Monday, March 25, 2019

Goldilocks, HRV, Resilience as a Function of Power and Protection

Acquired resilience effects every level of life from mitochondria, nucleus, cell, tissue, organ and organism.
The resilient organism has high HRV (relative to age and power)
The hormetically stressed (and resilient) organism has higher HRV for age.

This leads to an obvious paradox of organism resilience and organ damage coexisting.
In other words, high HRV  AND immune stress disease aka aging.

Obviously resilience declines with aging.
Immune stress increases with age.

The paradox  mentioned above is a phase equilibrium state like water and ice coexisting at 32° in the same body (of water/ice.) Safi Bahcall in Loonshots...

Protection is one side of resilience.
Power is the other side of resilience.

It is counterintuitive that adult dynamic equilibrium HRV is lower than the protection predominant state as in  healthy youth but  also higher than power deficit state of  healthy aging.
HRV is relative and not absolute meaning that the savings rate does not imply absolute wealth but relative wealth to salary (power.). 

Therefore absolute health is a function of power over (protection relative to power-HRV), and each is compounded to the apogee.  How can one stay longer at the apogee level of absolute power and relative Resilience/HRV.

Who is dominant or optimum in performance, adolescents, young adults or geriatric adults?. This is the counterintuitive Goldilocks and HRV relationship. It also fits the paradigm of six sigma mean and upper and lower control limits as OUTLIERS.
One is an outlier of protection (youth) and one is an outlier of decreased power (aged.)

I have recently embarked on increasing power as an aging adult by taking niccotinamide riboside (NR.)to increase ATP production. Previously I was increasing protection by addition of Nrf2 activators to increase antioxidant enzyme capacity, and cell healing with methionine components.  Both of these later components when deficient reduced further power in a negative feedback loop as measured by inflammatory biomarkers associated with aging as reported in unpublished trials.
Adding NAD precursor increased power and reduced aging inflammatory biomarkers transiently in human trials.
By addressing and restoring protection relative to power, 13 individuals have now continued to show steadily reducing inflammatory biomarkers or reversing aging.

Why was restoring protection necessary to increasing power in aged individuals?

One cannot increase power relative to the apogee of young adulthood without maintaining dynamic equilibrium with protection (and repair) forces.

HRV at peak physical, emotional and social age is the Goldilocks equilibrium of healthy adults. 
In 50 year old humans NAD is 50% lower than apogee or peak.
In 50 year old humans Melatonin is likely 50% lower than apogee.
Age 50 has decreased power and protection relative to apogee or peak.

Picture the adolescent where protection is greater than power when rising to apogee or peak.  HRV high.
Picture  the aged where that protection is lesser than power when declining secondary to aging.  HRV low.
Therefore the dynamic equilibrium state is peak power with adequate protection say age 25-35.
HRV is intermediate HRV 62 down from 68% at age 16-25.

HRV ultimately measures tone and capacity of sympathetic and vagal reserves in the locus ceruleus of the brain stem.  The reserves are a function of stored fast acting chemicals and slow adding peptides.

Developmentally, the brain uses the most power as it develops and preserves a large and functioning network.  Adult muscular peak lean body mass also adds power use.  This is the apogee or peak mental, physical and emotional.

One might say that each system is peaking, but what about their tuning or alignment?
If our capacity to love is powerful, but the mind and bodily desires are driving without soulful controllers we are not adding both harmony and innovation.

It is this last dynamic equilibrium state that matters.  Morality allows freedom, immorality ensures captivity.  The rigidity of stability (homeostasis) must coexist with the flexibility of new strategies and products to drive productivity (power) safely (protection) to more and better for Mercy's and Goodness's sake.  This results in more Wealth and Health as a function of time.  A truly rich life requires a mission or raison d'etre.

Acquired Resilience: An Evolved System of Tissue Protection in Mammals


This review brings together observations on the stress-induced regulation of resilience mechanisms in body tissues. It is argued that the stresses that induce tissue resilience in mammals arise from everyday sources: sunlight, food, lack of food, hypoxia and physical stressesAt low levels, these stresses induce an organised protective response in probably all tissues; and, at some higher level, cause tissue destruction. This pattern of response to stress is well known to toxicologists, who have termed it hormesis. The phenotypes of resilience are diverse and reports of stress-induced resilience are to be found in journals of neuroscience, sports medicine, cancer, healthy ageing, dementia, parkinsonism, ophthalmology and more. This diversity makes the proposing of a general concept of induced resilience a significant task, which this review attempts. We suggest that a system of stress-induced tissue resilience has evolved to enhance the survival of animals. By analogy with acquired immunity, we term this system ‘acquired resilience’. Evidence is reviewed that acquired resilience, like acquired immunity, fades with age. This fading is, we suggest, a major component of ageing. Understanding of acquired resilience may, we argue, open pathways for the maintenance of good health in the later decades of human life.

Joseph Thomas (Tony) Liverman, Jr.

Saturday, March 23, 2019

Irrational Decision Making is Normal; Why and Can one Improve?

The mind body connection has a trinity of controllers (processors and activators).
Vagal, Sympathetic and Neuroenteric.
Heart, mind and gut decision making parallels these three  decision making systems.

Recently  nerve connections called synapses, previously thought of as plug like connections, are now known to be microprocessors with computer like processing and activation.

Auditory processing appears to have a subcortical buffer or memory of milliseconds that allows sound sampling in relation to words not letters.

Visual processing  appears to have a similar subcortical working memory  buffer such that word shapes allow rapid processing without  every letter awareness.

Considering fractals (markov blankets) or distinguishable and scalable processors, processing is multilevel and pattern recognition comparators that predict or project.  Therefore the Trinity of controllers is itself patterned at smaller and presumably larger (or corporate) scales.

Processors likely output as super imposed waves that are in phase or out of phase to change the wave form like recording "voice"as sound waves.  Lean Six Sigma lingo compares the voice of the customer to the voice of the process.

The processors  act like rheostats, voices in a choir, modulating decisions and processes into harmony or discordance in both individual and group (classroom) decision making.

Pedagogy and Preaching always target the brain, and less directly targets the intuition duo of feelings and gut.  Decisions are derived from all three.  A recent Nobel economics prize winner, Richard Thayer who wrote the book "Nudge" shows that humans are predictably irrational.  In effect they make decisions with gut, heart and mind, then rationalize the consensus.

What if we taught, coached, evangelized and medically treated the TRINITY of DECISION MAKERS to align with the better aspects of each?

1. Gut palability.  
You are neither hot nor cold but lukewarm and I will spit you out.
2.  Autonomic nervous system/ vagal and sympathetic/(heart) - vagal compassion, connection and learning; sympathetic energy, focus and action. 
Create in me a new heart.
3. Mind rationality (not rationalizations) derived from a connected human ensemble of language, theory of mind, inference, time travel and executive function/working memory. 
Blessed is the man... Delight is in the law (learning what the right thing, at the right time for the right reason)...

We might leverage all three decision makers into an emergent biological property of improved complex decision makers who have tuned guts, hearts and minds.  

De Tocqueville wrote in Democracy in America, "America is great because she is good. If America ceases to be good, America will cease to be great."

Great decision making individually and en mass collectively projects increasing goodness which compounds into greatness.  Emergent property in which simple algorithms create complexity and if disturbed can be restored through simple algorithm.

Head, Heart, and Gut in Decision Making: Development of a Multiple Brain Preference Questionnaire

There is a growing body of literature that supports the idea that decision making involves not only cognition, but also emotion and intuition. However, following extant “dual-process” decision theories, the emotional and intuitive aspects of decision making have predominantly been considered as one “experiential” entity. The purpose of this article is to review the neurological evidence for a three-factor model of head, heart, and gut aspects of embodied cognition in decision making and to report on a study carried out to design and validate a psychometric instrument that measures decision-making preferences across three separable interoceptive components, representing the complex, functional, and adaptive neural networks (or “brains”) of head (analytical/cognitive), heart (emotional/affective), and gut (intuition). Development and validation of the Multiple Brain Preference Questionnaire (MBPQ) instrument was carried out in three phases. Translational validity was assessed using content and face validity. Construct validity was undertaken via exploratory factor analysis of the results from the use of the instrument with 301 subjects from a global sampling, and reliability tests were performed using internal consistency and test–retest analysis. Results confirmed extraction of three factors (head, heart, and gut) was appropriate and reliability analysis showed the MBPQ to be both valid and reliable. Applications of the tool to coaching and leadership are suggested.


There is now a robust body of research into the nature of decision making and in particular into the roles of cognition, emotion, and intuition in human decision making. This research spans more than three decades (e.g., see Bohm & Brun, 2008Burke & Miller, 1999Lerner, Li, Valdesolo, & Kassam, 2015Schwarz, 2000Sinclair, 2014). In earlier research, decision theorists suggested there were two dominant systems humans use in decision making: the “analytic system” and the “experiential system” (Gutnik, Forogh Hakimzada, Yoskowitz, & Patel, 2006). Evans and Stanovich (2013) discuss two major channels for decision making within the “dual-process/dual-system” decision theories. These two theories both assert that human information processing is accomplished in two different, but complementary ways (“analytically” or “intuitively”) through two substantially different and differently evolved types of thinking. System 1 is both fast and intuitive and System 2 is much slower and more deliberate in function. System 2, the analytic system, is slower and involves conscious, deliberate cognitive processes and logical, reason-oriented thinking. In contrast, System 1, the faster experiential system, uses emotion-related associations, intuitions, and “gut instincts” when making decisions (Bechara, Damasio, Tranel, & Damasio, 1997).
This decision model also fits well with work emerging over the last decade from the fields of embodied cognition and interoceptive awareness. Most notably this includes Damasio’s somatic marker theory (Bechara & Damasio, 2005Damasio, Tranel, & Damasio, 1991), Thayer’s neurovisceral integration model (Park & Thayer, 2014Thayer & Lane, 20002009), Craig’s findings on the neurobiological basis of interoceptive awareness (IA; Craig, 200220092014), and Critchley’s work on heart-based viscerosensory signaling (Critchley, 2015Critchley, Wiens, Rotshtein, Ohman, & Dolan, 2004). These models and theories and the research supporting them all suggest that human cognition and decision making are strongly influenced by, or actively involved with, deep somatic and embodied re-representation and interoceptive processing. For example, Damasio’s “somatic marker” hypothesis (Damasio, 19941999) states that meta-representation of bodily states constitutes a set of emotional feelings, accessible to consciousness and providing the “gut-feeling” and “heart intelligence” that guides our decision processes.
According to Burr (2017), the older traditional cognitivist account of analytical decision-making “views choice behaviour as a serial process of deliberation and commitment, which is separate from perception and action” (p. 1). However, as Burr points out, recent work in embodied decision making has shown that this account is incompatible with emerging neurophysiological data. For example, current work on embodied decision making (Cisek & Pastor-Bernier, 2014Lepora & Pezzulo, 2015) indicates that decision making is inextricably intertwined with sensorimotor control such that there is a blurring of the boundaries between perception, action, and cognition, involving reciprocal communication between affective and sensorimotor neural regions.
Burr also highlights that Barrett and Bar (2009) have convincingly argued that neural activity in perception is reflective of ongoing integration of sensory information from exteroceptive cues, with interoceptive information from the body and that this supports the view that when it comes to decisions, the involved perceptual states are “intrinsically infused with affective value,” such that the affective or emotional salience is deeply intertwined with its perception. This indicates that far from involving only head–brain based cognitive or logical (System 2) processes, decision making is intrinsically and deeply entwined with emotional and interoceptive bodily sensorimotor (System 1) experiences.
Interestingly, this notion that decision making involves deep aspects of somatic re-representation and embodied “cognition” leads to an important insight. Given our interoceptive processing and embodied cognition emerges up from embodied neural circuits into the deep limbic structures and eventually the frontal lobes of our cranial brain (Critchley, 2009Critchley & Harrison, 2013), then this neuroceptive processing must deeply involve our system of autonomic afferents (Craig, 2014Critchley, 2009Porges, 20012011). And this embodied autonomic and affective processing has two major key neural systems communicating to it and interacting with it within the body: the intrinsic cardiac neural plexus (Armour, 2007) and the enteric neural plexus (Gershon, 1999).
In colloquial terms, humans often ascribe intuitive and informational roles to heart and gut regions of the body. We talk about “gut instincts,” “gut feelings,” “messages from the heart,” and “heart intuitions” (Soosalu & Oka, 2012a). Given that we have two separable and complex neural plexuses in these regions, it may not be surprising then that the importance of the heart and gut in human processes such as decision making are being validated by a growing list of studies both in the lab and in real-world scenarios.

The Intrinsic Cardiac Network

The heart contains a complex, functional and adaptive intrinsic neural network (Armour, 2007). Intracardiac neurons are concentrated in multiple heart ganglia, and the structure of the interactions between neurons, both within intracardiac ganglia and also between individual ganglia, provide the basis for the complex nervous network of the heart (both anatomically and functionally) and has been labeled by researchers in the new field of neurocardiology as a functional “brain” (Ardell, 2004Brack, 2014Kukanova & Mravec, 2006D. Randall, 2000C. Randall, Wurster, Randall, & Xi-Moy, 1996).
Dr. J. Andrew Armour (1991), a pioneer in this field, has undertaken extensive research and introduced the concept of the intrinsic cardiac network as a functional “heart brain.” His work demonstrated a complex intrinsic nervous system in the heart, that is deemed sufficiently sophisticated to qualify as a “little brain” in its own right (Armour, 2007). The complexity of the neural circuitry in the heart allows independent action, separate from the cranial brain. Armour (1991) has demonstrated the ability of the heart to learn independently, it has its own memories, and it can feel and sense information. This information from the heart is sent to the brain through a variety of different afferents, including autonomic afferents. These afferent nerves enter the brain at the medulla, and from there are dispersed to the higher centers of the brain, where they may have a variety of influences including in the context of perception, decision making, and other cognitive processes (Armour, 2004Thayer, 2007). In Thayer’s (2007) work on neurovisceral integration, he has shown how the heart influences neural structures in the head–brain deeply involved in cognitive, affective, and autonomic regulation.

The Enteric Neural Plexus

The enteric neural plexus consists of approximately 500 million neurons (Cognigni, Bailey, & Miguel-Aliaga, 2011) and is said to be of a similar size and complexity to that of a cat’s head-brain (Mosley, 2012Watzke, 2010). The network of enteric neural tissue is spread across the organs of the gastrointestinal tract, from oral cavity and esophagus to anus. Dr. Michael Gershon (1999) in his groundbreaking work in the field of neurogastroenterology has described the enteric nervous system as “the second brain.” Gershon’s work, however, follows as a rediscovery, since Byron Robinson, MD, an American medical physician and anatomist working over 100 years ago, published in 1907 a book titled The Abdominal and Pelvic Brain, in which he described a complex nervous system or “brain” that he had discovered in the region of the gut (Robinson, 1907).
The enteric brain has been shown to be able to control the gut independently of the cranial brain (Gershon, 1999Goldsteon, Hofstra, & Burns, 2013). Virtually every aspect of gut activity is under the regulatory influence of this independent enteric nervous system (Holzer, 2017Holzer, Schicho, Holzer-Petsche, & Lippe, 2001). There is also growing evidence that the enteric brain deeply influences head-based affective information processing (Berntson, Sarter, & Cacioppo, 2003Holzer, 2017). As Mayer (2011) points out in his paper titled “Gut Feelings: The Emerging Biology of Gut-Brain Communication,”
Recent neurobiological insights into this gut–brain crosstalk have revealed a complex, bidirectional communication system that not only ensures the proper maintenance of gastrointestinal homeostasis and digestion but is likely to have multiple effects on affect, motivation and higher cognitive functions, including intuitive decision making. (p. 453)

Head, Heart, and Gut in Decision Making

Thus we see that both of these gut and heart neural systems evince complex processing, learning and appear to be involved in higher order human functioning. That these “brains” or complex, adaptive and functional neural systems are involved in decision making is being uncovered by a growing body of fascinating research. For example, a number of researchers have found that enhanced cardiac perception is associated with benefits in decision making (e.g., see: Dunn et al., 2010Werner, Jung, Duschek, & Schandry, 2009).
As Dunn et al. (2010) state,
These findings identify both the generation and the perception of bodily responses as pivotal sources of variability in emotion experience and intuition, and offer strong supporting evidence for bodily feedback theories, suggesting that cognitive-affective processing does in significant part relate to “following the heart.” (p. 1835)
In terms of gut-based functioning, Klarer et al. (2014) examined anxiety and fear learning and decision behaviors in rats that had their gut vagal afferent nerves severed. They found that once the gut vagal neural pathways that subserve “gut feel” had been disconnected, the rats, as compared to sham controls, were no longer able to respond with normal innate anxiety decision-behaviors to fearful stimuli and that fear learning and conditioning was concomitantly affected. As they suggest, “The innate response to fear appears to be influenced significantly by signals sent from the stomach to the brain” (Meyer, 2014, p. 1) and “These data add weight to theories emphasizing an important role of afferent visceral signals in the regulation of emotional behavior” (Klarer et al., 2014, p. 7067).
That similar processes operate in humans is suggested by Mayer (2011) in his examination of the emerging biology of gut–brain communication and the gut–brain interface. As Mayer points out, “ . . . the popular statement that somebody has made a decision based on their gut feelings may have an actual neurobiological basis related to brain–gut interactions, and to interoceptive memories related to such interactions” (p. 463).
Also supporting this notion that there are three separable domains in decision making of head (rational/logic), heart (emotions), and gut (intuitions) is the work of Sadler and Zeidler (2005), who examined patterns of informal reasoning and moral decision making and demonstrated evidence for individual patterns of rationalistic, emotive, and intuitive styles. They found that while some subjects employed all three decision styles, many subjects utilized individual patterns or combinations of these three styles of reasoning.
In the field of leadership decision-making, there is also a growing awareness of the importance of the separable domains of head, heart, and gut (Brack, 2011Genovese, 2016). For example, Dotlich, Cairo, and Rhinesmith (2006) found that in complex business decision environments, the use of head, heart, and gut in decision styles lead to wiser and more effective decisions. As they point out, “Complex times require complete leaders . . . leaders capable of using their head, their heart, and their guts as situations demand” (p. 1). And backing this up, Heifetz and Linsky (2004) in their work on adaptive leadership claim that
Solutions to technical problems lie in the head and solving them requires intellect and logic. Solutions to adaptive problems lie in the stomach and the heart and rely on changing people’s beliefs, habits, ways of working or ways of life. (p. 35)
Finally, as Markic (2009) points out in her examination of “Rationality and Emotions in Decision Making,”
Decision making is traditionally viewed as a rational process where reason calculates the best way to achieve the goal. Investigations from different areas of cognitive science have shown that human decisions and actions are much more influenced by intuition and emotional responses than it was previously thought. (p. 54)
Showing that there is a burgeoning awareness in the literature that logic, emotion, and intuition are all involved in the process of decision making.

Individual Differences

Given that current research findings suggest that within the body there are three key neural systems, or “brains,” involved in decision making, one in the head, one in the heart, and another in the gut, it would not be surprising then that individual differences, competencies, and preferences might show up in how people use these neural systems in decision making. Indeed, emotions involving the heart and instincts/feelings involving the gut have evolved over time because of their adaptive functions in both genotypic and phenotypic survival (Haselton & Ketelaar, 2006Ketelaar, 2004). We also know that the enteric nervous system evolved first before the intrinsic cardiac network and before the encephalization of the head-brain (Bishopric, 2005Mayer, 2011Porges, 2001). So it would not be surprising therefore if head, heart, and gut neural intelligences have come to be used for differing aspects of decision making and that thereby different people might have differing propensities and preferences in their use of embodied cognitive functions.
Cardiovascular system research, looking at interoception (Critchley et al., 2004Katkin, 1985Pollatos, Herbert, Matthias, & Schandry, 2007Pollatos, Kirsch, & Schandry, 2005) and the gastrointestinal system (Herbert & Pollatos., 2012Stephan et al., 2003), demonstrates that there are a range of important interindividual differences in “interoceptive awareness” (IA) and interoceptive sensitivity. As Herbert and Pollatos (2012) indicate, individual degrees of IA can be conceptualized as a trait-like sensitivity toward one’s visceral signals. With, for example, a greater sensitivity to how an individual emotionally responds being related to cardiac awareness, which can be developed through a range of embodied learning processes. In addition, Wiens, Mezzacappa, and Katkin (2000) reported that individuals with heightened IA (as quantified objectively from performance in a heartbeat detection task) report more intense emotional experiences. So it would not be surprising then that such individuals might give more attention or salience to heart-based affective signals during decision making.
From a gut perspective, Riezzo, Porcelli, Guerra, and Giorgio (1996) found that gastric electrical activity as measured by electrogastrography (EGG) was a useful indicator of psychophysiological stress created by activities such as arithmetic tasks and Stroop color–word tests, and that wide interindividual variability was observed during the stress period.
Thus people may have marked individual differences in their awareness of and focus on head versus heart versus gut aspects of decision making. Supporting this idea, Fetterman and Robinson (2013) explored the different ways individuals metaphorically perceived or located the self in either head or heart. In a paper reporting seven studies, Fetterman and Robinson (2013) demonstrated that those individuals described as head-locators perceived themselves to be rational, logical, and interpersonally cold, whereas heart-locators described themselves as emotional, feminine, and interpersonally warm. Head-locators showed more accuracy in general knowledge assessments and obtained higher grade results. Conversely, heart-locators favored emotional rather than rational considerations within the context of moral decision making. Adam, Obodaru, and Galinsky (2015) also examined head versus heart-locators and found strong individual differences among men versus women and in American versus Indian cohorts. These findings show strong support for individual differences in head versus heart preference in decision-making style.
Epstein, Pacini, Denes-Raj, and Heier (1996) and Epstein (1990) in their work on cognitive-experiential self-theory (CEST) and the associated Rational-Experiential Inventory (REI) also showed that people differ in their reliance on the experiential/intuitive system versus the rational/cognitive system. CEST is a dual-process model of perception and cognition that posits that people operate using two separate systems for information processing: analytical-rational and intuitive-experiential. Norris and Epstein (2011), more recently, identified intuitive-experiential system: intuition, emotionality, and imagination as three reliable subfactors, and we can see that these three facets nicely mirror the aspects of head (imagination), heart (emotion), and gut (intuition) that Soosalu and Oka (2012a2012b) have highlighted as key functions in decision making of the three brains. The research using the REI has also found strong individual differences in preference for these particular decision styles and that this preference is often associated with a number of meaningful life outcomes (Shiloh, Salton, & Sharabi, 2002Sladek, Bond, & Phillips, 2010).

Intuition and the Conflation of Heart and Gut

One of the key challenges in the existing decision-making research literature is the conflation or mixing of heart and gut into the “intuitive” domain. Researchers often appear to lump heart, gut, and (general) intuitive labels into their questionnaire instruments. This is not surprising given the focus in decision-making research on the dual-factor theory of System 1 (intuitive/experiential) and System 2 (cognitive/rational).
However, if it is true that embodied cognition utilized in decision making involves separable interoceptive components from the key neural plexuses of the cardiac and enteric regions, then it would be useful for greater theoretical and empirical specificity for the field of decision-making research to begin examining head, heart, AND gut preferences in decision-making mode or style.
To show that heart and gut are often conflated together in studies on intuitive versus cognitive decision making, let us examine some representative research. For example, in a series of studies examining differences in decision modes (intuitive vs. analytical), Weber and Lindemann (2008) used questions such as,
How likely would you be to make this decision based on your immediate feelings or gut reaction to the situation? (p. 199)
Thus showing that (heart-based) feelings and gut reactions have been conflated or mixed into the one question. Interestingly from an individual differences perspective, the results of their research showed that while many respondents could be influenced into using either the intuitive or analytical modes based on domain and situational compatibility, nevertheless nearly one third of subjects exhibited a chronic disposition to operate in an affect-based (intuitive) or a calculation-based (analytic) mode, showing that individual differences in decision mode preference can be strong and enduring.
Betsch (2008) also examined chronic preferences for intuition and deliberation in decision making. In her study she developed what she called the “Preference for Intuition and Deliberation Scale (PID).” This scale grouped questions such as the following:
My feelings play an important role in my decisions.
When it comes to trusting people, I can usually rely on my gut feelings. (p. 246)
And grouped such questions into the single “intuition” (or affective-decision) category, once again mixing and conflating emotional/affective (heart) with gut (visceral) signals. Importantly, however, she found, “People differ in the way they rely on their heads or their hearts. Even though virtually everybody is able to feel and to think, people follow their strategy preferences if they have the chance to” (p. 243). In an earlier series of studies, Betsch (2004) asked people directly which strategy they would rely on in different situations (those requiring intuition or deliberation to different degrees). She found that, beyond the situational requirement, a subject’s preferred strategy significantly explained variance in strategy selection (Betsch, 2004, Study 3), which led people who favored intuition to choose intuition more frequently than deliberation across all scenarios.
A further example of the conflation of heart and gut interoception in decision research is that of the work of Katkin, Wiens, and Ohman (2001). They examined the development of “gut feelings” in subjects presented with fear inducing stimuli through behavioral conditioning; however, they used heartbeat detection as a measure of visceral or gut feeling sensitivity.
In examining decision making in nursing practice, Hams (2000) also looked at intuition as “gut feeling.” However, she then conflated gut instinct with heart-based intuiting, stating that
For me [the nurse] it’s a physical sensation. I have two kinds of knowing. I have the knowing that comes from my head that is subject to conscious awareness. And I have the knowing that, for me, comes out of my heart which is where I feel it. (p. 311)
Unfortunately, this mixed focus on head, heart, and gut and the undifferentiated lumping of heart and gut into the appellation “intuition” has lead to a number of challenges in the study of individual difference in decision making. Indeed, Appelt, Milch, Handgraaf, and Weber (2011), in their development of a Decision-Making Individual Differences Inventory lamented that “Individual differences in decision making are a topic of long-standing interest, but often yield inconsistent and contradictory results” (p. 252). One possible reason for such inconsistency in the examination of individual differences is that researchers have tended to contrast decision-making style as either cognitive or intuitive, and have conflated intuitive style with differing focus on heart interoceptive–based intuitions versus gut-feel intuitions. Indeed in numerous studies we see that authors talk about studying intuitive decision making by examining “gut feel” and then use heart interoception monitoring as the experimental measure, thus conflating heart and gut embodiment aspects of interoceptive intuition. In contrast, intuition can be divided into at least three domains of head (based on conscious reasoning or unconscious cognitive heuristics, for example, Gigerenzer & Gaissmaier, 2011Kahneman, 2011), heart (cardiac interoception), and gut (enteric/visceral interoception).
That the field of decision-making research is only now beginning to become aware of the difference in types of intuitive signaling is shown by a very recent study. Sadler-Smith (2016) examined the linguistic structure of human resource practitioners’ experience of intuition. He found that intuitions emerge into consciousness as “bodily awareness” and “cognitive awareness” and that bodily awareness comprised two first-order concepts of “gut reactions” and “feelings.” Such a categorization of intuition specifically into differing elements of cognitive, feeling, and gut reaction is currently relatively rare and a commendable addition to the field of decision-making research. For as Pollatos (2015) in examining cardiac versus gut-based IA and sensitivity points out, these bodily signals represent distinct and separate processes and should therefore not be conflated.

Head, Heart, and Gut Preference in Decision Making

To support the examination of and research focus on head, heart, and gut domains in decision making, in the present study, we developed and validated a psychometric instrument that explores multiple brain (head, heart, and gut) preferences in decision making. While it is expected that people will exhibit individual differences in their preference for head, heart, and gut decision-making patterns, existing research suggests that these neural systems are interconnected and interdependent (Mayer, 2011Thayer & Lane, 2009). The Multiple Brain Preference Questionnaire (MBPQ) instrument explores individual patterns or preferences for head (analytical/cognitive), heart (emotional/affective), and gut (intuition) based decision-making styles, which accumulatively create an individuals’ holistic and integrated response in decision making.

Joseph Thomas (Tony) Liverman, Jr.

Tuesday, March 12, 2019

ANS the Autonomic Nervous System and Compassion for Self and Others; Golden Rule(r)

Why my 8 minutes can change your life blog post is relevant.
Why the podcast, though primitive in understanding physiology, was sent to my colleagues yesterday.

Because it represents two important legs or foundations of neuroimmune regulation.
Cardiac autonomic dysfunction (30-70% in chronic diabetes) has a 5x mortality rate with dysfunction rather than function!
Function requires feedback and positive and negative controls.
The controls are focused in brain stem,the locus ceruleus,where fast neurotransmitters/neuromodulators and slow neuropeptides (bdnf and gdnf) affect structure (imaging and pathology) and function (imaging and nerve function testing.)

Also hidden in the article is the word antidromic which means backwards nerve transmission.  This implies that nerve communication, though directional, actually goes both ways.

What does this have to do with daily hormetic doses of high intensity rest (vagal biofeedback breathing) and Tabata (high intensity interval feedback?
It strengthens and increases these chemical reserves and their responsiveness!

Consider shoulder pain secondary to tendinopathy.
Therapy stimulates a hormetic response that includes rest with progressive doses of exercise; isometric and passive motion, eccentric and passive and active motion, concentric and active followed by return to normal activities.  Brief hormetic doses to stimulate nerves and growth factors for healing.
It takes a minimum of six minutes to stimulate a healing response.

Therefore, promoting healing and recovery forces is medicine's mandate.  
The ANS is the systemic driver of healing for shoulders, brains and other organs.
In fact, the wandering vagus nerve, is the internet for compassion and healing both within and without.

Why not follow sage advice and exercise rest and therapeutic acute (not chronic) stress systems for enduring health, recovery and resilience?

Autonomic nervous system and neuroimmune interactions

New insights and clinical implications

Normal organ function, homeostasis, and adaptation through change (allostasis) require close reciprocal interactions between the autonomic and the immune systems. The 3 subdivisions of the autonomic nervous system—sympathetic, parasympathetic, and enteric nervous system (ENS)—as well as primary sensory afferents, receive signals from immune cells and release neurochemical transmitters that regulate the functions of these cells. These neuroimmune interactions occur at multiple levels, including the gut, the CNS, and lymphoid organs. For example, enteric neurons and glial cells interact with enteroendocrine cells and local macrophages and can sense signals from the gut lumen, including those from the microbiota; these signals elicit local immune responses and reach the CNS via humoral and neural pathways. Interleukins (ILs) and other signals from immune cells can access the hypothalamus via the neurovascular unit or circumventricular organs; these signals can also activate receptors in nerve terminals, such as vagal afferents, and thereby reach the brainstem. In response to these signals, the CNS initiates immunomodulatory autonomic and endocrine responses. For example, sympathetic output to lymphoid organs, including the spleen, elicits potent anti-inflammatory responses via β2 adrenergic receptors (adrenoceptors) expressed in multiple cells of the innate and adaptive immune systems. Vagal efferents affect immune responses in the gut via the ENS, and both vagal and dorsal root ganglion afferents trigger immunomodulatory responses via antidromic release of neuropeptides and other signals at the target organs. Since the last review on autonomic control of immune function in this series,1 studies performed primarily on mice have provided new insight into the role of the microbiota, enteric neurons and glial cells, and autonomic immunomodulatory pathways in these neuroimmune interactions. These studies have elucidated some mechanisms by which these interactions may contribute to the pathophysiology of neurologic disorders including multiple sclerosis (MS) and spinal cord injury (SCI). These findings thus have potential therapeutic implications. There are several recent reviews on these topics.2–12
Go to for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the article.

Joseph Thomas (Tony) Liverman, Jr.

Friday, March 8, 2019

Somatic and Stem Cells Health is Binomial and Reciprocal for Health and Longevity

Fasting mimicking diet reverses inflammatory bowel disease.
Note that this was superior to water only fasting.
Clean diet (fat burning) with Mediterranean supplementation with young cells containing Nrf2 drivers increased antioxidant enzyme status reversing disease in SOMATIC CELLS.  
Fasting improved regeneration and stemness in STEM CELLS.

I recommend a ketodiet, low carb high fat diet with Mediterranean supplements (wheat germ, nuts, olives, fruits and vegetables).

I recommend twelve or more hours of daily fasting.

Valter Longo endorses interval fasting mimicking diet in cancer treatment and cancer prevention.  This is another way of age (inflamaging) reversal which also improves "stemness".  This should be added at intervals on the above regimen.

Loss of "stemness" and accumulation of senescent cells is the proximate cause of decline and death"

MiFasting-Mimicking Diet Modulates Microbiota and Promotes Intestinal Regeneration to Reduce Inflammatory Bowel Disease Pathology: Cell Reportsmicking Diet Modulates Microbiota and PromoteFastinSummary

Dietary interventions are potentially effective therapies for inflammatory bowel diseases (IBDs). We tested the effect of 4-day fasting-mimicking diet (FMD) cycles on a chronic dextran sodium sulfate (DSS)-induced murine model resulting in symptoms and pathology associated with IBD. These FMD cycles reduced intestinal inflammation, increased stem cell number, stimulated protective gut microbiota, and reversed intestinal pathology caused by DSS, whereas water-only fasting increased regenerative and reduced inflammatory markers without reversing pathology. Transplants of Lactobacillusor fecal microbiota from DSS- and FMD-treated mice reversed DSS-induced colon shortening, reduced inflammation, and increased colonic stem cells. In a clinical trial, three FMD cycles reduced markers associated with systemic inflammation. The effect of FMD cycles on microbiota composition, immune cell profile, intestinal stem cell levels and the reversal of pathology associated with IBD in mice, and the anti-inflammatory effects demonstrated in a clinical trial show promise for FMD cycles to ameliorate IBD-associated inflammation in humans."

Monday, March 4, 2019

LDL Cholesterol is not the correct target for treating heart disease?

This is heresy in medicine but the evidence appears sound to me.

A single exception questions a rule.  Multiple exceptions disprove the validity of a rule. The evidence is cited here based on that rule of logic.

My take away is that LDL is not the cause or appropriate  target for treatment or prediction of heart disease.

Endothelial dysfunction treatment or increased resilience is the appropriate treatment target.

Endothelial function is measured by plethysmography or increased compliance (from NO and H2S) flow mediated dilation and increased HRV heart rate variability.  Erectile dysfunction indicates decreased flow mediated dilation of the cavernosa.  ED is a predictor of premature cardiovascular events. Similarly migraine is decreased flow mediated dilation or decreased autoregulatoon of cerebral blood flow as a function of dysautonomia.

HRV is lowered by dysautonomia and increased by hormesis induced by both high intensity interval exercise (Tabata) and high intensity interval rest (Biofeedback breathing two minutes twice daily.)

Highly sensitive balanced autonomic tone or high HRV index indicates atherosclerosis resilience.

What are your thoughts on this matter?


Saturday, February 23, 2019

How are Love AND Learning Related?

Resilience determines locus of control, success and happiness.

Consider that learning and loving are predominantly physiological and natural pursuits.  How well one learns and loves is therefore increased or decreased by the drivers of executive control/working memory, language, theory of mind, inference and mental time travel.  Consider first a romantic "spark" or scene from Pride and Prejudice, starting Keira Kneightly.

The camera highlights a discreet touch between Darcy and Elizabeth, flashes their facial awareness or fighting awareness and then shows Darcy clench his fist.  Body language 101 reads his taciturn face and clenched fist as struggle.  This touch or caress to fist as Darcy gives a hand to Lizzie as he helped her into the carriage after her visit is a "spark."

Aren't students a continuum of active learners and reluctant taciturn learners?

Consider a student as needing to find the "spark" and love of lifetime learning required for happiness and success.  How can we best fan this physiological spark into a flame?

We all know students who love learning or have a passion for learning. 
I posit that every one of them has resilience.
I posit that society believes that wealth and social capital is the source of resilience.
I also posit that they are wrong!
The driver of resilience is the locus ceruleus and is a function of strong sympathetic and vagal tone.  
It is physiological not sociological.  
It is plastic, malleable and can be strengthened.

Can one tune attraction and attachment in love and learning?
I posit one strengthens physiological resilience with physiological tools based on excitement/exercise AND relaxation breathing.
These can be paced just as concretely as a pacemaker produces a steady heart rate.

Jolt of noradrenaline, increases focus with awareness of effort, joined by  jolt of acetylcholine, effort floats away with the strong impression of feeling safe and content within the bubble of communion/classroom.
No longer biased, no longer judging and aware of too much or too little. All that remains is just right.
Righteousness with self, other and the world.
The perfect physiological state for learning and love of self and others.

Isn't this recapitulated in every intimate encounter physiologically with vagal arousal and sympathetic climax between attached couples. The strength of the attachment is a function of strong vagal and sympathetic tone.  Resilient individuals and teams have strong accelerators and brakes, high HRV.  (The marriage study showing success was greater with physiology than communication/teaching) I am paralleling learning with love because orthodoxy states that love is predominantly physiological and learning is predominantly pedagogical.

I have previously reframed RESILIENCE as the relative strength of sympathetic and vagal capacity in the locus ceruleus and its projections into both brain and body.  One can stratify students and their educational attainment on the resilience to vulnerable continuum.  One can also stratify their relative vulnerability to "mind altering" substance and behavioral addictions.  A secondary benefit of resilience.

Does the resilient vulnerable continuum vary with HRV?
Does educational attainment vary directly with HRV.
The resilient are vibrant learners and high on life.
The vulnerable are searching for external drivers of vitality and are willing to JOLT their bodies with stimulants and depressants.

Unfortunately, external drivers are uncontrolled and use up precious physiologic capital needed to strengthen resilience by strengthening rest AND stress.  The vulnerable who raise HRV or strengthen autonomic tone build the physiologic capital to feel confident, try and succeed. (Amy Cuddy Body Language study showing two minutes of posing/breathing reduced or increased cortisol, affected confidence, trying, and succeeding.)

Twelve step programs have no scientific validity and a poor track record for resilience building.
Does public education have scientific validity?
What track record for building resilience do average schools have?
Even if it correlates with socioeconomic status of students, aren't there exceptions?
A single exception should make one question the correlation and not mistake socioeconomic drivers as the cause.  One can certainly point to myriad examples of failure to launch from success predicted launch pads.  And vice versa.
I suspect tuning our ANS physiology will have effects on both fluid and crystallized intelligence, educational attainment, life success and happiness.

Saturday, February 16, 2019

Biological Anti-Aging Biomarkers

Inflamaging and inflammation biomarkers are predictive of performance and cognition in elders.
Telomere length is a derivative of low inflammation; not vice versa.

If renal function improves, biologic age goes down and function goes up.
If inflammatory markers go down, biologic age goes down and function goes up.
If cortisol, insulin and IGf goes down, and FOXO3 and bdnf goes up, biologic age goes down and function goes up.

Conjecture from senescence markers: when senescent cells go down, and stem cell markers go up, biologic age goes exponentially down and enduring function goes up.
The fate of stem cell health determines destiny and fate.  Our bodies have two progenies; offspring and replacement somatic cells.  Therefore biologically young offspring (children, grandchildren and great grandchildren) and biologically young somatic cells PROFIT US MUCH.

Inflammation, But Not Telomere Length, Predicts Successful Ageing at Extreme Old Age: A Longitudinal Study of Semi-supercentenarians.

2015 Jul 29;2(10):1549-58. doi: 10.1016/j.ebiom.2015.07.029. eCollection 2015 Oct.


To determine the most important drivers of successful ageing at extreme old age, we combined community-based prospective cohorts: Tokyo Oldest Old Survey on Total Health (TOOTH), Tokyo Centenarians Study (TCS) and Japanese Semi-Supercentenarians Study (JSS) comprising 1554 individuals including 684 centenarians and (semi-)supercentenarians, 167 pairs of centenarian offspring and spouses, and 536 community-living very old (85 to 99 years). We combined z scores from multiple biomarkers to describe haematopoiesis, inflammation, lipid and glucose metabolism, liver function, renal function, and cellular senescence domains. In Cox proportional hazard models, inflammation predicted all-cause mortality with hazard ratios (95% CI) 1.89 (1.21 to 2.95) and 1.36 (1.05 to 1.78) in the very old and (semi-)supercentenarians, respectively. In linear forward stepwise models, inflammation predicted capability (10.8% variance explained) and cognition (8(.)6% variance explained) in (semi-)supercentenarians better than chronologic age or gender. The inflammation score was also lower in centenarian offspring compared to age-matched controls with Δ (95% CI) = - 0.795 (- 1.436 to - 0.154). Centenarians and their offspring were able to maintain long telomeres, but telomere length was not a predictor of successful ageing in centenarians and semi-supercentenarians. We conclude that inflammation is an important malleable driver of ageing up to extreme old age in humans.


ALT, alanine aminotransferase or alanine transaminase; ANOVA, analysis of variance; AST, aspartate aminotransferase or aspartate transaminase; Ageing; CD, cluster of differentiation; CMV, cytomegalovirus; CRP, C-reactive protein; CVD, cardiovascular disease; Centenarian; ELISA, enzyme-linked immunosorbent assay; GGTP, gamma-glutamyl-transpeptidase; IL-6, interleukin 6; IQR, inter-quartile range; Inflammation; JSS, Japanese Semi-Supercentenarians Study; LTL, leukocyte telomere length; MMSE, Mini-Mental State Examination; NK cells, natural killer cells; PCR, polymerase chain reaction; SD, standard deviation; TCS, Tokyo Centenarians Study; TNF-alpha, tumour necrosis factor-alpha (TNF-alpha); TOOTH, Tokyo Oldest Old Survey on Total Health; Telomere; eGFR, estimated glomerular filtration rate

Publication type, MeSH terms, Substance, Grant support

Joseph Thomas (Tony) Liverma