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AAEM Physician Wellness and Burnout Prevention Committee
Originally Published: Common Sense November/December 2017
Resilience is the ability to bounce back from an adverse life situation. Some individuals are born with this trait and we are all envious. However, the majority of us need a little help. Even those individuals with the inborn resilience trait, need help maintaining it.
Now having and maintaining this trait is not very simple — there is no magic “resilience pill.” The key is lifestyle changes, which may initially be a bit daunting, but can better equip us to meet life’s challenges head on without breaking down.
The basic lifestyle factor is diet. You are what you eat. What you eat effects how you will feel. Eat junk, feel junk. Eat healthy, feel healthy. It’s as simple as that.
Making healthy “clean” food choices should be a priority. Including more fruits and vegetables and less red meat in our diet is known as the “Mediterranean diet” which is known to be anti-inflammatory and is the key in maintaining healthy physical and mental health. Junk food is processed food. Processed meats and frozen entrees that we grab-and-go are heavily laden with pesticides, endocrine disruptors, and poorly laden with nutrients. This will soon make our bodies nutrient deficient and when this happens symptoms of anxiety, feeling overwhelmed, and depression develop.
An important food component that is detrimental to our brain health is sugar. Sugar, especially the simple sugars such as glucose, cause rapid increase in blood sugar are very inflammatory to every cell including neurons. Complex sugars, on the other hand like beans, lentils, sweet potatoes are beneficial because they do not cause acute rise of blood sugars and hence less inflammation.
So, making this choice of not consuming processed and sugar laden foods but instead spending a little time doing some grocery shopping and cooking is investing in long-term physical and mental wellbeing. And this wellbeing will translate to longevity of our careers. Isn’t this what we want?
In addition to eating wholesome foods, are there any food/supplements that can help us maintain our body and mind? Few supplements are proven to support our mind and body effectively.
One of these is probiotics. Probiotics are healthy bacteria or actually life enhancing bacteria. These bacteria are present in our digestive tracts in abundance, about 100 trillion of them. These not only line up our GI tract intestinal walls, but research has now proven that these little creatures secrete substances that are transported to the brain where they exert anti-anxiety, anti-depressive effects. This gut-brain connection is truly a two way street. In fact this is the basis of nutritional psychiatry — an exciting new field to manage mental disorders. Their presence in each of us is individualized and is based on genetics, diet, age, and guess what? Stress! So even if we are born with the most robust microbiome, the stress we experience, especially circadian disruption, can kill tons of these. It is important to replenish these little bugs with probiotics. Now probiotics can be in the form of supplement but better is food. Foods like plain yogurt, not the sugar laden “fruit at the bottom” kind, unsweetened kefir, fermented foods like kimchi, sauerkraut, and pickles all will replenish our microbiota so that we function optimally. If getting these healthy probiotics feels like a chore, then by all means at least take the supplement which there are plenty in the market.
Another nutrient that is essential for our brain health are fatty acids. Now for decades we were made to believe that fats are bad for us but sugars are ok. Now since the research has been exposed, we know that the reverse is true. Fats are good for us. In fact phospholipids form the wall of each and every cell in our body. By fats, I mean healthy fats, both saturated and unsaturated in moderation. Trans-fats are pro-inflammatory and are bad fats, but good fats are olive oil, butter, coconut oil, avocados and ghee. So don’t eliminate fat from your diet but consume these good fats in moderation and improve cognition and emotional health.
Brain is 80% lipids and 30% of these lipids are polyunsaturated fatty acids (PUFA) and these are known to significantly modulate our neuronal function. These PUFA are essential (EFA) since these are exclusively obtained from our diet. Omega 3 primarily the DHA and EPA and Omega 6 mainly arachidonic acid are the principal CNS EFA’s. Both Omega 3 and 6 are essential but the ratio needs to 3:1; unfortunately, our typical western diet has significantly reversed this ratio and hence the rise of mental illness in our country. Bottom line, increase intake of Omega 3 fatty acids. These acids are abundantly found in fish, walnuts, chia and flax seeds. Include these rich foods in your diet for healthy brains.
In summary, what you eat is how you feel. Include a rainbow of fruits, vegetables, unprocessed grains and fish in your diet. Supplement with probiotics and essential fatty acids.
1. Anti-inflammatory effects of the Mediterranean diet: the experience of the PREDIMED study, Estruch R, Proc Nutr Soc 2010, Aug69(3):333-40
2. Sugar- and artificially sweetened beverages and the risks of incident stroke and dementia, A prospective cohort study, Matthew P Pase et al, Stroke April 2017.
3. The Gut Microbiome and the Brain, Leo Galland, Journal of Medicinal Food, J Med Food, Dec 2014;17 (12), 1261-1272.
4. Essential Fatty Acids and the Brain, Marianne Haag, Can J of Psychiatry, Vol 2003;48: 195-203.