monitored with this, good results have been obtained from reducing symptoms for some people.
• Fish oil may help prevent the development of schizophrenia in teenagers and young adults, according to a promising study from Australia. Adding the form of fish oil called “eicosapentaenoic acid” (EPA) to standard antipsychotic drug therapy may assist treatment response and improve the tolerability of antipsychotic medications in schizophrenia patients (Bambling, 2014).

Learning and memory

If clients come to you disturbed that they cannot seem to learn or recall things, they do not need to go away empty-handed. The following substances (many already mentioned) assist the taking-on and retention of information.

L-Theanine, lemon balm, Gingko Biloba, and Vinpocetine help modulate neurotransmitters involved with attention and memory. Phospatidylserine supports neuroplasticity. Acetyl-L-Carnitine, Arginate, Ashwagandha, Choline, and blueberry are neurochemical and neuron modulators. Pregnenolone and Rhodiola (an herb) support energy production in neurons (very helpful for older people). Omega 3 is good for most aspects of brain development and maintenance (Bambling, 2014).

Weight loss

If you are working with clients as a wellness coach or weight-loss adviser/ therapist, there is ready assistance here, too, in the natural – substance category.

Saffron extract (mentioned above) helps with food cravings and emotional issues, reducing the desire to snack, along with actual snacking between meals, by about 50 percent. Pinolenic acid (pine nut extract) increases hunger-suppressing hormones and thus reduces the desire to eat by over one-third. CLA (conjugated linoleic acid) makes it harder to gain weight; more loss occurs when CLA is used in a weight loss program, and it preserves lean muscle during weight loss. Fibre, carbohydrate and fat blockers can help in a weight-reduction program (although one must monitor nutrient absorption, which might be affected) (Bambling, 2014).

Just do it: Exercise as the single best solution for problems

Nike came up with the “Just do it” advertising campaign in 1988, and vastly increased its North American market share: from 18 percent to 43 percent in ten years (Wikipedia, 2014b). The overwhelming impact of this now-iconic slogan is an excellent metaphor for your advice to clients regarding the vast potential of exercise for both actual and potential brain challenges. The client just needs to do exercise: like, regularly. Ivey (2009) routinely “prescribes” it to his counselling clients along with whatever other “homework” they are to do between sessions to reach their goals. Increasingly, research is showing that our brains simply like our body to be moving. Exercise has been demonstrated to help reduce symptoms in a wide range of mental health problems, from depression and anxiety to schizophrenia, addictions, and other issues (Bambl ing, 2014).

Exercise stimulates our neural growth factors and enhances the formation of new neurons. It stimulates dendritic connections to grow between neurons and enhances neurotransmitter levels, especially in areas of the brain involved in memory, learning, and mood. Regular high-intensity exercise (especially when younger) and moderate-intensity exercise (for those middle-age and older) has been shown to reduce the risk of cognitive decline and dementia in old age, thus providing protection against Alzheimer’s, depression and anxiety disorders and improving recovery from addictions. As a bonus, it modifies risk factors for most health problems, such as heart disease, diabetes, hypertension, obesity, age-related muscle loss, and stress: all factors which are thought to be involved with cognitive decline over the long term (Bambling, 2014).

This article was adapted from Mental Health Academy’s CPD course “Counselling and the Brain: An Overview”.

References

• Bambling, M. (2014). Nutrition and the healthy brain. Mental Health Academy. Retrieved on 18 June, 2014, from: hyperlink.