Cobbers on the Brain

The ideal diet for humans contains high-quality food that is not processed such as veggies, fruits, whole grains, healthy fats, and protein. (1)

The ideal diet is the Mediterranean diet. This diet has been named the best 4 years in a row. It consists of mostly plant-based foods in addition to whole grains, seeds and nuts, spices and herbs, fruits and veggies, and olive oil. Fish, seafood, dairy, and poultry, are used sometimes while red meat and sweets are used rarely. Above is a hand-drawn diagram of the Mediterranean diet. (2)

Fatty fish and olive oil components of this diet are very healthy and have great benefits. Fatty fish can contain high amounts of omega-3 fatty acids which helps decrease inflammation, triglycerides, blood clotting, and risk of strokes and heart attacks. Olive oil is a monounsaturated fat that can lower cholesterol. The Mediterranea diet overall can decrease an individual’s chances of developing heart disease, stroke, Alzheimer’s, Parkinson’s, and type 2 diabetes. (2, 3, 4)

However, the Mediterranean diet can cause weight gain due to consuming higher amounts of fats from olive oil and nuts than what is recommended. A lower dose of iron from eating a small quantity of meat. Also, a decrease in calcium levels can be seen from consuming smaller portions of dairy products. (2)

The new food guide consists of:

• 1/2 plate of diverse fruits and veggies
• 1/4 plate of whole grains (whole wheat, quinoa, brown rice, oats, etc)
• 1/4 plate of protein (fish, meat, etc.)
• Water, coffee, or tea (consume less dairy, juice, and sugary drinks)

History of the Ideal Diet

The ideal diet has changed throughout the years. There has been a total of 9 food guides for American citizens approved by the USDA.

The first guide was introduced in 1916 by Caroline Hunt called “Food for Young Children”. It aimed to guide parents and caregivers on proper nutrition for children. This guide included 5 groups consisting of:

1. Cereals
2. Fruits & veggies
3. Meat & milk
4. Fats & fatty acids
5. Sugar & sugary foods

In 1917 Hunt and Helen Atwater created a food guide for the whole family called “How to Select Foods”. It included and guided parents and caregivers on ideal meals along with the estimated cost of each meal.

In 1943 the United States Department of Agriculture (USDA) released the “Basic 7” food group guide to the public. This guide was made to help the United States citizens meet proper daily nutrition while rationing on food during World War II. Due to food rationing there the guide did not include serving sizes. The 7 food groups include:

1. Green and yellow veggies
2. Oranges, tomatoes, grapefruit, cabbage, and salad greens
3. Potatoes and other fruits & veggies
4. Milk and other dairy products
5. Meat, poultry, fish, eggs, dried beans, peas, nuts, and peanut butter
6. Bread, flour, cereal, and natural whole grain
7. Butter and fortified margarine

In 1955 the Harvard School of Public Health (HSPH) introduced a shorted and condensed form of the “Basic 7” to the “Basic 4” which was approved by the USDA. This new guide included the food groups:

1. Milk – includes the amount each age should consume daily
2. Meat – 2+ servings per day
3. Fruits & Veggies – 4+ servings per day
4. Bread & Cereal – 4+ servings per day

In 1977 Mark Hegstend, a professor at HSPH developed the “1979 Hassle-Free Daily Food Guide”. This guide includes the food groups:

1. Fruits & veggies – 4 servings
2. Bread & cereal  4 servings
3. Milk & cheese – 2 to 4 servings
4. Meat, poultry, fish, & beans – 2 servings
5. Fats, sweet, & alcohol – in moderation

In 1984 the “Food Wheel” was developed and introduced by the American Red Cross and the USDA. This updated guide included the daily food groups and appropriate calorie intake. The groups included:

1. Bread, grain, & cereal – 6 to 11 servings
2. Fruits – 2 to 4 servings
3. Veggies – 3 to 5 servings
4. Eggs, meat, poultry, & fish – 2 to 3 servings
5. Cheese, yogurt, & milk – 2 servings
6. Alcohol, sweets, & fats – in moderation

In 1992, the “Food Pyramid” was introduced. The large amount of recommended bread caused negative feedback of this guide. The 6 food groups included:

1. Bread, cereal, rice, & pasta – 6 to 11 servings
2. Fruits – 2 to 4 servings
3. Veggies – 3 to 5 servings
4. Milk, yogurt, & cheese – 2 to 3 servings
5. Meat, poultry, fish, beans, eggs, & nuts – 2 to 3 servings
6. Fats, oils, & sweets – in moderation

In 2005 “MyPyramid” was introduced. The graphic for the updated guide showed the importance of fitness along with adequate nutrition. The food groups include:

1. Grains
2. Veggies
3. Fruits
4. Milk
5. Meat & Beans

In 2011 the USDA took a different approach to display food guides. “MyPlate” depicted the food portions on a plate rather than a pyramid, bullet points, or wheels.

This image was updated by HSPH to the “Healthy Eating Plate” and is held as the current food guide to American citizens. It stresses the importance of physical activity and eating healthy grains, proteins, oils, and vegetables that aren’t potatoes.

(5, 6)

Sources

1. https://www.hsph.harvard.edu/nutritionsource/healthy-weight/best-diet-quality-counts/ 
2. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801
3. https://www.helpguide.org/articles/diets/the-mediterranean-diet.htm
4. https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/february/mediterranean-diet
5. https://www.hsph.harvard.edu/news/magazine/centennial-food-guides-history/#jp-carousel-111354813228
6. https://guides.lib.unc.edu/nutrition-history/government

FAD diets and Leptin:

FAD diets promise quick weight loss, but they involve unhealthy and unbalanced eating plans. When proper food is brought back into someone’s diet, they gain weight rapidly. Leptin is a hormone that is important for its role in regulating food intake and energy expenditure. This hormone is produced by fat cells that signal satiety. Leptin is also shown to control the insulin-glucose axis as well as insulin responses. Since it was discovered, leptin has been used as a therapy for obesity and diabetes. Leptin, however, has been shown to be the reason why dieting does not work. With FAD diets, leptin receptors can become resistant the same way people with diabetes experience insulin resistance. The problem with these quick diets and fast weight loss is that the body becomes depleted of leptin, which makes individuals hungry all the time.

Keto diet and Leptin:

The Keto diet is one that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar for energy, which comes from carbohydrates, however once on a ketogenic diet, there are very few carbohydrates for the body to utilize. In the absence of carbohydrates and circulating blood sugar from food, the body starts to break down stored fat into molecules called ketone bodies. Once the body has reached the stage of ketosis, most cells in the body will use ketones for energy until carbohydrates are consumed again. During a keto diet, the ability of insulin to regulate blood sugar levels is changed due to the content of macronutrients. During a high-fat diet, individuals can experience insulin resistance and an inability to maintain good glucose levels. While on a keto diet however, it has been seen to help symptoms of diabetes. Some Studies show that the ketogenic diet can increase leptin and decrease insulin, which is unusual because leptin and insulin levels normally change together, with both either increasing or decreasing. During conditions associated with weight loss, like fasting, there was a decrease in both leptin and insulin. During conditions associated with weight gain, like overeating, caused both Leptin and insulin resistance to increase. This shows that the ketogenic diet plays a unique role on the metabolic state and the opposite changes in levels of leptin and insulin also lead to a unique neurohormonal state

Sources:

Alex. (2021, October 31). The problem with fad diets. Ryan and Alex Duo Life. Retrieved November 24, 2021, from https://www.ryanandalex.com/problem-fad-diets/.

Amitani, M., Asakawa, A., Amitani, H., & Inui, A. (1AD, January 1). The role of leptin in the control of insulin-glucose axis. Frontiers. Retrieved November 24, 2021, from https://www.frontiersin.org/articles/10.3389/fnins.2013.00051/full.

Kinzig, K. P., Honors, M. A., & Hargrave, S. L. (2010). Insulin sensitivity and glucose tolerance are altered by maintenance on a ketogenic diet. Endocrinology, 151(7), 3105–3114. https://doi.org/10.1210/en.2010-0175

Obesity Basics 

Obesity has been identified a top 10 global health problem by the World Health Organization. According to the CDC, nearly 42.4% of the adult population in the US were obese in the year of 2017. In figure 1, the color of each state represents the percentage of obese individuals in that state within 2020.

An important contributor is increased caloric intake without increased physical activity. An increase in calorie consumption is conducive to an increase in appetite from increasing craving and liking of food. The main brain system involved in craving and liking is the endocannabinoid system (ECS).

The Endocannabinoid System

The ECS functions to adjust behavior and metabolism according to food availability. Its action range from regulating sensory responses to developing preference for the consumption of high caloric food. In today’s world it appears that the ECS favors obesity and metabolic disease as food is readily available, especially “junk” food.

The ECS receptor in the brain is the cannabinoid-1 receptor (CB1). Researchers have examined the effects of activating and deactivating this receptor has on the body.

CB1

Cannabinoids and endocannabinoids bind this receptor. Figure 2 represents a simple schematic of the retrograde signaling of the ECS system.

Cannabis has been documented as promoting eating through strong cravings and an intensification of the sensory and hedonic properties of food. It has been demonstrated that the hyperphagic actions of THC (one of the psychoactive constituents of cannabis) were mediated in large part by cannabinoid CB1 receptors. Additionally, researchers saw that, systemic anandamide (an endocannabinoid) administration caused an increase in food intake. Later experiments confirmed that other endocannabinoids (2-AG and noladin ether) also increased food intake. Therefore CB1 agonists promote eating behaviors that lead to obesity.

In addition to CB1 agonists, researchers determined that CB1 antagonist suppressed food intake. They found that mice without CB1 receptors had a reduced sensitivity to the motivating properties of food, exhibiting reduced rates of responding for food and lower breakpoints when given a task to obtain food. In effect, the stimulatory actions of cannabinoids on eating resembles the changes that occur in food deprivation: levels of

anandamide and 2-AG increase after fasting. Therefore, this shows that endocannabinoids have an effect on the food intake of the brain without any drug influence.

In figure 3, you can see how some researchers believe CB1 signaling can affect insulin signaling that could in turn mediate weight gain. This activation of the CB1 signaling can be done by endocannabinoids (anandamide) or cannabinoids (THC).

In figure 4, it describes the different locations of CB1 receptors and their pathological implications. As you can see the ECS is implicated in many agents of obesity development.

Overall, CB1 agonists show to increase wanting and liking of food AND CB1 antagonists show to decrease these. The endocannabinoid system plays an important role in the development and control of obesity. However, the exact mechanisms of these neurotransmitters on a cellular level are still not completely understood. Therefore, research must continue to clarify how endocannabinoids and cannabinoids can mediate obesity and how they might be able to be a part of treatment.

References:

https://www.cell.com/trends/endocrinology-metabolism/fulltext/S1043-2760(15)00140-X

https://www.mdpi.com/1422-0067/20/9/2109

https://gaiaguru.co.uk/cannabinoid-receptor-1-basics/

https://www.cdc.gov/obesity/data/prevalence-maps.html#overall 

https://doi.org/10.3389/fnins.2017.00293 

Concussions are no joke, and it’s nice to see that people are finally beginning to take them seriously both on and off the field. The most dangerous part of a concussions is the chance of re injury, which means the most important piece to helping people with concussions is to stop them from a secondary impact. This is usually done by stopping players from playing for a while, but in order to do that the first step is recognizing the problem, which can be a challenge for many reasons. Such reasons include wanting to keep playing, dismissing it as a headache, or even ignoring the concussion to keep a player on the field. As concussions have become more recognized and dangerous, players and coaches need to change that mentality to one of a fast recovery. One of the best ways to get that first recognition and fast recovery in is by using the SCAT test.

The SCAT test is designed to be both user friendly and efficient, combining two of the key problematic factors regarding concussion diagnosis. Every coach, family member, and player should be able to use this tool effectively due to the functional layout and simplified instructions. By having these tools accessible to the public, concussions can be traded much more efficiently provided they are given the attention they deserve.

Below is an image of the first page of a SCAT-3 test as it would be administered in the field. One of the main strengths of the test besides its ease of use is the ability it has to cover all its bases. The test begins with important baseline information, such as level of consciousness and basic cognition, which are the most important indicators of a severe concussion. From there the test moves to a self-report, which can be both helpful and harmful depending on how it’s used. If this test were stand-alone it could lead to a series of issues, but the SCAT test instead uses it as a part of the baseline establishment, which allows for much more important information to be gathered by the observer. The test then goes into an in depth analysis of how the test taker performs on a variety of physical and cognitive tasks, with a score value assigned to each test. It may seem like a lot to the casual observer, but the level of detail combined with the ease of administration makes these tasks both manageable and effective at diagnosing a concussion. After the tests are done a concussion diagnosis can either be made or ruled out, and if a concussion is determined to exist the test outlines the next steps to take for seeking help.

There is still much work to be done regarding concussions and public opinion, but focusing on catching them before they can cause permanent damage is an important first step in recognizing the severity of concussions and moving towards a safer recovery period for people that live in high contact potential scenarios like contact sports or manual labor. In conclusion, ask your local coaches if they would be willing to have a copy of the newest SCAT test on hand, they never know how important it could be for their team!

Source for Featured Image

About 1.6 to 3.8 million sports and recreational concussions occur in the USA each year. 1 in 5 of these individuals will develop mental health concerns and disorders. Signs and symptoms that are severe can last as long as 6 months. Females, the elderly population, athletes, and individuals in the military are the most susceptible to concussions. Females are more susceptible because of weaker and thinner neck muscle fibers. Below is an image showing these differences: (3, 5)

Mental Health symptoms after experiencing a concussion include but are not limited to:

• social anxiety
• irritability
• anger
• depression
• feelings of overwhelm
• general anxiety
• mood swings
• emotional lability
• impatience
• difficulty concentrating
• brain fog
• sensitivity to light
• fatigue or burnout
• memory loss
• sleep problems

Researchers have stressed that an individual’s personality doesn’t change after a concussion or traumatic brain injury but their behavior does. Their mood can be altered due to the symptoms of a TBI such as poor quality or lack of sleep, the frustration of not remembering things, feeling burnout easily, developing anxiety, etc. Personality is described to be a part of the person such as their dislikes, favorite food, activities, color, people, etc. How the individual reacts to such variables may change but they are not necessarily gone. This is not to say that personality can’t change because it can be depending on the location of the injury such as Phineas Gage in which his personality and behavior dramatically changed after suffering an injury to his frontal lobe. The diagram below shows the impact of the incident on the damaged regions.  (7, 1)

One study found that experiencing a TBI can increase your chances of developing a mental health disorder by 439%. Many people suffer from social anxiety, irritability, anger, depression, feelings of being overwhelmed, general anxiety, mood swings, or emotional lability (uncontrollable or inappropriate crying) after their injury. (3)

Concussions disrupt the communication between neurons and the blood vessels along with damage white matter within the brain. The damaged pathways will take a couple of weeks to heal but full recovery is expected for nonrepeated or infrequent concussions. In 30% of individuals who experienced concussions noticed a long-lasting slow and disruptive cognitive processing and responses. (1)

Females, the elderly population, and individuals who have had prior experiences of concussions, seizures, migraines, learning, mood, and anxiety disorders are the most susceptible to experiencing PCS (post-concussion syndrome). PCS is when the individual has prolonged symptoms and has continued experiencing such signs and symptoms past the expected recovery time given by doctors. The NINDS found that 20% of individuals who were in the military had experienced injuries during Iraq and Afghanistan. Of this 20%, 83% obtained a concussion or mild traumatic brain injury. Depression after sustaining a concussion is a common symptom. These individuals are twice as likely compared to individuals without TBI’s, to be at higher risk for self-harm and attempting suicide. Depression may contribute to the struggles that come with social interactions after a concussion as the person becomes easily fatigued and irritable due to intense lighting, loud noises, or too much movement and stimuli. (5)

Overall, concussions can lead to behavioral changes due to the symptoms and signs followed by the incident. Seeking professional help on how to manage these symptoms and signs is encouraged.

Resources:

1. https://www.cognitivefxusa.com/blog/personality-changes-after-a-brain-injury-or-concussion
2. https://www.nih.gov/news-events/news-releases/mental-health-disorders-common-following-mild-head-injury
3. https://sciencenordic.com/biology-denmark-depression/head-injury-can-cause-mental-illness/1395035
4. https://www.cognitivefxusa.com/blog/multiple-concussions-effects-and-treatment
5. https://www.medicalnewstoday.com/articles/326227#complications
6. https://www.spokesman.com/stories/2019/apr/03/researcher-mental-health-issues-often-progress-aft/
7. https://www.npr.org/sections/health-shots/2017/05/21/528966102/why-brain-scientists-are-still-obsessed-with-the-curious-case-of-phineas-gage

We all want to keep our friends and family safe. That includes protecting them from outside harm and making sure that they won’t get hurt. The problem is that it cannot always be prevented. One example of an adolescent child getting hurt is through a concussion and it is even more common to occur if that child is in sporting events. A concussion is described to be a traumatic brain injury (TBI) resulting from a blow to the head causing the brain to move back and forth at a fast pace [1]. This rapid and sudden movement causes the brain to form chemical changes and sometimes damage important brain cells [1]. A picture of what the brain is exposed to during a concussion is shown in the figure below. Concussions are potentially very dangerous as any damage to your brain can cause detrimental long term effects. 

A study on the neurometabolic cascade of concussion went into detail on what goes on in a person’s head when their brain experiences a concussion. Biomechanical injuries caused by a concussion lead to ionic flux and glutamate release triggering voltage gated ion channels [2]. This leads to the brain increasing ATP pumping to restore homeostasis, but in turn causes depletion of cellular energy reserves leading to multiple dysfunctions such as altered neurotransmission [2]. This shows a possible energy crisis involved after a concussion, possibly impairing other important mechanisms throughout the body. Because of this, important mechanisms may not be able to perform as adequately after the concussion symptoms have subsided. 

With these multiple changes happening in your brain, this can result in possible axonal injury causing potential damage to important sections. According to the same study on concussions, axonal injury causes disruption in transports resulting in impaired cognition, slowed processing, and slowed reaction times [2]. This implies that concussions can lead to impairment and possible destruction of neuronal receptors leading to become difficult in processing information and possible difficulty in motor behavior. This is scary to think about because this makes it possible that concussions could even cause paralysis. 

After a person experiences a concussion, there is a chance that post-concussive symptoms will stay. It should be known that while they are rare for a person who experiences one concussion, these symptoms can become more likely to occur in somebody that has had multiple concussions in a short period of time. Such as if they had repeated blows to the head in a football game. Some of these long term symptoms include but are not limited to headache, dizziness, memory problems, irritability, insomnia, depression, sensitivity to noise and light, and sometimes it can even cause a personality change [3]. With these effects in mind, it is no wonder why people say it is important to wear your bike helmet.

From these studies on concussions, people should be able to understand the dangers of concussions when doing a very physical activity that can involve the safety of your well being. The brain is the most important organ in your body and it is every person’s job to make sure it is protected from any outside harm it may come across. 

1. https://www.cdc.gov/headsup/basics/concussion_whatis.html
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4479139/ 
3. https://www.healthline.com/health/post-concussion-syndrome#symptoms