Hi folks! I’m Emily Deans, M.D., a psychiatrist who normally blogs over at Evolutionary Psychiatry  and at Psychology Today . However, Mark Sisson was kind enough to ask me to do a guest blog for Mark’s Daily Apple, and of course I am thrilled to oblige. My main interest is to explore how the differences in our modern lives and diets compared to a traditional/evolutionary experience may influence how our brains work and leave us more vulnerable to mental illness. If modern diets and lifestyle do leave us ragged in brain as well as body, The Primal Blueprint , being a practical diet and lifestyle that specifically emulates evolutionary conditions, would then theoretically be part of an antidote to modern mental health problems.
Certainly there are a number of anecdotes  in the MDA forums of these Primal changes improving mood and anxiety problems, and some other anecdotes where mental state had no change or became worse. Of course, by the time our brains are strained enough to begin experiencing psychiatric symptoms, the problem can be complex and hard to undo. For now, let’s examine how a Primal Blueprint lifestyle and diet would presumably help the brain be healthy and resilient. Oftentimes diet and lifestyle changes are most effective as a preventative or protective measure, and treatment requires diet and lifestyle changes as well as more specific and personalized interventions.
To understand how Primal living would protect and nourish the brain, it’s important to understand a few things about how the brain works and what makes it vulnerable to modern diet and stress. First, the brain is very fatty (60% dry weight) and needs lots of the proper fatty precursors to work to the brain’s design specifications. That means having enough cholesterol and long chain omega 3 fatty acids (specifically DHA). A Primal Blueprint diet will supply these building blocks in spades. In fact, very low cholesterol is associated with violent death, accidents, and suicide, which I discuss at some length in this post, Low Cholesterol and Suicide . The association does not prove causation, of course, but I find it makes common sense and would be prudent to make sure we have the appropriate building blocks available for our nerves and synapses to work properly.
The second thing to understand about the brain is that it is hungry. It uses energy like gangbusters. Depending on what source you read, the brain makes up between 2.5-5% of our total body weight, but it uses around 20% of our energy. The reason it uses so much energy is because thought is expensive and basically runs on electricity. All this energy is used to pump ions across membranes, rather like ski lifts taking skiiers to the top of the hill. Once you have enough skiiers at the top, open a gate, set them loose, and they use all the stored energy to zip to the bottom. Thought runs the same way – ions are pumped against a charge gradient, so that when the proper signal comes, you have a whole host of ions to release and start that spark of nerve communication. But it takes a lot of energy to get those skiiers to the top of the hill, and it takes a lot of energy to keep the brain primed and working at maximum efficiency.
And here is where the problem with energy efficiency comes in – the brain uses so much energy that it is vital for brain health for the energy systems to be working at tip-top efficiency. If you start to overtax the systems, you get build-up of metabolic byproducts. Ion gradients discharged aren’t replaced as fast as they ought to be, and you end up with toxic brain signals being perpetuated, and inflammation gumming up the works. And it is not as if we can really decrease our need for our brains – we can’t just voluntarily stop all thinking, after all, and conscious thought is only a small part of the whole. We do use all of our brain – most of it for involuntary actions like breathing or posture control. Things we can’t just put a stop to when we need our brains to rest and recover. Poor energy efficiency and metabolic garbage building up is thought to play a part in a whole host of brain problems, including psychiatric disorders, migraines, autism, and dementia.
Fortunately, there are all sorts of things we can do  to help with cellular energy efficiency in our bodies and brains. I don’t think it is a coincidence that these things line up with a Primal Blueprint diet and lifestyle – the Primal lifestyle is meant to mimic what our systems are “designed” for, after all, so it would make sense that our cells would work efficiently within a Primal paradigm. Energy for our animal cells is made primarily in the mitochondria – the power plants of the cells. Mitochondrial researchers (who, I’m guessing, know nothing about a Primal Blueprint lifestyle and diet), have come up with the following list of things that keep mitochondria happy and promote efficiency and clean energy:
- A high-fat diet and utilization of ketones – ketones require a bit less processing by the mitochondria to make energy than glucose does.
- A ready supply of energy and mitochondrial cofactors such as the animal flesh-derived carnitine and carnosine , along with the cholesterol buddy ubiquinone  (CoEnzyme Q10), vitamin A, and the crew of B vitamins which are also utilized in the respiratory chain.
- Protein and/or calorie restriction which promotes the activation of PPAR (that is peroxisome-proliferator activated receptors). See, the mitochondria have two major types of garbage containment facilities, the lysosomes and the peroxisomes. They are the waste clean-up crew, and they become more active in states of protein restriction and ketosis. In addition, the old and inefficient mitochondria spewing more reactive oxygen species than they ought get properly decomissioned in states of protein restriction. This is one part of a positive clean-up process called “autophagy .” The Primal Blueprint diet, with the recommendation of intermittent fasting, will promote autophagy.
- Aerobic exercise seems to stimulate  the creation of new, shiny, efficient mitochondria.
What sorts of things promote mitochondrial inefficiency and general dirty cell-killing, dementia promoting badness?
- Micronutrient deficiencies
- Never dipping into ketosis
I find it striking how well a Primal Blueprint diet and lifestyle converge to make happy mitochondria (and by extension, a happy and efficient brain). Intermittent fasting  combined with eating plenty of fat  will promote ketosis  and autophagy. Primal Blueprint dieters will be focused on eating whole, natural foods and nose-to-tail consumption  to improve the chances of getting all the vitamins and micronutrients our mitochondria love. In addition, the amino acids such as creatine and carnosine that make mitochondria hum can be made from other essential amino acids, but are readily available from eating meat directly. And of course a key part of the Primal lifestyle is activity in reasonable levels of exertion  and meaningful quantity. The Primal Blueprint diet , being antinflammatory and muscle-sparing, is the perfect fuel to spur activity.
In contrast, the Standard American Diet du jour will promote inflammation, hyperglycemia, weight gain, fatigue, and sedentary living. Micronutrient deficiencies will be the rule, unless one is exceedingly careful. One is told never to let 3 hours or more go by without eating lest the metabolism sputter to a halt. Restricting calories to the point of avoiding obesity only while eating 5-6 times a day is no picnic. Welcome constant food with constant hunger and constant restriction. One could hardly think of a more unnatural way to eat, or a better way to make for miserable free-radical spewing mitochondria, and eventually a cranky brain.
When you have a happy brain, you will still (and should still!) experience sadness when things go bad, or stress in hard times, but you will be more focused, energetic, and motivated. You will be resilient and should be able to relax easily. To me it seems a Primal brain is more likely to be a happy brain, and the first prescription should always be whole, nutrient-dense food, avoidance of inflammation, appropriate exercise, sleep, and play.
Read more articles written by Emily Deans, M.D. at Evolutionary Psychiatry