In any classification system, there is a miscellaneous, or catch all type of category. Never is this more true than in your kitchen drawers, there’s that one drawer with all the random items (usually scissors, a tool or two and some tape amongst other thing). This article is in a way, just that, a collection of discordant research articles that I think have value but perhaps not as me writing full articles about them.
Treatment and Risk Mitigation in Traumatic Brain Injury
I’ve long been a fan of Dr Tommy Wood and his work (check out his podcast for some high yield, short episodes on brain health). He and some colleagues very recently released an article on traumatic brain injury (TBI, which includes concussion) including treatment and prevention angles.
The article is extensive and well worth reading for those interested. That said, the below figure caught my eye specifically. The preventative lens used is something I deeply appreciate (something the authors call “left of the bang” referencing the diagram below and things that occur before impact). Specifically optimising brain health and ensuring nutrients that may aid in initial management of the injury are present.
For those interested, and I know many readers are, below is a table from the paper with nutrients and dosing thoughts for each of them (as well as potential food sources) some of which are for use in pre injury (ie all of the time) whilst others are more for use if a TBI has occurred.
Regular readers would recognise some of these supplements given I have written about them. But they’d also intuit that many of these would resonate with me given their low cost, high upside, low downside and potential pluripotent benefits - something I touched on in this article on decision making lenses I use.
In my mind, optimising brain health prior to any injury is a absolute no-brainer (I had to, I’m sorry), especially if you’re engaging in any sort of activities when any head trauma is a possibility. From there, anything that can be done to mitigate further issues and/or aid in recovery is crucial, this article goes a long way to helping with the playbook for this as well as flagging a few potential treatments lacking current evidence but with potential.
Mitochondrial Health
For those readers whose knowledge of the mitochondria extends no further than “mitochondria are the powerhouses of the cell” (which MUST be a mandatory phrase for all teachers of biology & physiology) fear not this is surprisingly helpful as a starting point (perhaps the reason for it’s ubiquity in discussing these organelles).
Mitochondria are central to both endurance performance and aging, forming one of the key mechanisms by which endurance training aids in prolonging healthspan. Things can get a little convoluted when looking at mitochondrial research (it’s hard to sample these and track changes over time, a lot like muscle fibres) so sometimes enzymes are used as a measure of their function whereas other times mitochondrial mass is the key parameter. Though to be honest, this is beyond what most folks need to understand about mitochondria.
In short, mitochondria are fascinating and absolutely vital organelles in our cells, which are indeed, the source of our energy.
Fun Facts About Mitochondria
Mitochondrial DNA is transferred from mothers to their offspring (yup, your genetic code is pretty much 50/50 but 100% of your mitochondrial DNA is from your mother).
The origin story of mitochondria effectively boils down to them being separate, single-celled organisms which were engulfed to be included in a symbiotic (aka mutually beneficial) relationship with another organism.
There are a group of mitochondrial diseases which can wreak metabolic havoc on sufferers.
A recent article which caught my eye specifically because it discussed mitochondrial health through the lifespan, linking it to healthspan and performance in an aging population (I am right in the middle of the venn diagram for this article).
Of note, the researchers mentioned one key way to maintain healthy mitochondria (or at least healthier) is exercise (both strength and endurance training), as illustrated in the below figure.
*I have an article in the early drafting phases on where some folks go wrong assuming a steady decline in function with age, and what can be done to prevent it - so make sure you’re subscribed to avoid missing it!
Beyond exercise though, the authors spend some time discussion some nutrients/supplements which may aid in mitochondrial health. Without wanting to make this an article about supplements, these did catch my eye as they are a few that are growing in research base and interest (as well as some classics of course).
The article itself contains a table summarising the research on the molecules of interest which is worth reading given the context for the research is important. That said, the molecules of interest with potential for improving mitochondrial health in an aging population (younger folks haven’t got the same research at this point) include:
MitoQ (mitochondria-targeted, coenzyme Q10 aka Mitoquinone)
Urolithin A (“a natural compound produced in the large intestine by gut bacteria from ingested ellagitannins and ellagic acid, which are polyphenols present in a variety of plant products and foods, including pomegranates, strawberries, raspberries and walnuts”)
Glycine and N-acetylcysteine (GlyNAC)
Omega-3 polyunsaturated fatty acids
There is little argument towards increasing omega 3 intake, that said the other nutrients and molecules likely warrant some discussion with your care team. This is especially true because of their respective mechanisms of action when it comes to mitochondrial health and ensuring any strategies are both targeted and effective.
Nasal Breathing & Cerebral Blood Flow During Exercise
Some of the myriad of benefits of exercise pertain to brain health (in ALL senses of that word). Part of the reason for this relates to increased blood flow to the brain, so naturally I was interested when I read this article relating to nasal breathing as a possible way to augment this.
For the record; as a general rule, if you can be nasal breathing, you should be.
Some Basics of Breathing
In non-smokers, breathing or the sensation to breath, is driven by concentration of carbon dioxide, not low oxygen. Hence, as a child when holding your breath underwater, if you exhaled you could go a little longer - your drive to breath was a carbon dioxide buildup not oxygen hunger or you’d not have felt relief from the exhalation.
Ventilation (more accurately known as “minute ventilation”) as defined in physiology is the result/product of respiratory rate (number of breaths per minute - this is where the “minute” in comes from) and tidal volume (the volume of air moved per breath. Said simply; the amount of air you move is a result of how many breaths you take and how deep they are.
When we talk about breathing (and generally in physiology) we use lots of latin: the prefixes; hypo- being low, hyper- being high and the suffixes; -oxia being of oxygen, -capnia being of carbon dioxide.
When nasal breathing, we require more force as the airways (nose) are narrower (compared to the mouth) we also cannot move the same volume of air. Hence we usually switch to mouth breathing at some point during exercise (generally intensity driven).
To be clear, nasal breathing has many benefits, some of which may be overstated or over-extrapolated (I am not sure we know or have a way to tell). That said, considering this is free and low risk, the burden of proof is slightly different when it comes to using it from time to time, at least in my eyes.
The premise of the article is that nasal breathing at a moderate intensity of exercise will mean you mildly hypoventilate (under breath), thus driving mild hypercapnia which will increase blood flow to the brain and induce a stimulus that is similar to hypoxia. This hypoxic stimulus generally causes a cascade of effects, notably increased blood vessel growth/formation (angiogenesis) which can improve brain health. See below figure for some more details.
Figure from the above linked article
As mentioned, nasal breathing is low downside and free. Having done quite a lot of it when exercising, I can assure you it can be uncomfortable to have the sensation to breath. The good news is starting is quite easy; do it for a while then stop doing so as needed, similarly you can using a hybrid solution (described in the above diagram as “oronasal breathing”) whereby you breath in through the nose and out through the mouth. You will find that you adapt to this over time and have an increased ability to sustain it and likely will find you can increase output whilst nasal breathing (see more below).
Other potential benefits of nasal breathing whilst exercising (and the reason I started it) include more respiratory muscle strength and endurance developed - reducing the oxygen cost of breathing and respiratory muscle fatigue during exercise. Yup, that’s right, it costs oxygen to breath because it takes muscles and these can, of course, become fatigued (which can drive our feeling of fatigue significantly).
I also used nasal breathing as bit of a restrictor plate on my easy days, that is, if exercise was hard enough to mean I couldn’t breath solely through my nose, it was too hard.
Hopefully the miscellaneous format was something you enjoyed, please do send me feedback on the format either in the comments on Substack or reply via email - this feedback can be positive or negative, this writing is ultimately in service of readers. It’s likely that with positive or middling feedback I will continue to produce these periodically rather than transitioning completely to this format given my propensity for longer form content.
References:
Conti, F.; McCue, J.J.; DiTuro, P.; Galpin, A.J.; Wood, T.R. Mitigating Traumatic Brain Injury: A Narrative Review of Supplementation and Dietary Protocols. Nutrients 2024, 16, 2430. https://doi.org/10.3390/nu16152430
Broome, S.C., Whitfield, J., Karagounis, L.G. et al. Mitochondria as Nutritional Targets to Maintain Muscle Health and Physical Function During Ageing. Sports Med (2024). https://doi.org/10.1007/s40279-024-02072-7
Martin, W. & Mentel, M. (2010) The Origin of Mitochondria. Nature Education 3(9):58.
Moris JM, Cardona A, Hinckley B, Mendez A, Blades A, Paidisetty VK, Chang CJ, Curtis R, Allen K, Koh Y. A framework of transient hypercapnia to achieve an increased cerebral blood flow induced by nasal breathing during aerobic exercise. Cereb Circ Cogn Behav. 2023 Sep 13;5:100183. doi: 10.1016/j.cccb.2023.100183. PMID: 37745894; PMCID: PMC10514094.