[large version of the above image]

From the NIH, this is a nearly 7 hour video of a recent conference on the cellular of molecular mechanisms of physical activity-induced health benefits (i.e. prevents disease or improves overall health).

Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits

Thursday, October 30, 2014 
Runtime: 06:46:51


Description: The NIH Common Fund is currently exploring research needs and opportunities related to the molecular mechanisms whereby physical activity prevents disease and improves health outcomes. This activity is undertaken with the leadership of the NIH Institute Directors Richard Hodes, M.D., National Institute on Aging (NIA), Stephen I. Katz, M.D., Ph.D., National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), and Griffin Rodgers, M.D., National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and with broad support throughout the NIH. The Trans NIH Committee Physical Activity Common Fund (PACF) Working Group plans to cover the broad aspects of physical activity related benefits under 5 sub-working groups within these ICs (NIAMS, NIDDK, NIA and OSC)

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Exercise Is Good for Your Brain

Two new studies demonstrate the power of exercise to heal our brains, or to prevent illness in the first place. One study (Cell, Sept 25) showed that a muscle gene activated by physical exercise protects the brains of mice from stress-induced depression. The other study (Pediatrics, Sept. 29) showed that kids who participate in regular physical activity showed enhancement of cognitive performance and brain function (executive control).

Here are summaries of each study, along with the abstract. The Pediatrics article is actually open access for those who want to read it.

Muscle to Mind

Exercise-induced muscle metabolites protect the brain from stress-induced depression in a mouse model.

By Jyoti Madhusoodanan | September 25, 2014

 

WIKIMEDIA, JEPOIRRIER (FLICKR)

A muscle gene activated by physical exercise protects the brains of mice from stress-induced depression, according to results published today (September 25) in Cell. Triggering this gene, PGC-1α1, blocks the transport of a metabolite that, within the brain, may cause inflammation that leads to depression. Understanding the biochemical reason why exercise improves symptoms in some patients with depression “opens up a very interesting therapeutic future,” said study coauthor Jorge Ruas of the Karolinska Institute in Sweden.

Previous studies have shown that physical exercise can prevent or improve the condition of many diseases, ranging from diabetes and obesity to mood disorders and depression. But whether the improvement stems from cardiovascular effects, muscle conditioning, or psychosocial benefits has been unclear.

In 2012, Ruas and his colleagues found that different forms of the skeletal muscle PGC-1α gene responded to different kinds of exercise. The gene could be transcribed from two different promoters: one version was responsive to resistance training, such as lifting weights, while the other, PGC-1α1, responded to endurance activity. To understand the different variants of the gene, the researchers created various mouse models that constitutively expressed different forms of these genes at high levels, as well as knockout lines. The animal models also offered a means to separate the biochemical effects of exercise from less tangible psychosocial effects, Ruas explained.

In the new study, Ruas and his coauthors subjected transgenic PGC-1α1-expressing mice and control animals to chronic mild stress to mimic one trigger of human depression. After five weeks, the control animals showed behavioral signs of anhedonia and despair, such as failing to exert themselves during a forced swim test. Their brains also revealed changes that included decreased synaptic plasticity, imbalances in glutamate metabolism, and lower levels of neurotrophic factors. The transgenic mice, however, showed neither behavioral nor anatomical signs of depression.

Analyzing metabolic differences in the animals revealed differences in tryptophan metabolism, said Ruas. “From a brain perspective it made sense that tryptophan metabolism because it’s used by the brain to make serotonin,” he said, “but for the skeletal muscle it made less sense.”

Digging deeper, they found that the PGC-1α1 gene controls a step in muscle metabolism of tryptophan where one metabolite, kynurenine (KYN), is converted to a different form, kynurenic acid (KA). Previous studies have linked KYN within the brain to inflammation, which is correlated to depression and schizophrenia-like symptoms. Outside the brain, the liver converts more tryptophan to KYN in times of stress, and KYN can cross the blood-brain barrier to trigger an inflammatory response.

In mouse muscle, increased PGC-1α1 levels—such as those induced by exercise—converted more KYN to KA, which cannot cross the blood-brain barrier. To test whether the depression-like symptoms seen in their experiments were indeed mediated by KYN, the researchers administered KYN to both control and transgenic mice; only the former group showed gene expression and behavioral changes linked to depression.

The conversion of KYN to KA by PGC-1α1 may be a key metabolic step in linking stress-induced inflammation and depression, the results suggest.

“It is important to remember that ‘stress’ is not only having a stressful everyday life —but outside events that activates [the cellular] stress-response,” coauthor Maria Lindskog told The Scientist in an e-mail.

When control mice were put through an eight-week exercise regimen, skeletal muscle expression of the PGC-1α1 gene increased. Similar results were seen in healthy human adults after a three-week training program. Collectively, the results show that “exercised muscle acquires a detoxification role in stressful conditions that have not been described before,” said Ruas. “I don’t think anyone had previously thought of correlating muscle changes with inflammation [in the brain].”

“This is a very interesting study about the non-pharmacologic mechanisms of antidepressant action, a topic that’s not addressed very much,” said neuroscientist Michael Lutter of the University of Iowa who was not involved in the work.

Behavioral immunologist Andrew Miller of Emory University added that exercise, or drugs that target PGC-1α1, would likely be effective only in depressed patients who also had signs of inflammation and elevated KYN, such as those with early life stress, obesity, cancer, or other diseases. In physically healthy patients, brain levels of KYN are not clearly correlated to symptoms of depression. “Exercise may be especially relevant to those depressed patients who have increased inflammation,” said Miller, who was not involved with this study. These results “allow us to target therapies like exercise to select populations of individuals,” he added.

“Finding that certain aspects of muscle metabolism may be associated with the development of mood disorders adds to [an emerging] theme,” said Lutter. “There’s a much more intimate connection between the mind and body than was previously appreciated.”

L.Z. Agudelo et al. (2014, Sep 25). Skeletal muscle PGC-1α1 modulates kynurenine metabolism and mediates resilience to stress-induced depression. Cell; 159(1): 33–45. doi:10.1016/j.cell.2014.07.051, 2014.

* * *

Skeletal Muscle PGC-1α1 Modulates Kynurenine Metabolism and Mediates Resilience to Stress-Induced Depression

Leandro Z. Agudelo, Teresa Femenía, Funda Orhan, Margareta Porsmyr-Palmertz, Michel Goiny, Vicente Martinez-Redondo, Jorge C. Correia, Manizheh Izadi, Maria Bhat, Ina Schuppe-Koistinen, Amanda T. Pettersson, Duarte M.S. Ferreira, Anna Krook, Romain Barres, Juleen R. Zierath, Sophie Erhardt, Maria Lindskog, Jorge L. Ruas

Highlights

• •Skeletal muscle-PGC-1α1 transgenic mice are resilient to stress-induced depression
• •PGC-1α1 induces skeletal muscle kynurenine aminotransferase (KAT) expression
• •Skeletal muscle PGC-1α1 controls plasma and brain kynurenine/kynurenic acid balance
• •Exercise training activates PGC-1α1:PPARα/δ:KAT in mouse and human skeletal muscle

Summary

Depression is a debilitating condition with a profound impact on quality of life for millions of people worldwide. Physical exercise is used as a treatment strategy for many patients, but the mechanisms that underlie its beneficial effects remain unknown. Here, we describe a mechanism by which skeletal muscle PGC-1α1 induced by exercise training changes kynurenine metabolism and protects from stress-induced depression. Activation of the PGC-1α1-PPARα/δ pathway increases skeletal muscle expression of kynurenine aminotransferases, thus enhancing the conversion of kynurenine into kynurenic acid, a metabolite unable to cross the blood-brain barrier. Reducing plasma kynurenine protects the brain from stress-induced changes associated with depression and renders skeletal muscle-specific PGC-1α1 transgenic mice resistant to depression induced by chronic mild stress or direct kynurenine administration. This study opens therapeutic avenues for the treatment of depression by targeting the PGC-1α1-PPAR axis in skeletal muscle, without the need to cross the blood-brain barrier.

* * * * *

Exercise Is ADHD Medication

Physical movement improves mental focus, memory, and cognitive flexibility; new research shows just how critical it is to academic performance.

James Hamblin | Sept. 29 2014

 

Electrophysiological plots representing brain processing capacity and mental workload (P3 amplitude) during cognitive tasks that require executive control in children in the experiment and control groups. Red represents the greatest amplitude, and blue the lowest. (Hillman et al, Pediatrics/The Atlantic)

Mental exercises to build (or rebuild) attention span have shown promise recently as adjuncts or alternatives to amphetamines in addressing symptoms common to Attention Deficit Hyperactivity Disorder (ADHD). Building cognitive control, to be better able to focus on just one thing, or single-task, might involve regular practice with a specialized video game that reinforces "top-down" cognitive modulation, as was the case in a popular paper in Nature last year. Cool but still notional. More insipid but also more clearly critical to addressing what's being called the ADHD epidemic is plain old physical activity.

This morning the medical journal Pediatrics published research that found kids who took part in a regular physical activity program showed important enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, "demonstrate a causal effect of a physical program on executive control, and provide support for physical activity for improving childhood cognition and brain health." If it seems odd that this is something that still needs support, that's because it is odd, yes. Physical activity is clearly a high, high-yield investment for all kids, but especially those attentive or hyperactive. This brand of research is still published and written about as though it were a novel finding, in part because exercise programs for kids remain underfunded and underprioritized in many school curricula, even though exercise is clearly integral to maximizing the utility of time spent in class.

The improvements in this case came in executive control, which consists of inhibition (resisting distraction, maintaining focus), working memory, and cognitive flexibility (switching between tasks). The images above show the brain activity in the group of kids who did the program as opposed to the group that didn't. It's the kind of difference that's so dramatic it's a little unsettling. The study only lasted nine months, but when you're only seven years old, nine months is a long time to be sitting in class with a blue head. It may potentially be advisable to consider possibly implementing more exercise opportunities for kids.

Earlier this month, another study found that a 12-week exercise program improved math and reading test scores in all kids, but especially in those with signs of ADHD. (Executive functioning is impaired in ADHD, and tied to performance in math and reading.) Lead researcher Alan Smith, chair of the department of kinesiology at Michigan State, went out on no limb at all in a press statement at the time, saying, "Early studies suggest that physical activity can have a positive effect on children who suffer from ADHD."

Last year a very similar study in the Journal of Attention Disorders found that just 26 minutes of daily physical activity for eight weeks significantly allayed ADHD symptoms in grade-school kids. The modest conclusion of the study was that "physical activity shows promise for addressing ADHD symptoms in young children." The researchers went on to write that this finding should be "carefully explored with further studies."

"If physical activity is established as an effective intervention for ADHD," they continued, "it will also be important to address possible complementary effects of physical activity and existing treatment strategies ..." Which is a kind of phenomenal degree of reservation compared to the haste with which millions of kids have been introduced to amphetamines and other stimulants to address said ADHD. The number of prescriptions increased from 34.8 to 48.4 million between 2007 and 2011 alone. The pharmaceutical market around the disorder has grown to several billion dollars in recent years while school exercise initiatives have enjoyed no such spoils of entrepreneurialism. But, you know, once there is more research, it may potentially be advisable to consider possibly implementing more exercise opportunities for kids.

  

Children in the Illinois after-school physical activity program
(L. Brian Stauffer)

Over all, the pandemic of physical inactivity, as Hillman and colleagues put it in their Pediatrics journal article today, is "a serious threat to global health" responsible for around 10 percent of premature deaths from noncommincable diseases. But it clearly manifests in ways more subtle than deaths, including scholastic performance, which we're continuously learning. I talked last week with Paul Nystedt, an associate professor of economics and finance at Jönköping University in Sweden, who just published a multi-country study that found that obese teenagers go on to earn 18 percent less money as adults than their peers, even if they are no longer obese. He believes that's most likely because of the adversity that obese kids experience from classmates and teachers, which leads to both cognitive and noncognitive disparities between obese and non-obese kids. Because obese children are more likely to come from low-income homes to begin with, that only perpetuates wealth gaps and stifles mobility. Nystedt and his coauthors conclude, "The rapid increase in childhood and adolescent obesity could have long-lasting effects on the economic growth and productivity of nations."

John Ratey, an associate professor of psychiatry at Harvard, suggests that people think of exercise as medication for ADHD. Even very light physical activity improves mood and cognitive performance by triggering the brain to release dopamine and serotonin, similar to the way that stimulant medications like Adderall do. In a 2012 TED talk, Ratey argued that physical exercise "is really for our brains." He likened it to taking "a little bit of Prozac and a little bit of Ritalin." As a rule, I say never trust anyone who has given a TED talk. But maybe in this case that's a constructive way to think about moving one's body. But not the inverse, where taking Ritalin counts as exercise.

Hillman, CH, et al. (2014, Sep 29). Effects of the FITKids Randomized Controlled Trial on Executive Control and Brain Function. Pediatrics; doi: 10.1542/peds.2013-3219

* * *

Effects of the FITKids Randomized Controlled Trial on Executive Control and Brain Function

Charles H. Hillman, PhD, Matthew B. Pontifex, PhD, Darla M. Castelli, PhD, Naiman A. Khan, PhD, RD, Lauren B. Raine, BS, Mark R. Scudder, BS, Eric S. Drollette, BS, Robert D. Moore, MS, Chien-Ting Wu, PhD, and Keita Kamijo, PhD
Abstract

OBJECTIVE: To assess the effect of a physical activity (PA) intervention on brain and behavioral indices of executive control in preadolescent children.

METHODS: Two hundred twenty-one children (7–9 years) were randomly assigned to a 9-month afterschool PA program or a wait-list control. In addition to changes in fitness (maximal oxygen consumption), electrical activity in the brain (P3-ERP) and behavioral measures (accuracy, reaction time) of executive control were collected by using tasks that modulated attentional inhibition and cognitive flexibility.  

RESULTS: Fitness improved more among intervention participants from pretest to posttest compared with the wait-list control (1.3 mL/kg per minute, 95% confidence interval [CI]: 0.3 to 2.4; d = 0.34 for group difference in pre-to-post change score). Intervention participants exhibited greater improvements from pretest to posttest in inhibition (3.2%, 95% CI: 0.0 to 6.5; d = 0.27) and cognitive flexibility (4.8%, 95% CI: 1.1 to 8.4; d = 0.35 for group difference in pre-to-post change score) compared with control. Only the intervention group increased attentional resources from pretest to posttest during tasks requiring increased inhibition (1.4 µV, 95% CI: 0.3 to 2.6; d = 0.34) and cognitive flexibility (1.5 µV, 95% CI: 0.6 to 2.5; d = 0.43). Finally, improvements in brain function on the inhibition task (r = 0.22) and performance on the flexibility task correlated with intervention attendance (r = 0.24).  

CONCLUSIONS: The intervention enhanced cognitive performance and brain function during tasks requiring greater executive control. These findings demonstrate a causal effect of a PA program on executive control, and provide support for PA for improving childhood cognition and brain health.

Brain Science Podcast - "Go Wild" with Dr. John Ratey

Dr. John Ratey is the co-author, along with Richard Manning, of Go Wild: Free Your Body and Mind from the Afflictions of Civilization. This podcast originally appeared on Dr. Ginger Campbell's Books and Ideas podcast, where Dr. Ratey has been a guest a couple of times.

Here is the publisher's blurb from Amazon:

The scientific evidence behind why maintaining a lifestyle more like that of our ancestors will restore our health and well-being.

In GO WILD, Harvard Medical School Professor John Ratey, MD, and journalist Richard Manning reveal that although civilization has rapidly evolved, our bodies have not kept pace. This mismatch affects every area of our lives, from our general physical health to our emotional wellbeing. Investigating the power of living according to our genes in the areas of diet, exercise, sleep, nature, mindfulness and more, GO WILD examines how tapping into our core DNA combats modern disease and psychological afflictions, from Autism and Depression to Diabetes and Heart Disease. By focusing on the ways of the past, it is possible to secure a healthier and happier future, and GO WILD will show you how.

Good podcast.

"Go Wild" with Dr. John Ratey (podcast)

Ginger Campbell, MD
Monday, June 23, 2014


Richard Manning and John Ratey (click photo to play mp3)

Episode 55 of Books and Ideas is an interview with Dr. John Ratey, co-author of Go Wild: Free Your Body and Mind from the Afflictions of Civilization. There is considerable evidence that our hunter-gatherer ancestors were generally suprisingly healthy, so the purpose of this book and our conversation was to explore the scientific evidence supporting a return to a healthier lifestyle. We touch on diet, exercise, the role of sleep and even meditation. We also explore the importance of our relationship with nature and each other.

Listen to Episode 55 of Books and Ideas

Episode Transcript (Download PDF)



Since I have previously interviewed Dr. Ratey about his books Spark: The Revolutionary New Science of Exercise and the Brain (BSP 33) and Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood (BSP 45), I will be also be posting this episode in the Brain Science Podcast feed.

References:

• Spark: The Revolutionary New Science of Exercise and the Brain by Dr. John Ratey (BSP 33)
• Go Wild: Free Your Body and Mind from the Afflictions of Civilization by John J. Ratey and Richard Manning
• Mindfulness by Ellen J Langer
• Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health by Gary Taubes (Audible Link)
• Why We Get Fat: And What to Do About It by Gary Taubes (Audible link)

Additional references are available in the Free Episode Transcript. 

Announcements:

• This episode of Books and Ideas will appear in the Brain Science Podcast feed tomorrow. The next episode of the Brain Science Podcast will be posted in late July.
• Since I am starting a Fellowship in Palliative Care Medicine next month I am not sure when I will publish another episode of Books and Ideas, but I do plan a future episode about Palliative Care.
• I am speaking at The Amazing Meeting next month in Las Vegas. Check the schedule for the exact time and be sure to drop me an email if you are going to be there.
• I also plan to attend Podcast Movement 2014 which is being held in Dallas in August.

Share Your Feedback:

• Join the conversation in our Group on Goodreads
• Post to the Books and Ideas Facebook Fan Page or Google+
• Send me feedback at docartemis@gmail.com.

This is wonderful to see, finally - even if it is less than honest about the existing evidence for lifestyle interventions to affect depression levels. Drugs for depression are not treating the depression, they are creating an effect of feeling better through making people, for lack of a better word, stoned.

I have seen, firsthand, a client start walking 3-5 days a week (exercise and nature/environment), begin practicing contemplative prayer (meditation), spend more time with her dog (animal therapy - goes on the walk, then fetch in the park), and start spending less time at home by joining church activities and spending time with her kids and granddaughter (socializing). These synergy of these simple changes have been more effective than years of medications and various attempts at therapy.

Lifestyle medicine for depression

Jerome Sarris, Adrienne O'Neil, Carolyn E Coulson, Isaac Schweitzer, and Michael Berk
Author Affiliations | For all author emails, please log on.

Published: 10 April 2014

Abstract (provisional)

The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. "Lifestyle Medicine" provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Full Citation:
Sarris, J, O'Neil, A, Coulson, CE, Schweitzer, I, and Berk, M. (2014, Apr 10). Lifestyle medicine for depression. BMC Psychiatry, 14:107 doi:10.1186/1471-244X-14-107

Introduction

While modernity has provided multiple technological and medical advances including increased life-expectancy, it has come at a cost, in that a range of lifestyle issues are now negatively affecting our mental health [1]. As Hidaka [1] and Walsh [2] comment, in Western society people are increasingly becoming more sedentary and eating a poorer diet than previous generations. This, in combination with sleep/wake cycle pressures, substance misuse, and psychosocial factors such as more competition and time pressure, social isolation and less intimate engagement with the family unit, may exert a cost on mental health. Further, the combination of stress, fatigue, inactivity, and sleep deficiency in people who are “timepoor”, may advance obesity, and this in turn may promote a sedentary life with potential for resultant depression.

Due to the afore-mentioned challenges of modern urbanity, there is now the need to consider a “Lifestyle Medicine” approach for the potential prevention, promotion and management of depression. While medication and psychological interventions are first-line treatments for depression, Lifestyle Medicine offers a potentially safe and low-cost option for augmenting the management of the condition. While the evidence base remains patchy, many lifestyle or environmental factors are mutable and can provide the basis of practical interventions for the management of depression (summarised in Table 1). Lifestyle Medicine involves the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing, adding a therapeutic and potentially preventative approach to illness [3]. This may involve modification of: diet; physical activity and exercise; relaxation and sleep-wake cycles; recreation and work-rest balance; and minimisation/avoidance of smoking, alcohol or illicit substances, in addition to the use of mindfulness-based meditation techniques [2]. Although the evidence base remains in its infancy, environmental issues are also considerations, such as reducing exposure to pollution (air, water, noise, and chemicals) and increasing time spent in nature, and are areas of current investigation. Activity scheduling such as encouraging engagement in meaningful activities and adequate social contact [1] is additionally of value. Further, Lifestyle Medicine may involve the application of clinical psychological techniques, insofar as motivational and behavioural factors are intrinsic to people trying to embrace lifestyle changes [3].

Table 1 Lifestyle Medicine for Depression

Lifestyle element................Evidence level....................Cost
Diet............................................CS, LO.................Moderate expense 
PA/Exercise..........................CS*, LO*, CTs ...............Inexpensive 
Recreation.................................OB, CTs..................Variable expense 
Relaxation/Meditation.................CTs..........................Inexpensive
Sleep......................................CS, LO, CTs...................No expense 
Environment..........................CS, LO, CTs...........Potentially not adjustable 
Socialization..............................CS, LO.........................No expense 
Animal/Pet therapy....................CS, CTs.....................Moderate expense 
Vices (smoking/alcohol)............CS, LO.................Potential to save money

CS = Cross-sectional, OB = Observational Study, LO = Longitudinal, CTs - Clinical Trials, NAT = Nature-Assisted Therapy, PA = Physical Activity. 
*Data assessing the relationship between exercise and depression has revealed mixed outcomes.

Comments on each Lifestyle Element:

Diet - Relationship found between dietary quality and depression; RCTs now required to validate
PA/Exercise - Strong evidence of efficacy for improving mood
Recreation - No studies exploring recreational activities for depression (aside from music therapy)
Relaxation & Meditation - Evidence supports relaxation techniques (especially with a mindfulness component) in improving mood
Sleep - Strong causal link between sleep amount and quality, and depression risk
Environment - Association between reduction of pollution and mood; CTs showing NAT improves mood
Socialization - Strong association between social support/networks and mental health
Animal/Pet therapy - Studies support the psychological benefits of animals and pets
Vices (smoking, alcohol) - Association between smoking and alcohol, and depressed mood

While lifestyle modification has been recognised by practitioners for centuries as a means by which to improve health outcomes, the field of “Lifestyle Medicine,” particularly in the context of mental health, is a relatively new field. While papers have discussed its broader application on health and in particular prevention of chronic disease and cardiovascular/metabolic conditions, little attention has been given to its application for mental health, and in particular depression, which is predicted to be the predominant cause of disability in the developed world [4], and is being argued as one of the prevalent noncommunicable disorders [5]. Some studies show that patients with sub-threshold depression rate lifestyle or psychosocial approaches as strategies that are most helpful in improving their mood [6], while patients with clinical depression have rated exercise as the most effective intervention [7].

There is a heuristic theoretical framework explaining why the modern lifestyle may be impacting mental health. Obesity [8], poor diet [9], poor/decreased sleep [10], exposure to chemicals and pollutants [11], and high stress levels [12], may potentially disrupt the hypothalamic pituitary adrenal axis, increase cortisol and increase low-grade systemic inflammation and oxidative stress. Both neuroendocrine disruption and inflammation have been linked to the aetiology of depression [13,14]. Specifically, increased levels of proinflammatory cytokines, interferon gamma and neopterin, reactive oxygen and nitrogen species and damage by oxidative and nitrosative stress, in combination with lowered levels of antioxidants, may potentially damage mitochondria and mitochondrial DNA; this may result in neurodegeneration and reduced neurogenesis [14].

This opinion paper aims to provide a context for Lifestyle Medicine by providing an overview of the lifestyle factors that are linked with depression risk before exploring the evidence and clinical application of modifying these elements. The paper firstly explores data for which there is sound evidentiary support (diet, physical activity and exercise, mindfulness meditation, management of recreational substance misuse, sleep, and social interaction), and then touches on lifestyle and environmental elements that have nascent data and are subject to confirmatory investigation (greenspace and pollutant exposure, hobbies and relaxation, and animal/pet therapy).

Read the whole article.

Forbes, of all places, posted a nice summary of their ten picks for the top brain science and psychology studies for 2013 - most of these I had seen, a few I hadn't, so it's a good read (with lots of links for further exploration). David DiSalvo also posted a list of 10 issues neuroscience needs to deal with in the next year (or ten), which I will post tomorrow.

The Top Ten Brain Science And Psychology Studies Of 2013

David DiSalvo, Contributor

fMRI scanner at a neuroscience lab (Photo credit: Wikipedia)
Putting it mildly, 2013 was an eventful year for brain science. This Top 10 list isn’t meant to be exhaustive (given how many studies are published each year, it never could be), but it’s a sturdy sampling of incredible work being conducted around the world, moving us closer to solving some extremely vexing puzzles about brains and behavior.

1. How the Brain Takes Out Its Trash While We Sleep

In 2013, layers were peeled back from two interrelated mysteries: the function of sleep, and how the brain removes its waste byproducts.

While it’s been known for some time that the brain doesn’t directly use the body’s lymphatic system (our body-wide filtering and waste removal system) to dump its toxic waste, the mechanism that it does use wasn’t identified until 2012. The research team that made this discovery was led by University of Rochester neurosurgeon, Maiken Nedergaard, who dubbed the brain’s waste-removal mechanism the “glymphatic system.”

The glymphatic system relies on cerebrospinal fluid (CSF) to flush out neurotoxins via pathways separate from the lymphatic system. Among the toxins that are flushed is beta amyloid, a protein that’s found in clumps in the brains of Alzheimer’s sufferers.

In 2013, Nedergaard’s research team followed up on this discovery by identifying “hidden caves” that open in the brain while we sleep, allowing cerebrospinal fluid to flush out neurotoxins through the spinal column.

The implications of this research can’t be overstated: failing to get enough sleep isn’t just a bad idea for all of the reasons we already know, but over time it could also lead to neurological disorders like Alzheimer’s. If the study’s findings are accurate, our brains need sleep to remove waste byproducts like amyloid beta that eventually become brain killers.

The study was published in the journal, Science.

2. To Your Brain, Me is We

A 2013 study from University of Virginia researchers supports a finding that’s been gaining science-fueled momentum in recent years: the human brain is wired to connect with others so strongly that it experiences what they experience as if it’s happening to us.

The researchers had participants undergo fMRI brain scans while threatening to give them electrical shocks, or to give shocks to a stranger or a friend. Results showed that regions of the brain responsible for threat response – the anterior insula, putamen and supramarginal gyrus – became active under threat of shock to the self; that much was expected.

When researchers threatened to shock a stranger, those same brain regions showed virtually no activity. But when they threatened to shock a friend, the brain regions showed activity nearly identical to that displayed when the participant was threatened.

“The correlation between self and friend was remarkably similar,” said James Coan, a psychology professor in U.Va.’s College of Arts & Sciences who co-authored the study. “The finding shows the brain’s remarkable capacity to model self to others; that people close to us become a part of ourselves, and that is not just metaphor or poetry, it’s very real.”

The study was published in the journal, Social Cognitive and Affective Neuroscience.

3. Your Brain Sees Even When You Don’t

A 2013 study published in The Journal of Neuroscience suggests that the brain can “see” someone else’s actions even when the ability to visually see has been destroyed.

Cortical blindness refers to the loss of vision that occurs when the primary visual cortex no longer functions, generally as the result of injury. There’s no longer an ability to visually perceive the world in the sense with which we’re most familiar (even though the eyes still technically work), but that doesn’t necessarily mean the brain no longer sees.

In this study a patient with full cortical blindness could still react to another person’s gaze. While in an fMRI machine, the patient was exposed to gazes directed at him and gazes directed away from him. On the face of it, neither should matter — his visual cortex couldn’t perceive any sort of gaze. But the brain scan indicated that another part of his brain definitely could.

The patient’s amygdala, the brain area associated with figuring out whether external stimuli is a threat, showed a distinctly different activation pattern when the gaze was directed at the patient than when directed away from him.

In other words, it didn’t matter that his visual cortex couldn’t catch the gaze—another part of his brain did regardless, and that’s quite incredible.

4. Yes, Stress Really Does Feed Cancer

For years we’ve heard that there’s a mind-body connection between stress and cancer. The claim is anecdotal, but has a certain horse sense that appeals to reason – stress is hard on the body, causing hormonal reactions that can potentially influence the development of cancerous cells.

A 2013 study didn’t quite prove the claim, but did indicate that once cancer has taken hold, stress biochemically feeds its growth. The study, by researchers at Wake Forest Baptist Medical Center, focused on the effects of stress on prostate cancer, and found that stress can both reduce the effectiveness of prostate cancer drugs and accelerate the development of the cancer.

The study team, headed by George Kulik, D.V.M., Ph.D., associate professor of cancer biology, tested the effects of behavioral stress in two different mouse models of prostate cancer.

One model used mice that were implanted with human prostate cancer cells and treated with a drug that is currently in clinical trial for prostate cancer treatment. When the mice were kept calm and free of stress, the drug destroyed prostate cancer cells and inhibited tumor growth. However, when the mice were stressed, the cancer cells didn’t die and the drug did not inhibit tumor growth.

In the second model, mice genetically modified to develop prostate cancer were used. When these mice were repeatedly stressed, the size of prostate tumors increased. When the mice were treated with bicalutamide, a drug currently used to treat prostate cancer, their prostate tumors decreased in size. However, if mice were subjected to repeated stress, the prostate tumors didn’t respond as well to the drug.

After analyzing the data, researchers identified the cell signaling pathway by which epinephrine, a hormone also known as adrenaline–triggered at high levels during times of stress–sets off the cellular chain reaction that controls cell death.

“Considering that prostate cancer diagnosis increases stress and anxiety levels, stress-induced activation of the signaling pathway that turns off the cell death process may lead to a vicious cycle of stress and cancer progression,” Kulik said.

The findings were published in the Journal of Clinical Investigation.

5. Move Over Extroverts and Introverts, Here Come the Ambiverts

In the psychology of personality category, a 2013 study overturned yet another personality stereotype that’s gone virtually unquestioned for decades: that extroverts are inherently better sellers than everyone else.

The study, published in the journal Psychological Science, indicates that not only is that stereotype wrong, but there’s an entirely different personality type that stands well above the others in sales prowess.

The study was conducted by researcher Adam Grant of The Wharton School of the University of Pennsylvania, also author of the book Give and Take: A Revolutionary Approach to Success. Grant predicted that extroverts, contrary to popular lore, would not bury other personality types when it came to closing sales — but rather, ambiverts, people who are more or less equal parts extroverted and introverted, would perform best.

Grant conducted a personality survey and collected three-months of sales records for more than 300 salespeople, both men and women. As he predicted, people whose scores put them in between extreme extroversion and introversion turned out to be the best salespeople. In a three-month period, they made 24% more in sales revenue than introverts, and 32% more in revenue than extroverts.

Perhaps even more surprising, Grant found that the two extreme personality types pulled in roughly the same percentage of sales. Being highly extroverted wasn’t even a plus when compared against the personality type we generally think of as the worst candidate for high-performance sales.

Because ambiverts embody traits from both sides of the personality spectrum—in a sense, they have a built in ‘governor’ that regulates their exuberance–they don’t trip over the obstacles that handicap their more extroverted counterparts.

“The ambivert advantage stems from the tendency to be assertive and enthusiastic enough to persuade and close, but at the same time, listening carefully to customers and avoiding the appearance of being overly confident or excited,” Grant said.

6. Mini Brains Created With Stem Cells

This past year also saw some groundbreaking news in the stem-cell category of neuroscience: for the first time, scientists grew miniature human brains from stem cells, reported Reuters Health. The implications of this development are massive, not the least of which is eventually understanding the inner workings of severe neurological disorders and how to defeat them.

The researchers started with human stem cells—the often-controversial, undifferentiated (or “blank”) human cells that are capable of giving rise to a host of differentiated cells—and cultured them into “cerebral organoids” (more simply, “mini brains”). Stem cells have been used to grow a variety of organ tissue—including a liver and a trachea—but never before has brain tissue with multiple, distinct parts been created in a lab.

According to the Reuters report, Juergen Knoblish and Madeline Lancaster at Austria’s Institute of Molecular Biotechnology and fellow researchers at Britain’s Edinburgh University of Human Genetics cultured the stem cells with a cocktail of nutrients, and grew tissue called neuroectoderm – a layer of cells in the embryo from which all parts of the brain and nervous system develop.

This tissue was then placed into a spinning bioreactor that circulates oxygen and nutrients, catalyzing the eventual growth of cerebral organoids. After one month, the tissue had organized itself into basic developing brain regions, including the retina and cerebral cortex. At two months, the tiny organoids—about 4 millimeters long—contained firing neurons and identifiably different types of neural tissue. The scientists had created tiny, primitive human brains.

To demonstrate the usefulness of their discovery, the researchers used the organoids to model the development of a rare neurological condition called microcephaly—in which patients develop an abnormally small head. By modeling the condition in a lab, researchers can reverse engineer it and find out why it develops.

The research team acknowledged that they had not created a full-scale, fully functioning human brain, and that doing so is a long way off, but they said they had accomplished their initial goal—to “analyze the development of human brain tissue and generate a model system…to transfer knowledge from animal models to a human setting.”

Source: Scientists Grow “Mini Human Brains” From Stem Cells; Reuters.

7. How Exercise Makes Your Brain Grow

Research into “neurogenesis”—the ability of certain brain areas to grow new brain cells—took an exciting turn in 2013. A study published in the journal Cell Metabolism suggests that not only can we foster new brain cell growth through exercise, but it may eventually be possible to “bottle” that benefit in prescription medication.

The hippocampus, a brain area closely linked to learning and memory, is especially receptive to new neuron growth in response to endurance exercise. Exactly how and why this happens wasn’t well understood until recently. Research has discovered that exercise stimulates the production of a protein called FNDC5 that is released into the bloodstream while we’re breaking a sweat. Over time, FNDC5 stimulates the production of another protein in the brain called Brain Derived Neurotrophic Factor (BDNF), which in turns stimulates the growth of new nerves and synapses – the connection points between nerves – and also preserves the survival of existing brain cells.

What this boils down to in practice is that regular endurance exercise, like jogging, strengthens and grows your brain. In particular, your memory and ability to learn get a boost from hitting the pavement. Along with the other well-established benefits of endurance exercise, such as improved heart health, this is a pretty good reason to get moving. If jogging isn’t your thing, there’s a multitude of other ways to trigger the endurance effect – even brisk walking on a regular basis yields brain benefits.

Researchers from the Dana-Farber Cancer Institute at Harvard Medical School (HMS) have also discovered that it may be possible to capture these benefits in a pill. The same protein that stimulates brain growth via exercise could potentially be bottled and given to patients experiencing cognitive decline, including those in the beginning stages of Alzheimer’s and Parkinson’s.

“What is exciting is that a natural substance can be given in the bloodstream that can mimic some of the effects of endurance exercise on the brain,” said Bruce Spiegelman, PhD, of Dana-Farber and HMS and co-senior author of the research report with Michael E. Greenberg, PhD, chair of neurobiology at HMS.

8. Electrical Stimulation Helps the Brain Put On the Brakes

In the “exciting but frightening” category, research published in the The Journal of Neuroscience showed that harmless electrical stimulation can boost self-control by amplifying the human brain’s “brakes.”

Researchers from The University of Texas Health Science Center at Houston (UTHealth) and the University of California, San Diego asked study participants to perform simple tasks in which they had to exert self-control to slow down their behavior. While doing so, the team used brain imaging to identify the areas of the participants’ prefrontal cortex (sometimes called the brain’s “command and control center”) associated with the behavior—allowing them to pinpoint the specific brain area that would need a boost to make each participant’s “braking” ability more effective.

They then placed electrodes on the surface of the participants’ brains associated with the prefrontal cortex areas linked with the behavior. With an imperceptible, computer-controlled electrical charge, researchers were able to enhance self-control at the exact time the participants needed it.

“There is a circuit in the brain for inhibiting or braking responses,” said Nitin Tandon, M.D., the study’s senior author and associate professor in The Vivian L. Smith Department of Neurosurgery at the UTHealth Medical School. “We believe we are the first to show that we can enhance this braking system with brain stimulation.”

Though this research conjures a few frightening visions, you can relax knowing that we’re a long way from externally controlling peoples’ behavior. The true value of this study is to demonstrate that the brain’s self-control circuit can be amplified, at least under certain conditions–and eventually that could be good news for sufferers of behavioral disorders like OCD and Tourette Syndrome.

9. Tool That Seeks Consciousness in the Brain

An experimental tool designed in 2013 to “peek” into a patient’s brain and find signs of consciousness could eventually give doctors a way to more accurately judge chances of recovery from serious brain trauma – and in the process change the nature of end-of-life decisions.

Until now, doctors don’t have many methods available to gauge the consciousness of a patient unable to respond verbally or in other subtle ways in response to simple questions–such as blinking an eye, squeezing a hand, or raising a finger. In these cases, typically when a patient has suffered a severe brain injury, there’s ample guesswork that goes into determining whether consciousness is still lingering under the surface.

The best clinical method available to get closer to an answer involves placing the patient in an MRI machine and scanning the brain while telling the patient to envision an action like throwing a ball or running through a field. By tracking activity patterns in the patient’s brain, it’s theoretically possible to tell if the person is able to unconsciously acknowledge and process the request. If it appears that the patient’s brain can respond even though the patient can’t verbalize the response, the person is said to suffer from “locked-in syndrome”.

The problem with this method is that it’s far from clear what the brain activity is actually revealing about consciousness. Significant brain activity is possible even in a vegetative state, and isn’t necessarily a clue that recovery is possible.

Since consciousness is spread across multiple brain regions, it’s possible for one part of the brain to respond while others are entirely unresponsive. One way to think about this is the starter on a damaged car engine still working even though gas can’t reach the engine; a minimal “signal” from the starter is produced by turning the key, even though the engine can’t run.

The new tool, developed by researchers from Italy’s University of Milan, could provide doctors with a more objective method that gauges the complexity of a patient’s consciousness. The tool combines three steps: first a magnetic pulse is sent through a coil into the brain designed to “wake it up,” and then an EEG machine measures brain wave activity produced by neurons firing in response to the pulse. Finally, the activity is measured via a formula that puts a finer point on the nature of the patient’s consciousness.

That final step is the secret ingredient that makes this tool different: instead of simply trying to identify brain activity (something MRI machines can already do) it produces a measure of the complexity of consciousness–what the researchers call the perturbational complexity index (PCI). “Consciousness can grow and shrink,” said Dr. Marcello Massimini, a neurophysiologist who led the research, in an AP report about the experimental tool. By figuring out the level of “growing” or “shrinking”, doctors can more objectively gauge whether a patient is exhibiting an adequate level of consciousness to recover.

The researchers emphasized that the tool is far from becoming a bedside medical option, but the research opens the door to measuring levels of consciousness that correlate with recovery from serious brain injury. This knowledge could potentially change the way end-of-life decisions are made by providing doctors and loved ones with a firmer means to evaluate whether a patient has the capacity to recover.

The study was published in the journal, Science Translational Medicine.

10. The Antidepressant Sweet Spot for Coffee Drinkers

Coffee research is a crap shoot at best – every year new studies come out suggesting benefits and drawbacks of our favorite morning companion. But in 2013, researchers from the Harvard School of Public Health made an especially significant contribution to coffee research that found a correlation between drinking 2-4 cups of caffeinated coffee each day and lower suicide risk among adults.

The study, published in The World Journal of Biological Psychiatry, was a meta-review of three extensive U.S. health studies that included a total of 43,599 men and 164,825 women. Consumption of caffeine (from tea, soda and chocolate), coffee and decaffeinated coffee was evaluated among study participants every four years via questionnaire. Across all three studies, coffee accounted for the majority of caffeine consumed at 71% of the total.

Causes of death were tracked during the study period by reviewing death certificates; 277 deaths were the result of suicide.

The analysis showed that the risk of suicide among adults drinking 2-4 cups of coffee (the equivalent of about 400 mg of caffeine) a day was 50% less than the risk for adults who drank decaffeinated coffee or one cup or less of caffeinated coffee. Drinking more than 4 cups of coffee wasn’t associated with lower suicide risk.

The neurochemistry behind the finding makes sense. As discussed in a previous article, caffeine acts as an expert mimic of a chemical called adenosine in the brain and other parts of the body. Adenosine is a sort of checks-and-balances chemical produced by neurons as they fire throughout the day; the more adenosine is produced, the more the nervous system ratchets down activity, until we eventually fall asleep and reboot the process.

By mimicking adenosine, caffeine blocks receptors in the nervous system from receiving the signals to decrease energy expenditure. When that happens, levels of the brain’s homegrown neuro-stimulants—dopamine and glutamate—increase, and we experience the brain stimulating effects associated with drinking a big cup of java. Those effects may be a potent counterbalance to depression for a segment of the coffee-drinking population.

Have more studies you’d like to add to this list or comments on any of those above? Please put them in the comments section for all to see. Thanks!

You can find David DiSalvo on Twitter @neuronarrative and at his website, The Daily Brain. His latest book is Brain Changer: How Harnessing Your Brain’s Power To Adapt Can Change Your Life.

The Year in Fitness and Nutrition

A lot of blogs and websites are doing their year in review pieces as we approach the beginning of 2014. Here are a few that have popped up on my radar.

From Pop Sugar:

The Headlines That Helped Us Drop Pounds in 2013

by Leta Shy December 26, 2013

Another year, another 365 days to unlock the secrets to sustainable weight loss — and in 2013, researchers did not disappoint. From finding the best time to eat a big meal to finding yet another reason to chow down on chocolate, here are the most interesting weight-loss news stories of the year!
 

1. More Sleep Decreases Junk-Food Cravings

We've been learning more and more about just how important sleep is for our waistlines; this year, researchers showed that lack of sleep can actually change how we respond to junk food. When sleep-deprived participants were shown photos of fatty foods like pizza and doughnuts, the reward centers in their brains lit up much more than those who had gotten enough sleep — proving that when you're sleep deprived, you're more likely to make less-than-optimal diet choices than when you're well rested.
 

2. Dark Chocolate Blocks Fat

Last year, it was red wine, and this year it's even more good news: a new study found that dark-chocolate eaters who ate more calories than non dark chocolate eaters still had lower BMIs. The study suggests that an antioxidant found in dark chocolate, epicatechin, may block your body's absorption of fats and sugars.
 

3. Eat More Protein, Lose More Weight

A small study published in September found that the optimal amount of protein for those trying to lose weight may be more than the recommended daily allowance (RDA) set by the Food and Drug Administration. Researchers put patients on specific diets that differed in protein — groups either ate the RDA of protein, double that amount, or triple that amount. Those who ate double the RDA of protein lost more fat than muscle, which is important for keeping metabolism levels up when you are trying to lose weight.
 

4. A Well-Timed Big Lunch Is Key

If you find it hard to schedule a midday meal break during your hectic work day, listen up: a recent study found that late lunchers (those who ate after 3 p.m.) ended up weighing more than those who ate a big lunch earlier. The study also found that late lunchers were more likely to skip breakfast — also a no-no if you're trying to drop pounds. Since the Spanish participants ate their biggest meal at lunch, the study also suggests that front-loading your filling meals during the day can be beneficial for your waistline.
 

5. Start With Exercise

Losing weight requires dedication to both a healthy diet and a consistent workout routine, but if you can't quite fit both into your schedule, start with exercise first, according to a study published earlier this year. The researchers tracked inactive participants as they either started a new diet and exercise routine at the same time, started a new exercise routine followed by a new diet later on, or started a new diet followed by an exercise routine later on. While the diet-and-exercise group fared the best, the study found that those who established a workout routine first (before dealing with their diet) were more successful at sticking to both a workout routine and healthy eating plan later on — which meant more weight loss in the long run.

Source: Thinkstock

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Here are links to several useful articles from The Daily Beast:

Study: Exercise Could Be The Key to Mitigating the Christmas Weight Damage

Take away: regular exercise can help mitigate the effects of short-term overfeeding and inactivity, regardless of energy balance. Caveat: They studied young men, and the results may be different for women and for older adults (whose metabolism slows as they age).


Wheat Threatens All Humans, New Research Shows


Take away: Wheat is capable of producing 23,000 different proteins, and while 1 in 16 people seem to be intolerant to gluten, it is the other 22,999 proteins that may be the real issue, particularly wheat germ agglutinin (WGA), which is technically a lectin. WGA binds to gut proteins quite readily, which may leave these cells less well protected against the harmful effects of the gut contents.


These Are The 15 Supplements to Keep In Your Medicine Cabinet

By Ari Meisel
December 28th 2013
More Stories by Ari Meisel

As evidence mounts that multivitamins provide no nutritional benefit, it’s time to forget the ‘daily dose.’ Instead, turn to these 15 supplements and think of your medicine cabinet as your toolbox, taking only what you need.

A lot of people start their days by popping a multivitamin.

Unfortunately, there’s more than enough evidence to show that these “multis” provide absolutely no nutritional benefit. There’s even compelling research that shows they can even do harm to your body. It’s also very confusing since every supplement has different ratios of various vitamins which don’t take into account an individual’s diet or biological makeup. They tend to contain fillers like magnesium stearate, which you might think is a form of the mineral magnesium, when in fact it is an industrial lubricant, meant to keep the pills from sticking to machinery (and has been shown to reduce immune function).

Truth it, there are very few supplements that you should be taking every day.

In fact, when you see RDA values for various vitamins and minerals on a package, you might think that stands for Recommended Daily Amounts, when in actuality, its Recommended Dietary Amounts.

So if you want to take supplements, you need to think of your medicine cabinet as a toolbox, where you use what you need, when you need it, and throw out the idea of a daily dose.

These are the 15 “tools” I keep in my cabinet and what I use them for:

1. Probiotics—A lot of diseases of the industrialized worlds (like my personal favorite, Crohn’s Disease) are thought to be a result of our hyperclean environment with hand sanitizer stations around every corner. Probiotics are the beneficial bacteria that help regulate our digestion, strengthen our immune system and maintain sanity. Unless you are eating fermented foods like sauerkraut, natto, or kefir on a daily basis you should take a probiotic most days and double if you are taking antibiotics.

2. Vitamin D3—Most of you reading this are probably vitamin D deficient if you wear clothes and work indoors. In addition, if you’re diet doesn’t contain adequate amounts of fat then you won’t be able to properly process vitamin D (as well as A, E and K). Most people should be taking around 5,000 IU per day unless you get to spend a good amount of time outside and in the sun. Even those people should take some during the winter months. One more thing, take it in the morning otherwise it can disrupt your sleep since vitamin D and melatonin are inversely related.

3. Krill Oil - Krill Oil, like fish oils can help fight inflammation and lower cholesterol. In tests Krill seems to be better absorbed by the body so you’ll tend to get more bang for your buck and added benefits such as blood sugar regulation and even possible fat loss.

4. Astaxanthin—The red pigment in salmon and a major skin protectant thought to aid in eye health and inflammation, I take this carotenoid mostly in the winter months when my skin tends to get dryer as the lips in Astaxanthin appear to help maintain elasticity.

5. Phenocane—Nature’s Tylenol, Phenocane’s main ingredient is Curcurmin with a couple added friends that make this an incredibly powerful anti inflammatory and pain killer.

6. Oil of Oregano Capsules—Oil of Oregano (different plant from the stuff on your pizza) contains Carvacrol, an incredibly potent bacteria killer. I take this anytime I travel, am exposed to people I know are sick, or feel a cold coming on.

7. Oil of Oregano Liquid—in liquid form this stuff is really powerful and will burn a little but a couple drops in a glass of water gargled for a minute will stop a sore throat or sinus infection dead in its tracks.

8. Goat Colostrum—colostrum is the first two or three days of breast milk and contain the building blocks for a strong immune system and health body. Goats milk is the closest equivalent to human breast milk and I always take these in combination with oil of oregano capsules.

9. Xylitol Nasal Spray - xylitol is a sugar alcohol and has antibacterial properties. As a nasal spray it keeps the passages moist and bacteria free, ideal for travel or ducted heating systems.

10. MCT Oil - Medium Chain Triglycerides are the fat transport mechanisms you get when you put coconut oil in a centrifuge. It’s an odorless, tasteless oil that provides an immediate source of ketones (fat energy) to you blood stream and will actually help your cognitive function. I use it in salad dressings or yogurt when I want to up the fat content without adding any taste. If I’ve had a rough night with the kids I’ll add it along with so we grass fed butter to my coffee for a nice cup of Bulletproof Coffee(TM).

11. Digestech—We have different enzymes to help us digest fats, carbs, and protein. Digestech capsules contain those and then some. They help me digest large meals and extract more nutrition from the foods I eat.

12. Activated Charcoal Capsules—sometimes you eat or drink something and wish you Hsn. Don’t panic about the toxins mounting an attack against your body. Just pop a couple capsules of activated charcoal and let natures Brita filter (which actually contains charcoal) trap those toxins and take them out of your body.

13. Alpha Brain - Nootropics are substances which increase cognitive performance. On the pharmaceutical side think Adderall or Modafinil. I’m not one for taking drugs so I turn to Alpha Brain, which contains 11 natural, well studied compounds that will increase focus and memory while offering neuroprotective anti stressors. You can use this daily but I use it when I know I’ve got a big day or meetings or a client engagement ahead of me to help me break through some inner barriers. This won’t turn you into an Einstein, but if you know the answer to the question is inside you somewhere, this might help you find it.

14. Collagen and Whey Protein Powder—Unless you are a bodybuilder or trying to experiment with eating only specific amounts of protein, most people do not need to supplement with protein. Sometimes I’ll do a protein fast for a day or two where I’m limiting protein to 50 grams or less and the easiest way to do that is to eat a whole bunch of veggies and then have a serving of protein power. The two forms are pretty similar but the nice added benefit of collagen powder is that it’s heat stable so you can add it to your coffee if you want.

15. Greens Powder - I try to eat lots of dark leafy greens in my diets but somedays are more difficult than others. A green powder mix like Powerfood from Onnit acts like a dietary insurance policy and gives me things I might never get otherwise like camu for antioxidants or olive leaf for internal cleansing.

That’s what I use—but how about you? Tell me what supplements are in your medicine cabinet in the comments below.

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From the Today Show:

Fitness fails: Workouts you need to stop doing in 2014

Take home: Pole dancing, stiletto workouts, gas mask training, backward running, stability ball stands, and yes, even Tough Mudder and warrior dash all need to go according to this piece. 

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Another article from the Daily Beast:

The Busy Person’s Guide to Becoming a Fitness Minimalist
By DailyBurn
December 27th 2013

by Joe Vennare for Life by DailyBurn

Imagine a workout that can be done anywhere, anytime. This routine doesn’t require any equipment. There’s no instructor and no membership dues. Better still, completing this workout wouldn’t take all day. Heck, it wouldn’t even take up an entire lunch break.

What if this workout existed?

Well, it does. Call it the Rise of the Fitness Minimalist, or the realization that short, high-intensity workouts (even just seven minutes in length) might be better than slogging through longer exercise sessions. In fact, research shows that 20 to 30 minutes of high-intensity interval training can produce the same aerobic and anaerobic benefits as steady-state cardio workouts twice as long. Stripping away the excess and upping the intensity has also been shown to improve cardiovascular endurance and burn fat—not to mention boost the “afterburn effect.”

Do More With Less

Ready to opt for efficiency over exercise machines while saving precious time in the process? Try these simple strategies to skip the false starts and time-sucks, and start connecting with your inner fitness minimalist.

1. Keep it simple. Sometimes all you need is your own bodyweight to get great results. This workout, created by researchers at the Human Performance Institute in Orlando, Florida takes seven minutes to complete and only uses 12 bodyweight exercises, a wall and a chair. The result: a quick, high-intensity form of circuit training focused on building strength while burning maximum calories. (And who doesn’t love push-ups, wall-sits and high knees?)

2. Up the intensity. When it comes to exercise, we all know something is better than nothing. But when you’re short on time, the trick is thinking about exercise in terms of effort. So while another slow jog around the neighborhood might seem pretty tough, it’s by no means the fastest way to make progress, research suggests. Cram as much intensity into brief workouts as possible by supersetting burpees, mountain climbers or jump squats in between exercises. And if you need an extra push, take the Inferno challenge for a high-internsity program that’s available ’round the clock.

3. Set a timer. When time is short supply, rest periods should be, too (ideally kept to 30 seconds or less). Try this: Set a timer to reflect the length of the workout. Let’s pretend that’s 15 minutes. Now, create a circuit of three to five exercises. Then, start the clock and complete the circuit for as many rounds as possible (AMRAP) in 15 minutes. Of course, never compromise quality over quantity, but by the end of these workouts you should feel sufficiently spent.

4. Watch the clock. Another technique that utilizes the timer is the Tabata protocol. This interval workout only requires four minutes to complete, but can be repeated as part of a 15 or 20-minute routine. Start by selecting an exercise (think burpees, kettlebell swings or thrusters). Then, perform that move for 20 seconds, followed by 10 seconds of rest. Repeat that work-rest routine for eight rounds, clocking in at four minutes flat. On paper it might not seem like much, but these short, intense intervals have been shown to improve athletic capacity, conditioning and fat burning in less time than longer, less intense workouts. Need more guidance? Try these Tabata workouts.

5. Go all out. Jogging is a great way to get moving and stay healthy. But, since we’re aiming for greater results in less time, sprinting is better—specifically HIIT workouts, which alternate between periods of all-out effort and brief recovery. So grab that timer we’ve been using and set it for 60 seconds. Then, sprint, swim, bike, or row all-out for that minute. Take 60 to 90 seconds to rest before repeating at max effort again.

Stick with the Essentials

A great workout requires very few bells and whistles (sometimes none at all). But when the time comes to move beyond bodyweight training, mixing in the right tools can help take your training to new heights. Fitness minimalist and trainer Al Kavadlo, CSCS, recommends picking up a few pieces of versatile exercise equipment (check out what he can do with just a pull-up bar), and using movements like pull-ups, push-ups, dips and squats to get stronger before attempting more difficult moves like the muscle-up or pistol squat. Here’s the essential equipment even a fitness minimalist should consider investing in.

TRX. Set up shop in a doorframe and practice the basic moves, like the horizontal row and suspended push-ups, before moving on to single-leg exercises and explosive moves that require more strength and balance. This type of Total Body Resistance Exercise (TRX, get it?) is a form of suspension training that targets multiple muscle groups at once, limiting the length of workouts and the need for additional equipment.

Jump Rope. The perfect tool for warming up or working cardio into bodyweight routines, the jump rope is a fitness minimalist’s dream. Try fast-paced skips, single leg jumps, and double-unders to improve conditioning and coordination.

Kettlebells. This versatile training tool is the total package. Do cardio and strength train simultaneously while engaging every major body part. Now that’s efficiency at its finest!

Sandbags or SandBells. Make a DIY sandbag or spend a few bucks on a Hyperwear Sandbell and you’ll never have to worry about being bored with a workout, or going to the gym again. This versatile training tool allows for more creative and functional total-body workouts when the usual tools start feeling stale.

Skip the Time Sucks

So far we’ve managed to pack more work into less time. But before we can become true fitness minimalists, it’s important to steer clear of the time sucks that could derail our best efforts. As fitness authority Alwyn Cosgrove puts it, some equipment is a “nice to have, not a need to have.” Cosgrove goes on to state that, “your gains have nothing to do with what equipment you have access to, but everything to do with the work you put in.” If your current routine isn’t delivering results, take a closer look at how you’re using the following.

Exercise machines. Navigating a maze of machines, waiting in line, and wiping them down after each use takes a whole lot of time—time that could be better spent on a more effective workout routine. Plus, some machines like the leg extension and Smith machine might be doing harm than good. Take a page from Cosgrove’s playbook by sticking to workouts that use less equipment but are, “simple, time efficient and brutally effective.”

Cardio equipment. It’s nice to watch television while gliding effortlessly forward and backward on an elliptical, but it’s not effective, efficient and it’s certainly not necessary. Go for a trail run or bike ride instead.

Exercise balls. Sure, the guy balancing on the BOSU ball looks fancy, but research has shown that training on an unstable surface yields few benefits. Plus, the women performing chest press or shoulder press on the Swiss ball could be spending her time more wisely as well. In one study, the chest press and shoulder press were most effective when executed on a stable surface. Sometimes keeping things simple pays off.

No More Excuses

No time, no money, and no gym membership are no longer a reason not to exercise. Become a fitness minimalist and eliminate the excuses along with the excess. By upping the intensity of workouts and using the right equipment, if any, it’s possible to workout anywhere, anytime—even when you’re short on time.

MORE FROM DAILYBURN

• HIIT Workout: What It Is and How It Works
• 7 New Ways to Switch Up Your Cardio Routine
• How to Get Fit in Half the Time