Our physical, spiritual and mental lives are all connected to the brain. Since the brain is the “CPU” of our bodies, it is through the brain we experience every aspect of life. At Life Skills Village, we promote a holistic approach to traumatic brain injury rehabilitation. We believe keeping your brain healthy is vital – especially during neuro rehab. That’s why the upcoming series of blog posts focus on diet, exercise and sleep.
Eating right is the best way to ensure your brain and body receive the crucial nutrients that will nourish them during rehab. Your brain is only a small portion of your body weight, but it greedily gobbles up 20% of your metabolic energy. People who eat a healthy diet tend to live longer lives, enjoying better-than-average cognition and memory. Conversely, a poor diet is associated with a lower quality of life and diseases like "heart disease, hypertension, diabetes, osteoporosis and cancer," as reported by U.S. Department of Health & Human Services.
How do we know what foods to eat and what foods to avoid? How do we make healthy changes to our diets? By categorizing the food we eat into nutrients that we know are good for the brain, it's easier to see how a healthy diet inspires a healthy, fulfilling life.
Magnesium is a dietary mineral with many psychological benefits and a deficiency is likely to result several side effects including increased general anxiety. There are a few reasons for this: magnesium activates Gamma-aminobutyric acid receptors in the brain whose purpose is to relax the brain and magnesium filters stress hormones like cortisol before they enter the brain. These stress hormones activate immune system messengers called cytokines that inflame the brain in an attempt to “heal” the stress. This autoimmune response doesn't work because there is no actual damage and can leave you with long-term memory problems. When these messengers are blocked, inflammation is reduced or prevented. Another physiological/chemical benefit of magnesium is that it binds with heavy metals in the body and carries them out. It is not known if this process is active in the brain, so it important to address the issue before the toxic elements collect. Studies have concluded that a magnesium supplement can help hypoglycemic individuals better maintain their blood sugar levels.
Magnesium could also bolster neuroplasticity, a process made mainstream by brain game apps such as Lumosity, which pairs well with cognitive rehabilitation because of its capacity to promote the creation of neural pathways and increase base-level serotonin. For this reason, magnesium may help alleviate depression without aggressive medication.
When these issues are addressed, it helps put the individual back in control; sleep is improved, stress is reduced, and focus and concentration are bolstered.
Magnesium should not be treated as a cure all, the research is not complete, and it should only taken in appropriate amounts. It has benefits but cannot solve your mental health issues on its own.
Sources of the best dietary sources of Magnesium.
These are the supplements to look for:
Protein is one of the 3 macronutrients essential to body and brain function. Protein is made up of many different amino acids, eight of which the body cannot produce on its own.
Diane Roberts Stoler, writer with Psychology Today, explains that if we don't get all eight in one meal, the proteins are broken down for energy rather than growth and repair and that "getting all eight together is most easily accomplished by eating animal products." However, it is possible to get complete proteins from non-animal products. Ask a registered dietician on how to best calculate your daily protein intake.
Protein can be acquired through powder supplements to be mixed into drinks. There are a lot of these out there and some are not good to use; be sure to research your protein shake before you buy and consume them regularly.
Dietary sources of Protein:
Folate (also known as vitamin B9 and folic acid depending on where it's found - folate is in food, folic acid is in supplements) is critical to healthy brain and body function. After being digested and absorbed it becomes methylfolate, which is essential for the brain's production of DNA and neurotransmitters.
Folate is also crucial for women attempting to get pregnant or who are already pregnant. During pregnancy: 400 micrograms per day are recommended. During lactation, 500 micrograms per day. This is especially important one month before trying to get pregnant and within 21 days of conception. Refer to our sources for more complete information. The National institute of Health has a list of recommended folate intake.
Good food sources of Folate:
Vitamin D is synthesized in our skin when it comes into contact with sunlight. However, because of our lack of contact with sunlight during winter, Americans are often Vitamin D deficient. Symptoms of this deficiency include bone pain, muscle weakness, seasonal depression and a study in the UK found evidence of impaired cognition. If a physician diagnoses a deficiency, it is important you take the active forms of Vitamin D: Calcitriol or Vitamin D3. While it is found in many foods, 10-20 minutes of direct sunlight will produce more Vitamin D in our bodies than a day’s worth of food. As we age your body is less efficient at producing the vitamin, so it is important to include in your diet and daily supplements.
Tips for supplementation: magnesium helps increase effectiveness of absorption. A safe amount of Vitamin D to include in your diet is 400 IUs for infants, 600 IUs for adults and 800 IUs for seniors.
Good sources of Vitamin D:
Antioxidants are in many fruits and vegetables, and can be made into supplements. They also have varying effects on brain and body function. Vitamin E has been shown to ward off depression; Vitamin C is linked to reduced incidents of stroke and enhances skin healing; and Vitamin A is good for eye health and cholesterol. All Antioxidants are used in the body's natural response to reactive compounds called free radicals (pollution, smoke, UV light). This process is useful because it helps preserve our cells in the presence of these irritants. They are also an anti-inflammatory, which is associated with reducing pain, preventing neuro degenerative disease and cardiovascular disease.
Flavonoids, carotenoids, and other phytonutrients are responsible for the bright coloring in fruits and vegetables. There are over 6,000 different types make up the largest group of phytonutrients, and are powerful antioxidants to seek out.
Antioxidants to look for in your food and supplements:
Various antioxidants can be found in these foods:
Healthy Fats (yes, they exist) are necessary for proper brain function, considering the brain runs on 60% fat. In utero and as we mature, our brains use fat to grow membranes, myelin sheaths and other structures. These are important to protect neurons and axons. The brain never stops needing fat to function and it will utilize available fats should the correct ones not be available. Omega 3 EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) fats are what the brain craves and allows it to function at peak performance. Heather Pratt, with Natural Grocers, postulates that these omega 3 fats are correlated with "neurotransmitter production and function, meaning... serotonin and dopamine (the chemicals in our brain that control happiness) absorption is improved [by omega 3 fats],” and that helps stabilize mood as well as stress response.
Healthy fats have a wide variety of positive body outcomes. Monounsaturated and polyunsaturated fats raise good cholesterol while lowering the bad. Omega-3 and omega-6 are good for the brain and skin.
Good fats to find in better food and supplements:
Good sources of healthy fats:
Vitamin K is known for its benefits to the circulatory system like improving bone health, reducing inflammation, and increasing blood flow. all of which helps improve cognitive function. The Vitamin comes in two varieties: K1 and K2. K1 is important to blood coagulation and is stored in the liver. K2 is more active around the body, and does everything mentioned above. Watch out for MK-4 and MK-7 on supplement labels, as those are the forms of Vitamin K2 that should ingest.
Good sources of Vitamin K:
Collagen production in our bodies declines as we age, making it important later in life to boost your collagen intake. It is usually known for its role in joints, cartilage and muscle, but it has also been shown to protect brain-cells from amyloid-beta proteins known to cause Alzheimer's disease. Watch out specifically for Collagen VI as it has been researched in these Alzheimer's findings.
Good sources of Collagen:
We wouldn't need good nutrition articles if we didn't have bad nutrition! Here are the bad things in food to avoid:
Trans fats are guaranteed to age your brain should they be consumed frequently. This quote by Psychology Today, describes it best: "Trans fats can lead to serious health complications including heart disease, cancer, diabetes, low birth rate, obesity and immune dysfunction. They also have serious consequences on brain health.” Look for partially hydrogenated vegetable oils in the ingredients list to know which items to avoid.
Avoid these foods, especially if packaged and store-bought:
Saturated Fats can be tolerated in amounts higher than trans fats but will still show the same raised levels of bad cholesterol and cognitive decline over time.
Saturated fats can be found in these food products:
Sugar, syrups and simple carbs cause obesity, metabolic syndrome and an assortment of other disorders and diseases that arise from those conditions. Studies have shown that high fructose corn syrup, a cheap sugar alternative, hampers cognitive ability, slowing down memory and learning. It is believed that this is because the test subjects (rats) developed insulin resistance which inhibited insulin's ability to regulate stored sugar for brain function.
Foods to avoid with High Sugars:
Mercury is a neurotoxin. It is found in seafood and can accumulate if eaten too regularly. After being ingested, or inhaled, mercury is stored in the kidneys, blood, liver, spleen, brain, fatty tissue, and bones. It is known to inhibit the development of babies’ brains, hearts, and circulatory systems in utero. It is a known cause for several types of cancer, can cause neurological and behavioral disorders, and can change neuromuscular activity.
Do not touch it with bare skin, avoid being in closed spaces with it, and do not eat it.
Foods to avoid with Mercury in them:
Brominated Vegetable Oil (Or Bromide) is a chemical used in citrus sodas to help keep flavor syrups from separating from the water. Bromide can also produce a sedative effect on the brain. It can replace the neurotransmitters that neurons use to communicate.This is a problem because the dosage for sedation is close to the dosage for toxicity, and the amount used in soda can be toxic to a person addicted to soda.
Drinks to avoid with Brominated Vegetable Oil:
There is a lot to consider when it comes to your brain health but the task of diet improvement doesn’t have to be daunting. With a few tweaks here and there over time your new habits will keep you healthy! Sign up for notifications from the blog to find out when we post the next part of our series “Brain Healthy!” What is your favorite super food? What would you like us to cover next?
This list is incomplete, and I am not a registered dietician. Research your nutrients before changing your lifestyle, and ask your doctor before changing your diet if you have digestive disorders or immune system deficiencies.
*General food sources: Draxe, EatThis
*Magnesium fact sources: BeBrainFit, Ancient-Minerals, Draxe
*Protein fact sources: PsychologyToday
*Folate fact sources: AuthorityDiet, PsychologyToday
*Vitamin D fact sources: Webmd, ScientificAmerican, PsychologyToday, ReadersDigest
*Vitamin E fact sources: Life-Enhancement
*Antioxidant Fact sources: Livescience, EveryDayHealth
*Healthy Fat Fact Sources: Greatist, NaturalGrocers, Draxe
*Vitamin K Fact Sources: EverydayHealth, Medlineplus
*Collagen Fact Sources: NewBeauty, ScienceDaily
*Trans Fat Fact Sources: IVLProducts, PsychologyToday
*Saturated Fat Fact Sources: IVLProducts
*Sugar Fact Sources: IVLProducts
*Mercury Fact Sources: GlobalHealingCenter, GreenFacts
*Brominated Vegetable Oil Fact Sources: ChemistryWorld
Brain Games are a recent upload to the modern digital milieu. Most are made for mobile formats. Some are surprisingly enjoyable. All of these apps endeavor to improve cognition, lower your mental age or improve focus by playing a variety of short games. Users are scored according to performance in each game and receive alerts intended to encourage consistency.
It's only natural that brain games have become a useful tool, perhaps nowhere more-so than in field of neuro rehabilitation. When a person experiences a brain injury, they inevitably suffer cognitive deficits. But they can still recapture some of their former attention, memory and focus through hard work on multiple fronts.
Neuroplasticity is the ability of the brain to adapt to change within the duration of a single lifetime. This process allows for damaged areas of the brain to pass along their responsibilities to other parts of the brain. Playing certain brain games on a very regular basis can "assist neurons during their hunt for a way around the obstructing injury." Repetition of both actions and games over time can help the survivor's brain facilitate and strengthen a neuroplastic response.
There are many useful applications designed for TBI survivors. These can be used as an extension of the mind; for example, reminder systems and note taking apps. Brainline.org compiled a large list of apps that can prove to be life changing for TBI Survivors including some of the apps on this list. You can read their list here. Our list focuses on just brain games that could prove useful during rehabilitation.
A very usable app with lots of variety, reminders, statistic tracking and pleasing, minimalist interface. When you first boot up the app you immediately notice that the interface is all about much options and self-motivation. The makers of Lumosity are very transparent about wanting you to upgrade to their paid "premium" version. This is one brain game that keeps some of your stats under wrap. Or, at least behind a pay wall. The interface displays your current cognition scores for speed, memory, attention, flexibility, problem solving and math ability.
On the other hand, the games themselves are quite easy to understand and usually fun. An article from Businessinsider.com takes an in-depth look at exactly how beneficial these games really are, noting that "specific populations [of people]... have shown some improvements in memory and executive function after Lumosity-like brain training." They are referring to differently abled individuals. This is in contrast to non-concussed people, who would improve in their ability to perform a specific task, yet not show improvement in their general cognition.
This one is subscription based. More available games than any other app on this list. Also, it is the most expensive.
Compatible with Android, and iOS.
Very similar to Lumosity in that it uses brain games, reminders and score features, but presented differently. Of the apps on this list, I find the games most stimulating visually and conceptually, and give the added bonus of being informational. These games practice skills that are relevant to daily activities like quickly calculating percentages, estimating price, and reinforcing correct spelling and grammar. Similarly the stats it collects are presented less as attributes of cognition and more of practical ability. This means it gives you writing, listening, speaking, reading and math scores and graphs them for you to see your progress.
This app guides you through the process of selecting and participating in activities. You will receive reminders that regularly track your progress. However, some of these games may prove frustrating or too difficult for some clients.
Paying their subscription fee allows you to play more games, and unlocks more performance statistics. Elevate is cheaper than Lumosity, and offers a more polished experience. The drawback is that Elevate doesn't have as many activities. Of this group I'd be most likely to pay for this one and you still get a lot for free.
Compatible with Android, and iOS.
Unique concept that takes its tenets and encourages users to internalize them and "practice" away from your phone. Happify's purpose (and mantra) revolve around positivity, happiness, and mindfulness. At Life Skills Village we use these same concepts in our TBI day program. Using Happify feels like meditation and helps to reframe your thinking; Happify is worth checking out. It's a refreshing mix of in-app mini-games, self-reflection techniques and real-life applications that makes for an interesting experience. This app helps you track your goals and progress - it even and asks you questions about your actions! Happify offers periodic checks-ins and a happiness assessment (so you know how happy you really are).
For all the positive vibes you get on this app, it can feel gimmicky at times. That said I am quite optimistic about positive outcomes and can't recommend this app enough. However, take note: the free version is restrictive and slow.
The subscription fee is the same as Lumosity's. and the app itself does not use any ads.
Download: iOS, Android
Fit Brains Trainer
Polished product with a decent variety of games available in the free version. Games can be somewhat derivative from other products (in some cases the only difference is color), but at least these are available in groups of five per day rather than the three that is standard from the big names. The product is no cheaper than others and the statistics offered aren't very in depth and are almost exactly the same as Lumosity's. I would have said that this one offers the most activities for free, but after five sessions the game locks up and you cannot continue training for free. Lumosity is probably a better option.
Download Here: iOS, Android
This is the first of the group that does not request you pay a subscription, instead it has one time charges for optional features, like removing ads, or their brain currency that makes the app easier. It is most likely entirely funded by ads, which are ubiquitous in the app. The lower your game score, the more ads you see. Skillz has a minimum viewing time as well. The upside is that you are not limited by how many games you want to play per day and can retry each game as much as you like. The games are somewhat low visual quality and unforgiving; however it's completely free and still offers the cognitive training desired. The app even tries to have a sense of humor and, for what it's worth, it helps you get through the games.
Downloads: iOS, Android
This app has both ads (a one time charge for removing ads) and add in-game currency (though at three dollars it's one of the cheapest on the list). The free version is not as restrictive as Elevate, Lumosity or Brain Fit. It's a happy medium that has many of the same games as other apps but doesn't lock them behind a pay wall, but rather a progression wall. So to play other games you have to play games! Smart offers no progress metrics and makes no specific claims about brain training. It just offers the same type of games as other well known brain training apps, and lets you play as much as you'd like. Its layout and transaction scheme is similar to the Skillz app, though a bit more polished.
Download Here: Android, iOS
Brain it on!:
The most unique entry in this list, Brain it on! is a series of puzzles that you solve by drawing shapes. It's a relatively simple concept and all of it sticks to the basic principles, but they extrapolate these ideas and keep adding and adding until the game becomes very difficult. Thankfully they offer hints (behind ad videos). The free version also has you unlock levels by playing other levels kind of like an early Mario game. The app does not offer progress metrics, but does award pleasing little stars and shows you how many you've earned. People with limited hand dexterity may find this outside their abilities, but it offers enough engaging content that I'd recommend it to people who wish to improve their hand-eye coordination.
The premium version is a one-time fee of $3, and removes all ads, unlocks all hints, and unlocks all levels.
Download Here: Android, iOS
The Ideal Brain Game for Brain Injury
This list was written to give a brief rundown of the most popular brain games currently on the market. Each app has its merits - be they functional or economical. My personal favorite has been Elevate, but I am biased because I had used it before, and opted in to the "pro" free trial.
The ideal brain game app would have vast scaling potential and variability. It would track a TBI survivor's cognition and offer a tracking system to show how the user has improved over time. Statistics like these are useful to the subject because they provide a sense of pride and accomplishment, but can be useful to a provider who might integrate this information into their treatment.
What do you think about brain games? What's your favorite?
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About the Doc
Dr. Bryan Weinstein is a practicing psychiatrist with certification from the American Board of Psychiatry and Neurology. He has practiced psychiatric pharmacology and psychotherapy since 1997. Dr. Weinstein is the CEO of Life Skills Village.