The Rising Epidemic of Brain 'Obesity'

PART ONE:

Let’s travel back in time to 11,000 BC. This is one thousand years before the first agricultural revolution. People use their bodies to work for the food that they eat. They travel in a hunter and gatherer fashion. The human diet consisted of fruits, nuts, and meat from hunted animals. Obesity does not exist. The first agricultural revolution in 10,000 BC marks a huge transformation for humans. It allows the transition from a nomadic lifestyle to one of settlement. Nonetheless, people still implement arduous physical labor to reap the benefits of their crops.

Flash forward to the age of industrialization and urbanization when machines take over the physical labor for which humans were previously responsible. The automobile is invented. Over time, people become less physically active; life becomes increasingly sedentary. Introduce the concept of mass production of food with little nutritional value. At this point, it is no surprise that the rates of obesity rise. According to the US Census Bureau, the rate of obesity in the US has increased from approximately 10% in the 1950s to 36% in 2014 (2). A study on the epidemiology of obesity has predicted that by 2030 “an estimated 38% of the world’s adult population will be overweight, and another 20% will be obese”(1). What is even scarier is that in the US a whopping 80% of the population is estimated to be overweight by the year 2030. The rising rates of obesity have resulted in a heavy burden placed on the overall health of people as well as the economy. Obesity increases the risk of coronary artery disease, cancer, sleep apnea, and cognitive and memory problems.

Industrialization, urbanization and mass production of non-nutritional, high-density food have transformed the human body from an evolutionarily efficient machine to a sick, corpulent entity that is terrifyingly and rapidly approaching the fate of a cadaver.

But there is hope. We know what causes obesity, and we also know how to prevent and cure it: through exercise and a healthy diet. The future is not grim for those who discover these two powerful antidotes against a sedentary lifestyle.

PART TWO:

Now, I’d like for you to turn your attention from the corporal epidemic of obesity to the rising epidemic of the brain. If you have been able to read to this point in the article, I am impressed. In the current age, the typical attention span is so short that a 280-character tweet probably marks the upper limits of the concentration threshold.

Lets go back in time again. This time to a more recent year: 1994. This marks the year before the internet is introduced to the mainstream population. It is two years before the first car GPS is introduced. At this time, cab drivers still memorize complex diagrams of large cosmopolitan cities (there is no such thing as Waze!!). Google does not exist, and people actually still use paper encyclopedias and dictionaries to look things up. People even visit… libraries (for definition of ‘library’, see below). Flash forward to 2006, the year before the first iphone release. Books are read on bound paper - not on kindles, ipads, or iphones where the tempting distractions of Facebook scrolling and responding to incoming text messages are constantly at bay. In order to get from point A to B, people actually have to lug out huge paper books from their cars’ backseat pockets called ‘maps’ and navigate using their own brain.

Flash forward again to 2017. What does the daily life of the average individual look like?

Let’s review Rebecca’s life as an example. Rebecca is a 39 year old professional. She has two children. Her typical day consists of waking up at 5am, rushing through the morning - showering, dressing, haphazardly splashing on her makeup to look as put together as possible so that no one suspects her life is a catastrophic disaster. At 6am, she wakes her children and hurriedly gets them dressed, shoves waffles into their hands and rushes them off to the car. She barely has time to say goodbye to her husband, also a busy professional, and who feels more like a roommate than a spouse. Who is he..are they even married anymore??? On the drive to drop her children off at school, she engulfs her coffee, which has become her meal replacement. She runs into traffic, and her stress speedometer revs up. Because of her tardiness, Rebecca’s first client of the day will have to wait and will likely be dissatisfied and angry. She attempts to text her secretary that she will be late, and in the process almost runs into the car in front of her. Where is her mind, of course she shouldn’t be texting and driving! She then receives a text alert from Facebook. She forgets about the frighteningly close encounter with another car, and opens her social media app to inspect the activity more closely. After all, she needs a distraction from all the stress of the morning... She is disappointed to find the selfie of a previous colleague from college, sipping on a colorful alcoholic beverage on an exotic beach. Rebecca arrives to work, frazzled and late. She plummets through the door of her office. She briefly notices the unruly stacks of paperwork on her desk welcoming her, before encountering her angry client. Already off to a bad start…

Rebecca’s story may or may not have similarities to your own story. At this point, I encourage you to really evaluate how much time of the day you spend feeling distracted and/or ‘on edge.’

 

TECHNOLOGY'S EFFECT ON THE BRAIN

Technology has made life easier for us, and has provided us with a multitude of valuable knowledge and assistance that is now literally at our fingertips. Smartphones, for instance, now not only have ‘the capacity to be used as phonebooks, appointment calendars, internet portals, tip calculators, maps, gaming devices, but … seem capable of performing an almost limitless range of cognitive activities for us, and of satisfying many of our affective urges’ (3). Is technology replacing certain remarkable mental functions that we have been gifted with? And if so, can that be harmful to our brains?  Despite the growing advantages of technology, we are approaching a tipping point.  We must become aware of the growing perils that come along with ever expanding technology. An article by science writer Susan Greenfield in 2013 asserts that smartphone technology poses a “threat to our society [that is] “almost as important as climate change” (4).

A growing body of literature suggests that the constant distractions that result from technology (i.e., smartphones) impair our concentration, memory, and our ability to regulate emotions and implement delayed gratification (3). Over time, the side effects from excessive smartphone use can potentially negatively alter neural connections, by rewiring our brains to crave instant gratification(3). A small study based out of Korea found that teenagers addicted to smartphones had significantly higher levels of GABA (the neurotransmitters responsible for slowing down the brain) compared to controls. Moreover, the group addicted to smartphone use scored significantly higher in depression, anxiety, impulsivity and insomnia (5).

Moreover, the increasing societal and technological pressures on the individual to multitask is ever expanding. Studies show that those who engage in multitasking and in multiple forms of media ‘tend to demonstrate smaller gray matter area in the anterior cingulated cortex,…the area of the brain responsible for top-down attention control.’ In other words, being too dependent on your iphone can impair your ability to concentrate and be attentive (5).

The rising expectations of multitasking, as well as the constant interruptions from our smartphones, and the increasing time spent on social media at the compromise of true human interaction is leaving human brains in a tizzy. Humankind is at risk of a second intellectual “Dark Age’ period (ironic during the Technology and Information Age) if it doesn't learn to use technology in moderation.

 

WHAT CAN YOU DO TO PREVENT “MENTAL OBESITY”?

When I mention 'moderation' in the latter paragraph, I mean setting aside quiet time each day away from phones and/or distractions - no matter how uncomfortable it might be.

I myself find it difficult to do this at times, especially during the weeks that I am on call. While I cannot leave my phone or pager for even one minute during these weeks, I still take a few minutes each day to meditate, write, or be mindful (pay attention) to the things, smells, and sounds around me. The brain is a muscle, and it needs consistency in practicing mental exercises in order to form and strengthen neural connections.

The good news is that studies show that the structural and neurotransmitter changes seen in iphone and social media addiction is reversible with mindfulness training.

Just like our body, our minds need exercise in the form of introspective mindfulness, meditation, and time away from the disruption of smartphones. Below are a 3 tips that I have found helpful in my life to calm my mind and improve my attention. I’ve found tremendous (albeit anecdotal) results in anxiety reduction, as well as my ability to concentrate. Please keep in mind that two of these involve the use of smartphone technology, so I advise you to turn your phone on ‘airplane mode’ during use of these applications to limit the risk of distractions.

Headspace

This is a nifty app that teaches you how to meditate. It offers daily meditation lessons. You can even adjust the time you want to dedicate to the meditation lesson. I have started off with 3 minutes, which is doable with my busy schedule as a physician. An added bonus is that the lessons are given by a man with a British accent, which adds to the soothing qualities of the lessons. The app keeps track of how well you keep up with the daily lessons, and also offers additional lessons for helping with sleep and anxiety.

Dual N-Back App (by Mikko Tyrskeranta)– this app provides you with a neuropsychological test that has been shown to be effective in improving working memory and attention. While there are plenty of ‘brain training games available, the dual n-back test was recently shown to be superior over other common brain training tests in a Johns Hopkins study. This study not only showed improved working memory and attention in the group of individuals who performed the dual n-back test, but also showed that there were functional changes in the prefrontal cortex, the part of the brain associated with concentration and decision-making.

Yoga – yoga offers the promise of stress reduction and cognitive and psychological enhancement. People who perform yoga regularly have lower levels of anxiety and improved cognitive functioning (6). Moreover, it has been shown to help reduce the risk of osteoporosis, low back pain, and also improves flexibility. Although yoga may sound boring to some people, I encourage you to try it for two weeks.

Make a goal of going to a yoga class daily for two weeks. Pay attention to how you feel before you begin, and after two weeks of doing it daily, and then make your final judgments about it.

 

Active dedication to mindfulness and time away from smartphones are important for maintaining healthy neural connectivity. These techniques are emerging as the ‘new exercise’ to prevent the rising epidemic of the brain.

 

 

Library — (noun) a building or room containing collections of books, periodicals, and sometimes films and recorded music for people to read, borrow, or refer to.

References

1. Hruby, A., & Hu, F. B. (2015). The Epidemiology of Obesity: A Big Picture. PharmacoEconomics33(7), 673–689. http://doi.org/10.1007/s40273-014-0243-x

2. Mitchell, N., Catenacci, V., Wyatt, H. R., & Hill, J. O. (2011). OBESITY: OVERVIEW OF AN EPIDEMIC. The Psychiatric Clinics of North America34(4), 717–732. http://doi.org/10.1016/j.psc.2011.08.005

3. Wilmer, H. H., Sherman, L. E., & Chein, J. M. (2017). Smartphones and Cognition: A Review of Research Exploring the Links between Mobile Technology Habits and Cognitive Functioning. Frontiers in Psychology8, 605. http://doi.org/10.3389/fpsyg.2017.00605

4. Greenfield S. (2013). Screen Technologies. Available at: http://www.susangreenfield.com/science/screen-technologies/ [accessed April 16, 2015].

5. Lamotte, Sandee. Smartphone addiction could be changing yourbrain. http://www.cnn.com/2017/11/30/health/smartphone-addiction-study/index.html

6. Gothe NPMcAuley E. Yoga and Cognition: A Meta-Analysis of Chronic and Acute Effects. Psychosom Med. 2015 Sep;77(7):784-97. doi: 10.1097/PSY.0000000000000218.