BIOHACKING (Part Two)

Brain ‘food’ and cognitive enhancement

By Emma Dollery 16 May 2021

Image: Diana Polekhina / Unsplash

Nootropics and intermittent fasting have been popular ways to hack one’s body into better health and diet. We explore the pros and cons.

Read Part One, Are we humans or are we hackers? here.

If you read the first part of our biohacking series in which we outlined the theory behind the Wim Hof Method, you might recall the name Dave Asprey, the self-proclaimed “father of biohacking”, and the founder of Bulletproof products. Asprey’s products are Nootropics, known to some as “smart drugs.” Could they be the way to hack ourselves towards ultimate efficiency and unprecedented smarts?

Nootropics — nuggets of genius or money-sucking placebos?

Avowing cognitive enhancement, these little nuggets of (alleged) genius are defined in Volume 14 of Current Medicinal Chemistry as “a heterogeneous group of compounds of diverse chemical composition and biological function that allegedly facilitate learning and memory or overcome natural or induced cognitive impairments.”

According to this definition, nootropics is a broad umbrella term that includes prescription drugs (like Ritalin or Adderall) that aid people with disorders like ADHD (Attention Deficit Hyperactivity Disorder), as well as less regulated (and less thoroughly researched) over-the-counter supplements.

Dr Renata Schoeman, Cape Town-based psychiatrist who specialises in cognition and ADHD explains that there are a variety of reasons why individuals can struggle with concentration and attention issues. “A lot of people with depression can struggle, also people with anxiety, and other disorders that are on medication which might impair their concentration.”

Sometimes, Dr Schoeman expands, these issues can stem from more lifestyle-based causes. “Some people don’t get enough exercise, they don’t sleep enough, or they use too much technology and that’s why they’re struggling.”

For people who are officially diagnosed with concentration impairments (like ADHD), the major cognitive enhancement drugs used in South Africa are methylphenidate (Ritalin) and Strattera (atomoxetine hydrochloride), which, Dr Schoeman explains, “increase dopamine and noradrenaline in the pre-frontal cortex.” Dopamine, a neurotransmitter, controls reward and pleasure centers in your brain, creating the feeling of motivation, while noradrenaline (also known as norepinephrine and, interestingly, allegedly released during the cold immersion phase of the Wim Hof method) is a hormone that increases blood flow and makes you alert.

Image: Mika Baumeister / Unsplash

These pharmaceuticals are used widely by qualified physiatrists throughout South Africa because there is ample evidence through “randomized control trials to show that these drugs are effective in the treatment of ADHD” explains Dr Schoeman. These medications are proven to help normalise a previously impaired brain. But, and it’s a big “but”, there is no substantial evidence that methylphenidate or Strattera improve cognition in people that do not suffer from a disorder.

In fact, to the contrary; as Schoeman points out, if you do not have abnormal brain chemicals and you take these medications, you could be throwing off your natural balance. “For most people, it should be ok, but some people have convulsions, and some people can become psychotic so it can be potentially dangerous, and we can’t predict it. Where there are clear safety studies for people with ADHD on this medication, we do not have all those studies available, at this stage, for healthy people.”

Further, according to Dr Schoeman “there is actually not that much of a benefit” to taking these cognitive-enhancing drugs. “Studies have shown that people without ADHD that use the medication only have a 2% improvement in performance. It’s pretty much a placebo effect as well. The medication makes you more alert, it keeps you awake. The students feel like, now I’ve had a Ritalin and I’m more awake, therefore they put in more effort, so it’s the effort that increases performance. They’re more awake, but it doesn’t really improve their cognition.”

A 2016 study, called “Methylphenidate as a cognitive enhancer in healthy young people”, concludes that there was no difference in the performance of the students who took methylphenidate and those who took a placebo, suggesting that the placebo effect Dr Schoeman talks about is, in fact, the reason behind increases in performance.

Even if cognitive-enhancing drugs were to vastly improve the cognition of perfectly healthy brains (which it seems they don’t) Schoeman brings up an ethical issue: is it fair to use drugs to enhance anyone’s brain? “Think about sport,” she says, “we’re against doping in sport, but now suddenly doing it academically is ok?”

It certainly makes for a less level playing field (no pun intended), especially as these medications are on the pricey side. Any question of academic realms being socially mobile spaces where intelligence trumps bank balance could be thrown out the window. (Though, to be fair, has that ever been a valid claim to make?)

This brings us to the second category of nootropics, what Schoeman calls “complementary and alternative medication”. The type that you can buy over the counter and on which, Schoeman reminds us, there is “not enough research necessarily to say that they can treat a condition”.

While these kinds of nootropics, or “brain-food” as Dr Schoeman referred to them, are not effective for treating ADHD, there is a small amount of “evidence that some of them can improve cognition” for healthy brains.

Asprey’s brand Bulletproof falls into this category. The brand is most famous for its coffee, a mixture of coffee beans, MCT oil and butter which the website maintains helps you feel full while increasing your focus and metabolism. Other nootropics that the site offers include supplements that aid your mood, memory, gut health, performance, immunity, and sleep. With Bulletproof, the idea, as mentioned by Jenna Wortham in a New York Times article from 2015 is, “that you can outsource that work. ‘That fundamental laziness, where I want everything to be easier, is part of what drives me,’ he (Asprey) told me that first day. ‘I don’t want to do more work than is necessary to do great things. I don’t see why anyone should do more work than is necessary to do great things.’”

Alas, as Wortham pointed out, “there are more than a few nutritionists who are dubious of Asprey’s bold claims. It’s hard not to be — there’s little research outside his own that backs them up […] We all want to live forever, and if changing one thing in our diets can do that, we can all hope. The success of the dietary supplement industry is best explained by wish-fulfilment fantasies.”

Dr. Schoeman agrees, that “a lot of this stuff is actually just good marketing”. She outlines how a few nootropics could actually be made at home with ingredients from your pantry. A good example is the nootropic Bio-Strath, which is essentially a mixture of orange juice, malt, and a bit of honey.

That’s not to say that other nootropics do not work. While the research is still at its formative stages, Dr Schoeman explains that there is already some evidence backing up the cognitive enhancement powers of nootropics like magnesium, ginkgo biloba, ginseng and omega oils.

In fact, Dr Schoeman shared that the only thing she recommends to her patients in addition to prescribed medication is the omega oils. Studies, like this one, “Omega-3 fatty acids in ADHD and related Neurodevelopmental disorders,” assert that omega is “critical to brain development and function.” Relative lack of it may be cause or contribute to a lot of cognitive issues, and there is increasing evidence that supplements may be beneficial and safe for patients to use alongside their prescribed meds.

However, this article in Harvard Health Publishing relates the sceptical opinion of Dr Scott McGinnis, an assistant professor in neurology at Harvard Medical School, on the matter. There is evidence that omega fats “can have anti-inflammatory and antioxidant effects as well, which means they might promote healthier brain cells and less deterioration of the brain” when they come from natural sources, like fish, nuts, and seeds. But there is very little to say that omega in supplement forms actually work to increase cognitive performance.

Ginkgo biloba, and ginseng, two more popular nootropics, also have some research backing their cognitive enhancing potential. A study on the short-term effects of ginkgo biloba extract for enhancing cognitive abilities in individuals with no history of significant neurocognitive dysfunction, showed some promising results, with the adults who received doses of the extract showing significantly higher processing abilities than those who received a placebo. Similarly, a 2006 study on ginseng showed that young adults who took the supplement suffered from far less mental fatigue over a period of sustained mental activity than the control subjects, who did not.

But, Dr Schoeman cautions, you should always be careful with nootropics, especially if you have an underlying psychiatric condition. Combining ginkgo biloba with antidepressants can cause “what we call serotonin syndrome,” which causes tremors, nausea, and anxiety among other symptoms. Or “you can get bleeding tendencies. It can even cause a coma when it’s [ginkgo] combined with certain antidepressants.” And ginseng “can create various side effects like mania, blood-pressure problems, headaches, nervousness, sleeping problems, so that’s one that we’re always careful about.”

Countless have said it once, and we’re going to say it again: consult your health care physician before you take anything!

One thing you can safely take part in, according to Dr Schoeman, is exercise. “It’s the one thing we know works. Regular exercise can improve your concentration by 20%, so it’s one of the most effective nootropics that you have because it’s improving the neuroplasticity in your brain, it’s improving your working memory, it’s growing new cells in your hippocampus, so exercise is the best thing you can do for yourself.”

The crux of the matter is this: there is not enough substantial proof that most of the nootropics you see for sale (at hefty prices) are going to do any of the amazing things that they say. Unfortunately, it is highly unlikely that Asprey’s bulletproof coffee will turn you into Einstein. There’s not even much evidence that it will make you simply a smarter version of yourself.

Apart from his own products, Asprey is also an advocate for the practice of intermittent fasting, an increasingly popular diet that calls for extended periods of not eating.

Intermittent fasting

There are a few different ways to partake in intermittent fasting, the most popular being the 16/8 method, in which one fasts for 16 hours and has an 8-hour feeding window. Within the feeding window (usually falling between 12pm and 8pm), an intermittent faster may eat what they want. Other approaches include the Eat-Stop-Eat (a 24-hour fast two times a week), and alternate day fasting (fast for a day, eat normally for the next, and so on.)

Intermittent fasting is, reportedly, highly effective in weight loss endeavours, though it’s up for debate as to whether it is superior to other calorie-restrictive diets. The reason for its alleged effectiveness has to do with metabolic switching – the idea is that after 10-12 hours the body depletes its glycogen (stored glucose) and starts burning ketones (energy made in the liver by breaking down fat.) Ostensibly, the presence of ketone bodies has some influence over glucose regulation, blood pressure, heart rate, and abdominal fat loss.

In 1988, a study called “Retardation of ageing and disease by dietary restriction” showed that intermittent fasting has a direct correlation to extended life span in rodents, although it is still highly debated as to whether this translates to humans. It has become clear that multiple variables, like sex, genetic composition, and age, also determine whether or not intermittent fasting works for you.

Maverick Life spoke to  South African dietician Johannita Cox last year for an article about intermittent fasting. Cox warned that before trying to fast (or any diet, for that matter) you should think hard about whether or not it is sustainable. She noted that alternate-day fasting “may cause hunger pains going to bed, making this method unsustainable in the long term.” If you’re looking for a sustainable way to lose weight, or perhaps a potential (though seemingly unlikely) way to live longer, and you’re unable to stick long-term to the rules of intermittent fasting, then it’s not the diet for you. 

As mentioned before, Twitter founder Jack Dorsey, perhaps the most rich and famous of intermittent fasters worldwide, eats one simple meal (usually salmon or chicken) on weekdays, and on the weekend, he fasts from Friday to Sunday. The man is, one could say, robotic in his discipline, and his method raised concerns around the glorification or the risk to accentuate an eating disorder, as diets can sometimes be triggers for more obsessive behaviours around food. 

That obsession — be it of being ‘super’ healthy, beating our natural ageing process and living longer — could cause, as Mark Grief, co-founder of literary magazine n+1, aptly puts it in his book Against Everything, our “haste to live mortal life diminishes. The temptation towards perpetual preservation grows. We preserve the living corpse in an optimal state, not so we may do something with it, but for its own good feelings of eternal fitness, confidence, and safety. We hoard our capital to earn interest and subsist each day on crusts of bread. But no one will inherit our good health after we’ve gone.”

Some biohackers, like Asprey, believe that the first person who will live to be 1,000 years old is already alive today. The question becomes, if you lived to 1,000 years old, would be live like an aged 1,000-year-old? Can we be forever young?

There are more than a few US companies that are in the process of researching the transfusion of healthy blood from young donors to the sick and elderly. There is potential that this method may be a cure for Alzheimer’s and stroke recovery. There is also the ever-alluring possibility that it may be a way to radically slow the inevitably burdensome process of ageing as a whole. Have we finally found the bloody fountain of youth? DM/ ML

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  • This is a poorly researched piece – for one, Ritalin, Concerta, and Adderall are not Nootropics and will never be considered nootropics because of the list of common and often adverse side effects. I would urge you to do your own research into biohacking and nootropics – I can be life-changing!

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