Brain Health: Natalie Mackenzie Of The Brain Injury Therapist On Lifestyle Habits Supporting Cognitive Well-Being

Surround yourself with people that make you feel positive. Negative environments do alter our brain and behaviour. This is linked to reducing time online too, not only does it often increase exposure to negativity, the act of doom scrolling is not something that promotes neural activity or synaptic growth.

In a world inundated with distractions, constant connectivity, and a plethora of information, our cognitive well-being has never been more crucial. Amidst the clamor, how do we nurture our minds, keep our focus sharp, and cultivate habits that promote mental clarity? The right lifestyle habits can be the cornerstone to maintaining and even enhancing our cognitive abilities, ensuring not just longevity but also the quality of our mental faculties. As a part of this series, I had the pleasure of interviewing Natalie Mackenzie.

Natalie Mackenzie is a cognitive rehabilitation therapist who has 20 years of experience in supporting families with brain injury. She also supports individuals with fatigue and offers cognitive assessments. For more information on Natalie’s work visit: https://www.thebraininjurytherapist.co.uk/

Thank you so much for doing this with us! Before we start, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?

My early years are a bit of a long story; born in a military family i spent the first 5 years in Germany on an army camp, my dad was killed in a military accident in Canada just before my 6th birthday, and recently i learnt that his official cause of death was traumatic brain injury; I don’t think there is much that happens to us fully consciously, there was clearly a reason i went into the neuro rehab sector. My mum and I were forced to move back to the UK quickly, to the North of England where my dads family live. It quickly became clear i struggled in school so off i went to an all girls boarding school age 7. I think its safe to say it wasn’t a great place for a bereaved young child, and not my favourite time. Secondary school I was able to leave the single sex schooling and go to a mixed school, where i was given lots of opportunities to learn more about what i was actually good at, with a couple of teachers who really believed in me, despite the fact i was bottom of the academic pile! I worked in all sorts of jobs from age 13, all teaching me something different about business, and people. Which led me to study psychology, where i found a love of neuro and since 2002 i’ve worked solely in brain injury rehab and run a company that provides specialist cognitive rehabilitation to brain injury survivors.

Is there a particular book, podcast, or film that made a significant impact on you? Can you share a story or explain why it resonated with you so much?

The ‘brainiac’ side of my head will always say Interstellar, it just blows my mind everytime I watch it, about the possibilities of our existence but also the complexities of the universe! The other side will always pick Top Gun! It made me want to be a pilot when I was younger, despite being dreadful at science!

Let’s now talk about lifestyle habits that support cognitive well-being. Are there specific foods or diets that have been scientifically shown to enhance cognitive functions?

EPA and DHA omega-3 fatty acids in fish oil that are vital for normal brain function and development, found in fatty fish and fish oil. Because most people do not consume the recommended amounts of fish, but most people don’t get enough EPA and DHA in their diet. It is also needed for the maintenance of normal brain function throughout life, preserving cell membrane health and prompting communication between brain cells. In older adults, lower levels of DHA in the blood have been associated with smaller brain size, a sign of accelerated brain aging.(Tan ZS, Harris WS, Beiser AS, Au R, Himali JJ, Debette S, Pikula A, Decarli C, Wolf PA, Vasan RS, Robins SJ, Seshadri S. Red blood cell ω-3 fatty acid levels and markers of accelerated brain aging. Neurology. 2012 Feb 28;78(9) Getting these essential oils can be improved by eating fish and other seafood (especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines), Nuts and seeds (such as flaxseed, chia seeds, and walnuts), Plant oils (such as flaxseed oil, soybean oil, and canola oil) and Fortified foods

MAGNESIUM RICH FOOD

Magenium is neuroprotective and also benefits for blood pressure (high BP a risk factor for dementia) so there are benefits to ensuring magnesium levels are promoted. Too high can have side effects so don’t just start on high doses of supplements without having things checked first, always try to increase levels through dietary changes. Spinach, leafy veg, bananas, skin on potato, broccoli,salmon, mackerel, pollock, bran cereal, Quinoa, brown rice, soy, cheese, yoghurts, Dark choc, avocado

LIONS MANE

Some early results indicate lion’s mane may reduce inflammation and Alzheimer’s markers. Often referred to as the smart mushroom it is thought to promote neuronal growth, something that is super important as we age but also for any injury to the brain. Research suggests as well it can aid memory, focus and overall cognitive function, as well as promoting mood and wellbeing. It is often recommended across concussion populations for its neuro stimulating properties. Remember though, this isn’t just an edible for you to go foraging in the woods, ensure you find a reputable and quality provider. It comes in various forms, tablets, powder, and even coffee!

What are your thoughts on the importance of movement and exercise in the context of cognitive decline? How do different forms of exercise, such as aerobic vs. strength training, influence cognitive well-being?

Movement is one of the most important things we can do to promote good cognitive health, alongside keeping the brain active. Individuals with sedentary lifestyles may not perform as well as those who are even moderately active.

Exercise is a great boost for cognition. The release of feel good neurochemicals boosts cell growth and synaptic creation, giving the brain a surge of powerful neuronal activity. Studies on rats have actually evidenced that such activities increases levels of intelligence compared to those who are sedentary.

Exercise doesn’t have to mean hitting the gym though, moving through yoga, dance, hiking or another fun activity can be great. We often recommend climbing walls and bouldering to our brain injured clients, it’s a wonderfully cognitive activity as well, forward planning, decision making, risk assessing, aids vestibular rehabilitation and builds physical strength too.

A change of environment, moving away from the chains of the desk to get outside in nature, expands our exposure to more ‘feel good’ brain chemicals too. The best bit is that these chemicals stay elevated past the actual activity itself, allowing for more cognitive benefits and increasing cognitive performance. When those cells get firing, that’s where the magic happens and thoughts win through the cloudiness of a less stimulated brain. Add on the release of other calming neurochemicals (endocannabinoids) and you can start to see things clearer.

Exercise has been shown to increase the size of our hippocampus too, and that’s where the neurogenesis begins. It happens to be where a lot of the memory work goes on, plus the hippocampus has been shown to shrink with age which of course goes hand in hand with cognitive decline. So get moving to literally grow your brain!

Neurotransmitter secretions and the increased serotonin brings in the feel good factor, boosting mood and allowing us to feel that things might actually be possible!

Can mindfulness practices or meditation offer measurable benefits to cognitive health?

Absolutely yes, you may have seen some of the newer technologies that enable individuals to practice neurofeedback techniques at home, which is effectively enabling measurable impacts of mindfulness. Such practice, as well as the more ‘general’ practices of mindfulness and meditation aid metacognitive skills, which basically put means thinking about thinking. How we plan, evaluate, predict and monitor. All high level executive functional skills which enable us to maintain cognitive health. Practicing such things allows for less emotional rumination and self doubt, which can impact processes such as decision making, information processing, and attentional processes. Better emotional regulation results in better metacognitive and memory skills, resulting in better performance overall. This coupled with a general increased sense of self assurance and wellness gained from mindful engagements, individuals tend to have lower levels of stress and anxiety, resulting in more cognitive clarity.

How does the quality and quantity of sleep correlate with cognitive performance and long-term brain health?

This is one of my favourite areas to be honest, sleep is so important. Yes, there are the Margaret Thatchers of the world that function to a high level on minimal sleep, but it is not the norm. To function well cognitively we need sleep, restful sleep, quality sleep. For some it might be only 6 hours a night, others might need 10, there isn’t actually much evidence to support the whole 8 hours requirement. Exploring your own sleep needs is important, i know how much it impacts me when i don’t sleep well. Having a newborn is a clear indicator of how lack of sleep impacts our cognitive functioning. However, often having a broken nights sleep isn’t the end of the world, we tend to feel worse because we believe its ‘bad’ that we have woken a few times, and the psychological impact of that is what makes us feel tired. We can actually still have a good quality sleep even with night wakings, we’ve just been taught that we need solid sleep. Not actually the case. Studies have shown that we are not able to function to a safe level to drive a vehicle with less than 4 hours sleep. Even if you are a 5 hourer! If you are someone that needs 8 hours and you get 6, that might be enough to throw off your cognitive functioning, but someone else who needs 10 hours might really struggle on 9 hours. Lack of sleep impacts higher level functions again, the executive functions such as decision making, information processing and attention. The fogginess that lack of sleep brings is real, and often people struggle with word finding, become clumsy or forgetful and mood is greatly impacted.

Evidence indicates that those who sleep poorly have metabolic changes in their brain, particularly in areas such as the amygdala, hippocampus and pre-frontal cortex, areas relating to memory, learning and emotion. Its worth noting that there is research ongoing about the potential misdiagnoses of children being diagnosed with ADHD when it may actually be a sleep issue. The symptoms of ADHD are almost identical to the cognitive impacts of lack of sleep, which is a great indicator as to the importance of sleep on cognitive performance. Shift workers often report the same changes in behaviour.

Long term sleep issues also have been linked to a higher risk of dementia. Sleep is when the brain magic happens, when we filter and sort our memories and experiences, where neural repair happens and when the magic of neuroplasticity really comes alive.

How do social connections and interpersonal relationships influence our cognitive well-being?

Hugely. Humans are social animals (although we may not feel it sometimes!) and group socialisation is really important for both emotional and cognitive wellbeing. Being around others engages a number of cognitive areas, isolation does not stimulate a brain! Being around others that make us feel good keeps confidence high and encourages social communication skills to stay sharp, debates, conversations, quizzes all keep those cells firing. Conversely, being around negative environments and people also has a detrimental impact on our wellbeing and can actually change the neurochemicals in our brain which increases anxiety, stress and impair brain function due to surges of stress hormones.

What are your five favorite lifestyle habits that proactively support cognitive well-being?

1. Get outside. Being outside in the light is one of the easiest and more beneficial activities. Natural daylight can help us a lot with our sleep as well because outdoor light is much brighter than indoor light.This light helps our brains to make a hormone called melatonin which improves our sleep. Remember when granny used to say the sea air made us tired as kids? Its actually the exposure to the light
2. Leads nicely onto this. Quality sleep is key. Which means having a good sleep routine. Most poor sleepers, have a poor routine. We are either morning larks or night owls, determine which one you are (you will lean more to one even if traits of another) will help you set a realistic routine. Consistency is key, going to bed at the same time and waking the same time. If you can learn how to recognise the patterns in your 90 min circadian rhythm this will help determine the optimal time to go to sleep. We did at around 45 mins into the 90 min cycle, clock your mid morning yawn as thats a marker you are in the dip, and you can work out your 90 min circadian rhythm from there. I kid you not, it’s usually spot on.
3. Ensure a good mix of exercise, strength based work is best, but if you are a gym bunny or HIIT fan, make sure you are also adding in a good mix of low/moderate intensity exercise. HIgh intensity isn’t always best in terms of raising cortisol levels, and definitely avoid high intensity 2–3 hours before bed, it’s not proven to help sleep, quite the opposite. Walking and moderate runs, as well as weight based work is some of the best for cognitive health, reducing stress and enhancing cognitive clarity.
4. Surround yourself with people that make you feel positive. Negative environments do alter our brain and behaviour. This is linked to reducing time online too, not only does it often increase exposure to negativity, the act of doom scrolling is not something that promotes neural activity or synaptic growth.
5. Learn. Always learn. Push yourself to do things that you find difficult, these things literally promote neural activity and growth, even much later in life. Learn a new language, take up the ukulele, learn the samba. If you can do it around others, all the better. Also, singing and music. Huge cognitive benefits here too as well as positive impact on the nervous system.

Are there any proven techniques or habits that can help protect against age-related cognitive decline?

Research suggests that learning a new skill or language can help with cognitive decline. Learning something new promotes synaptic growth and boots cognitive reserves. Activities that promote learning, either in an informal or formal education setting all aid cognitive stimulation. Basic cognitive practice activities still have their place, like crosswords, simple maths calculations and puzzles. It literally is never too late to learn, new growth can happen in later life, and the magic of neuroplasticity doesn’t have an age limit. Even learning to crochet, paint or samba will do the trick. It’s all about the learning and pushing yourself to do something new.

In your professional or personal experience, what can be done to delay cognitive decline if the genetic predisposition is there?

A genetic predisposition is a risk factor but in most cases, not a certainty. But maintaining cognitive health with activity, cognitively stimulating activity, learning, socialisation, exercise, a good diet and reduced stress there is a lot that can be done to maintain cognition with aging.

Is there a person in the world whom you would love to have lunch with, and why? Maybe we can tag them and see what happens!

Hannah Waddingham! I am a musicals fanatic, and have seen her on the stage before, i love she has been finally recognised as a brilliant actress, phenomenal singer despite many years of being on smaller screens and stages. Mainly though I want to have a peak in her wardrobe and have a good laugh with her, she seems to have a great sense of humour! Or David Attenbourgh because he’s just awesome and a wonderful example of someone who clearly keeps their cognitive health in mind!

How can our readers follow you online?

I can be found on instage @thebraininjurytherapist and on facebook and at www.thebraininjurytherapist.co.uk

Thank you so much for sharing these important insights. We wish you continued success and good health!