Out of the fog: Helping pilots maintain peak performance

written by Staff reporter | October 26, 2019

The latest in a series of articles written by Ben Cook that looks at how pilots maintain peak performance first appeared in the August 2019 edition of Australian Aviation.

The flight deck of the Cirrus SR22T GTS G5. (Seth Jaworski)
The pilots office. (Seth Jaworski)

I sit patiently watching my dad, who is resting quietly in his bed in the nursing home. A highly respected airline captain who finished up in command of very large A380 jets, he should be enjoying the fruits of his labour in semi-retirement. Instead, he lays for many hours in his nursing home bed and while he looks fit and healthy on the outside, the almost complete loss of memory has resulted in a state of lifelessness. It’s the outcome of the early onset of dementia which has taken his life away.

It all started a few years ago with increased bouts of forgetfulness, confusion and, over time, ever growing frustration. After a scare with a stove top being left on that could have ended very badly, dad eventually agreed to see a doctor. He’d already taken sick leave and after numerous tests the diagnosis of early onset dementia (he was in his late 50s) came as a shock to the family. Everything seemed to happen so quickly, and dad eventually lost his aircrew medical.

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Always the eternal optimist and not one to let the early change in his career path get him down, he started to do everything he could to try to renourish his brain: enhanced sleep, more regular exercise, a diet considerate of the foods that maximise the right chemicals for long-term brain health, a significantly reduced intake of alcohol, and he even started completing crosswords, Sudoku and other applications that are known to exercise the brain.

Unfortunately, it was too little too late. All the years of deprived sleep and the other bad habits associated with long-haul flying, including a poor diet, had contributed to his ultimate demise.

We’ve learned the hard way that you need to live life now and that there are many subtle changes that can be made in our own lifestyles to maximise good brain health.’

The nasty rise of dementia

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Dementia describes a collection of symptoms that are caused by disorders affecting the brain. It is not one specific disease and affects thinking, behaviour and the ability to perform everyday tasks. Brain function is affected enough to interfere with the person’s normal social or working life.

The early signs of dementia are very subtle and vague and may not be immediately obvious. Some common symptoms may include progressive and frequent memory loss, confusion, personality change, apathy and withdrawal, and a loss of ability to perform everyday tasks.

Dementia is now the second leading cause of death for Australians and in 2016 became the leading cause of death among Australian females, surpassing heart disease.

Some of the risk factors associated with dementia can be managed through lifestyle changes or appropriate medical treatments:

Cardiovascular risk factors: brain infarcts (an area of necrotic tissue in the brain resulting from a blockage or narrowing in the arteries supplying blood and oxygen to the brain), heart disease and high blood pressure increase the risk of Alzheimer’s disease and vascular dementia. Smoking has also been identified as a risk factor.

Diabetes: a recent study found that having diabetes increases the risk of developing Alzheimer’s disease by 65 per cent. This risk can be reduced through a good diet to avoid diabetes in the first place or through careful management of diabetes with medications that maintain blood glucose levels within a healthy range.

High homocysteine levels: homocysteine is a common amino acid in your blood. You get it mostly from eating meat. High levels of it are linked to early development of heart disease.

Genes and/or a family history: while an increased factor if there is a family history, most cases of dementia are not inherited.

The reality for anyone confronted with the trauma of losing a loved one to dementia is the constant question: what could have been done earlier to avoid such a brutal disease?

It’s time to revisit the work of Dr Mike Dow (The Brain Fog Fix) and Dr Barry Sears (Enter the Zone) to reinforce the links between nutrition and long-term health.

What your brain needs

In the first article of this series I provided insights from Dr Dow who summarises a large body of research to identify what your brain needs to thrive and to maintain the right balance of chemicals to deliver sustained, high performance. This article will provide some further insights into the role nutrition plays for longer-term health.

When you consider the many factors that make your airline workplace more challenging, many of you have (or will) experience the following vicious cycle: demanding flight schedules, with large time zone changes that result in disrupted sleep; lack of sleep resulting in increased consumption of caffeine (or worse high sugar, caffeinated energy drinks); the increased caffeine impacts your normal night time sleep making fatigue even worse, with the outcome a further increase in caffeine; this puts the body into a survival and store energy mode that results in cravings for sugar (energy); feeling drained the need for rewards (e.g. sugar, beer, wine) increases, which further impacts your quality of sleep; the ongoing stress increases the need for more beer or wine as a means to relax and to counteract the high levels of caffeine; exercise seems to drop away; the waistline starts to increase and this nasty cycle continues to repeat.

All the time you’re feeling low on energy, emotionally drained and in many cases unhappy or depressed.

Brain fog

From Dr Dow’s research, many of these lifestyle circumstances are conspiring to destabilise your brain chemistry, leaving you to think badly and feel worse. Your brain is simply not getting the support it needs to produce the essential brain chemicals that keep you energised, calm, focused and inspired. And many of the foods you consider healthy are working against you and contributing to poor brain health.

Nutrition is critical to rebalancing the three brain chemicals most responsible for thinking and feeling: serotonin (feelings of calm, serenity, optimism, and self-confidence); dopamine (feeling excited, motivated, energised and pleasured); and cortisol, the stress hormone that revs you into high gear. Excessive and unresolved stress leading to an ongoing cortisol imbalance over time can leave you feeling exhausted, nervous, or sometimes both: listless and dragged out during the day, anxious and sleepless at night. When the cortisol levels are off balance you might feel so frazzled that the smallest problem sets you off, or so unmotivated that you can barely drag yourself through the day. High cortisol levels have also been shown to inhibit neurogenesis – the creation of new brain cells.

Skipping the gym to stay up late watching Netflix, answering emails at all hours, too much time on social media rather than connecting face-to-face with loved ones, is all setting you up for brain fog. Your sedentary life is softening your body and depriving your brain of the hormones it needs to thrive.

For pilots, appropriate exercise is another key to your overall brain health.
For pilots, appropriate exercise is another key to your overall brain health.

The most powerful performance drug – food

Dr Barry Sears, one of the world’s leading medical researchers on the hormonal effects of food, provides the following insights:

One of the key factors to reach peak performance and sustain it involves using the most powerful drugs found everywhere – food.

The ratio of macronutrients (protein, carbohydrate and fat) in the meals you eat generates complex hormonal responses in your body that ultimately determine how much body fat you will store.

Carbohydrates are a significant contributor to being overweight.

Dr Sears cites the body requires a continual intake of carbohydrates to feed the brain which uses glucose (a form of sugar) as its primary energy source. In fact, the brain is a virtual glucose hog, using up more than two thirds of the circulating carbohydrates in the bloodstream while you’re at rest.

Any carbs not immediately used by the body will be stored as glycogen (a long string of glucose molecules joined together) in two sites: the liver and muscles. The glycogen stored in the muscles is inaccessible to the brain. Only the glycogen stored in the liver can be broken down and sent back to the bloodstream to maintain adequate blood sugar levels for proper brain function.

The liver’s capacity to store carbs in the form of glycogen is very limited and can be easily depleted within 10-12 hours, hence the reason we eat carbs. The critical question is what happens if you eat too many? Once the glycogen levels are filled in both the liver and the muscles, excess carbs have just one fate: to be converted into fat and stored as fatty tissue.

Furthermore, any meal high in carbs will generate a rapid rise in blood glucose and to adjust for this the body releases insulin into the bloodstream to lower the level. The problem is insulin is essentially a storage hormone, evolved to put aside excess carbohydrate calories in the form of fat in case of future famine. Dr Sears states “when we eat too much carbohydrate, we’re essentially sending a hormonal message, via insulin, to the body to store fat”.

The entry rate of a carb into the bloodstream is known as the glycemic index (GI): the lower the GI the slower the rate of absorption.

Three primary factors determine the GI: the structure of the simple sugar; the soluble fibre content; and the fat content. Fibre is a significant factor in controlling the speed at which the body absorbs carbs and in effect acts as a control rod to prevent a runaway rate of carb absorption. This is why the popularity of juicing (the removal of fibre from fruits) has been a dietary disaster!

This leads to carbohydrate hell, the source of all carbohydrate cravings including the infamous sweet tooth and the constant cycle of recurring hunger (every two to three hours) that goes with them. Even after the big meal of carbs you find yourself craving a dessert as a night cap! If you’re not consciously aware of some of these processes there is a good chance you’re not maximising your best opportunities to use food to its full potential to break this cycle.

For pilots, good nutrition is not only about feeding the appetite but, importantly, about feeding the brain. (Wikimedia Commons/wordridden)
For pilots, good nutrition is not only about feeding the appetite but, importantly, about feeding the brain. (Wikimedia Commons/wordridden)

Blood sugar and the brain

While researchers don’t yet fully understand the mechanisms of this relationship, a recent study has linked an “inflammatory dietary pattern” (ie foods that cause certain parts of the body to become inflamed) to depression. And the damage doesn’t stop there as research also shows depression can trigger a cascade of other harmful changes to the brain that can ultimately lead to dementia.

Our brain requires twice as much energy as the cells in the rest of our body. Carbs are the preferred source of energy, which is why when you’re feeling foggy or tired you have a tendency to reach for something sweet or starchy like chocolate bars or chips. That high glucose food gives you an immediate rush and for a while your brain has the energy it so desperately needs. You feel clear, focused and motivated.

Carbs provide the boost to body and the brain alike, but as per the research of Dr Sears the GI is critical over the longer term. While high GI foods might help your memory in the short term, over time they can contribute to insulin resistance. Brain cells can’t store glucose and the blood sugar spike inevitably leads to a crash, leaving your poor brain more starved for energy than ever. You feel even foggier and more forgetful than before.

The solution that remains critical and should be part of your conscious decision making when considering the food you eat is to focus your attention on getting the ones that deliver the sustainable, slow burning energy (low GI) your brain needs. Replace the high GI carbs that trigger blood-sugar spikes with more complex carbs. A critical first step is cutting back on carbs in the form of flour and sugar.

And don’t simply be fooled by switching to diet products eg diet soft drinks. Research has identified that artificial sweeteners can disrupt the good bacteria in the gut. Disruptions to gut bacteria have been linked to seriously mood-altering consequences. In some research it has been found that those drinking diet soft drinks are more likely to be depressed than those drinking full sugar soft drink.

High GI carbs are everywhere

Dr Dow has found that high GI carbs are everywhere and they’ve made their way into even the most innocent-seeming foods: companies have added sugars to fats like salad dressing, and flour to meats in the form of breading and sugar-laden sources. By cutting back on flour and sugar, you will not only reduce blood-sugar spikes, but you can increase the amount of anti-inflammatory foods in your diets by replacing them with more healthy products such as vegetables, beans and fish.

Slow burning carbs contain amino acids like tryptophan, which is a precursor to serotonin. These foods also allow tryptophan to “get in” the brain. The blood-brain barrier is the gatekeeper that allows nutrients you need in while keeping toxins out to protect your most precious organ. This process is facilitated by what’s known as transporters that recognise tryptophan and other amino acids. When tryptophan lingers through the help of a slow burning carb, more of this mood-boosting amino acid gets into the brain, and you feel better as a result.

Dr Dow identifies that when you don’t get enough tryptophan (along with the cofactors it needs such as vitamins), our brains just aren’t able to produce the serotonin that soothes anxiety and boosts mood. And the Catch-22, when you aren’t making enough serotonin you crave carbs. It’s back to the vicious cycle.

Getting the brain balance back
Your brain needs proper nutrients, including the right vitamins (from food, not pills), essential amino acids and healthy fats. Products renowned for fogging your brain include sugar, high-fructose corn syrup (hidden in many products) and artificial sweeteners, processed white flour, too many inflammatory foods (eg some conventionally grown meat), unhealthy fats and many artificial ingredients and preservatives.

Some simple insights from Dr Dow to minimise blood sugar spikes and optimise the good chemicals for long-term brain health:

80/20 rule – 80 per cent of the time stay focused on the brain-healthy foods and the other 20 per centof the time you can let loose a bit.

Cinnamon: sprinkle cinnamon in your coffee instead of packet sugar.

Increase your intake of raw or slightly cooked vegetables.

Vinegar: switch out store-bought salad dressings that often contain sugar to a simple blend of vinegar and olive oil.

Red wine: one glass with dinner can reduce the production of glucose.

Cut the amount of pasta in half and replace with vegetable noodles for the other half.

Reduce your intake of red meats and replace grain fed meat with organic and/or grass fed.

Increase brain boosting foods, such as salmon/trout, blueberries and olive oil.

The path to peak performance

With a little self-education or the use of a nutritionist/dietician, once you understand the power of the hormonal responses generated by the food you eat, you no longer view food simply as a source of calories but as critical control systems for hormones that can allow you to tap into new levels of performance.

The outcomes of the application of Dr Sears and Dr Dow’s research has helped high performance teams to have more energy, greater mental focus, and a greater sense of calm in very high-pressure, demanding vocations.

If you’re battling the bulge, a focus on sleep (last month’s article) and nutrition go hand in hand with resetting what could be years of bad habits. For the younger generation in good physical fitness, enhanced knowledge of the application of the new science of nutrition is a performance enabler that can allow you to make subtle changes in your existing diets now to ward off emerging threats, such as dementia.

If your energy levels and motivation remain low and you’re struggling to break bad habit patterns that have built up over years of demanding flight schedules, it may just be time to get the help you need through nutritionists and/or dieticians.

This story first appeared in the August 2019 edition of Australian Aviation. To read more stories like this, subscribe here.

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