Uncommon Cold: Mental Health (pt. 1)
The science and practice of deliberate cold exposure (during midlife crisis)
SUMMARY
The brain is the single most metabolically demanding organ in the body. When energy conversion mechanisms in the brain aren’t functioning well, mood and cognitive disorders result.
Mitochondria are critical to metabolism, and mitochondria can be damaged by eating too many carbohydrates. Over time, the body adjusts to chronic carbohydrate overload by developing insulin resistance to protect mitochondria inside the cell from damage.
Insulin resistance is a sure sign of metabolic dysfunction. It is associated with a myriad of resulting disease states, including cognitive decline and mood disorders.
Deliberate cold exposure is effective for reversing insulin resistance by activating brown fat, clearing glucose from the blood stream, stimulating secretion of ketones and neuroprotective hormones, and promoting mitobiogenesis.
THE METABOLIC ORIGINS of ALZHEIMER’S
Deadly breakfast
I got the call from my sister four days after Thanksgiving. Mom passed away in her sleep.
It wasn’t a surprise.
Mom has suffered from Alzheimer's dementia for over a decade. Almost five years ago, when she exploded in fits of rage that endangered her caregivers, her doctor told us her behavior had become unmanageable and she might not have more than six months to live.
My sisters and I decided to discontinue all her medications, including her statins, because she didn't like swallowing pills and that was a major point of conflict between her and her nurses.
Why would a woman with six months to live care about her cholesterol, anyway?
Mom began to improve immediately. She outlived her doctor’s death prognosis by more than four years.
I visited her a month before she died. Her Alzheimer's was so advanced that she couldn’t speak. She had almost no motor control -- just unsteady use of her dominant hand.
She had no idea who I was.
Her nurse fed Mom Cream of Wheat wih Ensure for breakfast. When Mom finished all of that, she got apple juice and a cookie as a reward. It took Mom an hour to feed herself a cookie, because her motor control was so bad that she struggled to lift her hand to her mouth.
Watching Mom eat breakfast reminded me that her diet has been a problem as long as I've known her. Despite being a champion High School swimmer, she struggled with her fitness and her weight all her life.
Parents aren't so smart
As I child, I thought my parents were the smartest people in the world. I know that's a natural position for any child to take, but my impression survived the usual rebelliousness, cynicism and disillusionment that comes with adolescence, because they had a lot of evidence on their side.
My parents met in graduate school at Harvard. My Father was a Professor of Education at the University of Pittsburgh, and my schoolteachers, principals, and administrators were all his former students -- or at least it seemed that way to me. He wasn't just the smartest man in my child world. The admiration and respect my teachers held for my Father meant that he seemed like the smartest man in their world, too.
He also had complex diet requirements that resulted from his extensive food allergies. So when my Mother read Diet for a Small Planet (Lappé 1971) and changed our meals towards more plant-based, more industrialized and processed, less fat, and more carbohydrates, I didn't see that as the act of political ideology that it was.
I thought it was because my parents were smarter.
As it turned out, the corn oil margarine, the skim milk, the breakfast cereals, the corn syrup concentrates... they were all contributing to my childhood obesity and my Mother’s cognitive decline. Although she was convinced that the solution to negative feelings about her body would be to eat more plants, less meat, less fat, more processed foods, fewer eggs, and attempt strict calorie control…
… she was wrong.
It seemed like she got fatter and sicker every year, without stopping to wonder if maybe the diet she adopted to satisfy her environmental ideology was really hurting her health.
She raised me and my sisters on breakfasts of Lucky Charms and Trix cereal, with white bread toast and corn oil margarine. At the dinner table, she lectured us about "complete proteins" that could hypothetically be achieved by mixing canned sweet corn with canned beans, and she scolded me for eating too many eggs.
To please my Mother, I ate everything she fed me, and I got fatter and fatter.
What most people don't realize is that my Mother's diet was exactly the type that would elevate her risk of Alzheimer's disease. Concentrated carbohydrates like sugary cereals flood the bloodstream with glucose and require the islet cells in the pancreas to produce more insulin. To make matters worse, a diet that is chronically high in carbohydrates causes a phenomenon called insulin resistance, which is a precursor to Type 2 diabetes.
The future of my brain
Because of my Mother’s medical history of dementia, sometimes well-meaning friends suggest that I should get tested for genetic signatures that are associated with risk of dementia.
“Why?” I ask them.
There are no effective pharmaceutical therapies for Alzheimer’s. So even if you do have a genetic pre-dispostion (as I might), your typical physician will not be equipped to prescribe to you a drug that will prevent or reverse progression of the disease.
Yet, now that I’ve cast aside the lies and misconceptions that drove my Mother’s diet, I’m open to non-pharmacological approaches to caring for my brain, because the key to brain health is maintaining a healthy metabolism.
That’s what this chapter is all about.
Mental disorders are metabolic disorders?
We typically think of mental health as engaging two dimensions of the brain:
Mood is how well we feel, and
Cognition is how well we think.
Mood disorders describe persistent negative feelings, like when we’re anxious or depressed. Cognitive disorders describe lapses in our problem-solving and planning, like when we forget things or fail to focus attention.
Most people think these two dimensions are independent from one another, but the evidence reveals a close association. For example:
Cognitive subdomains such as learning and memory, executive functioning, processing speed, and attention and concentration are significantly impaired during, and between, episodes in individuals with major depressive disorder.
- Pan et al. (2018)
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