‘Organic systems can improve under stress’ - Interview with the team from the MOJO Institute

How regular exercise can strengthen our immune system and why we shouldn't view our bodies as machines. A conversation with "Performance Doc" Gerrit Keferstein and his colleagues from the MOJO Institute for Regenerative Medicine.

Gerrit Keferstein - Physician, founder and medical director of the MOJO Institute
David Höhfeld - Sports scientist and head of MOJO MOTION (the institute's movement department)
David Köhler - Senior Physiotherapist and Osteopath
Daniel Scheck - Physiotherapist
Paulina von Wieding - Therapist for regenerative nutrition
Joshua Sauren - Research Director of MOJO Cryotherapy

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Gerrit, you are the founder of the MOJO Institute. How did you come up with the idea?

Gerrit Keferstein: I've always been fascinated by the fluid spectrum between illness and full emotional, mental, and physical performance. I've been a coach in professional sports for over ten years and have always researched the most innovative methods to optimize performance. That's why I studied medicine alongside my coaching work.

I discovered that we in medicine are very good at solving acute mechanical problems. The acute treatment of injuries, broken bones, accidents, infections, heart attacks, and strokes is incredibly precise, professional, and simply excellent.

However, we in medicine are very poor at solving chronic, organic problems. This is reflected, on the one hand, in the fact that we have more cancer, circulatory diseases, neurodegenerative diseases, intestinal diseases, and metabolic disorders today than ever before in human history. This is not due to purely genetic reasons. Our brothers and sisters in indigenous peoples live just as long as we do, yet they hardly suffer from any of these diseases at all.

On the other hand, this also shows that we in medicine aren't really helping elite athletes if we only use the broad guidelines aimed at preventing and treating acute, mechanical problems. To help elite athletes, we need to take a much more detailed, organic, and biological look at the athlete than we are traditionally taught in medical teaching.

To prevent and treat chronic diseases and to help elite athletes optimize their performance, medicine needs a complementary organic paradigm to the purely mechanical paradigm. And that is regenerative medicine. To provide a space and platform for this regenerative medicine, I founded the MOJO Institute for Regenerative Medicine in Hennef at the beginning of 2020. This makes us a unique contact point in Germany for people seeking causal therapy for chronic diseases and for athletes seeking rehabilitation or optimization based on the latest scientific findings. In addition, I founded the International Association of Performance Medicine (IAPM) with several colleagues in 2019.

What distinguishes regenerative medicine from conventional medicine?

Gerrit Keferstein: Just like acute medicine, regenerative medicine is also part of evidence-based medicine. In regenerative medicine, only scientifically sound methods are used. The big difference from widespread acute medicine, however, is that the human body is viewed through the eyes of a biologist rather than a mechanic. If we had a houseplant whose leaves were wilting, we wouldn't paint the leaves green. We would consider the plant's function and needs and modify its environment accordingly. We would ensure it had sufficient nutrients and light. And then, with the patience of a biologist, we would observe how the plant improves a little bit day by day. The reality is that we humans are much more similar to organic plants than to mechanical cars.

Are humans structurally identical to plants?

Gerrit Keferstein: Yes. Organic systems and mechanical systems are fundamentally different in the way they deal with stress. A mechanical system like a car or a machine deteriorates under stress. Every strain leads to degeneration.

However, organic systems like plants and humans improve through stress. Try running eight 200-meter sprints with your car every Monday. It won't get more horsepower. Do it with your body, and it will. Organic systems like plants and humans can improve through stress because they have an ability that no mechanical system in the world has: They can adapt.

So adaptability is the defining characteristic of organic systems?

Gerrit Keferstein: Yes, exactly. The greater the adaptability of a system, the more strain, or stress, that system can convert into positive adaptation. Simply put: If your adaptability is good, then stress makes you better. If your adaptability is poor, then stress makes you worse.

The diagnosis, management, and optimization of adaptability are the central themes of regenerative medicine and are absolutely crucial for the prevention and treatment of chronic diseases as well as the optimization of performance.

Adaptability has several biological foundations. These include the immune system as the central adaptation organ and the mitochondria as the most important energy suppliers. Unlike other organs, the immune system and mitochondria do not have a fixed location in the body but are present everywhere. Therefore, a holistic, systems approach is necessary to improve adaptability.

At the MOJO Institute for Regenerative Medicine, you pursue this holistic approach by combining medicine, physiotherapy, nutritional science, and neuroscience under one roof. What influence do these fields have on our immune system and our mitochondria?

Gerrit Keferstein: For us, all of these areas are equally important and make a crucial contribution. As Medical Director at the MOJO Institute, I focus on detailed diagnostics of the immune system, mitochondrial function, and relevant micronutrients.

Optimal immune function and mitochondrial function are important components of adaptability. To improve adaptability, we need two things: stress and resources.

So stress is necessary?

David Höhfeld: Yes, exactly. Stress, in the sense of strain, is absolutely vital for any organic system. Organic systems improve with stress and worsen in the absence of stress. "Use it or lose it," as the saying goes. The immune system and mitochondria, in particular, are absolutely dependent on us challenging them.

For example, walking or running barefoot across meadows or through the forest has several very positive effects. Direct skin contact with the ground causes the body to discharge its energies, which is called "grounding"—the body becomes grounded. This neutralizes free radicals, known as oxidants, which accumulate in cells during chronic stress, and allows the cells to regenerate more effectively. Small scratches in the skin repeatedly challenge the immune system to react to these micro-damages and learn to adapt more quickly and efficiently. Things get better.

Sitting, walking and running in the forest - the Japanese call it "Shinriyoku" (forest bathing) - has been proven to reduce chronically active stress hormones and increase the number of natural killer cells, one of the most important cellular components of our immune system. The main reason for this is the aromatic oil vapors produced by the trees. It is best to combine forest bathing with high-intensity acute exercise every now and then, for example, ten hill sprints of 30 seconds each. High-intensity interval training (HIIT) increases the performance of the mitochondria, among other things through the increased release of AMPK (activated protein kinase), which protects the mitochondria from energy deficiency, and through the reduction of chronically elevated TNF-alpha concentrations, a multifunctional signaling substance in inflammatory processes. Mitochondrial function is essential for good immune function.

Daniel Scheck: It's similar with strength training. Interval training and strength training are acute stress stimuli for the immune system. This is exciting because the immune system also lives in the muscles. During intense exercise, muscles release so-called myokines. These myokines are part of the immune system and have an immunomodulatory effect; they reduce chronic inflammatory processes and strengthen the immune system. The myokine interleukin-6 (IL-6) plays a key role in the immune system. People who live an extremely unextreme lifestyle, i.e., are physically inactive, have chronically high IL-6 levels. Short-term, acute stress stimuli with short-term IL-6 peaks lead to positive adaptation, whereas long-term elevated IL-6 levels due to inactivity are associated with inflammatory diseases.

So if you want to strengthen your immune system, you should do endurance exercises such as Run, To swim or cycling or Full-body strength training exercises How Deadlift and incorporate squats into his training plan.

Can you have too much stress?

Gerrit Keferstein: Yes. If stress exceeds your ability to adapt, you'll get worse. However, the way out isn't simply by reducing stress. That doesn't work, because then your ability to adapt will diminish over the months and years, and you'll become less and less stress-tolerant. You have to reduce chronic stress and increase acute stress.

Do we need to increase acute stress?

Gerrit Keferstein: Yes, definitely! That's the principle of hormesis. Hormesis is the ability to improve through stress, and it's inherent in every organic system. However, the principle of hormesis is currently largely ignored in medical teaching. As a result, we're becoming increasingly stress-intolerant.

A key reason why people lose performance and become sicker is their unextreme lifestyle. We live extremely unextreme lifestyles. And that makes us sick and weak.

Joshua Sauren: A good example of these positive effects of acute extreme stress is cryotherapy.

Cold is often perceived as a nuisance. In truth, however, cold is one of the most important evolutionary growth stimuli for our immune system. Just as running is considered a strain, cold is also a strain that can be trained in the same way as running. Cryotherapy strengthens the immune system, stimulates fat metabolism, and inhibits inflammation, ultimately relieving pain. Particularly noteworthy is the effect of cold on brown fat tissue. Brown fat tissue is the most recently discovered organ in adults. Unlike normal white fat tissue, brown fat tissue can burn fat to generate heat. The mitochondria in fat cells have the ability to generate heat through combustion. The more mitochondria, the browner the cells are. When we are regularly exposed to cold, white fat cells become brown fat cells. This maximizes fat burning and thus energy yield. This is a particularly remarkable process because it demonstrates the effectiveness of regular cryotherapy.

Doesn't cold cause colds?

Joshua Sauren: No, that's a misconception. The truth is that too little regular cold exposure actually promotes a cold. Colds are caused by viruses. They're more common in winter because we spend more time indoors, heated air circulates the viruses, and there's less UV-B and UV-C radiation from the sun that could inactivate the viruses.

In addition, our immune system becomes less effective in winter due to lower vitamin D levels. However, if we repeatedly expose our bodies to cold throughout the year, they will become accustomed to it, our immune system will become more competent, and our risk of catching a cold in winter will decrease.

Our immune system becomes more competent because cold is a so-called vitagen. Just as vitamins are essential for life, vitagens are essential for our genes.

Cold is an important factor that keeps our genetics adaptable. Living a comfortable 22°C temperature throughout our lives deprives our immune system and our epigenetics of their adaptability. Therefore, we should view cold as a potential for growth.

You said that improved adaptability requires not only stress but also the right resources. What do you mean by that?

Gerrit Keferstein: We improve our adaptability by providing our bodies with the right resources. Remember the example of the plant with wilted leaves? We don't paint them green, but rather we give the plant the nutrients it needs.

When was the last time you checked whether your body really has all the relevant nutrients? The reality is that over 80 percent of all people are nutrient deficient – ​​and not just in developing countries. This has fatal consequences: fatigue, reduced performance, and even serious illnesses. The reasons for this are simple. Firstly, the nutrient density in vegetables has decreased by up to 60 percent due to monocultures, fertilization, etc. Secondly, our nutrient consumption is higher than it was 30 years ago, because nutrients such as zinc are needed to eliminate environmental toxins. Since 1976, 80,000 new synthetic, industrial substances have been approved. Of these, 60,000 were approved without prior safety testing.

The third reason is that we consume significantly more antinutrients that block the absorption of important minerals such as zinc, iron, vitamin C, and calcium. These antinutrients include phytates, which are found in high quantities in grains.

These are also the reasons why I discover significant vitamin and micronutrient deficiencies in lab tests in virtually every elite athlete I test. These deficiencies aren't apparent in a standard complete blood count at a doctor's office.

These micronutrients are involved in energy production, bone and tendon regeneration, immune function, muscle growth, and brain function. And of course, athletes feel better when they have adequately replenished these micronutrients—ideally through slight dietary changes. They then say something like, "I have 30 percent more energy and am making greater progress in training." Sure, that's what better adaptability feels like."

Which nutritional principles are important for the greatest possible adaptability?

Paulina von Wieding: Adaptability primarily requires energy in the form of freely available biological energy (ATP – adenosine triphosphate). For optimal adaptability, our body needs approximately 80 kg of this ATP per day (for a 75 kg person). This 80 kg of ATP is then used by our body in the 30 trillion cells of the body to constantly restructure the body as fluidly as possible (within fixed genetic limits) and adapt to its environment. Connective tissue cells use this energy to produce new connective tissue, bone cells use this energy to produce new bone, heart cells use this energy to produce new heart cells, etc.

If the energy yield falls below 80kg per day, then the ability of our cells to do their work decreases – and with it our ability to adapt.

The better our body is at generating ATP (adenosine triphosphate = biological energy) from the calories in food (physical energy), the more biological adaptation energy is available to our body.

For our ancestors 30,000 years ago, energy availability was the limiting factor. Food was hard to find.

Today, the problem is no longer energy availability, but energy yield. Food is available everywhere. And yet people are tired and losing their ability to adapt. People are getting fatter. Body fat is potential energy. How can it be that one can be fat, meaning full of physical energy, and tired (with little biological energy) at the same time?

This is because energy yield is the limiting factor these days. Our body has two metabolic pathways to produce bioavailable ATP from calories: carbohydrate metabolism and fat metabolism. If you're fat and tired, it means that fat metabolism isn't working. And the main reason for this is very simple: Carbohydrate metabolism blocks fat metabolism. Firstly, the insulin released by carbohydrates blocks hormone-sensitive lipase (HSL), and secondly, carbohydrate metabolism in the cell also very directly blocks fat metabolism via malonyl-CoA/CPT-1.

To unblock fat metabolism, you have to abstain from carbohydrates for weeks at a time. This intermittent low-carb diet (intermittent fasting-mimicking diet (IFM)) maintains fat metabolism in evolutionary balance. This means you have more ATP (biological life energy) available each day and store less fat (physical energy).

Under stress, our body "sucks up" sugar. Cravings for sugar and carbohydrates arise. Therefore, to put ourselves in the best position to follow an intermittent low-carb diet, we need to regulate our nervous system.

Gerrit Keferstein: A relaxed nervous system is absolutely crucial for nutrition to take effect. If we're in fight-or-flight mode, we crave sugar. As a result, our intestinal barrier becomes permeable (sympathetic intestinal permeability), food intolerances develop, and this can lead to autoimmune diseases and other chronic illnesses.

Can the status of the nervous system be tested? How can it be improved?

David Köhler: At our institute, we have well-validated diagnostic tools. In training, we work with some small neurological devices from ARTZT to modify the nervous system. This allows for significant progress in a short time. We use primarily Color glasses. Every color has a different wavelength. Our brain processes these wavelengths and links them to our experiences. For example, red has a stimulating (toning) effect on most people, whereas blue has a more relaxing (detoning) effect.

>> Learn all about colored glasses at artztneuro.com

We utilize this effect in active therapy, for example, to improve mobility. In passive therapy, blue light can stimulate the parasympathetic nerve (vagus nerve), which is responsible for regeneration and relaxation. Through various osteopathic techniques and breathing exercises, we further enhance the stimulation of the autonomic nervous system.

But you can also gain insight into your own nervous system at home by measuring heart rate variability. Biofeedback devices that display pulse, skin conductance, and skin temperature, for example, via an app, can be used to train the activity of the nervous system.

Thanks for the insight! How can I follow you?

David Köhler: Every Sunday at 11 a.m., we host the MOJO Brunch live from the MOJO Institute. We have a variety of guests and discuss all topics related to regenerative medicine. And ursachenbehandlung.de you can contact us directly.