Most of us are probably interested in living longer and feeling great as we age. Since 60% of American adults live with at least one chronic disease, what’s the key to aging well? One crucial aspect is the health of our mitochondria, the powerhouses of our cells.
Why Mitochondria Matter
Mitochondria are structures in every cell that make energy by using oxygen and nutrients from food. They convert food into cellular energy in the form of adenosine triphosphate, or ATP, through a process called oxidative phosphorylation. Among other tasks, ATP powers our cells to communicate with each other, helps our muscles contract, creates new DNA and RNA, and allows our brains to function well.
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.
However, the process of making ATP itself can damage mitochondrial DNA (mtDNA), and the mitochondria are also vulnerable to damage from our inflammatory lifestyles. The creation of ATP itself, via a process known as oxidative phosphorylation, generates reactive oxygen species (ROS) that contribute to higher levels of oxidative stress and inflammation in the body. When the mitochondria can’t repair themselves effectively, poor aging, neurological diseases, cancers, type 2 diabetes, and obesity may develop. Making the mitochondria a priority is one way to potentially delay or even manage the effects of aging. Since inflammatory foods and excessive food intake may contribute to mitochondrial dysfunction, changing what and when you eat is a good start.
The MITO Food Plan: A Dietary Approach to Support Mitochondrial Health
The MITO Food Plan from the Institute for Functional Medicine (IFM) uses therapeutic foods and lifestyle strategies to support healthy mitochondrial function, especially in people with brain disorders, chronic pain, and fatigue.
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The Mito Food Plan may be described as an anti-inflammatory, low-glycemic, gluten-free, low-grain, high-quality- fats approach to eating. The MITO Food Plan is a way of eating that may promote optimal mitochondrial function, restoring a sense of vitality and encouraging healthy aging. This meal plan is anti-inflammatory, low-glycemic, gluten-free, low in grains, and moderate in high-quality fats, which may help manage inflammation and oxidative stress in the body.
The plan focuses on supporting healthy mitochondria through the use of therapeutic foods that improve energy production. The MITO Food Plan emphasizes therapeutic foods for energy, protective antioxidants, anti-inflammatory nutrients, and high-quality fats. It also reduces overall carbohydrate intake, with the recommendation to choose only limited amounts of gluten-free grains. In addition to bringing in therapeutic foods, the MITO Food Plan encourages intermittent fasting and calorie restriction, with recommendations for improving food quality and food preparation.
While mitochondria are present in all cells, specific high-energy tissues like the muscle, liver, kidney, and brain house more mitochondria than other tissues of the body. The inability of mtDNA to repair itself from inflammation-induced damage in these tissues may be one of the reasons we see the development of conditions like obesity, neurological diseases, and type 2 diabetes.
To support this process, the MITO Food Plan encourages the use of nutrient-dense foods. But it also considers when to eat, how much to eat, and how to cook your food to help manage oxidative stress and inflammation. All of these factors together may give your mitochondria a better ability to repair themselves.
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 the Mito Food Plan and Mito-Ketoflex Food Plan are typically implemented with a macronutrient ratio of 20% protein, 60% fat, and 20% carbohydrates. 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.
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Who Can Benefit from the MITO Food Plan?
As we age, mitochondrial function naturally begins to decline, so the MITO Food Plan is a good option for anyone hoping to age well. But according to IFM, the MITO Food Plan may also be used to support individuals who would like to specifically target brain function, pain levels, and fatigue.
Brain Function
Oxidative stress and inflammation may play a role in the development of neuropsychiatric disorders and cognitive decline. High levels of ROS, inflammatory markers, and mitochondrial membrane dysfunction have been found in people with depression. Patients with Alzheimer’s disease also seem to have a number of mitochondrial alterations. The MITO Food Plan may encourage good brain function by supporting the mitochondria and increasing brain-derived neurotrophic factor (BDNF), a protein that helps protect brain cells.
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. 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.
Chronic Pain
People with mitochondrial dysfunction often experience chronic neuropathic pain related to oxidative stress and inflammation. But muscle wasting (sarcopenia) may also be a common feature in those with chronic musculoskeletal pain. Adequate dietary protein intake is one important way to preserve muscle mass which contains a high concentration of mitochondria, but it also serves as the precursor to neurotransmitters that modulate pain. The MITO Food Plan may help manage pain by supporting oxidative stress and inflammation with anti-inflammatory foods, but it also ensures adequate protein for muscle tissue growth and repair, and healthy neurotransmitter production.
Chronic Fatigue
Feeling chronically tired may be a byproduct of poor mitochondrial function. Since the mitochondria play a central role in energy production, sluggish mitochondria, or mitochondria that aren’t able to repair themselves adequately, can’t efficiently turn the food you eat into usable energy. In addition to promoting healthier mitochondria, the MITO Food Plan eliminates high glycemic foods to help balance blood sugar, which may significantly improve energy levels.
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Foods Allowed on the MITO Food Plan
The MITO Food Plan includes foods known to support mitochondrial function, but it’s also designed to help manage blood sugar control and inflammation levels in the body. The MITO Food Plan emphasizes therapeutic foods for energy, protective antioxidants, anti-inflammatory nutrients, and high-quality fats. It also reduces overall carbohydrate intake, with the recommendation to choose only limited amounts of gluten-free grains.
Protein
High blood glucose levels can trigger an immune system response, ultimately increasing inflammation. Meals that contain adequate protein may help to control blood sugar levels and also help to stimulate muscle mitochondrial protein synthesis, which is vital for maintaining great metabolic health as you age.
The MITO Food Plan recommends high-quality protein with every meal. Free-range, grass-fed, organically grown meats and non-GMO plant proteins, and wild-caught fish are preferred. Particularly therapeutic options include wild Alaskan salmon, mackerel, sardines, cod, elk, venison, lamb, beef, and bison. But eggs, poultry, and cheese are also good sources of protein that can be included. Plant-based proteins like tofu, tempeh, beans, legumes, mushrooms, and various protein powders can be good substitutes if you don't eat animal products. But legumes and beans are high in carbohydrates, which can affect blood sugar and insulin levels, so the MITO Food Plan restricts these to one serving per day.
Healthy Fats
Healthy fats help to manage inflammation in the body and they may improve the function of the mitochondria in the brain. The fats, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are particularly important for the developing brain, but they may also support inflammation-related brain health. Interestingly, patients with a lower omega-3 index, a marker of EPA and DHA levels in the blood, may have a higher risk of cognitive dysfunction and neuropsychiatric disorders.
In addition, a higher fat, lower carbohydrate diet helps the body shift away from using carbohydrates (glucose) for fuel to using fat (ketones), which may be a supportive option for brain mitochondria. Ketones are an efficient way to make ATP, so they may help support against neurodegeneration.
The MITO Food Plan encourages minimally refined, cold-pressed, organic, non-GMO fats. So, you can include avocado, coconut milk, olives, and cooking oils like avocado, coconut, ghee, grass-fed butter, MCT, and olive. In addition to added fats, nuts, and seeds are sources of healthy fat and phytonutrients to support mitochondrial health. Include almonds, chia seeds, flaxseed, hemp seeds, pumpkin seeds, walnuts, Brazil nuts, cashews, hazelnuts, peanuts, pecans, pistachios, pine nuts, sesame seeds, and their various nut butters. Egg yolks and cold-water fish from the protein category also provide brain-supportive fat.
Fruits and Vegetables
Fruits and vegetables, rich in phytonutrients, can help manage inflammation in the body, which may improve mitochondrial function. The MITO Food Plan recommends eating 8-12 servings (1 serving equals one cup cooked or one-half cup raw) of fruits and vegetables each day to obtain the vitamins, minerals, and phytonutrients your body needs to support mitochondrial health. Focus mostly on non-starchy vegetables and add in therapeutic options like arugula, asparagus, Bok choy, broccoli, Brussels sprouts, cabbage, cauliflower, chard, chives, Daikon radish, fermented vegetables, garlic, greens of all kinds, kohlrabi, leeks, okra, onions, scallions, sea vegetables, shallots, spinach, and watercress. Fruit servings should be unsweetened and consumed with a meal instead of alone to minimize the effect on blood sugar. Therapeutic fruit options include apples, blackberries, blueberries, cherries, grapes, mango, pomegranate, raspberries, and strawberries.
Rules for the MITO Food Plan
In addition to bringing in nutrient-dense, whole foods and focusing on blood glucose regulation and inflammation, the MITO Food Plan addresses a few additional considerations.
Limit Grains and Dairy
While foods that contain dairy and gluten-free grains may be included in small amounts on the MITO Food Plan, they aren’t emphasized and are not necessary to include daily. Higher amounts of carbohydrates from gluten-free grains may affect blood sugar levels and don’t allow for ketones to be used for fuel. The MITO Food Plan recommends limiting the daily intake of carbohydrates to 60 grams for those aiming for ketosis. In addition, dairy products may promote inflammation in some people. If you’re using this meal plan to support brain health, chronic pain, or fatigue, it’s probably best to minimize these.
Intermittent Fasting and Calorie Restriction
Intermittent fasting (IF) is one approach with many potential health benefits. Essentially, IF involves avoiding food intake for hours or days while remaining hydrated. IF encourages metabolic flexibility (switching from glucose to ketones for fuel), which may support mitochondrial function to promote great brain health and healthy aging. It’s also a method of calorie restriction, which may increase BDNF levels, have favorable effects on the mitochondria, and support the aging process.
IF and calorie restriction can be accomplished in many different ways. One of the easiest may be a simple daily 12-hour overnight fast, but you can also choose to limit your food intake to 600 calories for one day each week or just cut your normal daily calorie intake by 20-30%.
Food Quality
The MITO food plan also encourages using high-quality foods to limit exposure to pesticides and synthetic fertilizers (which may affect the mitochondria) and grain-fed animals (which may have lower omega-3 fatty acid content). Look for local, free-range, grass-fed, and organic options whenever possible. 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.
Food Preparation
Certain food preparation methods, like grilling and high-heat cooking, create advanced glycation end products (AGEs) that can increase oxidative stress and negatively impact your mitochondria. AGEs are primarily found in meats cooked at high temperatures, highly processed foods, and full-fat cheeses. The browner the food, the greater the amount of potential inflammation from the meal. Opt for cooking methods that use moisture with low heat, like poaching, steaming, and stewing. A healthier option is to cook with moisture over low heat, such as cooking in a crockpot or slow cooker, poaching, steaming, and stewing. When you do choose high-heat methods, try to add fresh cooked greens (spinach, kale, chard, arugula, etc.) or a salad to your meal to help offset some of the inflammatory effects.
Other Considerations
Dairy Sensitivity: 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.
Spice It Up: 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. Combining black pepper with turmeric increases its availability in cooked dishes. This combination can also be sprinkled on eggs. Try incorporating rosemary into hamburger meat before grilling, or adding turmeric to a vegetable stir-fry.
Cocoa: 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.
Tea Time: If you dislike the taste of green tea, 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.
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. 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!
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. 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.
Sweeteners: 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. 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. 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. Gluten-free tamari or soy sauce, coconut aminos, Tabasco sauce, fish sauce, and most mustards are acceptable.
Exercise: Exercise is an important part of any program that is designed to improve brain health. Compelling research has indicated that exercise helps to oxygenate the brain and particularly affects learning and memory.
Functional Medicine Labs to Individualize the MITO Food Plan
Functional medicine labs can help personalize the MITO Food Plan. Here are some potential labs to order.
Fatty Acid Status
Since healthy fats are vital for mitochondrial function, knowing a patient’s fatty acid status can help assess disease risk and personalize the MITO Food Plan.
Oxidative Stress
The Advanced Oxidative Stress test gives providers an idea of how much oxidative stress is in the body and how effectively antioxidant enzymes are removing it. This test measures various glutathione markers, as well as 8-OHdG, which is a marker that goes up when there’s damage to the mitochondria. Practitioners can use this test to evaluate current levels of oxidative stress and then develop a personalized nutrition and lifestyle plan to optimize patient results.
The Four Phonetic F’s of Food
To jumpstart our microbiomes and mitochondria, consider the following:
- Fibers: (e.g. resistant starch, beta-glucan, arabinoxylan, inulin, pectin, gums) - oats, barley & other whole grains, beans, lentils & other legumes, yams, potatoes & other tubers
- Phenols: (e.g. curcumin, resveratrol, quercetin, EGCG, berberine) - green tea, other teas & coffee, berries, fruit & veggies, turmeric, other spices & herbs
- Healthy Fats: (e.g. omega-3 fatty acids) - sardines, salmon & other fatty fish, avocado, olives & their oils, nuts, seeds & their butters
- Ferments: (e.g. lactate, acetate, butyrate, conjugated fatty acids, probiotics) - olives, pickles, sauerkraut, kimchi & miso, vinegars, shrubs & kombucha, yogurt, kefir, artisanal cheese
Key Nutrients for Mitochondrial Support
- B Vitamins: Several nutrients play vital roles in the production of ATP, especially the B vitamins. Folate (B9) is necessary for the maintenance of mtDNA health, as well as a key role in one-carbon metabolism along with many of the other B vitamins. Although many one-carbon functions take place outside of the mitochondria, it also impacts many key functions within including the production of NADH and antioxidant balance.
- Coenzyme Q10: It is recommended that we get between 90-200 milligrams of CoQ10 per day. CoQ10 is a lipophilic molecule that sits in the membrane and acts as an electron carrier in the complexes that are part of oxidative phosphorylation. It also acts as an antioxidant and has a few other functions. CoQ10 is one of the more studied supplements for mitochondrial support.
- Carnitine (L-carnitine or acetyl-L-carnitine): this nutrient is crucial for beta-oxidation, or the breakdown of fatty acids into energy. Carnitine aids in the transport of acyl Co-A, the end product of fat breakdown that enters the beta-oxidation process to become acetyl-CoA, which is used in the Krebs cycle to create ATP energy, across mitochondrial membranes. Beta-oxidation is a key component of energy homeostasis, as fatty acids are an important energy source for anyone, not just those who consume a lot of fat.
- ALA (alpha-lipoic acid): In one study on male rates dosed 60 mg/kg of ALA after being exposed to reduced TNF-α and IL-6 levels (markers of inflammation), reduced levels of lipid and protein peroxidation, and increases in both glutathione levels and the GSH/GSSG ratio (a reflects the intracellular glutathione redox balance and is indicative of cellular health) were observed.
- Selenium: in the right balance, selenium protects against oxidative stress.
- Zinc: zinc plays a role alongside calcium in mitochondrial redox regulation in addition to being an important antioxidant. However, like selenium, excessive zinc may contribute to oxidative stress rather than alleviate it.
Lifestyle Factors
- Exercise: With some mitochondrial disorders, you may need to do so under the guidance of a doctor or professional, as exercise intolerance is common.
- Intermittent fasting and caloric restriction: one review found that the results of caloric restriction in terms of mitochondrial health varied from study to study, but generally there was a decrease in ROS generation.
- Lower stress levels: mitochondria can sense and react to stressors. This may be one reason for excessive stress, whether from work or social or relationship stress, contributes to chronic disease.
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