Mito & Mitoflex Food Plan

The Mito Food Plan may be described as an anti-inflammatory, low-glycemic, gluten-free, low-grain, high-quality- fats approach to eating.The plan focuses on supporting healthy mitochondria through the use of therapeutic foods that improve energy production. Mitochondria are structures in every cell that make energy by using oxygen and nutrients from food.The cells in the brain, heart, nerves, muscles, and organs all have higher concentrations of mitochondria.These parts of the body are also more susceptible to a premature decline in function caused by a host of common insults. Harmful food choices can contribute to this decline, leading to poor health and chronic illness.

For the Mito Food Plan, two food list options are available: the traditional Mito Food Plan (which includes dairy products) and the dairy-free Mito-Ketoflex Food Plan. Both versions will support the body in the production

of energy, restore a sense of vitality, and help the body use food to support a graceful and healthy aging process. Decreased utilization of glucose, leading to insulin resistance, has been seen in those with Alzheimer’s disease.The mildly ketogenic, low-carb approach of both versions of the Mito Food Plan is helpful in producing ketones, a more efficient fuel for the brain. Ketones are absorbed faster than glucose and produce less oxidative damage in our bodies.The Mito and Mito-Ketoflex food lists can assist in preventing the development of chronic neurological disease by helping people to choose specific foods that enhance mitochondrial function.

Below are answers to FAQs followed by several examples of foods contained in these plans.

Further Details and Answers to Frequently Asked Questions

What is the difference between the Mito Food Plan and the Mito-Ketoflex Food Plan?

In order to better meet the needs of a wide variety of patients, the Mito Food Plan has two mildly ketogenic, low-carbohydrate food list options: the traditional Mito Food Plan and the Mito-Ketoflex Food Plan.The traditional Mito Food Plan allows for the consumption of dairy products and some high-carbohydrate food categories like gluten-free grains on a regular basis, especially for those with higher caloric needs.The Mito- Ketoflex Food Plan is slightly more restrictive.This plan excludes all dairy products, which can be inflammatory and problematic for those with specific neurological conditions or health concerns.The plan also places a weekly limit on the number of servings of gluten-free grains allowed, and reduces the reliance on animal protein in order to meet daily macronutrient ratios.

Both the Mito Food Plan and Mito-Ketoflex Food Plan are typically implemented with a macronutrient ratio of 20% protein, 60% fat, and 20% carbohydrates. (See the macronutrient distribution tables below for more information.) However, a Functional Medicine practitioner may prescribe a more therapeutic macronutrient distribution (e.g., 15% protein, 80% fat, 5% carbohydrates) when a more aggressive ketogenic approach is warranted.

20P/60F/20C Macronutrient Distribution by Caloric Ranges (For Use with the Mito Food Plan)

The 600 calorie distribution is 32P/55F/13C. This very low-calorie level is recommended only for occasional intermittent fasting days.

† When consuming dairy alternatives in the place of dairy products, substitute 2 dairy alternative servings for every 1 serving of dairy.

20P/60F/20C Macronutrient Distribution by Caloric Ranges (For Use with the Mito-Ketoflex Food Plan)

The 600 calorie distribution is 32P/55F/13C. This very low-calorie level is recommended only for occasional intermittent fasting days.

† At all calorie ranges, no more than 1-2 servings of grains should be consumed per week. On days when a grain is consumed, servings of legumes should be omitted.

How does mito food plan benefit mitochondrial function?

Mitochondria, the powerhouses in every cell of the body, convert food and oxygen into clean energy called ATP that powers the cell’s activities. Mitochondria help to detoxify poisons (e.g., pesticides, toxins in the food supply, pollution in the air) that get into cells. Molecules called ‘free radicals’ are produced as part of this energy exchange. These free radicals need to combine with other molecules or oxidation will occur. Oxidation in nature is seen when iron rusts in the presence of oxygen and moisture. A similar process happens inside the body. Excess free radicals

can damage the brain by initiating cell-death, leading to premature aging.The body tries to defend itself against free radicals by producing antioxidants that neutralize their effects. In addition to the antioxidants the body is able to produce, a plethora of antioxidants comes from the phytonutrients in colorful vegetables and fruits.

Deterioration of mitochondria in the brain is a major cause of all neurological diseases such as Parkinson’s disease or dementia.The oxidative process, also called oxidative stress, contributes to the acceleration of these diseases.

What are high-antioxidant foods?

Many foods, particularly vegetables and fruits, contain an abundance of antioxidants. Some of the highlighted therapeutic foods on the Mito Food Plan are high in antioxidants. For example, grapes, red wine, purple grape juice, peanut skins, and dark chocolate contain an antioxidant called resveratrol that helps the function of the mitochondria.These foods will activate the genes for the production of detoxification enzymes and antioxidants and even improve fat burning for energy.

Other important antioxidants found in the broccoli family help the body make glutathione. Herbs and spices, green tea, and berries also help to control oxidation. Some less common vegetables that enhance digestion and provide beneficial intestinal flora include fermented foods, such as kim chi or sauerkraut, and seaweeds, like wakame and bladderwrack.

What are the benefits of intermittent fasting and calorie restriction?

Eating fewer calories increases the protein BDNF, which acts like a growth hormone for the brain, and also activates the Nrf2 pathway, which increases production of antioxidants and detoxification enzymes. Some experts suggest that you fast 1–2 times a month for 24 hours, drinking only water.This may be very difficult for some to

do. It is always wise to discuss it with your doctor before attempting a fast such as this. But, you can also practice the 12-hour fast from dinner to breakfast to increase your BDNF and Nrf2 pathway! Do this as often as possible; at least four times a week.The trick for success is to be sure to eat enough protein and veggies at dinner, so you will not be hungry later in the evening and want to snack.

Other methods of fasting include reducing calories to 600/day once a week, consuming 20–30% fewer calories than an individual’s BMR suggests, skipping snacks, and spreading out meals from 5 to 12 hours.The use of coconut oil mimics the effects of fasting; the MCTs in coconut oil increase levels of ketones, which create an effect in the body similar to fasting and carbohydrate restriction.

How do I calculate a 600-calorie meal plan?

One easy way to keep calories to 600 calories per day is to use one of the quality vegetarian-based protein powders or medical foods available today. Choose unsweetened protein powders made from quality pea proteins, rice proteins or combinations of pea, rice, chia, and hemp. Most provide a total of 130 to 160 calories and

15 to 25 grams of protein per two-scoop serving when added to unsweetened almond or coconut milk.This can provide a sustaining and balanced food replacement throughout the day. Another way is to use modest amounts of food as follows:

n 600-calorie “day at a glance” focusing on a protein powder:

use a cold milk alternative and shake well with powder in a shaker cup. Aim for four servings approximately 4 to 5 hours apart for best satiety.

Example: Two scoops unsweetened protein powder added to 1 cup unsweetened almond or coconut milk (40 to 50 calories) = 130 to 160 total calories. Repeat this three more times throughout the day. If desired, you may use a blender and add ice and a handful of greens to each smoothie.

n 600-calorie “day at a glance” focusing on a modest amount of quality protein, small amounts of healthy fats, and three to four servings of non-starchy vegetables:

Breakfast: One egg scrambled with ½ cup spinach sautéed in a small amount of chicken broth, topped with ¼ of whole avocado, pinch of sea salt, and pepper.

Lunch: About 2 ounces of cooked turkey or chicken over 2 cups of mixed baby greens, juice of ½ lemon, and 1 tsp olive oil drizzled over greens and chicken, with pinch of sea salt and cracked pepper.

Dinner: About 3 ounces poached or broiled salmon and ½ cup steamed broccoli drizzled with ½ tsp olive oil, juice of ½ lemon or lime, pinch of sea salt, and fresh herbs of choice.

How else can I reduce calories by 20–30% as suggested?

There are some simple ways to implement calorie reduction into regular eating patterns. Instead of making four 4-ounce burgers with a pound of ground meat, try making five 3½-ounce burgers.The difference will be hardly noticeable, but protein calories will be reduced by 25%! For breakfast, instead of having three eggs and two slices

of toast, try having two eggs and no toast, or just one slice for starters. Add a side of veggies and assess your hunger. Another idea is to reduce a 6-ounce portion of protein at lunch or dinner to 4 ounces. Generally, if one waits about 20 minutes after eating, they will no longer feel hungry. So be patient! Instead of having a sandwich at lunch, try half a sandwich and fill up the rest of the plate with veggies, which are the healthiest brain food. Better yet, avoid the bread altogether and have a large salad with greens, veggies, protein, and healthy oils for dressing.This meal will be

much more satisfying than the sandwich, resulting in feeling fuller for a longer period of time. In general, eating fewer calories, no matter how it is done, will benefit the brain and its mitochondria.

How many carbohydrates are in the foods I eat?

The Mito Food Plan lists the approximate carbohydrates in a serving of fruits, vegetables, grains, legumes, and dairy foods. Serving size varies within each group.

What would a typical day’s meals look like if I limit carbohydrates to 60 grams per day?

The Weekly Planner and Recipes will illustrate this, but here is a sample menu for a day. It is not as hard as one might think. Just focus on brain-healthy proteins and veggies!

Breakfast: two-egg omelet with 1 cup spinach cooked in coconut oil, plus a small handful of pumpkin seeds or walnuts and ½ cup blueberries

Lunch: organic, grass-fed beef, buffalo, or turkey burger with 2 cups of salad greens (or a mixture of kale and greens) plus 2 cups of raw veggies, tossed with olive oil and vinegar, and a roasted seaweed snack

Dinner: wild salmon with 1 cup steamed broccoli and salad of 1½ cups greens, ½ cup cherry tomatoes, ½ cup thinly sliced red cabbage, handful of almonds, and ½ avocado, tossed with olive oil and balsamic vinegar

How will I know if I am in ketosis?

Urinary testing for the presence of urinary ketones should be performed daily.The goal is mild to moderate ketosis.

If I wish a stricter ketogenic approach, how would I go about this?

The Mito Food Plan can be used for guidance but needs to be directed by a trained Functional Medicine practitioner (doctor or nutritionist) who is familiar with the ketogenic diet approach.This type of approach must be closely monitored by both the patient and

the practitioner.With that said, here are some basic considerations for a stricter ketogenic approach:

Keep carbohydrates low: This is very individualized and based on metabolic individuality and activity level.The range for adults can be anywhere from 20 grams to 80 grams per day for a very active athlete.

Eat healthy fats: These can make up as much as 50–60% of the diet. Focus on butter from grass-fed cows, coconut oil, MCT oil, nuts, olives and olive oil, avocados and avocado oil, and full-fat organic dairy if suggested by the Functional Medicine practitioner.

Moderate amounts of protein from pesticide- and toxin-free sources: Depending on a person’s size and activity level, average ranges can be from 70 to 80 grams per day on days that don’t involve exercise, and up to 120 grams on days that resistance exercise is performed.

Test for ketones often: As it takes 3 days on a ketogenic diet to achieve ketosis, urine testing should be started after 3 days. Daily testing is important, particularly for those who have epilepsy or ALS.The testing goal is for trace to moderate ketones. If ketones are not detected, adjust carbohydrates by increasing exercise or decreasing starchy vegetables or fruits by 7–15 grams (½ to 1 serving).

Be aware that: Occasionally the urine strips may not reflect ketosis even when compliance to the diet is high.This is fine if other markers are improving, such as glucose and insulin levels, triglycerides, or body composition.

Why is organic food so important?

The importance of pesticide- and toxin-free food from local, free-range, grass-fed, and organic sources cannot be stressed enough. Such foods are extremely important for brain health. Organic foods are grown without the use of pesticides and synthetic fertilizers. Organic meats, poultry, dairy, and eggs all come from animals that have not been raised on antibiotics or growth hormones. Free-range meats come from beef, buffalo, chicken, or lamb that have not been fed corn or other grains, but have been allowed to roam free and eat grasses that are naturally higher in healthy omega-3 fats. Research has shown that organically grown fruits and vegetables retain greater nutritional value than foods grown with pesticides and other chemicals.The food plan also stresses avoiding highly processed and junk foods and refined sugars. See the Environmental Working Group website (ewg.org) for a list of produce containing the highest level of pesticides (“Dirty Dozen”), along with those containing the least amount of pesticides (“Clean 15”). Be aware when purchasing foods from foreign countries, such as Mexico or China; these countries have different laws regarding organic foods.To avoid confusion, buy locally grown food as much as possible.

How can I cook in a way that supports brain health?

During cooking, tasty aromatic compounds form, but so do inflammatory substances called advanced-glycation end products (AGEs) that can actually inhibit your mitochondrial function, increasing oxidative stress.Typically, the higher the heat

and the browner the food, the greater the amount of potential inflammation from the meal. AGEs are primarily found in meats cooked at high temperatures, highly processed foods, and full-fat cheeses. A healthier option is to cook with moisture over low heat, such as cooking in a crockpot or slow cooker, poaching, steaming, and stewing. Food that is grilled, charred, broiled, seared, or crisped should be eaten with

fresh cooked greens (spinach, kale, chard, arugula, etc.) or a salad. Pairing the browned foods with fresh vegetables will help decrease the inflammation that may result.

Adding certain spices (see below) to food cooked over high heat may reduce the formation of other damaging molecules, such as heterocyclic amines (HCAs), as the chlorophyll in greens binds with HCAs.While it is not possible to totally avoid AGEs,

reducing your exposure whenever feasible will help reduce the total load.Try some of the recipes in the Mito Food Plan Weekly Planner and Recipes guide using healthier cooking methods to reduce formation of AGEs.

How will I know if I have an allergy or sensitivity to dairy?

If there is reason to suspect that dairy might be causing some negative reactions, it would be wise to avoid it for 2 to 3 weeks to see if symptoms improve. Casein (the protein in cow’s milk) has cross-reactivity to gluten, so if a person is sensitive to gluten, they may need to also avoid dairy foods to avoid an inflammatory response. Discuss this with a Functional Medicine practitioner if there are any concerns.

Why are herbs and spices important in this food plan?

Spices are medicinal, concentrated herbs that can have anti-inflammatory and antioxidant effects in neurological disease.The Mito Food Plan encourages a generous use of various spices, such as basil, black pepper, cayenne, cilantro, cinnamon, cloves, curry, fennel seed, garlic, ginger, marjoram, oregano, paprika, parsley, rosemary, sage, and turmeric. ALL spices and herbs have the potential to limit the damage from oxidation. For example, glutathione is an important antioxidant.The curcumin in turmeric is vital to brain health, as it has the potential to activate genes that produce detoxification enzymes and thus ramp up the production of glutathione.Turmeric has been shown to reduce buildup of the beta-amyloid protein that is found in high amounts in the brains of those with dementia.

Using a variety of herbs and spices will help individuals develop and experience new tastes. It is recommended that daily meals be dressed up with a spectrum of spices, as they will make food taste more interesting and increase the medicinal impact. Some studies even suggest that spices can reduce some of the oxidative damage and formation of cancer-causing substances that occur with cooking.Try incorporating rosemary into hamburger meat before grilling, or adding turmeric to a vegetable stir-fry. Combining black pepper with turmeric increases its availability in cooked dishes.This combination can also be sprinkled on eggs. Experiment with its flavor on different foods and sauces.

Also, try sprinkling cinnamon on warmed almond or coconut milk drinks to help the body better respond to high insulin levels, which can damage the brain over time.

Here’s good news for the chocolate lovers: cocoa, actually considered a spice, may also enhance healthy brain function by increasing cerebral blood flow to gray matter in the brain and improving memory and cognition! Cocoa’s high antioxidant levels may also help protect DNA and support healthy cardiovascular function. Dark chocolate with a higher percentage of cocoa is best in order to avoid added sugar and milk.

Suggestions for buying herbs and spices?

When buying spices in bulk, store them in airtight glass or tin containers. Buy only what will be used within 6 to 12 months.Whole spices will keep for a longer time, up to 2 to 3 years.
Purchase herbs and spices in all forms: fresh, dried, whole, cracked, coarsely ground, and finely ground.
Store herbs and spices in a cool, dark place. Heat, light, and moisture will accelerate the loss of flavor. High temperatures can cause spices to cake or harden and change or lose color.
Keep spice containers closed and away from the stove.
To test for freshness, rub between fingers and sniff to check for aroma.

I dislike the taste of green tea. What else can I drink on the Mito Food Plan?

First, try some of the creative suggestions given for integrating more green tea into the diet. If these don’t work, then try gingko biloba tea, which provides similar benefits as green tea. Herbal teas, black tea, and coffee also have some antioxidant benefits.Those who are sensitive to caffeine should purchase Swiss water-processed decaffeinated coffee to avoid the chemical solvents used in most decaffeinated brands. Please avoid anything with added sugars, including diet soda. As always, drinking plenty of pure, filtered water each day should be a priority.

What are “adaptogenic” herbs?

Another brain-protective use for herbs is in making herbal teas from certain herbs known as “adaptogenic herbs” because they can adapt to conditions in the body. Adaptogenic herbs are plants that exert a normalizing influence on the body.They neither over-stimulate nor inhibit normal body function, but help the body to cope more effectively with stress by recharging the adrenal glands.The star of these herbs for brain health is Asian ginseng, which also

has antioxidant properties. Other than Asian ginseng, various herbal teas such as American and Siberian ginseng, astragalus, cordyceps, licorice, reishi, and schizandra berries are beneficial. Remember the BDNF that we talked about earlier? It protects the nervous system and is vital for thinking and learning. Ginseng stimulates BDNF while helping with blood sugar management! What could be better?

How can I cook with or make tea from the adaptogenic herbs?

Herbs should be bought in small amounts in the bulk section of the health store. Pulverize any roots before use.To make tea, place herbs in a 1-quart glass measuring cup and pour 1 quart boiling water over the herbs. Allow to steep for 20–30 minutes and then strain before drinking. Herbs may be steeped longer (up to a few hours) if a stronger taste and more medicinal value is desired. Alternatively, herbal teas may be purchased at the health food store so they can be brewed more quickly.

When cooking adaptogenic mushrooms, such as reishi, cook in water rather than oil. Astragalus may be added to mushroom or chicken soup.

What about drinking alcohol?

Alcohol can improve blood flow to the brain by lowering blood pressure. Red wine in particular contains brain-friendly antioxidants and resveratrol, a phytonutrient that helps to relax the blood vessels. However, alcohol is also a form of sugar, which may not be good for those eager to improve brain health.

There is no consensus regarding the impact of alcohol on the health of the aging brain, particularly as it relates to Alzheimer’s disease. One study suggested that light to moderate alcohol intake, in particular wine, is associated with a larger brain and may have potential benefits for brain aging. Out of 19 studies on drinking and Alzheimer’s disease, 7 reported a decreased risk of the disease; 3 found an increased risk of the disease; and 9 reported no impact. For a generally healthy person, one glass of red wine may be perfectly acceptable at meals, even when leaning toward a more ketogenic diet.

Alternatively, one who wishes to avoid alcohol may incorporate foods that are high in resveratrol, such as red grapes, dark chocolate, peanuts, and purple grape juice. A Functional Medicine practitioner who knows a patient’s health history can make a determination as to whether moderate or occasional use of alcohol would be appropriate and consistent with health goals. In addition to adding food sources of resveratrol, he or she many suggest avoiding alcohol and take supplemental resveratrol.

I don’t see any sweeteners on the Mito Food Plan. What can I use on the plan as a sweetener?

It is essential to refrain from all added sweeteners to the best of one’s ability when following this food plan.The damaging effects from inflammation that sugar can have on the blood vessels and brain are long-lasting. In addition, high- intensity sweeteners can lead to blood sugar imbalances, increased calories and subsequent weight gain, and continued cravings.When craving something sweet, choose from the fruits on the Mito Food List.While label reading is important to detect added sugars, the Mito food plan doesn’t encourage eating processed foods. Fresh fruits and vegetables are safe foods, as they contain no hidden sugars.

Artificial (synthetic) sweeteners should also be completely avoided; new research is finding that these high-intensity sweeteners may have negative effects on metabolism and could spur food cravings. Some of these actually act as excitotoxins in the brain and promote free radical formation.These types of sweeteners include NutraSweet® (aspartame), Splenda® (sucralose), acesulfame-K (Ace K, Sweet One®, Sunett®), and Sweet N’ Low® (saccharin, sodium cyclamate).

What condiments are acceptable?

Many condiments like teriyaki sauce, ketchup, barbecue sauce, and glazes almost always contain added sugar. It would be best to avoid them entirely or make homemade versions that are healthy. Adding more spices and fresh herbs in food

preparation will create less need for unhealthy condiments. Gluten-free tamari or soy sauce, coconut aminos,Tabasco sauce, fish sauce, and most mustards are acceptable. Please check labels, as some brands have added sugars.

Can I exercise while I’m on this program?

Exercise is an important part of any program that is designed to improve brain health. It is strongly recommended that you

exercise aerobically at a moderate level at least 150 minutes (2½ hours) a week, including weight training at least twice per week. Compelling research has indicated that exercise helps to oxygenate the brain and particularly affects learning and memory. Exercise also activates the gene that turns on BDNF, which protects our neurons and helps to create new ones.

Below are several of foods in the Mito and Mitoflex food plans.