Sunday, July 1, 2018

Addiction damages the Brain

Addiction damages the Brain
Dr. Dwijesh Kumar Panda

Addiction hijacks the brain’s neural pathways. It is a moral failing of desire, unrestrained eating and withdrawal that traps tens of millions of people in the world. Addiction denote dependence of a substance with increasing tolerance. If it is used more and more nasty withdrawal effects occur when use stops. These are alcohol, nicotine and heroin. Nicotine is a water soluble poisonous alkaloid found in tobacco leaves which is smoked and chewed. Heroin is a white crystalline powder derivative of morphine having euphoric effect. Marijuana and cocaine don’t cause shakes, nausea and vomiting like withdrawal. Addiction is a disease, not a moral failing. It is characterized by compulsive repetition of an activity despite life damaging consequences. Anything that induces euphoria (feeling of vigor, well-being) or is calming, can be addictive. Addiction depends person’s vulnerability, which is affected by genetics, trauma, and depression. Many people have persistent desire to eat certain foods. Pizza- typically made with white-flour crust and topped with sugar-laden tomato sauce is the most addictive food, with chips and chocolate. That is a major reason why people struggle with obesity.
More than two lac people worldwide die every year from drug overdoses according to the United Nations office on drugs and crime. Much more than this die from smoking and drinking. A billion people smoke tobacco. It is the top five causes of death: heart disease, stroke, respiratory infections, chronic obstructive pulmonary disease and lung cancer. Nearly one of every 20 adults worldwide is addicted to alcohol. Gambling and compulsive activities are also recognized as addictions. In the United States 33,091 cases of opioids overdose deaths happened in 2015. The U.S. surgeon general’s report on addiction concluded that 21 million have a drug or alcohol addiction. 3.3 million worldwide die each year from alcohol. This disorder is more common than cancer. 1.1 billion people in the world smoke tobacco. Behavioral addictions are strong desires for gambling and other attractions of modern life- junk food, shopping, smartphones. These are potentially addictive because of their powerful effects on the brain’s reward system. Gambling and Internet gaming resemble drug addiction.
M.R.I. (Magnetic Resonance Imaging) can unravel the mysteries of addiction. The brain scans are coverted to images that pin point the circuits. The brain images visualize the brain state. There is a spike in the neurotransmitter dopamine. It is a chemical messenger that carries signals across the synapses. Dopamine plays wide-ranging roles in the brain. In addition, the flow of dopamine heightens. Each drug that’s abused affects brain chemistry. They all send dopamine level soaring far beyond the natural range. The brain’s executive control centre is the prefrontal cortex and other cortical regions. Changes in this part of the brain affect judgement, self-control and cognitive (memory) functions. People with addiction often in using drugs to relieve the misery they feel when they stop.

Normal Neuronal Activity
Cocaine addicts have reduced gray matter volume in the prefrontal cortex. The deficiency of the volume results in poor executive function, memory, attention, decision- making. They generally perform worse. Cocaine is a white powder obtained from dried coca leaves which is an American shrub. This drug that is abused affects brain chemistry. They increase dopamine levels far beyond the natural range. The cells that make dopamine are the little devils in our brain. They powerfully enhance the chemical drive desire. Several studies don’t answer the chicken-and-egg question. Does addiction cause these impairments, or do brain vulnerabilities due to genetics, trauma, stress or other factors increase the risk of becoming addicted? Goldstein, director of NIDA discovered disappointing evidence that frontal brain regions begin to heal when people stop using drugs.
Cocaine interfering with dopamine transport
Our brain evolved a dopamine –based reward system to encourage behaviors that help us survive. They are eating, procreating, and interacting socially. Different drugs interact with the reward system in unique ways to keep the synapses artificially flooded with dopamine. That dopamine rush can rewire our brain to want more drugs, leading to addiction. Brain’s reward system controls craving and pleasure. Craving is driven by neurotransmitter dopamine. Pleasure is stimulated by other neurotransmitters in “hidden hot spots.” When the craving circuits overwhelms the pleasure hot spots, addiction occurs. People use more drugs despite the consequences.

Heroin flood the synapses with dopamine
The application of electromagnetic pulses to the prefrontal cortex or transcranial magnetic stimulation is a hope of success. This technique is now being tested around the world. Medications that can prevent the activation and keep people from falling prey to unseen triggers are in the pipe line of modern research.
In the world of addiction, the best hope for treatment lies in melting modern science and depend on ancient meditating practice. Use of meditation and other techniques to bring awareness to habits that drive self –defeating behavior. In Buddhist philosophy, craving (strong desire) is viewed as the root of all suffering. Mindfulness can counter the dopamine flood of contemporary life. It is more effective in preventing drug-addiction. It can ride out the wave of intense desire.  Mindfulness trains people to pay attention to cravings without reacting to them. It breaks the habit of ice cream and chocolate. Yoga, counselling, amino acid supplements, and dieting changes can be more effective in preventing drug addiction. Meditation quiets the Posterior Cingulate Cortex and the neural space that don’t lead to obsession (evil spirit ruling a person). Our brains evolved a dopamine based reward system to encourage behaviors that help us survive, such as eating, procreating and interacting socially. The brain can rebuild itself. That’s the most amazing thing.
1.     Journal of European Neuropsychopharmacology, January 2016.
2.     Diagnostic and statistical Manual of Mental Disorders, 2016.

Let food be thy medicine, not medicine be thy food

Hippocrates, the Greek physician (377 B.C.) is called the Father of Medicine. He gave the message to the people that healthy food could cure the disease, not medicine. The actual quality of food is probably much more important for our health than the proportion of fat, carbohydrate and protein. The highly recommended diet is the Mediterranean diet which include lots of fish, nuts, vegetables, beans, whole grains and olive oil. People have lived on high- protein high –fat diets, on low-protein high-carb diets, on diets high on raw milk and cream and even on diets high in animal blood. They have done so without ravages of degenerative diseases that are epidemic in modern life- heart disease, diabetes, obesity, neuro-degenerative diseases, osteoporosis, and cancer. Eat the real food which the grandmother recognized as food, does not come in a package, minimal processing, contains nutrients, phytochemicals, enzymes, vitamins, minerals, antioxidants, anti-inflammatories and healthful fats. It can keep alive into tenth decade. How we eat is as important as what we eat.
What about Organic?
There are certain terms to define as we talk about food. Those are “grass fed,” “organic,” “cage-free,” and the natural. All are deceptive and dishonest term in food marketing. “Natural” has no legal definition. It is purely a marketing scam. “Organic” is a label seen everywhere and on everything. The organic food movement is a desire to return to basics. The healthy products of fruits and vegetables, goats and chickens lived in an independent atmosphere of pastoral tranquility, where food- whether animal or vegetable- was raised or grown the old-fashioned way. The animals are not fed growth hormones, steroids, and antibiotics. The crops are left to fend off the elements with their own protective antioxidants and anthocyanins, rather than chemical pesticides and carcinogens. The “Roundup Ready. “Genetically modified plants” (GMO) were unknown.  The real considered fruit fell from a tree, or was harvested from healthy animals grazing on pasture or wild fish from uncontaminated waters are true organic.

Antioxidants fight oxidation. Oxidation can be visibly seen when a cut apple is left in the air. Oxidation-or oxidative stress-is a factor in every degenerative disease. Antioxidants help fight oxidative damage. Deficiencies of antioxidants are implicated in the early stages of heart disease, cancer, eye disease, and age related decline in memory. A healthy food is loaded with antioxidants.

Glycemic Index:
It is a measure of how much a given food raises the blood sugar level. High sugar foods- or foods that convert quickly to sugar in the body- are considered high glycemic. High blood sugar raises level of the hormone insulin high enough for long time frequently contributes to diabetes, heart disease, aging and Alzheimer’s now referred as “type 3 diabetes”. Eat less sugar. Eat fewer foods that converts quickly to sugar in the body (almost all processed carbohydrates).
Healthy polyunsaturated fats (Omega- 3s):
·      Saturated fat is not always bad. It does not cause heart disease as previously believed. Coconut oil, dark chocolate, ghee from grass-fed cows- are healthy.
·      Trans fat, however, is poison. Metabolic poison. It’s found in cookies, crackers, baked goods and snacks, doughnuts, French fries and most margarines. There is hydrogenated oil in the ingredient list.
·      Monounsaturated fat- found in nuts and olive oil – is good and heart healthy.
·      Polyunsaturated fats come in two flavors: omega- 6s and omega-3s. We consume many omega-6s having some health benefits, but not enough omega-3s. There are three different omega-3 fats. One of them is called ALA (alpha-linolenic acid found in flaxseed.) It is considered an essential fatty acid because the body can’t make it, so it must be obtained from the diet. But the other two omega-3s- DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) - are found in fish such as wild salmon and Hilsa. These two are more important to the body than the first one. Omega-3s are incorporated into cells, making their membranes more fluid so they can communicate with one another. The feel-good neurotransmitters such as dopamine and serotonin can get in and out of the cell more easily, translating in better mood. It may have positive effect on depression, behavior, feeling, and thinking. The developing brain in human fetus is about 60 percent fat by weight. The child’s intelligence, fine-motor skills depends on fish diet during pregnancy.
Omega-3s are anti-inflammatory. Inflammation is a critical component of every degenerative disease from heart disease to diabetes to obesity to Alzheimer’s. Inflammation is the silent killer. They transport oxygen from red blood cells to the tissues. They prevent blood cells from clumping together (blood clots can be a cause of heart attack and stroke). They act as a blood thinner, much like aspirin, without the side effects.
The great cholesterol Myth:
Cholesterol might be the most misunderstood molecule in the whole world. It is not a health risk. It is the parent molecule of the sex hormones and vitamin D. It is an integral part of the cell membrane. The effect of eggs on heart disease has exactly zero to do with their cholesterol content. Eggs contain many valuable nutrients, such as protein and choline (which is great for the brain). Eye-nutrition superstars, such as lutein and zeaxanthin, healthy fats, vitamins and minerals are present in eggs. The cholesterol present in them is good thing. High cholesterol is protective in older people. High-risk men achieved a 30 percent reduction in heart disease with cholesterol-lowering statins. The women showed 31 percent reduction in heart disease just by eating fish once a week (WOSCOP study).
Fiber is roughage essential to the care and feeding of a healthy microbiome. There are two kinds of fiber (soluble and insoluble). Insoluble fiber doesn’t break down in the gut, so it acts as a bulking agent and is good for relieving constipation. These are seeds and skin of fruits, wheat bran and brown rice. Soluble fiber does break down in the gut. It is specifically broken down by good bacteria which convert it into short-chain fatty acids, the most important of which is butyric acid (butyrate). The cells lining the gut depend on butyrate for food. It has potent anti-inflammatory and anticancer effects. Lack of enough soluble fiber does not make enough butyric acid. The soluble fibers are prebiotics. They are food for the probiotics in the gut. A healthy, well-fed gut lining helps for a healthy microbiome. Soluble fibers are present in beans, oatmeal. Flax seeds, sprouts, apples, nuts, pears, black beans, unripe bananas. Bananas are high in soluble fibers called fructooligosaccharides which is prebiotic serving good food for good bacteria (probiotics) in our gut. “Wherever flax seed becomes a regular food item among the people, there will be better health” said Mahatma Gandhi. It was one of the original medicines, used by Hippocrates himself.
Superfoods help neurons in the brain communicate with one another effectively. They are brain food. “Old neurons are kind of like old married couples.” They don’t talk to each other so much anymore. Memory goes down, coordination and balance tend to decline. Communication between the neurons is signaling. One neuron can talk to another efficiently and new neurons grow. Polyphenols, anthocyanin present in superfoods turn on the signals. Inflammation and oxidative stress (damage done to cells and DNA by oxidation) are involved in virtually every major killer disease. “An apple a day keeps the doctor away”. Apples have highest level of antioxidants among the commonly consumed fruits. Its pectin content is a good source of soluble fiber that can lower LDL (bad cholesterol) cholesterol and help regulate blood sugar. Carrots “the king of the vegetables “and could possibly cut the rate of lung cancer in half”. They are high in carotenoids and antioxidants with wide health benefits. The great source of lutein and zeaxanthin protect the eyes and help to prevent macular degeneration and cataract. It raises the effectiveness of the light sensitive area of the retina preventing night blindness.
Pomegranate: Pomegranate protect LDL cholesterol from oxidative damage. It is capable of anticancer effects, to fight inflammation and prevent progression of Alzheimer’s disease. There is fair amount of natural sugar in the juice. It is associated with love and erotica.
The fat in coconut oil- a form of saturated fat (medium- chain triglyceride) - is among the healthiest fats in the world. This is more likely burned for energy. It has significantly higher HDL (good) cholesterol and an improved LDL: HDL ratio. The fatty acids (lauric acid) in coconut oil are powerful antibiotics. It kills Streptococcus (throat infections, pneumonia. sinusitis). Staphylococcus, Neisseria, Chlamydia and Helicobacter pylori. Dozens of pathogenic viruses are inactivated by the lauric acid it contains. This acid kills the bad bacteria but does not harm the friendly intestinal bacteria that we need for healthy digestion. Medium-chain- triglycerides also kill Candida and other fungi in the intestinal tract, supporting healthy gut ecology. Always buy virgin coconut oil which is not hydrogenated or processed with high heat and chemicals.
It is a poster child for a healthy high-fat food. The fat is largely monosaturated (oleic acid) benefits cholesterol profile, reduces risk of cancer and diabetes. Its significant source of lutein and zeaxanthin prevent macular degeneration.
It is a member of ginger family. Its medicinal value is curcumin having anti-inflammatory, anti-tumor and powerful antioxidant properties. Curcumin inhibits lipid peroxidation. It fights damage from oxidizing substances that age the body and contribute to disease. It prevents significant protection from cataract of eye. A paste of turmeric with honey heals sore throat.
Garlic fight leprosy, toothache and chest pain (Hippocrates). It lowers cholesterol and prevents blood clots. The active ingredient from garlic- allicin- has significant antiplatelet activity. It is also antimicrobial, ant viral and anti-parasitic. The crushed raw garlic combining it with cooked food shortly before serving is highly beneficial.  Garlic supplements are not healthy.
“Know thyself” is the Greek aphorism to take healthy food for a healthy life.
1. The 150 Healthiest Foods on Earth, 2017-Jonny Bowden, the Nutrition Myth Buster.
2. The Great Cholesterol Myth- Stephen T. Sinatra, Fellow of the American Cardiology.
Dr. Dwijesh Kumar Panda, M.D.Ph.D. (Medicine), Consultant Lymphologist, Pathologist & Microbiologist. M5/12, Acharya Vihar, Bhubaneswar,