 Stimulating the Vagus Nerve Happy Monday! We hope you are breathing and humming your way to some physiological peace via the Rest and Digest system. Beyond using the diaphragm, what else can we do to activate the Vagus Nerve, thus turning on the Rest and Digest System and breaking the Fight or Flight response (AND in doing so reducing the negative impact of stress on the brain)? Here are some ideas for you: Cold Water (free) Well, this may not be a favorite, but a dip into cold water can activate the Vagus Nerve. Ice water plunges have become popular for perceived health benefits. But not everyone can or should attempt cold water plunges, so consider these alternatives:
Some studies have noted the Vagus Nerve can be activated by binaural beats or pink noise. Listening to binaural beats requires headphones and is best attempted in moments of stillness. It is often recommended to do so before sleep or before a stress-inducing event (such as taking a test). Research is currently underway to evaluate the cognitive effects of binaural beats on AD patients. Pink noise is distinguished by sounds that rise and fall, like the sound of waves. We can listen to pink noise at any time but is certainly an ideal adjunct to the massage technique below and the breathing exercises from Week 1. Touch ($$) “Vagus Nerve Massages” are all over the internet. These massages target specific pressure points (the same pressure points used by acupuncturists) in the stomach, ears, neck and feet to activate the Vagus Nerve. Fortunately, it isn’t necessary to spend hours on YouTube tutorials or spend hard earned money on a specialty massage because any good old massage will do the trick, as well as acupressure and acupuncture. Level up the experience with sound and essential oils. Massages can get pricey! But you can look into steeply discounted student massages at a massage school near you. Truvaga and Apollo Neuro are two direct to consumer devices which claim to activate the Vagus Nerve and activate our Rest and Digest system. They are both a bit pricey, but anecdotal reports have been positive: Next week, we’ll explain how some of our past resolutions tone the Vagus Nerve. See you then! TRACK YOUR PROGRESS YOUR MINI RESOLUTION: BEST YOUR STRESS! This week, stimulate your vagus nerve to help stave off stress. Use the calendar to log your breathing exercises, as well as your exercise, sleep, sugar. water, fruit-n-veggie and micro goals! Click or tap to view and download the log.
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 Stress & Cognitive Decline Today, let’s explore some of the science behind the stress response and how it is considered a modifiable risk factor for cognitive decline. In this image, you can see the two primary chemicals released in response to sustained activation of the Fight or Flight response are adrenaline and cortisol. Adrenaline initiates the response and cortisol sustains it. In a true emergency, these are valuable secretions leading to physiological reactions that are beneficial for overcoming a mortal threat. But when released continuously throughout the day in the absence of a mortal threat, the body and brain are awash with these chemicals. Long-term effects of chronic stress are many and well-documented. They include: 
Decreased brain volume, particularly in regions of the brain involved with cognitive function, such as the hippocampus. Decreased BDNF expression (as discussed in the resolution to exercise, BDNF is “Miracle Grow for the Brain”). Increased oxidative stress in the brain. Increased tau pathology and an inability to clear amyloid from the brain. The result: Overall poor cognitive function marked by poor episodic and spatial memory, diminished executive function, reduced processing speed and language difficulties. In addition, elevated levels of cortisol have been implicated in worsening of neuropsychiatric behaviors in those already diagnosed with dementia and AD. Breathing Away Cognitive Decline Last week, we introduced your “home base” for putting the brake on the Fight or Flight response: breathing! How does deepening and slowing the breath activate the Rest and Digest system? Diaphragmatic breathing stimulates the Vagus Nerve—the 10th cranial nerve and which courses through the diaphragm (its innervation is in yellow in the previous image). The Vagus Nerve can also be activated by vibrations created by the following activities:
We will see you next week for more Vagus Nerve stimulation ideas. Feel free to email your Motivated Mondays Coach Michele at [email protected] with your individual questions. (NOTE: Medical devices that stimulate the Vagus Nerve to treat specific medical conditions will not be considered here.) TRACK YOUR PROGRESS YOUR MINI RESOLUTION: BEST YOUR STRESS! Practice diaphragmatic breathing for three minutes each day to help stave off stress. Use the calendar to log your breathing exercises, as well as your exercise, sleep, sugar. water, fruit-n-veggie and micro goals! Click or tap to view and download the log.  INTRODUCING YOUR NEW MINI RESOLUTION: Best Your Stress! Good morning and welcome to another mini resolution: BEST YOUR STRESS! Can you think of anyone that doesn’t regularly deal with stress? September is particularly a busy and stressful time for many, with summer vacations behind us, the kids’ return to school, and constant reminders about the upcoming holiday season, for which marketing begins earlier and earlier each year. So, this month, we’re focusing on techniques to take control of our stress and breathe. Understanding The Primitive Systems that Dictate Our Stress Response Generally, our stress response (AKA the Fight or Flight response) is quite primitive and has never adapted to modern life. This innate response is designed for mortal threats such as a confrontation with a saber-toothed tiger. See in the chart how the body is prepared to either stand and fight or turn and run from a potential fatal threat. All of that makes sense when you read it! Once that tiger has been dealt with, the body restores homeostasis by activating the Rest and Digest system, essentially the opposite of the physiology of the Fight or Flight response. All of that makes sense, too! In modern times, our stress response is not activated by a mortal threat, but by mundane routines, finances, traffic jams, deadlines, job loss, the news, etc. These are not threats to our existence nor do they dissipate. Instead, they persist all day every day. Thus, the stress response remains stimulated, and homeostasis is not achieved because the Fight or Flight response remains active. As a result, the Rest and Digest system does not have a moment to take the reins. What’s more, our primitive physiology responds as intensely to a traffic jam as a saber-toothed tiger. Our perception drives our body’s physiological response, which is why we are often told how we respond to a stressor is determined by how we perceive the situation. Dealing with Stress NOW Thus, advice for handling stress typically falls into two categories, both of which are worthy endeavors:
The former minimizes the occurrences of certain types of stressful events and the impact of prevention can be felt within a short period of time, like weeks to months. The latter, learning acceptance of “what is,” requires lifelong learning and work. But our bodies need a break now—not in weeks, months or years. So, what if there was a way to give the body a break from the Fight or Flight response, to intentionally activate the Rest and Digest system thereby restoring a modicum of homeostasis to minimize the negative health consequences of chronically activating the stress response? There is! Our resolution this month is to implement tips and use the tools to activate the Rest and Digest system. Below, we provide your home base: the number one tool at your disposal to change your stress physiology is your breath. Next week, we’ll dive into the science of the soup of chemicals released by the Fight and Flight response and how this impacts brain health. Then we’ll continue with additional tips and tools throughout the rest of September. In the Fight or Flight chart above, you’ll notice that the only physiological response you can control is your breathing. You have the power to take the breath from fast and shallow to slow and deep because, in response to deep diaphragmatic breathing, the body will quickly activate the Rest and Digest system. In other words, breath is the brake to the stress response. Keep in mind that shallow, quick breathing further activates the Fight or Flight response—which means we need to consciously take control of our breath with deep breathing techniques in order to activate the Rest and Digest system! Start with this quick test. If the hand on the chest rises first and more fully, then your breath is shallow. In this case, you must focus on directing the breath to hand on the belly to activate diaphragmatic breathing. This video, while old, simplistically talks you through the process. You can even practice this type of breathing while driving, using the back of the car seat instead of your hands to guide the breath. It is also a great exercise to apply prior to sleep to induce calm and stillness. Of course, there are other breathing exercises out there—like box breathing and alternate nostril breathing, for example—but belly breathing is still a component of those exercises, so this is our starting point. YOUR TASK: Each day, set a timer and practice the diaphragmatic breathing technique for 3 minutes. Want to level it up? Shoot for 30 breaths and try not to lose count! Struggling with diaphragmatic breath? Try adding essential oils to your breathwork, which may help you deepen your breathing. Bergamot and lavender have been studied for their calming influence on the nervous system. Place a few drops on a cotton ball and breathe! Feel free to email your Motivated Mondays Coach Michele at [email protected] with your individual questions. TRACK YOUR PROGRESS YOUR MINI RESOLUTION: BEST YOUR STRESS! Practice diaphragmatic breathing for three minutes each day to help stave off stress. Use the calendar to log your breathing exercises, as well as your exercise, sleep, sugar. water, fruit-n-veggie and micro goals! Click to view and download the log.  Environmental Exposure Last month, scientists at the Alzheimer’s Association International Conference shared the finding that long-term exposure to wildfire smoke increases the risk of being diagnosed with dementia. Surprisingly, this risk was found to be higher than that of other types of air pollution, such as vehicle emissions. Fortunately, this risk does not apply to all of us, but it does allude to the important conversation about environmental exposure and the associated risks of cognitive decline and neurodegeneration. Unlike our resolutions around exercise and diet, where the research is robust, this topic is more controversial. Why is that? What we know about the impact of toxins and toxicants on the human condition is largely drawn from people with occupational exposure in agriculture or manufacturing and hobbies, such as pottery or painting. Historically, these individuals became canaries in a coal mine due to their higher-than-normal exposures. And, unlike diet and exercise where you can intentionally expose some study participants and not others to the study variable, it would be unethical to intentionally expose any study participants to a toxin or toxicant. Thus, our studies are largely based upon epidemiology (rates of diseases in populations) and animal research or models. Today’s Special Edition Mini Resolution Today we will be addressing the toxins and toxicants that have demonstrated an association with neurodegeneration and declining cognitive function. These include the “cides” (pesticides, herbicides, etc.), heavy metals (like mercury and lead), and BPA and its alternatives. Keep in mind not everyone has equal exposure to nor equal genetic susceptibility with the substances discussed. Our goal is to generate awareness, not fear. PRO TIP: We have packed a lot of information into today’s Motivated Monday’s special edition. Bookmark this blog so you can refer back to it when needed! Toxins occur in nature and are all around us. Examples include heavy metals or mold. Toxicants are manufactured substances, such as plastics and pesticides. Both can make their way into the air we breathe, the water we drink, the food we eat and can even be absorbed by the skin. 
How do these substances impact our neurology?
Some substances, like forever chemicals and heavy metals, persist in the environment and our bodies. They are lipophilic (fat loving), meaning long-term chronic exposure can cause bioaccumulation in fat, both in humans and in our food chain. Certain substances (like BPA) may be rapidly metabolized into a reduced toxic form and then excreted, but not before impacting the body. Thus, reducing our exposure can be very impactful as a long-term strategy to chronic exposure. How can we do that? Let’s focus on what we can control, like the exposure to toxins and toxicants in our homes. EXPOSURE IN OUR AIR Since toxins and toxicants can enter the home via your central heating and air conditioning, the use of a MERV 8-13 filter on your HVAC system is suggested. In addition, some toxins or toxicants can be generated within the home (e.g., mold or chipping lead paint). In such cases, an indoor air purifier can help, both mechanically and via activated carbon filters. Ideally, you’ll want to select one that removes particulate matter as small as PM 2.5. You may even decide to have your air quality tested by an industrial hygienist. EXPOSURE IN OUR WATER Whether naturally occurring in the environment or a product of human activities, toxins and toxicants can enter the water supply by runoff into our aquafers. This also includes bottled water, which often originates from a tap, not a spring. Keep in mind, even though our water supply is routinely tested, guidelines regarding allowable limits may not meet the muster for your family. Your local water company is tasked with monitoring your water safety, so your first stop is to contact them for a water report. Testing the water from your own tap is probably a good extra step because a lot can happen between the reservoir and your home. Here is the EPA’s guide to certified labs for water testing. If you are on well water, the EPA recommends annual testing. You may alternatively decide to abandon the extra step of testing and just install a water filter—a market with many options. Point of entry (POE) filtration systems can be installed where your home connects to the water supply. If you live in an apartment and are unable to install a POE, filters can be added to your showers and faucets. For filtration, the EPA provides a comprehensive document on which types of water filters are best for contaminants. An industrial hygienist can also help you assess your water quality and implement solutions as indicated. EXPOSURE IN OUR FOOD
Diet is the main source of exposure to toxins and toxicants. Let’s break down a few concerns: Pesticides+ Herbicides While the “cides” serve a valuable purpose in public health (eliminating disease causing vectors such as rodents and mosquitos), they also create concerns for human exposure. Click here to view our Motivated Mondays 2023 email on “cides” in our food. Heavy metals Beyond “cides” and BPE exposure (below), there is the concern for heavy metals in food. In fish, one of the biggest concerns is mercury. This wallet card can be helpful when dining out or at the fish market. In rice, where arsenic is a concern, you can rinse the rice thoroughly and also cook it in a rice to water ratio more akin to pasta than rice, 1:6. Did you ever read a headline about heavy metals found in processed food, such as baby food or protein powder, and think to yourself, “What the heck?” Well, the potential contamination may come from one of two sources. One, manufacturing equipment itself may generate shavings of metal which end up in the product on the shelf. Or, two, since heavy metals naturally occur in the Earth’s crust, they may contaminate raw materials purchased by manufacturers from countries where regulations are more relaxed. Thus, It is also important to read labels for the country of origin, which is required of certain foods under certain conditions. In some cases, sourcing your ingredients from countries which tightly regulate their food production (such as Australia and New Zealand) is a better option. BPA Can you go a day, even an hour, without coming into contact with plastic? It’s virtually impossible! Plastic is simply in, on and around everything—it is ubiquitous in our lives. While BPA in plastic has garnered the most attention as a threat to our health, the “alternatives,” BPS and BPF, possess the same if not worse adverse effects on health. Thus, purchasing “BPA free” plastic is not always an effective strategy. Further support for plastic avoidance was evident in a pre-printed published (not yet peer-reviewed) study in which nano- and micro-plastics (NMPs) made of polyethylene (BPA- free), were found in human post-mortem livers, kidneys and brains in increasing numbers from 2016-2024 (50% more!). The highest concentration of NMPs was found in the brain, likely due to the fact that plastic is lipophilic, and the brain is 60% fat. With regard to heart disease, NMPs have previously been identified as drivers of inflammation, potentially precipitating cardiovascular events. For neurological health, it is currently unclear how or if the NMPs exert a deleterious effect. When plastic cannot be avoided, you can manage your exposure by keeping in mind that the nature of the food itself impacts the absorption of BPA to our foods, as does the temperature. Acidic, salty, fatty foods are more likely to absorb BPA, and certainly microwaved food is more likely to absorb BPA. For this reason, we strongly urge you to never microwave your food in plastic containers. Below are common food exposures to plastic:
OTHER CONSIDERATIONS IN THE HOME Pesticide-use in the home Human exposure can occur inadvertently by in-home use of “cides.” Routes of administration can include inhalation, dermal contact and ingestion via food and water. Acute exposure can lead to poisoning, but because the “cides” are lipophilic, long-term chronic exposure can cause bioaccumulation in body fat, both in humans and in our food chain. The decision to use the “cides” in and around the home is a personal one. The benefit of the “cide” must be weighed with the risk of use, especially if children or pets are in the home—while you are unlikely to lick the baseboards after a spray, they are likely to do so. The University of California has an excellent overview for use of pesticides in and around the home. If you garden, here is an article to learn more about general non-chemical pest controls, the specifics of what you need will vary by what you grow and the type of pests you encounter. Paint Lead in paint was banned in 1978, so homes built before then may contain lead. Importantly, intact paint (i.e., not chipping or flaking) is considered safe as long as it remains that way, but paint that is compromised can be of concern. Here is the EPA information on lead paint. As mentioned last week, an industrial hygienist can assess your home for all environmental concerns and recommend solutions or ways to minimize risk. Personal care products If you are interested in learning what heavy metals the government allows in, and how much, you may review this document from the FDA. If you seek safer personal care products, the Environmental Working Group provides lists of products they have verified that are free of concerning chemicals. Smoking We all know cigarettes contain harmful ingredients like nicotine, carbon monoxide and tar, but did you know they also contain heavy metals like arsenic, cadmium, chromium, nickel and lead? For this reason, and countless others, you may want to think twice about buying that next pack. If you need help quitting smoking, contact your concierge physician. Hobbies Certain hobbies such as jewelry making, painting, pottery and stained glass making have the potential to expose the artist to heavy metals. You may wish to source materials from this verified list by the Art and Materials Creative Institute. Dental The first recorded use of dental amalgams dates back to the Tang Dynasty in 659 CE. The decision to remove dental amalgams is a personal one, as the removal process itself creates the risk of mucosal absorption, ingestion and inhalation of mercury. If you decide to engage in a conversation with your dentist about the removal of dental amalgams, be sure to ask about the precautions they take, which should include use of dental dams (used to isolate the operative site to prevent mucosal absorption or ingestion). To avoid inhalation and high-volume suction, HEPA room air filters and an oxygen mask are recommended. Whew! We’ve left you with a lot of information this week. Feel free to reach Motivated Mondays Coach Michele at [email protected] with any questions. We’ll see you next week to kick off our NEW mini resolution for September! |
MICHELE MCCAMBRIDGE, MPH, MSMichele is the Senior VP of Membership Development at Concierge Choice Physicians. She is also a professional in the areas of nutrition, fitness and wellness. Archives
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