NUTRITION AND LIFESTYLE ADVICE TO PROMOTE MITOCHONDRIAL HEALTH

by Nutritional Therapist Melanie Rust DipION

Many adults strive for that boundless energy we may remember from our childhood; we all rely on its mental application for focus, concentration and memory recall, and physically for speed, strength and endurance. In an ideal world, it should be manufactured and spent in equal measure. However, imbalances between conservation and expenditure often occur and result in sub-optimal performance.

Supporting and improving energy production

The science - how the body makes energy

The sun is a fundamental source of energy for all life on earth, from plants to animals, and humans who consume either or both of these. Energy provides power to every cell in the body. The body harnesses this energy via dietary macronutrients: carbohydrates, fats and proteins. Once consumed, macronutrients are metabolised in the cells – through a process called the ‘Krebs’ or citric acid cycle into the energy-yielding substance adenosine triphosphate (ATP). This process takes place in tiny cellular organelles called mitochondria, which are found within almost all cells in the body. Mitochondria act as microscopic powerhouses, synthesising ATP through cellular respiration to power cells and are responsible for maintaining energy levels. The number of mitochondria depends on the energy requirements of the particular cell - for example, heart muscle cells house around 5000 mitochondria, whereas skin cells contain only a few hundred. Specific nutrient co-factors and co-enzymes are required for this complex and demanding process, including:

B-vitamins

iron

magnesium

co-enzyme Q10

choline

copper

manganese

taurine

carnitine

cysteine

lipoic acid

medium chain tryglycerides (MCTs) (1)

If these cofactors are readily available from the diet and mitochondria are performing efficiently, a healthy amount of ATP molecules should be manufactured per cycle. However, many obstacles can hinder this vital process.

Common barriers to energy production

Stress

Stress can have a huge negative effect on energy levels by increasing energy expenditure and temporarily affecting normal appetite. Prolonged or chronic stress often leads to poor dietary choices and reduced motivation for exercise long-term, with links to obesity, depression, neurodegeneration and cardiovascular disease. (2)

A temporary state of alarm can be caused by simple (and common) stressors such as an approaching deadline, a toddler tantrum or a work presentation. In these circumstances, the stress hormones adrenaline, noradrenaline and cortisol will be released, which, in turn, increase blood glucose levels, providing energy rapidly in preparation for acute physical or mental exertion. (3) During prolonged periods of stress, however, vital energy processes can become dysregulated. (4) Basic survival and defence will be prioritised, likely increasing inflammation, sensitivity to foods and other environmental substances and insulin and cortisol resistance – all of which have a significant effect on energy and can be detrimental to mitochondrial function. (5) In these circumstances the body adapts to its new heightened state of alert by diverting energy and resources away from non-essential systems such as fertility and digestion. (6)

Chronic stress can also affect the thyroid, with tiredness often reported as a primary symptom of thyroid dysfunction. (7,8)

Finally, exhaustion occurs when the body is no longer able to maintain ‘balance’, becoming dysfunctional and fatigued. Resources have been drained to such an extent that illness occurs. Fortunately, even at this point, recovery is still possible. (1)

Inflammation

As well as stress, infection, poor diet and poor gastrointestinal integrity can increase inflammatory load. Inflammation can disrupt mental health, cause pain and deplete nutrient resources, all of which can lead to chronic health conditions. In a state of low-grade inflammation the immune system is upregulated and mitochondria work harder to fulfil the additional energy requirements. Reactive oxygen species (ROS) are a by-product of energy manufacture and the mitochondria themselves may become damaged or destroyed by the surge in circulating ROS, in a vicious, energy-depleting cycle. (9) Supplementing omega-3 EPA and increasing antioxidant intake can help to balance inflammation and improve mitochondrial health.

Toxicity

The liver plays an essential role in energy metabolism by converting, synthesising and storing energy sources for the rest of the body. (10) As it is also required for the elimination of toxins in the blood, elevated toxicity from substances such as alcohol, medication and chemical exposure can increase the burden on the liver, impairing its efficiency.

Blood sugar dysregulation

Hyperglycaemia, which can occur as a result of consuming a diet high in glucose, can result in mitochondria becoming swollen and impaired in their functionality. (11) Hyperglycaemia can also increase ROS, further promoting mitochondrial damage. (12)

Thyroid dysfunction

The thyroid is responsible for managing the rate of metabolism in the body. Thyroid dysfunction can therefore present as poor energy regulation and result in either fatigue, if underactive, or hyperactivity, if overactive. (8, 13) Thyroid tissue is particularly susceptible to damage in those with inflammation, an autoimmune predisposition or genetic susceptibility. (14)

Iron deficiency

Oxygen is transported around the body to support energy synthesis by an iron-containing compound called haem found in red blood cells. An iron deficiency can therefore result in less oxygen being supplied to the cells for ATP manufacture and the onset of fatigue and cognitive impairment. Blood loss can often cause iron deficiency and it is therefore more prevalent in menstruating women. Other causes could be a plant-based or vegan diet, heavy metal toxicity, gastric ulcers, pregnancy or colon cancer. (15)

A nutrient-poor diet

Given the list of nutrients required to synthesise energy, as well as the demands from energy-hungry organs like the liver, it’s no surprise that a nutrient-poor diet can deplete resources and promote energy deficit. According to the WHO, in 2020 38.9 million people worldwide were considered to be overweight and malnourished with inadequate vitamin and mineral status. (16)

The role of sugar and caffeine

Whilst the nutrients required for energy manufacture can be obtained from a balanced and wholesome diet, in time-poor situations, it is often perceived as easier to obtain short bursts of energy from substances like sugar and caffeine.

Sugar

Whilst sugar is converted into energy quite simply via glycolysis – the first phase of the Krebs cycle - consumption of simple sugar alone can be problematic for several reasons. Leptin, the hormone associated with satiety and a feeling of fullness, is not activated on consumption of simple carbohydrates, which can lead to overeating, overwhelming the body quickly. Sugar consumption causes the release of insulin, the hormone responsible for shuttling glucose into the cells, and can be inflammatory if elevated in the blood for long periods of time. Therefore, continuous grazing (as a lifestyle habit) on chocolate and sweets for energy may cause low-grade inflammation and potentially lead to insulin resistance and diabetes, as glucose accumulates in the bloodstream but is unable to enter cells. Both inflammation and insulin resistance compromise mitochondrial health.

Slower-release, complex carbohydrates combined with protein and/or healthy fats may help to prevent insulin spikes and overeating. A Mediterranean-type diet is perhaps the most heavily researched diet for energy and longevity.

Finally, if energy expenditure is not equal to or more than sugar intake (for instance in those who do not regularly exercise or are sedentary in their jobs), excess glucose will be converted into fatty acids by the liver and stored in fat cells, which can promote inflammation. The short-term rewards of a high-sugar diet may therefore not be worth the long-term metabolic consequences.

Caffeine

Adenosine is a sleep-inducing hormone which builds up throughout the day. It contributes to regulating our sleep/wake cycle and when levels rise, we become drowsy. Caffeine exerts its action by blocking adenosine receptors, thereby preventing the natural feeling of sleepiness, usually for a period of 5-7 hours. Drinking too much coffee leads to an accumulation of adenosine, which can cause drowsiness once the effect of the caffeine wears off and the adenosine is allowed to bind to its receptors, causing us to reach for yet another coffee in a continuous cycle.

Combined with naturally occurring antioxidants found in coffee, tea and cocoa, caffeine exerts many benefits such as improvements in alertness, concentration, mood and wellbeing. (17) Some people have a genetic predisposition to experience a ‘wired’ feeling or shakiness in response to caffeine. Those with caffeine sensitivity may be able to ease their symptoms by consuming smaller amounts earlier on in the day.

Coffee is full of antioxidants and can help to reduce the symptoms of fatigue

WAYS TO SUPPORT ENERGY PRODUCTION

Feed your microbiome

A rich and diverse gut microbiome can provide numerous health benefits, enhancing sleep, energy and mood. Likewise, adequate sleep, intermittent fasting and a healthy sleep/wake routine can help to promote symbiosis (a state of microbial harmony). Some pathogenic bacteria, and their metabolites, are thought to be associated with sleep disorders, inflammation and circadian rhythm disruption and can directly affect energy. (18) In contrast, the metabolites of beneficial microbes include vital, anti-inflammatory short-chain fatty acids and energy-supporting B-vitamins. These beneficial compounds are produced by helpful species of bacteria in the colon in exchange for a fibre-rich diet from fruit, vegetables, wholegrains, beans and legumes. (19)

Intermittent fasting has been shown to positively affect both the microbiome and mitochondria by improving energy levels, diurnal rhythms, hormone function and by reducing inflammation. Fasting for at least 12 hours overnight can give time for the microbiome to replenish, and allow time for mitochondrial biosynthesis and mitophagy (programmed death and clearance of damaged mitochondria) whilst providing a much-needed break from the onslaught of immunological defences. Antioxidants, such as curcumin and astaxanthin, may further support mitochondrial rejuvenation.

A simple way to introduce intermittent fasting to everyday life might be to stop eating at 7pm and begin again at 9am the following day. This should be discussed with your GP if you are on any medication or suffer with a conditions which may be affected by fasting.

Sleep

Those who sleep the recommend eight hours per night experience improved wellbeing, cognitive function, information retention and enhanced memory, and creative ability. (20) Some enzymes involved in mitochondrial processes display regular diurnal fluctuations which suggests that good mitochondrial health supports restful sleep. (21)

Exercise

Exercise enhances mitochondrial health by promoting biogenesis of new mitochondria and stimulating mitochondrial turnover, meaning that damaged or abnormal mitochondria are replaced, leading to improved endurance and fitness. (22)

Whilst we know excessive ROS levels can promote mitochondrial damage, small levels created during exercise as a by-product of cellular respiration can be beneficial in activating antioxidant systems within the body, regulating certain immunological and metabolic responses and improving resilience of mitochondria long-term. This beneficial response, called hormesis (see table 1), depends on adequate scavenging ability of the antioxidant systems in the body versus the free radical levels (22)

Table 1

Hormesis explains the fine balance between healthy ROS exposure and excess

Energy or adrenaline

Extreme sports and activities like cold water swimming and ice baths are well known for their stimulatory and energising effects. However, the perceived increase in energy levels is actually initiated by a flood of neurotransmitters and hormones to the brain, such as adrenaline, cortisol and dopamine in an acute stress/reward response. (23) Whilst these exhilarating experiences initiate the alarm stress response, short bursts of exposure to stressors (as with exercise) can help to stimulate mitochondrial biogenesis, improving long term physical endurance and performance, cognitive function and memory retention. (24,25,26)

Supplementation for energy slumps

Mirroring the ingredients found in Super B-Complex, Super B-Complex Effervescent provides a fast-acting energy boost in a delicious orange flavour, ideal when a caffeine-free energy boost is required. The pre-methylated B vitamins included in the formula have been selected for optimal bioactivity to promote physical and mental performance and energy production.

Effervescent Vitamin B Complex can help to promote fast energy when required

Pure & Essential FOCUS can promote calm, sustained cognitive function and mental sharpness

For sustained mental energy and calm focus, Pure & Essential Focus combines stimulating caffeine with brain-boosting amino acids, L-Theanine, taurine and L-Tyrosine. L-Theanine, when paired with caffeine, can balance the stimulating effects of caffeine by providing a calm and concentrated focus. The combination of caffeine and L-Theanine has been shown to improve speed and accuracy by focusing attention whilst undertaking mentally demanding tasks. (27,28)

While caffeine has been shown to provide mental stimulation whilst feeling sleepy or undertaking a mundane task, L-Tyrosine (a pre-cursor to catecholamine neurotransmitters dopamine, norepinephrine and epinephrine) improves mental performance and cognition when severe stress would typically affect capabilities, such as in an exam situation or work presentation. (29)

Taurine may reduce the less desirable effects of caffeine on the cardiovascular system. When taken in balanced doses, the combination of caffeine combined with the antioxidant properties of taurine may provide neuroprotection by restoring glutathione levels (a powerful antioxidant made in the body). (30)

Super B-Complex Effervescent and Pure & Essential Focus contain well-tolerated and bioactive pre-methylated B vitamins, for improved energy and performance. Pure & Essential FOCUS also provides an optimal ratio of zinc and copper for additional antioxidant support, neurotransmitter and energy production.

references

1. Wesselink, E., Koekkoek, W., Grefte, S., Witkamp, R. and van Zanten, A., 2019. Feeding mitochondria: Potential role of nutritional components to improve critical illness convalescence. Clinical Nutrition, 38(3), pp.982-995.

2. Rabasa, C. and Dickson, S., 2016. Impact of stress on metabolism and energy balance. Current Opinion in Behavioral Sciences, 9, pp.71-77.

3. Thau L, Gandhi J, Sharma S. Physiology, Cortisol. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 6, 2021.

4. Yazdi, Z. and Sadeghniiat-Haghighi, K., 2015. Fatigue management in the workplace. Industrial Psychiatry Journal, 24(1), p.12.

5. Dhabhar, F., 2014. Effects of stress on immune function: the good, the bad, and the beautiful. Immunologic Research, 58(2-3), pp.193-210.

6. Whirledge S, Cidlowski JA., 2010. Glucocorticoids, stress, and fertility. Minerva Endocrinol, 35(2), pp.109-125.

7. Markomanolaki ZS, Tigani X, Siamatras T, et al., 2019. Stress Management in Women with Hashimoto's thyroiditis: A Randomized Controlled Trial. J Mol Biochem, 8(1), pp.3-12.

8. nhs.uk. 2022. Underactive thyroid (hypothyroidism) - Symptoms. [online] Available at: [Accessed 6 January 2022].

9. Liang, Q. and Kobayashi, S., 2016. Mitochondrial quality control in the diabetic heart. Journal of Molecular and Cellular Cardiology, 95, pp.57-69.

10. Rui, L., 2014. Energy Metabolism in the Liver. Comprehensive Physiology, pp.177-197.

11. Alcántar-Fernández, J., González-Maciel, A., Reynoso-Robles, R., Pérez Andrade, M., Hernández-Vázquez, A., Velázquez-Arellano, A. and Miranda-Ríos, J., 2019. High-glucose diets induce mitochondrial dysfunction in Caenorhabditis elegans. PLOS ONE, 14(12), p.e0226652.

12. Saad, M., 2018. Obesity, Diabetes, and Endothelium: Molecular Interactions. Endothelium and Cardiovascular Diseases, pp.639-652.

13. nhs.uk. 2022. Overactive thyroid (hyperthyroidism) - Symptoms. [online] Available at: [Accessed 13 January 2022].

14. Franco J, Amaya-Amaya J, Anaya J. 2013. Thyroid disease and autoimmune diseases. In: Anaya J, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From Bench to Bedside [Internet]. Bogota (Colombia): El Rosario University Press; Chapter 30. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459466/

15. Abbaspour, N., Hurrell, R., & Kelishadi, R. 2014. Review on iron and its importance for human health. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, pp.19(2), 164–174.

16. Who.int. 2022. Fact sheets - Malnutrition. [online] Available at: [Accessed 13 January 2022].

17. Nehlig, A., 2015. Effects of coffee/caffeine on brain health and disease: What should I tell my patients?. Practical Neurology, 16(2), pp.89-95.

18. Matenchuk, B., Mandhane, P. and Kozyrskyj, A., 2020. Sleep, circadian rhythm, and gut microbiota. Sleep Medicine Reviews, 53, p.101340.

19. Yoshii, K., Hosomi, K., Sawane, K. and Kunisawa, J., 2019. Metabolism of Dietary and Microbial Vitamin B Family in the Regulation of Host Immunity. Frontiers in Nutrition, 6.

20. Walker, M., 2018. Why We Sleep. London: Penguin Books, p.107.

21. Melhuish Beaupre, L., Brown, G., Braganza, N., Kennedy, J. and Gonçalves, V., 2021. Mitochondria’s role in sleep: Novel insights from sleep deprivation and restriction studies. The World Journal of Biological Psychiatry, 23(1), pp.1-13.

22. Sorriento, D., Di Vaia, E. and Iaccarino, G., 2021. Physical Exercise: A Novel Tool to Protect Mitochondrial Health. Frontiers in Physiology, 12.

23. Buijze, G., Sierevelt, I., van der Heijden, B., Dijkgraaf, M. and Frings-Dresen, M., 2016. The Effect of Cold Showering on Health and Work: A Randomized Controlled Trial. PLOS ONE, 11(9), p.e0161749.

24. Hyatt, B., 2018. Psychiatric Aspects of Extreme Sports: Three Case Studies. The Permanente Journal,.

25. Sharma, C., Kim, S., Nam, Y., Jung, U. and Kim, S., 2021. Mitochondrial Dysfunction as a Driver of Cognitive Impairment in Alzheimer’s Disease. International Journal of Molecular Sciences, 22(9), p.4850.

26. Ihsan, M., Markworth, J., Watson, G., Choo, H., Govus, A., Pham, T., Hickey, A., Cameron-Smith, D. and Abbiss, C., 2015. Regular postexercise cooling enhances mitochondrial biogenesis through AMPK and p38 MAPK in human skeletal muscle. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 309(3), pp.R286-R294.

27. Owen, G., Parnell, H., De Bruin, E. and Rycroft, J., 2008. The combined effects of L-theanine and caffeine on cognitive performance and mood. Nutritional Neuroscience, 11(4), pp.193-198.

28. Zaragoza, J., Tinsley, G., Urbina, S., Villa, K., Santos, E., Juaneza, A., Tinnin, M., Davidson, C., Mitmesser, S., Zhang, Z. and Taylor, L., 2019. Effects of acute caffeine, theanine and tyrosine supplementation on mental and physical performance in athletes. Journal of the International Society of Sports Nutrition, 16(1).

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30. Schaffer, S., Shimada, K., Jong, C., Ito, T., Azuma, J. and Takahashi, K., 2014. Effect of taurine and potential interactions with caffeine on cardiovascular function. Amino Acids, 46(5), pp.1147-1157.

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These achievable steps can go a long way towards improving your energy and helping you to take positive steps toward your health goals. If you require more assistance, feel free to contact our approachable team of nutrition professionals who will be more than happy to support you further or point you in the right direction.

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