Everyone has had days where they felt like they were moving in slow motion. Or as I like to describe it, like my brain is full of cotton candy.

‘Brain fog’ isn’t an official medical diagnosis or symptom, rather it’s a loose term used to describe the common feeling of poor concentration, forgetfulness, chronic mental fatigue, indecision, irritability and low energy. Mention brain fog and we all know instantly, even though there isn’t a definite definition, what it means.

Some of us are lucky and only experience it occasionally, for a couple of days, but having persistent brain fog can become very frustrating.

On the other side of things, there are days where we have incredible mental clarity, feel incredibly motivated, competent, level-headed and calm.

It got me thinking about the WHY and HOW I could optimise my brain to function better. My research kept leading me back to BDNF.

Please note that there are definitely other serious medical conditions that need to be excluded for persistent brain fog, such as anemia, diabetes, autoimmune conditions and hormonal disorders and this article DOES NOT COVER the DIAGNOSIS of brain fog. It is important, if you have any symptoms or conditions, to first consult your doctor and be tested and treated with TARGETED THERAPY. Having said that, everyone can definitely benefit from a better healthier lifestyle and increased BDNF.

What is BDNF?

Brain-derived neurotrophic factor (BDNF) is a powerful protein that stimulates the production of new brain cells and strengthens existing ones. More specifically, releasing BDNF activates a series of genes that develop new cells and brain pathways. Thus, having high BDNF makes you learn faster, remember better, age more slowly, and reconnect your brain quickly.

Low BDNF has been linked to many brain-related conditions. These include anxiety disorders, depression, obsessive-compulsive disorder, eating disorders, schizophrenia, dementia, Huntington’s disease, Alzheimer’s disease, post-traumatic stress disorder, burnout syndrome, and suicidal behaviour. It’s not clear whether low BDNF causes these disorders or is a side effect of them.

There have also been studies to show correlation between low BDNF and obesity, hypertension and insomnia.

High BDNF on the other hand counteracts the negative effects of stress on the brain and protects the brain from neurodegenerative disease by increasing the brain’s plasticity and suppressing brain inflammation. It also has a natural antidepressant effect on the brain. There has also been suggestions that hight BDNF levels are related to increased lifespan.

How do I increase BDNF?

1. Exercise

The link between BDNF and exercise has been known for a long time, but researchers have recently discovered that exercise actually activates the gene that sends a signal to create more BDNF.

All types of exercise help increase BDNF, but some types work better than others. Mind-body movements requiring co-ordination and multi plane movements such as dance, GYROTONIC, Pilates, Yoga were associated with higher levels of BDNF. High intensity exercises, were also associated with increases in BDNF.

The most important thing is to vary your exercises to include aerobic and anaerobic exercises and movements that challenge your balance, co-ordination and to include all three planes of motion

Tip: A favourite trick of mine mid-day when my brain needs a bit of wake up is to move my eyes side to side without moving my head. Everything we do on a day to day basis is pretty much on the same plane — up and down, forward and back. By moving my eyes side to side, it is a quick way to get my brain moving and aware of the coronal plane (horizontal plane).

2. Sun

Serum BDNF concentrations show strong seasonal variation and correlations with the amount of ambient sunlight. It was higher during spring and summer and lower during autumn and winter.

A lot of people only know of sunlight as being beneficial for vitamin D absorption and production thinking that if they supplement with vitamin D, they do not need the sun. Supplemental vitamin D in a human trial did not increase BNDF and supplemental vitamin D in postmenopausal women actually showed a decrease in BNDF.

Tip: Walk out for lunch in the sun without an umbrella and beat the afternoon slump

3. Food and Nutrition

Intermittent fasting has shown to increase BDNF.Lots of other foods have had associations with an increase BDNF. Although the mechanism isn’t clear, it is likely that these food are anti-inflammatory and reduce oxidative stress on the brain which in turn increases BDNF levels.

Some of these that are associated with increase BDNF are:

Flavonoids

• cranberries
• chocolate
• green tea
• olive oil
• spices
• black pepper
• turmeric

Ferulic Acid

• seeds of coffee beans
• apples
• artichokes
• peanuts
• oranges

Magnesium

• pumpkin seeds
• avocados
• salmon
• almonds
• leafy greens

Omega 3 Fatty Acids

• certain fishes
• flax seeds
• chia seeds
• walnuts
• spinach
• brussels sprouts
• purslane
• meats from grass-fed animals

Quercetin

• red onions
• grapes
• cranberries
• tomatoes
• capers

Theobromine

• raw cacao
• dark chocolate
• coffee

Resistant starch

• green bananas
• potato starch

Resveratrol

• peanuts
• pistachios
• grapes
• red and white wine
• blueberries
• cranberries
• cocoa and dark chocolate

Foods and supplements that are associated with decreased BDNF are:

• High dose zinc supplementation
• High in refined sugar and high fructose corn syrup

Traditional thinking often had people spot-reducing. Patients with hypertension were suggested to reduce salt, diabetics were asked to reduce sugar, patients with elevated cholesterol levels were told not to eat eggs and seafood, and gout sufferers were told to avoid peanuts and beer.

Over the course of my research and education, I have found that most, if not all, conditions benefit from the same anti-inflammatory diet: A whole food diet consisting of dark green leafy vegetables, a variety of fruits, protein, whole grains and healthy fats.

Tip: A really simple way to make sure you’re eating well is to think of your total daily food intake on a plate. 1/2 of it should be made up of dark green leafy vegetables, 1/4 of it complex carbohydrates from whole grains or fruits and the last 1/4 made up on high quality protein and fats.

4. Stress Reduction and Cognitive Stimulation

Stess reduction and the effects of stress on our body rightfully deserves an entire article on its’ own. Apart from BDNF, stress and stress reduction can affect our health in a variety of other ways through other biochemical mechanisms which we will not be discussing for now.

Chronic sleep deprivation, chronic or acute stress and high levels of cortisol were associated with reduce BDNF.

Activities that provided cognitive stimulation, such as enjoyable social interactions, puzzles, learning and music showed an increase in BDNF.

We’ve always known that we should never stop learning, and that we age when we do. BDNF provides a biochemical explanation for these wise words.

Tip: Develop good sleep habits. Maintain a regular night routine, so your body knows it’s time to wind down, and try to head to bed the same time every night (even during the weekends!). Try to wake up the same time every morning too and without an alarm clock if possible.Make an effort to schedule in weekly downtime, for your favourite activities or to just do absolutely nothing!

Originally published at http://drdeborahwong.com on September 6, 2019.

“How did you and your business partner get into business with each other?”

“Well…. we were in a relationship when the opportunity to start Breathe came along, but we’ve broken up since and that makes him my ex-boyfriend.”

This is often followed by awkward silence or comments about how we are still able to work together.

We had been dating for a year before taking over Breathe. We broke up after 5 years of dating, but are currently still business partners. It is not uncommon for businesses to fail because of a break up. With the hindsight of time, I have been able to reflect a little on why and how it worked out for us, and also how we could have done it better. For us it boiled down to four main reasons.

Distance and Space

The initial months were the hardest. We were lucky to have distance, 3803km to be exact, between Shanghai, where I was, and Singapore, where he was. It gave us space to allow the frustration, anger and resentment to settle without causing any permanent damage.

Boundaries

Running a business together while being in a relationship for 5 years meant that our lives were irrevocably intertwined in all aspects. We had joint accounts, joint property, overlapping social circles. I was used to sharing my stresses, emotions and daily life with him. Drawing boundaries and deciding what was appropriate as business partner vs a couple was something we had to navigate.

In the first few months, our fights were awful. They were everything the internet said NOT to do — bringing up unrelated past events, using each other’s vulnerabilities as weapons, yelling, harassing, ignoring, blackmailing. It was horrible and painful. Our solution to that was to create rules — to listen and not interrupt, to speak calmly and not raise voices and only sticking to the topic on hand. We would repeat these rules to each other before the start of every conversation.

Respect

He was handling the day to day operations of the business while I was in Shanghai, and having earlier set the course for the business together, I trusted the plan and his ability to execute it. I consciously backed off and disengaged from the business during the most heated initial few months. It wasn’t easy and I was constantly questioning my decision, but I trusted and respected him still and I knew that should I have persisted being involved in the business initially, the charged emotional states we were in might possibly result in catastrophic consequences.

Although our relationship failed, we still respected each other and recognised the traits unique to each other that have made the business successful thus far. Practically, it also made no financial sense for either of us to get rid of each other and/or the business.

Common Vision

Overarching it all, we still shared a common vision and goal to build integrated health centres throughout the region. Ending our partnership would result in none of us being better off and with both of us further from our goal. In all honesty, our relationship should have and would have ended a lot earlier had it not been for the business. We had mistakenly taken our common business goal to mean that we had similar life goals.

I suppose it was an evolution of our relationship. It went from being a mix of personal and business to being only a business one. We just had to figure out what that meant in a respectful, kind and loving manner.

Originally published at http://drdeborahwong.com on June 2, 2019.

Having moved country in the last year, my OCD dietary requirements were challenged by the lack of quality takeout. I had to decide, learn to cook or settle for substandard nutrition.

The only problem was, I had no idea where to begin and how to start. Asking google and friends who were meal prep gurus yielded the same answer — ”It’s easy, just start cooking!” As with anything new, everything just seemed too overwhelming. Cookbooks and websites all required me to have 50 different type of spices, 10 different type of pots, pans and various other kitchen equipment. I didn’t want to go out and buy a million things that I would never use!

Fast forward three months later, I think I’ve conquered the basics of ‘sustenance cooking’ and meal prepping. 80% of my meals are home cooked and while it wasn’t as hard as I thought it would be, it was not a stroll in the park either.

1: Prep your kitchen

I started out with just one pan, a wooden spatula, one chopping board, one knife and a baking tray. I also had a blender and food processor from my raw baking adventures, and while great to have, these are definitely not necessary for when you’re starting out.

I also had ziplock bags and a couple of tupperwares of varying size to keep my food in for the week. Pantry wise, I had black pepper, salt, rosemary, turmeric, garlic powder, avocado oil, coconut oil and tamari sauce (which is just gluten-free soy sauce)

2. Plan a menu

Forget variety and presentation for now. Cooking for a 10 course degustation dinner and sustenance cooking are two entirely different skill sets. With sustenance cooking, you want to be as efficient as possible while minimising food wastage. When starting out, keep things as simple as possible.

A huge challenge for me was knowing how much food to buy. As a crazy fitness person, I do have certain macros that I follow, so having that definitely helped me figure out how much food I would need each day. Vegetables don’t keep well, so I planned to cook all my carbohydrates and protein on the weekends, and vegetables every 2–3 days.

To keep things even simpler, when I first started, I came up with a menu for only a day and then multiplied it 7x for the week. An example would be:

Breakfast — 180grams of greek yoghurt, 20grams of blueberries, 1/2 cup of granola

Lunch — 150 grams of baked salmon, 200grams of steamed broccoli, 250 grams of sweet potatoes

Dinner — 150 grams of grilled chicken breast, 200 grams of steamed cauliflower, 250 grams of quinoa

When grocery shopping, I knew I needed to get 1.05kg of salmon, 1.05kg of chicken breast, 1.26litre yoghurt, 140 grams of blueberries, 1.4kg of broccoli, 1.4kg of cauliflower etc

For variety, I would switch the chicken and salmon on alternate days for lunch and dinner. Might sound really boring, but you don’t run a marathon the first week you start running!

Google recipes, find the easiest one and the only seasoning you need at the start would be pepper, salt and garlic powder. For myself, I would pop the salmon, unseasoned (you don’t need anything else if you have good salmon), in the oven for 20 mins at 220 degrees Celcius. I also found the easiest chicken breast recipe HERE. Sweet potatoes went in the oven with the salmon, for 60 mins at 220 degrees (multi tasking for the win!) Quinoa was cooked in the pan together with the vegetables (also means less dishes to wash!)

3. Set aside time

When I was first starting out, it was a mad shamble of grabbing my phone to figure out which step was next, weighing the food, making sure that the food wasn’t burned and cleaning up after myself so I didn’t slip and fall or electrocute myself.

Learning a new skill can be really stressful, so allow time to learn it. Treating meal prepping and cooking like a new skill I was acquiring made it a lot more fun and a lot less frustrating. I cleared my schedule for the month and just took my time figuring it out. There were last minute grocery runs, and I actually had to cook my proteins and carbohydrates over two batches, because my pot and oven just wasn’t big enough! With time, I got more efficient and by the end of the month, I had a system in place to minimise dish washing, learnt how to cook in batches for the week, could eyeball my food, knew how much it weighed and had started experimenting with new recipes. I incorporated steak, roasted vegetables, pulled pork, roast beef, tacos, pasta and dips in my weekly menu.

It was a really challenging month and I did feel like giving up during week 2 and 3. I was bored of eating the same food, the novelty had worn off and it was just incredibly time consuming. But by week 4, I was cruising. It’s been such a rewarding experience — knowing how to meal prep and cook for myself is definitely a very useful life skill. As someone whose life revolves around food and fitness, I feel much better knowing that I can still be healthy regardless of where life takes me. My enjoyment of dining out has also increased exponentially, and being able to control the tiniest of details about food source, type of oil used, amount of oil used and seasoning has really helped with my weightlifting training.

I often get asked how I run a business and hold down a full time job as a doctor. Which had me pondering the question — Are you able to run a business while holding down a full time job?

A quick search on the internet seemed to be of the idea that it is possible. It is a very broad topic, and depending on the nature of work you are doing and your business goals, it might be feasible. My gut response however, is a resounding no — you can’t work fulltime while running a business. Ran the question past a couple of my entrepreneur friends and they too were of similar opinion.

Running a business requires time and mental commitment. Time is definitely a limited resource and regardless of what one might think, so is mental capacity. Discipline, focus and mindfulness are able to help to a certain extent, but after a certain amount of output, our ability to think well is certainly compromised. By trying to juggle both, we end up not doing very well in either.

During the initial stages of running a business, much time will be spent networking & relationship building. Opportunities often arise at unpredictable times, and having to turn them down because of job responsibilities is going to be a deterrent to business growth. Even if you have a great team, as owner, you would need to be involved with every aspect of the business, which allows you to identify areas of opportunities and/or inefficiencies. If you were looking for investments or partnerships, potential investors/partners would be hesitant to work with a company who does not have a full-time founder.

Anyone who has ever started something new also knows that it takes time for progress. There are cycles of excitement, enthusiasm alternating with frustration and confusion. When you have a job, it makes it so much easier for you to give up when you’re facing challenges and slow progress in the business.

Starting a business, on the other hand, is most definitely doable while holding down a full time job. Planning, conceptualizing and getting a minimally viable product (MVP) can be done when not working. Planning is mostly less time sensitive than execution, and so the constrains of a full time job are not as limiting.

The business landscape is ever changing and challenging. As with life, staying at the same spot inevitably results in us falling behind as the world moves forward. Whatever your business goals are, whether they are of global domination or self-sustenance, running a business requires constant effort and innovation to stay relevant.

When I first started the business, I spent the first year running it full time with my business partner. The decision to return to full time work was because of synergism between healthcare, wellness and fitness. Being involved in market facing activities is an essential aspect part of business strategy and working as a doctor allowed me to keep abreast of the changes in the healthcare industry. However that meant that I was no longer as involved in the operational aspect of the business. Having a business partner allowed us to be flexible in the roles we played in the business. Weekly strategic meetings are where we share our insights and review our plans and execution meetings are done by my partner and the rest of the team.

I suppose that is also the reason why many freelancers often find it difficult to scale. Freelancing while trying to grow your customer base is essentially running a business while working a full time job and trying to perfect your craft.

The point of sharing this isn’t to deter anyone from starting their own business, but rather paint a realistic picture of what to expect when making the jump to entrepreneurship. After all, to be prepared is half the victory.

Two weeks ago, I competed in my first weightlifting/Crossfit competition. It was exhilarating, nerve wrecking, scary and satisfying all at the same time.

I have been training on my Olympic lifts for 6 months now. If you have ever picked up a new hobby, 6 months is when you have just gotten over the awkward part of learning, started to see some good progress and where everything is still fascinating and you are constantly learning. It is not the time where you are proficient or anywhere near the level that competing would require.

Nonetheless, I decided to bite the bullet and went ahead and joined an amateur weightlifting competition my weightlifting club had organized. Part of moving to a new city meant that I had to relearn a lot of things. One of the things I decided on was to never make fear a reason for not doing or doing something. Apart from fear of embarrassment and failure, there really wasn’t anything else stopping me from taking part.

On the 14th of March, I showed up at the competition, a nervous wreck, pretty convinced I was going to be a mess. But I wasn’t! I totally owned the first day at the competition, beat my previous personal records by a mile, didn’t finish last, and didn’t injure myself. The consistent training I had been doing over the last 6 months paid off. Went home on an adrenaline high — pretty sure I was going to be fine the next day with the CrossFit component.

The next day was a complete disaster. Having not trained my cardiovascular fitness for the last 6 months, while I focused on strength training, exercises that were previously a given for me felt like death. I ended the competition back where I thought I would be, last, humbled and reminded about the importance of consistency and the danger of complacency.

A decade ago, I would have been devastated. I was so competitive growing up, always having to win, being the best at everything and was such a sore loser. Being competitive wasn’t the problem though, being a bad loser was. Somewhere along the line, I learnt that results don’t matter if you genuinely tried your best. Being competitive against yourself is a great thing, having to be better than others to validate yourself isn’t.

Would I do it again? In a heartbeat. The sense of achievement and satisfaction from overcoming my fears and pushing my boundaries was invaluable. I want to live a full life. A life filled with adventure and escapades. Showing up and taking part in this competition reminded me what it took to live a life of daring and just how rewarding it can be.

In the last 5 years of entrepreneurship, we have had 100% staff retention. This is my proudest achievement and not the million dollars revenue or profits we achieved.

Perhaps a main reason is the industry we are in, but here are some of my thoughts on what worked for us.

1. Reward your employees

While some companies put their customer first, for us it has always been about our employees. We believe that when our employees are happy and motivated, the customers will be too. It is a fundamental desire in everyone to be seen, valued, loved and appreciated. We reward our employees financially far more than the average industry standard, not in a bid to retain them, but because we believe in rewarding them fair value for their time and effort. When we have an increase in profitability, we increase salary. Expansion plans are not our employee’s concerns and we prioritise rewarding them first over any expansion. If we can’t afford to reward them and expand, we choose not to expand.

Rewards do not only need to be financial, they could be flexible working hours, less working hours, more leave, extra benefits or health care. The mistake a lot of companies make is using these non financial rewards as a way to structure a package that allows them to reduce labour cost. Employees aren’t stupid and will be able to tell if it’s a management squeeze or the change comes from a true concern for their needs.

2. Find the right fit

Over the years, we have had periods where we were short staffed because we were unable to find the right fit. While many would have been willing to hire just to fill the gap, it was something we decided we would not do. Hiring the wrong fit result in brand dilution and poor team morale. Having to let someone go is a miserable experience for the management, the employee and the rest of the team that remains.

3. Be flexible and support their dreams

We maintain flexibility for all our employees and accomodate them as much as the business structure allows us to.

The crux is that our employees understand that we appreciate and treasure their contributions they make as individuals and not just as employees. In many companies, employees are often afraid to share their external passions for fear of these passions being viewed as distractions.

An interesting outcome we have experienced is that supporting their passions has also benefitted us. Finding the right fit means that often our employees side hustle are often synergistic to our business and supporting them has allowed the business to grow horizontally and vertically across our industry.

4. Approachable leadership and a no blame culture

As our company got bigger, roles become more specialized and we realized that management may lose touch with what is happening on the ground. That has often been the downfall of many good companies and to circumvent the problem, we intentionally create time in our work day to meet with different roles to understand the challenges they face. To encourage open dialogue, we adopted a no blame culture, and are solution, instead of problem, oriented. These approaches were done to help scale and grow our business, but has also had the effect of helping us retain our employees.

In summary, it is about treating people the way you want to be treated. It is about valuing your employees and viewing them as equal stakeholders in our entrepreneurial journey. Having a strong and loyal team has allowed our business to flourish as we are able to devote resources, that would have otherwise been spent on hiring and training, on growth and development.