“We are what we repeatedly do. Success is not an action but a habit”
Aristotle 350 BC
Less then 3% of Americans manage to follow the 5 basic pillars to good health.
1) GOOD NUTRITION is the most important pillar of staying healthy and reversing disease.
2) Movement and Exercise,
3) Stress management,
4) Sleep quality and
5) Having social interaction and loving support from family and friends.
There are many other aspects to maintaining good health however. It’s not about being perfect but about continually striving to improve. Below are some healthful practices to help get you to maximal wellness.
According to the World Health Organization, our own daily habits are responsible for the vast majority, 70-80%, of chronic disease and death. This includes:
- 80-90% of vascular disease, including heart disease.
- 90% of type 2 diabetes
- as much as 70% of cancer
They list 4 specific, easily modifiable issues which are the culprits:
- A sedentary lifestyle.
- Excessive alcohol consumption.
- Tobacco use.
- An unhealthy diet. This includes 3 main areas:
- Too much processed foods including too much salt, sugar and fat.
- Too much food coming from animal sources including meat, fish, dairy and eggs.
- Too few fruits, vegetables, whole grains and nuts and seeds.
We know the answer. We just have to implement it.
TABLE OF CONTENTS:
CHANGE IS HARD – FIND YOUR “WHY”
Anyone can change and improve their circumstances and lives at any time, at any age and at any stage of disease. All you have to do is decide how much better you want to get. As Dr. Dean Ornish says, “the degree you improve depends on how much you are willing to change”. Although this sounds great, change is hard. It’s estimated that 50% of all the things we do every day, including eating, is simple habit. 90% of people who set a New Years resolution fail, 50% of them by the end of January! It’s a whole lot easier to sit on the couch and binge watch Netflix rather than get up and move your body, let alone start an exercise plan. It’s easier to succumb to the temptation of pulling into the drive through fast food restaurant rather than put in the effort to cook dinner. It’s easier to blame others for things rather than look into yourself and assess your responses to the problems you have.
All that having been said, change is possible but most people need help doing it. Often we are challenged by our closest family members and friends who are themselves resistant to change and may not want you to change because it makes them feel like you are judging them. All you can do is stay true to your convictions that the changes you are making are for the better, not only for you but for them, as well as the world around you.
What I think is the most important thing when starting on a journey of change is to identify your “why” and remind yourself of this whenever you doubt yourself or fall off the wagon, which inevitably happens with everyone. Do you want to feel better? Do you want to get off your medications? Do you want to see your kids get married and have kids of their own? There are a lot of reasons people want to improve. Find yours and remind yourself of it daily or whenever you are tempted by poor food or behavior choices.
Having a “purpose” in life is extremely important. It is not surprising to hear of someone dropping dead soon after retirement. According to some surveys, after age 65, the early retirees have a 37% higher risk of death than counterparts that retired at 65. That’s not all. People who retire at 55 are 89% more likely to die in the 10 years after retirement than those who retire at 65. In Okinawa, where one of the longest lived populations live, there is no word in their vocabulary for “retirement”. that’s not to say that they may stop working at one job, they just keep staying busy. It may be by taking care of others or doing a different job. You need to have a reason to get up in the morning.
Motivation can be intrinsic or extrinsic. For example, as far as weight loss is concerned, if you want to lose weight so you can look good on the beach, that is an extrinsic motivation. If you are doing it because you want to be healthier overall and can live to see your grandchildren get married, that is an intrinsic motivation. Although they are different, as long as they achieve the goal of better health, it doesn’t necessarily matter. Of course, doing things because they are inherently good should always be the goal. It is more altruistic to help out a homeless person because it is the right thing to do rather than because others will think you are a good person.
It is said that “compassion helps the giver of the compassion rather than the receiver”.
As far as the nuts and bolts of what to eat, how to exercise (do anything you like, just do something), how to reduce stress (try meditating or simple breathing), I have provided a lot of advice on this site and provided numerous references including (my favorites in brackets) books (Forks Over Knives: The Plant-Based Way to Health), websites (www.21daykickstart.org, www.nutritionfacts.org), phone apps (21 Day Kickstart App), movies (Forks over Knives), cooking classes (rouxbe.com)… Ultimately, you need to take action on your own. Some can jump in with both feet while some need to dip their toes in the water and gently get in but into the water you must go. Change can be slow but as long as you are overall moving in the right direction, you’ll improve. As one of the vegan athletes I follow, Rich Roll, says:
“NOTHING CHANGES IF NOTHING CHANGES”
HABIT CHANGE – POSITIVE EMOTION CREATES HABITS
There are a gazillion books and programs out there on how to change habits. Many of them focus on small changes and repetition. Although these can be helpful, ultimately, the most important thing in making a change in a habit and making it stick, are positive emotions. Specifically, SUCCESS is what wires habit change in the brain.
When you make a change in any behavior and you are successful or see improvement, positive emotions are generated. Slogging through something which is not making you feel good, is much less impactful, even if you do it over and over again and know that it is good for you.
That doesn’t mean that if your body feels better sitting on the couch and that you are sore after one workout, that sitting on the couch is better. Changes do take some time to manifest. However, enjoyment and success are imperative for long-term, lasting changes to stick.
For example, with food, it may take a few weeks for your body to get used to eating more fruits and vegetables, if they were not part of your normal repertoire. Beans are a classic example. If you never eat beans, then when you start, you will have more gas and bloating because your gut does not contain the healthy bacteria which break down the complex fibers in beans. Over time, and it only takes a few weeks, you build those beneficial bacteria up and those negative feelings are replaced with a positive mood, weight loss and positive emotions. The same is true for salt, fat and sugar. After a few weeks of cutting back on these products, the brain gets used to a new level and adjusts. This is called neural-adaptation.
The same goes for exercise. The best exercise is the one you enjoy, because that is the one which makes you feel good and will be the one you keep doing, but it takes time for your body to get used to movement. Just like with everything, start slow and build up and you are much more likely to succeed in the long term, Don’t be afraid to try different things.
When people tell me that they “cannot give something up”, I remind them that a heroin addict or alcoholic says the same thing. They need to re-think their relationship, and likely dependence, on that particular food or behavior.
A great reference for making habit changes is a book by Dr. BJ Fogg entitled “Tiny Habits: The Small Changes That Change Everything”.
MODERATION IS A MYTH
I have this section on another page discussing nutrition but it is important enough to emphasize again here. Moderation should only apply to things that are good for you. Playing the piano is good for you but not if you’re playing 16 hours a day and you have become an antisocial recluse. Eating carrots is good for you but not if that is the only thing you eat. Exercise is great for you but over-training or doing marathons every week create excessive wear and tear on the body. If something is known to be bad for you, why would you accept any amount of it? Is a little heroin better than no heroin? Are 2-3 cigarettes a day better than a pack a day? Although I do believe that the more plant-based your diet is the healthier you will be, there is little substantive scientific evidence that being 100% whole food vegan is any more of an advantage than having a diet with less than 10% of your calories coming from animal products. Before all you omnivores get too excited, what this amounts to practically speaking is only 2 meals a week, or more frequent meals with much smaller amounts of animal products at each meal. A serving of meat is the size of a deck of cards.
“Everything in Moderation” is a slippery slope. St. Ignatius said in the 1500’s that “Complete abstinence is easier than perfect moderation”. A more modern version of this quote is from Harvard Business School professor Clayton Christensen “100% commitment is easier than 98% commitment”. It is easier to have absolute rules rather than have to grapple with situations where the rules can be bent or justified.
More recently, to paraphrase Dr. Caldwell Esselstyn, MD of the Cleveland Clinic, “Moderate improvement in diet and lifestyle only leads to moderate improvement in disease”. If you have an advanced disease or multiple chronic conditions, consider being stricter with your diet. Once things have settled down and you have eliminated some medications you can slowly reintroduce some occasional animal products if you must.
Although small changes over time lead to big gains in the long run, the more you improve your diet and lifestyle, the greater and faster your improvement will be. Dive in. In order to see real benefit, you need to make real change. When it comes to addictive behaviors, which includes eating patterns and habits, it is often better to “go cold turkey” and change completely. When you move slowly, change is also slow and not as rewarding. When you see and feel the change, you are more likely to keep up with it and continue to improve. When a drug addict or alcoholic tries to quit, they don’t do so incrementally or “in moderation”. It has to be all or nothing. Otherwise, there is always a taste of what you crave and quitting altogether becomes impossible. Having “reward” days or meals may be OK if you have the discipline to follow a healthful diet the rest of the time but if all you are thinking about is that reward, it becomes counterproductive and you are more likely to reward yourself more often.
“Complete abstinence is easier than perfect moderation” St. Ignatius, 1st century
One major issue with moderation is that it is easy to overdo it. If you are trying to eliminate some foods from your diet, just get them out of your environment. As vegan Chef AJ says, “If it’s in your house, it’s in your mouth”. If you are an alcoholic, you should stay away from bars. If you are addicted to gambling, don’t go to casinos. If you have a food addiction or craving, if you see it or know it’s around, you will eventually fall to temptation and eat it. Some people give themselves “cheat days” or “cheat meals”. The problem with this approach is that if you really want whatever you are “cheating” with, you spend all your time thinking about it and the drive or temptation to eat it never goes away. Alcoholics can rarely have an occasional drink and smokers can rarely have just one cigarette.
“The dose makes the poison. NOT always”
Although as a general rule, small amounts of unhealthy foods, chemicals and even behaviors are not overall damaging and the more you consume, the worse things are, this does not apply to all things things. An example in the nutrition world is processed meat. When looking at the curve of dose vs disease, the greatest rise is from 0 to 1 dose a day. If consume more, it’s worse but having none is still the best. Another example are the hormone-disrupting effects of the chemicals which leach out of plastics. Tiny amounts of these compounds are bad because they saturate the estrogen receptors and once they are all bound, the extra amounts have less of an impact.
There is a point of diminishing returns when it comes to most things. Just because carrots are good, doesn’t mean that a bag a day is also. Too much oxygen is lethal. Exercise is also a good example. It is crucial to exercise but too much is also not good. Runners definitely live much longer than non-exercisers, but those who run half marathons, do better than marathoners and those who run only 4-5 days a week or shorter distances at slower paces, do the best.
GENETICS and EPIGENETICS
“GENES may load the gun but LIFESTYLE pulls the trigger” Caldwell Esselstyn, MD.
A brief word about this important topic. In a nutshell, the genes you inherited are NOT, for the most part, your destiny. We do inherit genes but we have the power to impact on how they express themselves. The argument “(insert disease here) runs in my family” is in most cases simply not true purely genetic inheritance and is to a significant degree modifiable. Genetics and longevity is important but not as much as you would think. If both your parents lived into their 80’s, your lifespan is only predicted to be 3 years longer than the average (78 in the US).
Epigenetics, is the study of biological mechanisms that will switch genes on and off. The concept and term was first coned in the 1940’s but didn’t gain much attention until the last decade or so. You have no control over the genes you inherit but you have a great amount of control over how those genes are expressed and whether or not they get turned on or off. What is also inherited and plays a much bigger role than genes are familial lifestyle habits. We eat like our parents ate and we behave like our parents behaved. For example, less than 0.5% (1:250) of the many patients with elevated cholesterol truly have a genetic or familial component called familial hyperlipidemia. The vast majority of cases of elevated cholesterol is due to bad lifestyle choices such as a poor diet and lack of exercise, the seeds of which were planted during our childhood. Although there are genes which dictate certain traits and are not modifiable (eye and hair color, height, gender…), most other genes can be turned on and off, based on a variety of factors including to a significant degree lifestyle choices as well as toxic exposures and environment. Even the dreaded BRCA breast cancer gene and APOE dementia genes are modifiable. The study of how genes can be turned on or off is called epigenetics and this is an exploding area of research. In 1991, the Human Genome Project was started. This was the project which mapped the entire human genome and as completed in 2003. The Human Epigenome Project is now underway but this is SIGNIFCANTLY more complicated because of all the variables impacting on gene expression. Click here for more information about epigenetics. An example of upregulation and downregulation of genes is how our liver produces an enzyme alcohol dehydrogenase. This enzyme breaks down alcohol. The more you drink, the more this gene is activated, sending a message to the cell to make more of the enzyme. If you cut back on alcohol, the amount decreases, which is why after a period of abstinence, it doesn’t take much to get you tipsy. Another epigenetic example is how asthma can develop in kids. Kids are more likely to develop asthma if their grandmother smoked while pregnant than if their mother did. Why? Because the mothers eggs developed when she was in her mother’s womb. The grandmothers lifestyle impacted on the mother as she was developing, influencing her eggs, who then passed that activated gene through her egg to the grandchild. Even male behavior impacts on offspring. A child born to a father who smoked during conception has a significant greater risk of being obese.
Another interesting epigenetic phenomenon as to do with miscarriages. There are documented rises in miscarriages after certain world events like September 11 or World Wars. What is interesting is that after tragic events, miscarriages tend to favor male fetuses. Also interesting to note is that when times are good, there tend to be more male births but when times are tough, there are more female births.
The National Institutes of Health (NIH) reports that 92% of health is accounted for by epigenetics. In a nutshell, how we live our lives day to day impact on gene expression leading to improved or impaired health. Dr. Dean Ornish has done studies showing that within 3 months of improving your lifestyle, including following a plant-based diet, healthier expression and changes in over 500 genes were measured! 453 of these genes were cancer promoting genes which were down regulated (turned down) and 47 were cancer preventing genes which were up regulated (turned up). Those same lifestyle changes also increased telomere length. Telomeres are the “end caps” on our DNA strands which protect them. The shorter your telomeres, the more prone to damage your DNA is. Initially thought to only be a result of aging, we now know that poor lifestyle habits are mostly to blame. Improving your diet, along with other lifestyle changes not only halt this process, they can reverse it.
One just has to look at what happens to populations of people with regards to their health and disease when they move from their native lands to industrialized countries or adopt western patterns of eating and living. The health and lifespan of Okinawans for example, the longest-lived people on Earth, has deteriorated significantly within one generation, as soon as they started eating like Americans at home or when they move to the US and live and eat like us. Another example are the Pima Indians. Those who live on their native lands and follow traditional native lifestyles and diets have a diabetes rate of less than 8% whereas the same generation of Pimas who live on reservations in the us have a diabetes rate of greater than 50%! SAME GENES. The difference is diet and lifestyle. One last, even more striking example is what happened in Japan. Over the last 30 years, as the Japanese have adopted a more Westernized diet with a 5%, 10% and 20% increase in consumption of eggs, meat and dairy respectively, there has been a 25x increase in prostate cancer rate. That’s a 2500% rise! Genes did not cause this. An unhealthy lifestyle did.
Dean Ornish, the pioneer and father of modern lifestyle medicine, did a study looking at the genes of men with prostate cancer. One group followed the standard prostate cancer treatment protocol and continued with their baseline lifestyle behaviors and the other made lifestyle changes including following a plant-based diet, increasing exercise and working on stress management. In the standard group, no changes were noted. In the lifestyle modification group, gene-expression were positively affected in over 500 genes. Only 10% of all cancers are directly related to genetic changes that are not modifiable. That means that 90% of cancers could potentially be avoided with positive lifestyle changes. In addition, 85-90% of the chronic diseases can be treated or reversed with the same lifestyle changes. Our medical industry spends too much time working on treatment and not enough time on prevention. The best way to treat cancer or a chronic disease is to not to get it in the first place.
Although obesity and weight problems are more significantly genetically linked than most other conditions, (more on this below), lifestyle choices, especially foods we eat, impact greatly on how genes are expressed.
A whole food, plant-based diet has been shown to modify gene expression. Cancer promoting genes are down-regulated and anti-cancer genes are up-regulated in their expression as compared with an animal-based diet in which the opposite happens. What is even more interesting is that this good and bad gene expression is passed down to offspring, children and even grandchildren, in animal models! A parents’ diet impacts on the genes of their progeny! Furthermore, in humans, studies on obese kids under 5 showed and increased risk of some cancers, including breast cancer EVEN if they lost the weight. This shows how important a healthy diet is right from the start of life or even before it.
GENE MUTATIONS. Cancer forms when our genes mutate in such a way that the cells no longer respond to normal growth signaling and they divide and grow out of control. It may be shocking, but we all have cancer cells forming and being cleared every day. This is not surprising when you consider that on average, more than 10,000 errors are made in our DNA daily. A healthy immune system “surveys” and looks out for such cells and eradicates them. An unhealthy or suppressed immune system down-regulates this system resulting in more cancer. There has been an explosion in immune modulating drugs, also called biologics, to deal with the inflammation of many immune-system related conditions like rheumatoid arthritis, psoriasis or even cancer. The same mechanism that down-regulates the immune system leading to decreased symptoms, also increase the risk for many cancers because of the impairment of our immune system to “survey” for cancer cells.
MOVEMENT and EXERCISE
Just to clear the air, the road to weight loss includes exercise, but your mouth, and what you put in it is still by FAR, the most important factor.
- You can climb 25 flights of stairs and burn fewer calories than you would consume in just 1 Oreo cookie.
- Climbing just 1 flight burns the equivalent calories as eating 1 M&M.
- 10,000 steps burns as many calories as you consume in a standard 20oz soda or 1/2 a Big Mac.
- 3.5 miles of running = 1 chocolate glazed donut.
- 8 miles = a McDonald’s milkshake.
- 30 miles will burn about 1 pound, mostly water anyway.
One reason for this is that your body adjusts your basal metabolic rate (BMR) to how much you are burning calories. About 60% of the calories we burn at any given time is dedicated to the BMR. Powering the brain is by far the greatest expenditure. Other BMR functions include your immune system, digestion, sex drive and maintenance of other core functions like breathing and blood pressure. Most exercise can quickly reach a point where you burn enough calories that your body downregulates your BMR, so you burn less. There is a cost. For example, marathoners have suppressed immune systems for a day or two after a race or heavy training day which is why they may be more susceptible to colds afterwards. Movement and exercise are important for weight loss, but don’t ignore the more important part: your diet.
There are PLENTY of other reasons to exercise however.
Newton’s First Law: “An object at rest stays at rest and an object in motion stays in motion”. We simply don’t move enough! We evolved moving constantly. Our bodies crave and need it. Although exercise is important, what’s more important is constant movement. 80% of Americans do not get the minimum recommendation of exercise daily. Americans spend 15.5 of our 16-17 waking hours each day sitting. Sedentary people have a 112% increased risk of diabetes and a 90% increase risk of fatal heart disease and lack of activity is linked to as many as 173,000 yearly cases of cancer including: breast, colon, prostate, endometrial and lung. After 30, inactive people lose ~ 1% of their muscle mass yearly (~ 10-20 lbs./yr.). After 65, you lose muscle mass 6x faster. Muscle is crucial not only to keep you strong, it also uses 85% of the sugar circulating in your blood under normal circumstances. Daily exercise is extremely important but what you do all day long is more important. A sedentary lifestyle is as bad to your overall health as smoking! MOVE your body as much as possible. Sitting for more than 8 hours a day is associated with a 90% increased risk for type 2 diabetes. Those people who sit the most have a 147% increased relative risk of cardiovascular events compared with those who sit the least. Some studies have shown that even a little walking can help. One study showed That walking 20-30 minutes a day cuts risks of premature death by 20-30%. Even doing so a few times a week can have a similar benefit. If you take it up a notch, running, at whatever pace or mileage, decreased the risk of premature death by 40%. Go for a walk outside. Studies have shown that 70-year old’s have twice as many new ideas about a topic after a walk than sedentary 20-year old’s do! Other studies have shown that a brisk walk before work doubles the number of creative ideas people can think up.
Set up your environment to encourage more movement. At work, use a stand-up desk (Varidesk) or “core” chair. A great company called Fully makes great desks and chairs. Take walking breaks. Use the stairs. Any opportunity to move your body is good. Watches and smartphones are helpful since they can remind us to move at regular intervals. Putting reminders in strategic places helps. Notes that say things like “squat” or “push-up” will remind you to do a little something, even a little, frequently. Although we evolved sitting around quite a bit, HOW we sat was different. We didn’t have cushioned, ergonomic chairs, and certainly didn’t spend all day staring at a screen. There was constant movement. Constant muscle engagement.
WALK vs DRIVE. The average American spends 3x more time in their car today than they did in 1980. We can’t just blame where we live and proximity to stores for that. When there is an option to walk somewhere, or walk farther (park at the back end of the lot), choose to walk. Take the stairs rather than the elevator. Take the stairs rather than the escalator. There are lots of opportunities to move more.
Short bursts of High Intensity Interval Training (HIIT) is just as effective as longer cardio exercises so you can’t use lack of time as an excuse! All you need is 20-30 minutes a day, 3-4 times a week (although a little more is better). Even just 20 minutes of walking has been show to reduce C-reactive protein (CRP), a blood marker of inflammation. To argue that you are too tired is also not a good excuse. Remember that, as vegan ultra-athlete Rich Roll says, “Mood Follows Action”. Movement and exercise make you feel better. “If it’s important to you, you will find a way. If it’s not, you will find an excuse”. 2 examples of extremely short, but scientifically effective exercise regimens are A) 30 seconds of all out aerobic output (running or cycling) followed by 2 minutes of rest, repeated 3 times and B) The “Nitric Oxide” regimen developed by Dr. Zach Bush and you can see this regimen on this YouTube demonstration.
Less strenuous exercise practices such as Yoga, from East Indian traditions, and Chinese practices such as Qigong and Tai Chi are extremely beneficial. Some studies show equal benefit when compared to more tradition forms of aerobic exercise such as running, spinning and aerobics classes.
Although more exercise is better, the largest gap in improvement medically speaking, is seen in those people who do absolutely nothing and those who get off the couch and do something, as meager as that may be.
Even one single workout improves mood, increases focus, attention and reaction time. It increases the brain neurotransmitters serotonin, dopamine and noradrenaline. The effect of a single workout can last for 2 hours. Repeated, regular exercise has longer lasting and protective effects. It actually alters brain anatomy, physiology and function. It produces brand new brain cells in the hippocampus, the part of the brain responsible for long term memories. It increases the volume of this part of the brain. Exercise improves long term memory, attention, moot and energy. It also increases function of the prefrontal cortex, the brain organizer and administrator. These 2 parts of the brain are particularly prone to neurodegenerative diseases like Parkinson’s Disease and neurocognitive function.
If one single workout improves health, it also doesn’t take long for health to decline when you stop exercising. In this study published in 2018, scientists took healthy, active individuals (getting at least 10K steps in a day) and had them sit around a lot more and not exceed 1,500 steps in a day. Within just two weeks, the study participants had a significant decrease in artery function and a notable increase in liver fat production. A fattier liver is indicative of increased inflammation, reduced insulin sensitivity, and depressed metabolic function overall. Non Alcoholic Fatty Liver Disease (NAFLD) is, by the way, the most common reason for liver transplants in the US today.
Exercise lengthens telomeres, the caps on the ends of chromosomes responsible for aging. The more you exercise, the greater the impact on your telomeres. Even a single bout of exercise increases beneficial hormones which cause your arteries to dilate. This leads to improved blood flow to all your organs, including your brain, and reduces biomarkers of inflammation.
Exercise causes a small amount of inflammation, which allows the body to boost the anti-inflammatory response. Hormesis is the phenomenon of minor/micro trauma leading to bolstering up, rather than damaging our immune response. In other words, “that which does not kill you, makes you stronger”. 1 hour after exercise, there is a measurable increase in inflammatory markers followed 1-2 hours later by an anti inflammatory response.
Exercise makes you happier. Lifting weights has been shown to lift mood and decrease symptoms of depression. It doesn’t seem to matter if you go to the gym twice or 5 times a week or how many reps of lifting you do. It all helps.
Not only does exercise help us, it helps our offspring. Math and IQ scores are higher in kids of mothers who exercised before and during pregnancy. 3 months of exercise in men altered sperm DNA methylation, an important process in proper DNA function. Exercise literally improves your genes.
Exercise makes you smarter and makes your brain bigger. Overall cognitive function is better at all ages in people who exercise. Here are a few other examples of the benefit of exercise:
- Children who exercise have better grades in school and learn more easily.
- They show more improvement in many skills ranging from math to logic to reading compared with kids who do not exercise.
- Similar findings are seen in teens and young adults.
- 60-80-year old’s were able to process information much faster if they were physically active as a teenagers.
- Physical activity increases autophagy, the clearance of toxic substances, especially in the brain.
- Fathers who exercise have smarter babies. This is thought to occur through epigenetics.
- Just standing vs sitting makes a difference. Tests looking at selective attention were performed better by test subjects who were standing vs sitting.
- Neurogenesis, the phenomenon of growing new brain cells, making the brain bigger, is also positively influenced by exercise.
- The hippocampus, a part of the brain responsible for memory and cognitive functions, has been shown to grow, along with improved function, in those walked for 40 minutes a day 3-4 times a week.
- Overall grey matter volume increased along with improved cognitive function was shown to occur in adults with mild cognitive decline (early Alzheimer’s disease) in those who exercised 4 times a week over a 6-month period.
- Exercise causes new neurons to be born and new connections between neurons to be made in part by increasing levels of brain-derived neurotrophic factor (BDNF), a protein which stimulates neurogenesis and new neuron connections in the brain.
Exercise also has the following benefits:
- Exercise drives tryptophan, the amino acid precursor of serotonin, the “happy” neuropeptide, into the brain. This is why exercise helps with depression and anxiety.
- Increases the function and activity of Glucose Transporters, specifically the molecule glute 4. These are membrane proteins that facilitate the transport of glucose across the plasma membrane (cell wall). Insulin stimulates this pathway but exercise alone stimulated this molecule, independent of insulin. This is known as “Exercise induced glut 4 translocation” or “non-insulin glut 4 translocation”. It is site-specific, meaning that if you workout your biceps, the bicep muscle cells take up sugar…., but if you do a whole body workout, you get significant glucose transportation.
- Increases neurogenesis (growth of new brain cells) and reverses mild memory changes and cognitive decline. The only “prescription” that the American Academy of Neurology recommends that neurologists write is a prescription for exercise which does improve memory loss and early cognitive decline.
- It stabilizes angiogenesis improving blood flow to degenerating tissues and decreasing blood flow to cancerous cells.
- Opens up blood vessels improving blood flow to tissues.
- Lowers blood pressure.
- Improves microbiome health by lowering cortisol levels which damage the microbiome. It also improves the health of the gut wall tight junctions.
- Improves immune function.
- Improves mood and decreases depression by increasing serotonin production.
- Lowers triglycerides in the blood and improves other cholesterol measures.
The best exercise is the one you enjoy the most since this is the one you are most likely to continue doing. That having been said, doing a variety of exercises including cardio, is important. If you are only going to do one type of exercise, do resistance exercises since they have the greatest positive impact. Resistance exercises include lifting weights, body weight exercises and high impact routines like aerobics. These stimulate the muscles, tendons, ligaments, joints and most importantly the bones. Studies show that the most valuable way to keep your bones healthy, avoid and even reverse osteoporosis is to lift weights. Taking calcium supplements and consuming dairy actually worsen osteoporosis and increase hip fracture rate. It may sound counter-intuitive but lifting weight and gaining and strengthening muscles also results in faster and greater weight loss than any other exercise. Your metabolism remains elevated up for 2-3 times longer after a weight training session than with any form of cardio workouts. This ‘after burn effect” can account for a 10-15% increase in energy expenditure well after weight lifting has ended.
The most important muscle group to exercise are the legs. The quadriceps are the biggest “pump” in the body. The single most important weight bearing movement to do are squats. Squats work almost every muscle group in your body, especially the largest ones like the quadriceps and the back muscles. They also do a great job with your core muscles.
You can ALWAYS do something. Sit in a chair and march. You’d be surprised how much of a workout you get in 20 minutes of this. Get some arm dumbbells if your legs don’t work… Whatever it takes, just move your body.
Balance worsens as we age. The main cause of balance problems is loss of strength. The good news is that you can regain at least 30% of your strength even within a few weeks of starting a weight lifting regimen, at any age. Skeletal muscles are your largest endocrine and immunologic organ.
The good news is that you don’t have to do it as much as people think. Once a week is enough. The key is to push the muscles to what is called “failure’ meaning that you can’t even lift the weight one more time. One set to failure using a very slow cadence has been shown to be very effective. The most important 5 resistance exercises are:
- Bent over rows
- Overhead press
- Dead lift
- Bench press
Here is a link to an article about super-slow weight training.
Are we “over fat” and/or “under muscled”? Probably both.
Muscle is the largest organ in the body. A healthy percentage of body weight made up of fat is ~ 25%. Over 25-30% is overweight (35% of Americans are overweight) and over 30% is considered obese (about 40% of Americans are obese (20% or Americans under 20 are obese now). 30-40% of a healthy person’s weight should be muscle but if not kept in check, we lose about 1% a year after the age of 30!
Muscle is not just for locomotion and lifting. It is a very metabolically active organ.
- Muscle is the largest site of glucose disposal and metabolism.
- It’s involved in lipid/cholesterol oxidation and metabolism.
- Lack of muscle (cachexia or muscle wasting) is the biggest contributor to falls, breaks and other injuries.
- Muscle is our amino acid reservoir.
- The more lean muscle you have, the lower all-cause mortality.
- It’s an endocrine organ. It produces myokines which are anti-inflammatory. Myokines are proteoglycan peptides that are produced and released by muscle cells (myocytes) in response to muscular contractions. They have autocrine, paracrine and/or endocrine effects and their systemic effects occur even at picomolar concentrations.
- As we lose muscle, a variety of hormones are affected. These include:
- Cortisol and other stress hormones increase
- Testosterone decreases
- Growth hormone decreases
- Insulin increases
- Blood sugar increases.
- If you can’t do 10 push-ups, your risk of heart attack is significantly higher. 40 or more is a great sign.
As we age, we get anabolic resistance. Muscle has a more difficult time processing muscle which is partly why we need more protein as we age. We need more protein to maintain muscle.
BENEFITS of WEIGHT TRAINING. More muscle can save your life.
- STRENGTH. The main reason for falls and fractures in the elderly is lack of muscle strength. The weakened bones just make the easier to break. The key is not to fall in the first place.
- INCREASED GASTROINTESTINAL TRAINING TIME. Only 3 months of weight training increases GI transit time by 56%
- RESTING METABOLISM. Without proper weight training and muscle maintenance, resting metabolism decreases by 5% per decade. For every pound of lean muscle mass, the body burns an additional 35 calories a day.
- GLUCOSE METABOLISM IMPROVES. Glucose uptake by cells increases by 23% after only 4 months of weight training. Lifting weights also stimulates transport of sugar into the cells, independent of insulin. This phenomenon is called “Exercise Induced Glut 4 Translocation”. Glut 4 is one of the molecules responsible for glucose transport from the blood into the cells. Exercise improves the function of Glut 4 as well as the number of transporters available. It does have this effect throughout the body but with weight lifting, it is more site specific which means that if you exercise your biceps, the bicep muscle cells have increased glucose transport. So a whole body workout really increases glucose transport all over the body, leading to less insulin requirements and less pressure on the pancreas.
- INSULIN SENSITIVITY IMPROVES. This not only helps sugar get transported into cells where it is stored or used as energy, it also helps with fat metabolism.
- RELEASES BODY FAT STORES.
- IMPROVES CHOLESTEROL METABOLISM.
- BLOOD PRESSURE DECREASES.
- BONE MINERAL DENSITY INCREASES.
- ARTHRITIS SYMPTOMS and LOW BACK PAIN IMPROVE.
- FLEXIBILITY INCREASES.
- CARDIOVASCULAR STIMULATION.
You don’t get stronger by training, you get stronger by recovering
When we rest, especially when we sleep, muscles recover and grow. In fact, most of our growth hormone is secreted while we sleep. In addition, the idea that you need to consume protein within a few hours of exercise to maximize muscle growth is a myth. If you want to gain muscle, you do need to consume a little more protein, but timing is irrelevant. In fact, some people promote fasting as a way to improve musucle growth.
STRETCHING. Staying flexible and nimble is important for a variety of reasons. Some studies do suggest that stretching does not improve athletic performance but there are many other benefits of stretching. Stretching has even been shown to improve arterial flexibility. Forms of active stretching, like yoga, are also great as they add an element of exertion as well as mindfulness to the practice.
A recent review of the 15 most commonly prescribed medications for dementia and Alzheimer’s disease showed virtually no benefit with any of them. The ONLY consistently proven beneficial treatment for these dreaded conditions was daily exercise. Improvements in nutrition and social interaction were also very important. Regular exercise alone also lowers LDL cholesterol.
Exercise increases oxygenation of tissues and new growth of blood vessels all resulting in improved tissue function. This is partly why it helps reverse memory loss since it causes parts of your brain to re-grow and stay nourished. Exercise also increases formation and concentration of Brain-Derived Neurotrophic Factor (BDNF) which is responsible for forming and maintaining connections between neurons in your brain. This also leads to improved memory and less dementia.
When asked about the main cause of weight gain and obesity, 85% of Americans think it is lack of exercise. Although movement and exercise are extremely important, you can’t out exercise your mouth so what you eat is still the most important lifestyle factor. Exercise alone will not help you lose weight or keep you healthy. In fact, there are no studies linking the obesity crisis in the US and lack of exercise, although the food and beverage companies certainly claim that the lack of exercise is the main factor. It’s simply not true. You have to burn 3500 calories to lose 1 pound. On average, most aerobic exercise (running, swimming, biking…) burns about 200-300 calories each 1/2 hour of activity with running being the most efficient (~ 100 calories/mile). You would still have to run 37 miles to lose that 1 pound! The routine and repetition is the real benefit. Although weight lifting burns less calories per hour, the continued post exercise oxygen consumption and calorie burn is the highest. In addition, with added lean muscle, you burn even more so weight lifting is an important part of an exercise regimen.
- Here is a list of a few products and how much exercise you need to burn off the calories:
- 1 coke – bike for 1 hour and 15 minutes.
- 1 average cookie – jog for 20 minutes.
- A medium order of French fries – swim for 1 hour and 15 minutes.
- 1 Oreo cookie – climb 25 flights of stairs.
- 1 doughnut – climb 86 flights up the Empire State Building.
- 1 McDonald’s Happy Meal – 2 hours of jogging.
- 1 Slice of pizza – 1 hour of brisk walking.
The Coca-Cola company is well known to have spearheaded an advertising campaign claiming that present day obesity is associated with decreased activity and exercise however this is simply not true. Obesity rates have gone up 10x in just the last 100 years (most notably in just the last 30) and American society started to significantly move less over 100 years ago. In fact, the dishwasher, Model T automobile and vacuum cleaner, all inventions which dramatically decreased movement, were all invented before 1910!
At the age of 35, Jim Fixx weighed 240-pound frame and smoked 2 packs-a-day. He decided to quit smoking and to get in shape by running. He successfully turned his life around and become a running guru even authoring a best-selling book called “The Complete Book of Running.” While running up to 80 miles a week and appearing to be in incredible physical condition, he continually ate fast food and junk food. He often consumed excess amounts of sugar as well. After having gone out on a run one day in 1984, Fixx was found dead at 54. His autopsy revealed large amounts of plaque buildup in his arteries. A clear example of how you can’t out-exercise your mouth! Another more recent example is Ron Harper, host of the Biggest Loser, who, despite being in amazing shape, had a near life-ending heart attack at the gym, many argue because of his meat-heavy diet. He did have some genetic risk factors but these are modifiable by a healthy diet.
As far as fitness and nutrition are concerned, for most people, you really don’t need to worry about it, even if you are on a strictly plant-based diet. You will get all the necessary nutrients, vitamins and minerals, including the overemphasized protein, assuming you are eating a variety of fruits and vegetables. If you are interested in gaining muscle, you simply need to eat more and not focus on the protein. Although it is true that dairy is the highest source of muscle-building nutrients, those nutrients feed all rapidly dividing cells, including cancer cells. You needed these nutrients when you were an infant, but after weaning from breast milk, dairy only does harm. You can get deep into the weeds with this but dairy does stimulate production of Insulin Like Growth Factor (IgF-1) and mTOR (mammalian target of rapamycin), growth hormones, but these are only important in infancy. Afterwards, they only stimulate unhealthy cell growth and stimulation. Some of the greatest athletes in the world, including the strongest man and a few of the greatest endurance athletes are vegan and seem to be doing just fine. There is more information about this on my “Common Questions” page.
We’ve known for decades that when we exercise, we produce endocannabinoids, oxytocin, dopamine and serotonin, all compounds which make us feel relaxed, loving, happy and joyful. Exercise teaches the brain how to be more resilient to stress and more receptive to joy. There is an increase in dopamine, endocannabinoid and endorphin receptors. You feel joy better. Even minimal amounts of movement improve mood and have been shown to decrease depression symptoms.
An exciting relatively new discovery are myokines. Muscles are endocrine organs just like your thyroid and pancreas. They synthesize and pump out peptides and proteins which affect every system of the body. When you contract your muscles in a regular way, these compounds are released into your bloodstream. ANY kind of movement. “Myokines” basically mean “compounds set into action by motion”. Some have been shown to kill cancer cells, some reduce inflammation, others have been shown to reduce blood sugar, and improve cardiovascular health, independent of the impact exercise has on the heart and arteries.
Scientists now feel that these myokines may be the real reason that exercise is so good for overall health. It’s biggest impact however may be its impact on the brain, mood and our stress response. Not only do they act as an antidepressant, they actually change the structure of parts of your brain like the hippocampus, part of the limbic system, and plays important roles in the consolidation of information from short-term memory to long-term memory, and in spatial memory that enables navigation. It also changes the pre-frontal cortex, the region responsible for planning complex cognitive behavior, personality expression, decision making, and moderating social behavior. The pre-frontal cortex by the way, continues to develop well into our twenties. By the way, the constant trauma from things like soccer (heading the ball), football and hockey injuries is why there are so many behavioral problems and depression associated with head injuries in sports. I’m glad my mom wouldn’t let me play hockey and made me play piano and go to Ukrainian school!
Originally, myokines were dubbed “hope” molecules because of how much they impact on the ability for us to deal with stress.
Although there is a dose dependent response, to a point, even minimal movement like arm movement, leg movement. Even 10 minutes of movement a day reduces all-cause mortality. Recovery from any event or disease is improved with exercise. NO EXCUSES! Movement of any kind, especially if done outdoors, has an immediate positive impact on mood.
Lastly, lack of movement makes us less compassionate and loving, things we need more than ever during these times of division and isolation. I think it was the Dalai Lama who said that “The benefits of compassion are felt as much by the giver as by the receiver”
SUPPLEMENTS. You just don’t need them, especially protein. Don’t be fooled by advertising or gimmicks. Just eat a whole food, plant-based diet, eat enough calories if you are extra athletic, and you will be fine.
10,000 STEPS. Although every pedometer and exercise tracker beeps at you and every physical trainer yells at you if you don’t reach this magic number of steps, there is NO evidence that this number means anything at all. In fact, this number was randomly though up by a company which developed the first pedometer. It grew out of the marketing campaign for a pedometer invented in 1965 by a Japanese professor of health science who believed walking 10,000 steps daily would help the Japanese people avoid obesity. The name of the pedometer was Manpo-kei (10,000-step meter), and the ads for the device said, “Let’s walk 10,000 steps a day!” More than 50 years later, the idea that adults need to walk 10,000 steps a day retains its power. That’s not to say that these devices are bad or reaching the 10,000 step goal is not a good one. The average American takes about 5000 steps a day doing regular daily activities, assuming they are not completely sedentary. An average 30 minute aerobic exercise adds another 3000 or so so getting to 10,000 is actually pretty good. If these devices get you moving more, it’s all good.
“RUNNING HURTS MY KNEES”. There is absolutely no evidence that running causes knee arthritis. In fact, the opposite is true. Running builds cartilage and muscles supporting the knees. There are at least 15 randomized and controlled studies showing that running does not increase the risk of arthritis long-term. Now, if you already have arthritis, it may be painful and if all your cartilage is gone, running may not be the main exercise for you, but at that point, the damage has already been done.
Cardio-Metabolic Stress Tests. These are a few tests which measure cardiovascular health. People who achieved these landmarks were significantly less likely to have cardiovascular events. They are done with body weight.
- SQUATS. 30 squats to 90 degrees in 45 seconds.
- PUSHUPS. 40 at a cadence of 80 per minute.
- STAIR CLIMBING. 4 flights (about 60 steps) in 45 seconds.
- HEART RATE RECOVERY. One of the best indicators of heart health is how quickly your heart rate drops after a maximal or near maximal effort. Traditionally, this is measured 1 minute after cessation of exercise and compared with your heart rate as soon as you are done exercising.
- Excellent – >30 drop in beats per minute.
- Good – 20-29
- So So – 14-19
- Not great – 12 and less
- GRIP STRENGTH – without a device to measure this, usually found in rehab facilities, it is hard to measure but is basically an indication of muscle strength. The stronger you are, the better.
EXERCISE, GLUCOSE AND INSULIN SENSETIVITY.
- Exercise causes muscles to move glucose transporters from inside the cell to the cell membrane to facilitate glucose entry.
- Exercise can also increase insulin-dependent glucose uptake, lowering glucose levels.
- An increase in blood flow, and therefore glucose, to skeletal muscles allows for increased clearing.
In terms of reduction of insulin with activity after meals, the authors posited that:
- Exercise allows muscles to take in glucose without insulin; that decreases overall glucose levels, therefore decreasing the overall amount of insulin needed.
- Exercise may increase insulin sensitivity, so the muscles can take in more glucose with less insulin.
- Exercise may help insulin clear from the bloodstream more quickly.
- Because exercise causes muscles to get more blood flow, they also get more insulin; this means the pancreas doesn’t have to produce as much.
HEART HEALTH and EXERCISE
There is no question that those who exercise are healthier, live longer, have fewer chronic disease and are happier than those who don’t. And there is a dose-dependent response to exercise, meaning that the more you do the better off you are, but only to a point. And that point is not all that extreme. In fact too much exercise is damaging in a variety of ways. The health benefits of exercise follow a “J” curve. The biggest increase in health benefits occur in those who are couch potatoes, meaning, they do nothing, who then start doing something, anything. Even just walking 3 days a week for 20 minutes. Even just walking around the house, maybe going up and down the stairs a few times. More movement, even gentle movement, is hugely beneficial. If you add some resistance like weights, and some aerobic exercise, like walking faster, running or cycling, the benefits go up even more. But extreme training for extreme endurance sports starts to wear on the body, especially the heart.
At rest, the heart pumps 1 gallon (4-5 liters) a minute. With hard running, it pumps 4-5 gallons a minute. After 60 minutes of this intensity level, the heart starts to become damaged. The average runner who does a half marathon, runs for about 2 hours and 4 hours for a marathon, often running this long even during training. Small little tears occur which create micro-scars as they heal. As the scars build up, the electrical impulse which contracts the heart causing it to pump, becomes disrupted.
A study of marathoners showed that 50% of them examined after a marathon race showed elevated troponin levels (a heart muscle cell enzyme used to look for heart attacks in the emergency room), evidence of heart muscle damage. The vast majority recover. Occasionally, it’s not a problem, but over and over again, it causes minor tears, leading to scars in the heart.
Veteran marathoners have 5x higher risk of Atrial Fibrillation. Ventricular tachycardia (V Tach) is a common problem which results from overtraining and scarring of the heart.
A study of 52,000 people, about half runners and half non-exercisers. Runners had a 27% reduction in premature death overall but there were limits.
- 10-15 miles a week limit.
- 10 min/mile pace (6-7 miles an hour).
- 3-5 days a week was ideal. More is not better.
The good news is that some of the damage is reversible. Fibrous Cardiomyopathy (heart dysfunction from scarring) improves once you stop damaging and re-damaging the heart.
The “Blue Zones” cultures, those who live the longest and are the healthiest, don’t do formal exercise. But they are constantly moving. Walking, gardening, fixing… No sitting around binging on Netflix or staring at the computer for hours on end.
So, GET UP AND MOVE, just don’t take it to extremes.
PROTEIN and EXERCISE – BROtein vs PROtein. Myths and Truths
- “When I work out, I use muscle for energy”. FALSE. Your muscles do propel you and you do use up the energy stored in the muscle cells but muscle is not “used up”. Typically, low-intensity exercises start to burn fat and glucose is burned up early in high intensity exercises however, a mixture of both is used up during any exercise. With higher intensity exercise, if done long enough, the glucose does get used up and the body starts to burn more fat, but not a huge amount and you have to do a LOT of exercise.
- “If I don’t eat right after working out, I will lose my muscle”. FALSE. As long as you eat at some point in the day, getting enough calories, you will NOT lose muscle. You do not need a protein shake or some other concoction right away. You DO need enough calories for muscle gain however.
- “I must get a complete protein at every meal to gain muscle”. FALSE. Our bodies use the amino acids we consume and then pool the the extra, unused amino acids, but only to a point. It’s important to get some of the essential amino acids at some point throughout the day but not at every meal. By the way, animal protein is not the only source of complete and essential amino acids. ALL proteins are found in all foods, just in varying amounts.
- “If I overeat protein, I will just store it as muscle”. FALSE. Our bodies can metabolize and store limited amounts of protein and their breakdown products, amino acids. About 25 grams at a time is about as much as you can metabolize efficiently. You just pee out the rest. Animal protein put a lot of stress on the kidneys. Plant protein is much gentler on the kidneys.
- “I must eat over 100 grams of protein a day to gain muscle”. FALSE. 100 grams is the average amount an American eats and it is much more than they need. Below is a breakdown of actual daily protein needs:
- “Necessary” or minimum protein intake is 0.4-0.6. grams per kilogram of bodyweight per day (gm/kg/day). This is typically what people with kidney disease are advised to consume since excessive amounts stress the kidneys, whose job it is to filter out the protein. For the average American male (190 lbs. or 86 kg) and the average American woman (160 lbs. or 72 kg) is 51 and 43 grams respectively.
- “Normal” protein intake is 0.8 gm/kg/day. 70gm for men and 57 gm for women.
- “High” protein intake is 1.2 gm/kg/day. 103 gm for men and 86 gm for women.
- “Max” protein intake is 1.7 gm/kg/day. 146 gm for men and 122 gm for women. If you are working out 3 hours a day, maybe you need as much as that but this is extremely rare.
- “I need animal protein to gain muscle”. FALSE. Everything you consume has protein, even junk food. Plants contain all the essential amino acids and there are many world class athletes who are strictly vegan. As an example, calorie for calorie, broccoli has more protein than beef!
Almost 20% of Americans, 70 million, have some form of sleep disorder. Mostly, not getting enough good quality sleep.
Sleep is CRUCIAL. Even more than exercise. Even 1 night of poor sleep significantly impairs memory and cognitive function. Animals die of sleep deprivation sooner than they will of starvation. Sleep cleans the brain. The microglia are the “janitor cells” in the brain which remove beta amyloid, accumulation of which contributes to Alzheimer’s Dementia. Even 1 night of impaired sleep not only causes the microglia to stop cleaning the amyloid, it switches their function into a destructive one, breaking down healthy tissues. Even one night of poor sleep increases measurable amyloid in the CSF (cerebrospinal fluid) by 30%.
The day after Winter Day Light Savings Time, when you lose only 1 hour of sleep, there is a 24% rise in heart attacks and a similar reduction in heart attacks the day after the spring clock change, when you gain an hour of sleep. Similar increases and decreases are also seen in the number of road accidents and even in the suicide rate. Only 4 hours of sleep deprivation results in a 70% decrease in production of natural killer (NK) cells, immune cells responsible for looking for and destroying cancer and other unhealthy cells. Men who regularly sleep 4-5 hours a night have the testosterone levels of men chronologically 10 years older. A Harvard study followed patients with no history of cardiovascular disease for over 5 years. Those who consistently had less than 6 hours of sleep a night had a 200-300% increased risk of coronary calcifications, a sign of damage and repair.
Poor sleep results in a 70% increase in hyper-reactivity of the amygdala, the part of the brain responsible for emotion. In addition, the prefrontal cortex, the “administrator” of the brain which regulates the amygdala is down-regulated and the connections between the two is severed leading to uncontrolled emotions.
There is some startling data about how long workdays and poor sleep impacts on patient care. Here are a few examples:
- Medical residents who work 24-30 hour shifts can make as much as 460% (4.6x) more diagnostic errors in the Intensive Care Unit than residents who had shortened work hours.
- If you are having elective surgery and the surgeon has had less than 6 hours of sleep in the previous 24, there is a 170% (1.7x) chance of a significant surgical complication happening as compared with a surgeon who had better sleep.
- Medical residents after working a 24-30 hour shift, had a 168% (1.6x) more likely to get into a car accident themselves.
The waking brain is optimized for collecting information and the sleeping brain for consolidating all that information. At night we switch from recording to editing. Even one night of sleep deprivation will impact on brain function, immunity and has been linked with increased dementia risk. The Monday after daylight savings time changes, there is a 24% increase in heart attacks and a significant increase in fatal car crashes compared with other Mondays. Drowsiness is blamed for more than 100,000 vehicle crashes a year in the US. Improving sleep is twice as effective at decreasing symptoms of depression than the most popular antidepressant medications.
Many restorative functions occur during different stages of sleep all of which are important. It’s in deep sleep that we produce the most growth hormone, needed throughout life for healthy bone and muscle maintenance. Despite only representing 2% of our body weight, the brain uses 50% of the energy expended by the body during sleep. It’s very active. Sleep cycles consist of 1 REM (rapid eye movement) stage and 4 NREM (non-REM) stages.
- NREM Stage 1 – early stages of sleep when you are easily rousable. Last about 10 minutes. Breathing slows and heart rate becomes regular.
- NREM Stage 2 – Most of your sleeping time is spent in this stage. This is when the brain makes room for new memories. By completing this stage, your ability to learn new things is improved.
- NREM Stage 3 & 4, also called SLOW WAVE SLEEP (SWS) – These are very deep phases of sleep when you lose consciousness and new memories are formed.
- REM – this is when we dream and unlearn and process trauma. Certain parts of the brain are actually more active during this stage than when fully awake. This is the phase most affected by alcohol since the sleep-disruptive metabolite of alcohol, acetaldehyde, takes about 4 hours to be produced, which is right around the time REM sleep starts to increase. REM sleep increases as the night progresses.
Chronic disruption of sleep cycles (which last about 90 minutes) can impact on proper immune function, contribute to chronic stress and even development of cancer as well as accelerating cancer cell growth. Studies on shift-workers have shown increased risks if various illnesses and even a greater risk of breast cancer and prostate cancer. Poor sleep during the week before an immunization results in a 50% drop in immune response. Potent immune defense cells known as NK, or Natural Killer cells, drop off by 70% after only 1 night of poor sleep.
A British study looked at the impact of decreased sleep on gene expression. As compared with those who slept 8 hours a night , those who slept 6 hours a night had negative distortions in 711 genes. About half the genes, those associated with chronic inflammation, stress, cardiovascular disease and cancer, were up-regulated while the other half of the genes, those associated with immune system regulation and metabolic stability were down-regulated. There was also damage noted in the telomeres (protective end-caps on genes) in the group who slept less. In another study, those who slept less had a significantly more reactive amygdala, the part of the brain responsible for emotional control. There was a 60% increase in negative reactivity to stressful stimuli in sleep-deprived people.
Even the intestines repair themselves at night. All the toxins we consume, knowingly or unknowingly, cause damage to the gut lining. As much as 10% of the gut regenerates at night. To assist in this repair, gastric acid and saliva secretion decreases at night. In addition, gut motility (the contraction waves which move material through the gut) decreases substantially at night. This is partly why you should go to bed on an empty stomach. You do not need to be expending energy on digestion. Eat nothing with in 2 hours of sleep. If you struggle with reflux, also avoid all liquids, including even water.
Various compounds are secreted based on circadian rhythms in the body and many are produced at night when we sleep. Histamine, melatonin, cortisol, growth hormone and prolactin are just some examples. When sleep is disrupted, these hormones can’t function normally. For example, prolactin plays a role in apatite control and sugar cravings. It’s disruption is partly why poor sleep is associated with weight gain. When cortisol, our stress response hormone, is disrupted, blood pressure can go out of whack, not to mention the impact cortisol has on blood sugar control and the proper function of our microbiome.
Human growth hormone is also produced at night. Almost 95% of it. It is interesting to think that most of the growth hormone we produce which helps our muscles grow occurs when we sleep. This is why disrupted sleep impacts on exercise gains. The majority of the HGH (Human Growth Hormone) we produce is made between 10pm and Midnight so it’s best to already be asleep by 10!
Insomnia is a predictor for heart disease, diabetes as well as immune dysfunction. Risks of type 2 diabetes are increased by short sleep with a 28% increase in risk, difficulty falling asleep with a 57% increase and difficulty staying asleep, by 84%.
The lymphatic system, which cleans and protects the rest of the body, also has an important role in the brains especially during sleep. The Glymphatic system, the lymphatic of the brain, is most active during deep, slow-wave NREM sleep, clearing as much as 40% of the amyloid which builds up during the day. It comes from the Latin word “glue” since it was thought that the glial cells were structural, supportive cells in the brain. A mere 36 hours of sleep deprivation increases amyloid levels by 30%. A properly functioning glymphatic system also impacts on cardiovascular disease, diabetes and hypertension.
“Wakefulness is low level brain damage whereas sleep is sanitary salvation”. Matthew Walker, PhD
Poor sleep increases production of cortisol, the stress hormone, by up to 20%. One recent study found that not getting enough high-quality sleep can DOUBLE the amount of belly fat (also known as omentum fat) that you develop. Sleep deprivation leads to increased production of the “hunger-hormone” ghrelin leading to over-eating and weight gain. Poor sleep also impairs the function of the satiety hormone leptin. So poor sleep increases the hunger drive and decreases the fullness response. Studies have shown that poor sleeping patterns lead to increased caloric intake during the day by as much as 500 calories. This may be because fatigue leads to poor choices but there are also additional hormonal effects leading to cravings and poor apatite signaling. Every cognitive function is affected by sleep loss.
Whereas melatonin increases in the evening after light exposure decreases and diminishes through the night, cortisol, the stress hormone, increases in the latter parts of sleep. The Cortisol-awakening-response (CAR) is the cortisol increase which occurs within the first hour of waking, peaking ½ an hour after waking. It’s our “natural caffeination”. If your CAR flattens too much, it leads to feeling off in the morning. Cortisol also impacts on apoptosis of unhealthy T-reg cells in the thymus, which is why low cortisol levels are associated with autoimmune diseases.
On the other side, as sleep deficit increases (day after day of less than optimal sleep), our bodies ability to break down cortisol diminishes. This adds to the overall level of cortisol in our body, increasing its deleterious effects. Too much is not good and too little is not good either.
A study was conducted where people were taken out to the wild, without phones, lights, pads… for 2 weeks, allowing their natural rhythms to develop. Despite thinking that their “sweet spot” regarding the best sleep time was 11 pm, they eventually settled to a natural sleep time of 8:30, sleeping for 8-9 hours a night. However another study of societies who live in remote areas without electronics and their normal range was from 6-7 hours, but those cultures also live very different lives than Westerners. In the US and many developed countries, 79% of people get less than the recommended seven hours of sleep. If you think you can function on less, you are fooling yourself. On average, 99% of people need between 7-9 hours (about 5 sleep cycles). In 1900, the average American got about 9 hours of sleep a night. in 2018, the average was 6.8 hours. Aim for 7-9 undisturbed hours every night. Quality of sleep is as important if not more important than quantity. Napping is not as good as a good night’s sleep. You can’t “catch up” on weekends either. In case you were wondering, you can get too much sleep. There are some studies that report increased risks of depression in people who sleep more than 9 hours a night regularly.
SLEEP AND WEIGHT LOSS. Sleep disruption contributes to weight gain as well. After only 2 nights of sleep deprivation (only 4 hours), ghrelin, the “hunger” hormone, production increased by 28% and leptin, the hunger inhibiting hormone, production decreased by 18%. In other words, only 2 days of sleeping 4 hours makes you hungrier and reduces your body’s ability to know you are full. Poor sleep has been shown to increase caloric intake by 200-300 calories a day. It doesn’t seem like much, but day after day of poor sleep leads to significant weight gain. If you do manage to lose weight while sleeping poorly, 70% of that weight is lean muscle mass rather than fat, the exact opposite of what you want. Poor sleep also leads to decreased motivation to exercise as well as poorer efforts and output if you manage to exercise.
Glutathione, a compound produced by the liver, is one of the strongest antioxidants in our bodies. Depletion of 20-30% of our glutathione can impair cellular defense systems and lead to abnormal cell-to-cell communication, and cause various adverse effects including protein breakdown and cell injury. We’ve learned that as little as 5 days of sleep deprivation can impair the production of glutathione by 30%. However, sleep recovery showed restoration of glutathione and antioxidant activity in both liver and heart.
The top issues which impact on sleep quality are:
- REGULARITY AND CONSISTENCY. Waking up at the same time every day is more important than going to sleep at the same time. As a general rule, we evolved going to bed when the sun went down and getting up when the sun comes up. This is not practical in modern society but studies show that the majority of people naturally gravitate towards going to sleep around 9pm and wake up around 6-7 am.
- DIM THE LIGHTS. Screen time and light exposure in the evening. Stop looking at ANY screen at least an hour before bed. Earlier if possible and turn down lights ASAP. Try wearing blue light blocking glasses in the evening. This not only blocks the blue light from screens but ambient lights as well. Wearing them lessens the blue light from a cell phone more than what you would be exposed to reading a book by candlelight. An hour of iPad exposure before bed decreases melatonin production by 50% and delays peak melatonin production by 3 hours. In addition, the quality and duration of REM sleep is negatively impacted by blue light from screens and this effect can last for up to 3 days!
- TURN OFF ALL SCREENS. More importantly than the blue light effect of these devices, they overstimulate the brain. That is what they were designed to do. Excite! This is the opposite of what our brains should be doing in preparation for sleep.
- MEDITATE. Slowing down, or getting out of, your own head can be extremely helpful. In particular, doing a Body Scan meditation, which focuses on the body and body sensations, can be very relaxing. Click here is a link for some information and a sample meditation.
- CAFFEINE. Don’t consume ANY within 12 hours of your target sleep time. It may not prevent you from falling asleep but it definitely causes sleep fragmentation and causes poor sleep quality. Not only is caffeine a stimulant, it blocks adenosine receptors. Adenosine is the end by-product of energy use and builds up as the day progresses. ATP (adenosine triphosphate) is the main electrical molecule. When used, it is converted into ADP (adenosine diphosphate). During wakefulness, adenosine levels gradually increase in areas of the brain that are important for promoting arousal, especially the reticular activating system in the brainstem. As concentrations rise, adenosine inhibits arousal and causes sleepiness. Then, adenosine levels decrease during sleep. Therefore, scientists have long extrapolated that high levels of adenosine in effect cause sleep. In fact, caffeine found in coffee, tea, and other caffeinated beverages, is a xanthine chemical like adenosine and works to inhibit sleep by blocking the action of adenosine within the brain, which increases wakefulness. In other words, when you drink caffeine, it achieves its stimulating effects by blocking your brain’s adenosine processing.
- ALCOHOL. ANY amount will impact on sleep quality, even one drink. Alcohol causes sleep fragmentation and suppresses REM (Rapid Eye Movement) dream stages. It may not prevent you from falling asleep, and even might help you fall asleep but it impacts very negatively on the quality of your sleep. Although initially alcohol acts as a sedative, its breakdown products are actually stimulants and add to the disruptive nature of alcohol on sleep.
- EXERCISE. It’s good for you but don’t do it within 4 hours of sleep.
- STRETCH before bed. There is a reason that animals and kids give a big yawn and stretch out before they fall asleep. Both are very relaxing. Many different stretches help. Even pretending to yawn seems to help.
- Keep the bedroom dark, quiet, cool and reserved for sleep ONLY. The brain adapts to activities and location.
- TEMPERATURE. Although some people love the feeling of warm blankets, they work better if the room itself is cool, ideally around 68 degrees. Still, elevated body core temperature impairs sleep. One other way to cool the core by taking a bath or warm shower at night. By dilating the capillaries in the skin, they cool quickly, after you are done and the core temperature drops. This is why kids sleep better after their evening bath.
- WAKING UP AT NIGHT. It is normal to wake up at night. In fact, on average, we wake up between 15-20 times a night. You may not be aware of it but it happens. Sometimes, it’s to re position yourself and sometimes to just go to the bathroom but it happens. Excessive amount of waking up, especially if you have trouble getting back to sleep, is not good though. The bet way to limit excessive arousals is to avoid stimulation before bed, including TV or other screen time, exercise or caffeine (my rule of thumb is NO caffeine after noon). Make sure you also get checked out by a doctor, especially if you are going to the bathroom a lot.
- SHIFT WORK. Shift workers are noted to have higher cancer rates and their disrupted sleep is thought to play a major role. There is enough evidence for this that the World Health Organization (WHO) has categorized shift work as a type 2a, probably carcinogen. This is in the same category as red meat and various other chemicals. Diabetes and heart disease rates are higher in shift workers as well. Shift work is particularly bad if the shift is continuously changing. Regularity, even if at night is less bad.
- SLEEP ON AN EMPTY STOMACH. Our bodies were not designed to digest at night. Sleep is for resting, cleaning and re-building, not digesting. Don’t consume anything at least 2 hours, and preferably 3 hours before bed. Melatonin actually slows digestion and digestion impacts on melatonin production. It’s a loop. In addition, what you eat at dinner has an impact on sleep. Meals with animal proteins are harder to digest and also prevent serotonin, the happy brain chemical, from working. The Thanksgiving after-meal lull has nothing to do with tryptophan, as is commonly thought. It’s all the fat that clogs your blood, slows oxygen delivery to the brain and puts you to sleep. Meals with more carbohydrates (vegetables and grains) allow serotonin to work better.
- SNORING AND SLEEP APNEA. 20-30% of Americans have sleep apnea and significantly more snore. Both disrupt sleep. Please see the next section for a lot more information about these conditions.
- WEAR BLUE LIGHT BLOCKING GLASSES. Use them for 2 hours before going to bed. See below
- If you can’t sleep for more than 20′, it’s better to get up and do some reading or something light. The brain is an incredibly associative organ and you don’t want the brain to think that the bed is a place to lay awake thinking abut things and not sleeping.
BLUE LIGHT BLOCKING GLASSES. Wearing these, especially in the evening once the sun has gone down, improves sleep quality. A study comparing workers who wore or didn’t wear these glasses showed that those who wore the glasses for 2 hours before bed had:
- Slept 6% longer, which translates into 35-45 minutes more.
- Increased sleep quality improved by 11%.
- Work performance increases due by 9%.
- Work enjoyment increased by 9%.
- Interest in helping others increased by 18%.
- Interest in doing negative things decreased by 12%.
NAPS. More than 85% of mammals are polyphasic sleepers, meaning they sleep for short periods throughout the day. Humans are monophonic sleepers. That having been said, naps can be helpful. The optimal duration is 90 minutes, to be able to complete one full cycle of sleep stages. But even shorter naps increase alertness and decrease stress.
Naps help if they are a regular habit and you already sleep well at night. BUT, if you struggle to sleep at night, napping may be counterproductive. Catch-up sleep does not work. At best, you recover half 50% of the time but not the loss of physical effects. From the moment we wake up, adenosine has been building up in our brains. Adenosine is a normal compound which has various functions in the body including stimulating the hunger hormone ghrelin and affecting electrical conductivity in the heart. In the brain, adenosine is an inhibitory neurotransmitter functioning as a central nervous system depressant. In normal conditions, it promotes sleep and suppressing arousal. At night, it gets removed from the brain while we sleep. It takes about 8 hours to remove about 16 hours of accumulated adenosine (8+16=24! Funny how Mother Nature works!). After about 8 hours of quality sleep, all the adenosine should have been cleared, in addition to most of the melatonin being removed, and you should feel rested and refreshed. The danger with naps is that some of that sleepiness compound adenosine with be cleared away which impacts on how your ability to fall asleep later when you really need it. So power through and avoid caffeine. Caffeine attaches to adenosine receptors, blocking their ability to help with sleepiness later on. It basically hits the mute button on sleep.
A Greek study showed that when businesses started to open, rather than close between 2-4 for their “siesta”, there was a 35% increase in heart attacks with a 60% increase in men. This tended to occur in those who did not make up those extra 2 sleep hours at night.
Try not to nap within 6 hours of your regular sleep time since it can affect your normal night-time sleep. Also, depending on how long the nap is, if you wake up in the middle of REM sleep, you make up groggier than when you started the nap. Keep them short (less than 20 minutes) or allow yourself 90 minutes to try to complete a full cycle.
NAPS – CAN CAFFEINE HELP SLEEP?
Although overall, too much caffeine, especially after noon, has a negative impact on sleep, it may actually help with daytime power naps. Here’s why.
In addition to melatonin there is another compound in our brains which contributes to sleep. A compound known as adenosine increases gradually in the brain and is responsible for the feeling of tiredness. Its molecular structure is almost identical to that of caffeine. It’s interesting that the molecule responsible for putting you to sleep and the one responsible for keeping you awake are almost identical. They are similar enough that caffeine binds to the adenosine receptor in the brain.
Our neurons, or nerve cells, are embedded with adenosine receptors. When adenosine binds to these receptors, a variety of proteins that inhibit neurons are released. This suppression of nerve cell activity is what causes the feeling of drowsiness. Unlike adenosine, however, caffeine does not activate these receptors or suppress neuron activity. By reducing the concentration of available adenosine receptors, caffeine slows the rate of reaction. Less-bound adenosine means we feel less sleepy.
Adenosine is one of the body’s more powerful molecules and is linked to the digestion process. During digestion, the glucose in the foods we eat breaks down into, among other things, ATP, Adenosine Tri-Phosphate. ATP is responsible for energy transference between cells. After ATP is “used up”, it decomposes yet again into adenosine. As adenosine builds up in the bloodstream, it interacts with specific cell receptors, inhibiting neural activity and causing drowsiness.
Well, when the body runs out of fuel (glucose) in the form of easily digestible sugars from the food we eat, adenosine signals the body to become drowsy. This essentially tells us to sleep and rebuild our energy reserves. It’s a critical chain reaction that initiates the early stages of non-REM sleep and is essential to the natural sleep cycle.
So as the day goes on, adenosine builds up. If you feel tired, when you drink a caffeinated beverage, initially the caffeine binds to the adenosine receptors. If you fall asleep, the free adenosine is broken down so when you wake up, you first of all feel refreshed from the nap but, with less adenosine around, you feel awake longer. Now, this could also backfire if you consume caffeine too late in the day. Remember that caffeine has a half life of at least 6 hours, meaning that 6 hours after you drink it, at least half of it is still circulating in your body. 25% of it is still around 12 hours later.
HELPFUL HINTS: The following are some clarifications and additional helpful hints.
- Keep the bedroom for sleeping, and other bedroom activities. Nothing else.
- Keep it dark. Even small lights on chargers, alarm clocks, cable boxes… have an impact. As soon as the visual cortex in the brain is stimulated, even a little bit, melatonin (the sleep hormone) production stops and sleep becomes disrupted and fragmented.
- Avoid looking at ANY screen (TV, Kindle, iPad, Phone…) for at least 1 hour before going to bed. Even a brief look at email, weather apps or your alarm on your cell phone will also disrupt melatonin production and disrupt your sleep patterns. Reading a paper book is OK. The light from screens (even with the light filters) shuts off melatonin production also. These apps and filters simply do not work very well. Some sleep specialists recommend wearing blue light blocking glasses in the evening. There are even light receptors in your skin! Even small amounts of light exposure on your skin have been shown to affect sleep quality. The deleterious effect of light seems to decrease somewhat in older people. This is felt to be associated with a gradual yellowing of the lens of the eye resulting in less blue light being able to reach the retina. Try wearing blue light blocking glasses in the evening. This not only blocks the blue light from screens but ambient lights as well. Wearing them lessens the blue light from a cell phone more than what you would be exposed to reading a book by candlelight. Recent research has also linked blue light exposure to retinal deterioration leading to macular degeneration and even glaucoma. For more on this, look at this summary: Blue Light and Vision.
- Reading an iPad vs a paper book:
- Melatonin production, and resultant sleep latency (when you fall asleep) is delayed by 3 hours.
- Melatonin levels are reduced by 50%.
- There is less REM (dream) sleep leading to decreased creativity and more irritability.
- All of the above effects took 3 days to clear after switching over to paper.
- If you need an alarm clock, use a traditional, non-electric one. If you need an electric one, use one with a red light. This color has the least impact on the photoreceptors in your eyes which impact on melatonin production and subsequent levels.
- As important as turning down light exposure in the evening is, getting plenty of bright daylight during the day is as important. Sunlight turns down melatonin. We need bright light exposure.
- Keep it cool (65-68 degrees). Studies show that we sleep better in rooms that are cooler. Keep your hands and feet warm however.
- Keep it quiet. Obviously, noise can be a distraction.
- Keep it cool. See above comments on this.
- Keep the air quality good. No air fresheners, sprays or other air pollutants. Consider getting a HEPA (high-efficiency particulate air) air filter to keep the air clean. In the winter, if your home is dry, get a cool-mist humidifier.
- Avoid all caffeine for at least 12 hours before going to sleep. Caffeine clears the body very slowly (its half-life is 6 hours), disrupts sleep cycles and causes reflux. It may not prevent you from falling asleep but it will affect sleep quality.
- Alcohol also impacts on sleep quality. It breaks down to acetaldehyde which affects the sleep cycle and prevents the deeper stages of sleep. Alcohol is a diuretic so your brain dries up overnight making you foggy in the morning. Also, alcohol causes reflux further disrupting sleep. Nightcaps do not work.
- Don’t eat or drink within 2-3 hours of sleep. It first of all causes reflux. More importantly, anything in our intestinal tract needs to be metabolized and digested and this takes away valuable resources from the important reparative activities which must occur during sleep. In addition, 80% of the melatonin in our body is produced in the gut. When our intestines are pre-occupied with digestion, melatonin production is hampered. In addition, melatonin disrupts proper insulin function which disrupts blood sugar metabolism. In a nutshell, it can lead to or worsen diabetes. It’s a vicious loop. Food affects sleep and sleep affects digestion.
- Do not exercise within 4 hours of sleep. Exercise releases adrenaline and raise your core body temperature both of which affect melatonin production.
- Some people find that taking a warm bath or shower helps. The same goes for meditation, prayer or any other mindfulness practice you like to do.
- Sound generators can also help. Something as simple as a fan is helpful also. Sound does not stimulate the brain the way light does.
- Consider a weighted blanket. These have become popular and many people report significant improvement in sleep. One such product is a Gravity Blanket.
- A warm bath may help relax you before bed.
- If your bed-partner has poor sleep as well (restlessness, snoring…), consider a “sleep-divorce”. Sleeping in separate rooms may help both people sleep and this can actually improve, not only daytime function and health but also on intimacy since you will plan it, look forward to and be able to enjoy it better.
- Sleep becomes more fragile with age. More things affect it and to a greater degree.
- Sleep Inertia is how quickly you become fully awake in the morning. The prefrontal cortex, the “executor” of the brain responsible for emotional control and decision making, is the last part of the brain to “wake up” in the morning. This explains why some people are cranky in the morning.
- Your Chronotype, also is an important factor. Although most people fall into a pretty narrow range with respect to when they should physiologically fall asleep and wake up, some are truly “night owls” and some are “ morning” morning people. If you fight your chronotype. Click here to learn what your chronotype is. If you feel unrested all day, you may want to check your chronotype and see if you are trying to force a square peg into a round hole.
- It is well known that poor sleep worsens anxiety as well however, poor sleep even induces anxiety. In a study of healthy people without any significant anxiety, even 1 bad night of sleep resulted in 30% of them having so much anxiety the next day that by medical criteria, they would be diagnosed with an anxiety disorder. The cause of this again goes back to the prefrontal cortex, the master emotional regulator. When disrupted, there is less emotional control. Sleep disruption affects non REM sleep in this instance.
- Meditation helps to lower cortisol, the stress hormone and balances the autonomic nervous system, decreases the sympathetic (fight or flight) response and increasing the parasympathetic (rest and digest) system. Over an 8 week span, new meditators who had insomnia decreased their sleep latency (time it takes to fall asleep) by 40 minutes. This is in contrast to sleep aid medications which at best improve sleep latency by 8-10 minutes and placebo pills which improve it by 6-7 minutes. If you have not fallen asleep within 15-20 minutes, you should not continue to just lay there. The brain learns this behavior and associates the bed with being awake, rather than being the place for sleep. The same is true for people who fall asleep on the couch in front of the TV. Their brains have associated that activity with sleep. If you can’t sleep, it’s better to get out of bed and do something like meditate or read a book with dim light somewhere else. Your brain needs to re-learn that the bed is for sleeping. The same occurs when you do work in bed. The brain learns to associate that activity with that location.
- Social Jet-lag is the phenomenon of having a different activity/sleep schedule every weekend, whether it is a second job, travel, socializing or even trying to do what you think is the right thing by sleeping more to compensate for a busy week, you may be doing more harm than good. To put it into context, shifting your body clock by 2-3 hours on the weekend is the equivalent of traveling from New York to San Francisco every weekend and trying to deal with the physical jet lag.
- SHIFTING SCHOOL TIMES. Shifting start times for schools is an important issue. Studies have shown clear improvements in academic performance by shifting school start times by 1-2 hours later, allowing kids to sleep more naturally. A study at the Annapolis Naval Academy showed a standard deviation improvement across the board for a group of cadets who’s schedule starred one hour later. In addition, car accident rates have been shown to drop by 40-70% in school districts where such later start times were adopted.
MEDICATIONS may help you get to sleep but they do NOT provide quality sleep so do not rely on them. They are also addictive.
- 50% of Americans reported regularly using a mix of two or more sleep aids per night, such as prescription medications, over-the-counter sleeping pills, or herbal remedies/food supplements for sleep.
- A 2012 study of people taking prescription sleep medications was linked to a 5x increased risk of premature death.
- Magnesium. Many people are deficient in this mineral and it is important for proper sleep. Consider a supplement or make sure you have it in your multivitamin. If you take a magnesium supplement, take it in the evening.
- Sleeping pills are like alcohol, they act more like a sedative and produce natural, restful sleep. Sleeping aids, along with anxiety medications often used to assist with falling asleep, work by acting on GABA receptors in the brain. This receptor binds the neurotransmitter gamma-aminobutyric acid (GABA), the chief inhibitory (“STOP” signal) neurotransmitter in the body. A study of a few thousand patients showed that use of these drugs significantly increases premature mortality risk. An effect was seen with as few as 3-17 pills a year! Increased cancer rates were also seen.
- THC, the psychoactive part of marijuana affects sleep the same way that alcohol does. It is a sedative. Just like alcohol, it may help induce sleep but the quality of sleep is poor, also affecting REM sleep. Also, a tolerance is built up and when you stop using, not only do you return to the poor sleep you were having but you can have “rebound insomnia,” which is even worse. CBD however, might prove to be beneficial but the studies are still very preliminary. CBD does not appear to have a tolerance effect either but again, studies are preliminary.
- Sleep is when what you learn during the day gets solidified into memories. Poor sleep results in poor memory. Sleeping pills do not improve memory the same way unmedicated healthy sleep does. In a rat study, although sleeping pills made the rats sleep longer, it unwired the memory circuits formed during normal healthy sleep and worsened memory formation by 50%.
MEDICATIONS TO ASSIST SLEEP
These can be divided into one which can be purchased over the counter and those only available by prescription.
Over-the-counter sleep aids
- MELATONIN. Melatonin is a hormone made by the pineal gland in the brain, but it is also made by the gut lining cells in the intestines (400x more than in the brain). Melatonin does many things (see below) but its MAIN role however still has to do with sleep as it controls your natural sleep-wake cycle. Some research suggests that melatonin supplements might be helpful in treating jet lag or reducing the time it takes to fall asleep although the effect is typically mild. Side effects can include headaches and daytime sleepiness. Most doses are much too high. Natural melatonin circulates at a 0.3 mg level and many supplements are in the 3-5 mg range (at least 10x higher). This hormone was originally developed as a contraceptive since it does impact on sex hormones so be advised! There is a lot more about this commonly overused drug below. Keep in mind that melatonin has a very short half life. It clears the body within 1-2 hours so it may help you get to sleep, but if natural levels are not present, your sleep may still be disrupted. Keep in mind that the more and the more often you take melatonin, the less effective it becomes. Regular use downregulates melatonin receptors leading to the need for higher and higher doses to get achieve the same effect.
- DIPHENHYDRAMINE (Benadryl, Aleve PM, others). Diphenhydramine is a first generation antihistamine. As such, it crosses the barrier into the brain and can cause sedation. Subsequent generations of antihistamines like loratadine (Claritin), cetirizine (Zyrtec) or fexofenadine (Allegra) do not cross the brain barrier as readily and are much less likely to cause sedation. Side effects might include daytime drowsiness, dry mouth, blurred vision, constipation and urinary retention. Recent studies have also linked chronic Benadryl use with increased risk for dementia. Brain cells have histamine receptors and they get downregulated with chronic antihistamine use.
- DOXYLAMINE SUCCINATE (Unisom SleepTabs). Doxylamine is also a sedating antihistamine. Side effects are similar to those of diphenhydramine.
- MAGNESIUM. Magnesium deficiency is quite common since it is found in many fruits and vegetables, which most Americans don’t eat enough of. It does many things but it plays a role in supporting deep, restorative sleep by maintaining healthy levels of GABA, a neurotransmitter that promotes sleep. Magnesium oxide is the cheapest form but least absorbed. Magnesium absorbs water. In the gut, it forms clumps which get excreted unless it is chelated meaning that it is bound to something which helps transport. In the case of magnesium, if it is chelated to an organic compound, it helps it to cross the gut barrier and enter the bloodstream. Another important factor in magnesium’s absorption is the acidity of the gut, which increases the farther you go down the gastrointestinal tract. This is another reason why taking antacids chronically is not healthy. The best form of magnesium which leads to the best blood levels is magnesium glycinate.
- GABA (Gamma-Aminobutyric acid) is a neuropeptide which stimulates relaxation. It makes you calm. Serotonin, in contrast, is the neuropeptide responsible for elevating mood. GABAs production naturally decreases with age which is partly why older people may have trouble falling and staying asleep. In addition, many medications interact with GABAs function. Benzodiazepines, like valium, help with sleep because they bind to the GABA receptors in the brain stimulating the same response however they are habit forming and their effect decreases over time leading to people taking higher and higher doses. In addition, patients often feel a “hangover” effect in the morning and don’t necessarily feel rested. It is naturally occurring in some plants but GABA is available as a supplement and has fewer side effects. Jujube fruit, also known as red or Chinese date, is native to Southern Asia. Two types of phytochemicals in jujube, saponins and flavonoids, trigger changes to neurotransmitters, including GABA and serotonin, which can make it easier to fall asleep and stay asleep. At least one of the saponins in jujube, jujuboside A, helps to quiet activity in the hippocampus region of the brain. Jujube contains a flavonoid compound, spinosin, which appears to trigger sleepiness through its effects on serotonin. These are some of the explanations scientists have identified to-date for jujube’s sedative effects.
- VALERIAN. Supplements made from this plant are sometimes taken as sleep aids. Although a few studies indicate some therapeutic benefit, other studies haven’t found the same benefits. Valerian generally doesn’t appear to cause side effects. Valerian root, a Siberian root known as “nature’s valium”, can help with sleep but just like with benzodiazepines, it often leads to a “hangover effect” in the morning. It works by preventing the breakdown of GABA leading to higher levels however it also can lead to some stimulatory effects which can account for the hangover effect in some people.
- CHAMOMILE. Many people drink chamomile tea for its gentle sedative properties, although it may cause allergic reactions in those with plant or pollen allergies. To get the full sleep-promoting benefit, bring water to a boil, then add 2-3 tea bags (or the equivalent of loose-leaf tea), cover with a lid, and brew for 10 minutes.
- TRYPTOPHAN. Tryptophan is a basic amino acid used in the formation of the chemical messenger serotonin, a substance in the brain that helps tell your body to sleep. L-tryptophan is a common byproduct of tryptophan, which the body can change into serotonin. Some studies have shown that L-tryptophan can help people fall asleep faster. Results, however, have been inconsistent. It is commonly thought that the higher tryptophan content in meat, particularly turkey, is why people get tired after the Thanksgiving meal. This however is just a myth. What makes you tired is all the fat and all the overeating!
- KAVA. Kava has been shown to improve sleep in people with stress-related insomnia. However, kava can cause liver damage, so it isn’t recommended unless taken under close medical supervision.
Prescription sleep medications
There are several different types of prescription sleeping pills, classified as sedative hypnotics. In general, these medications act by working on receptors in the brain to slow down the nervous system. Some medications are used more for inducing sleep, while others are used for staying asleep. Some last longer than others in your system (a longer half-life), and some have a higher risk of becoming habit forming.
Keep in mind that most of these drugs affect people in different ways and dosing can be very individual. As an example, Ambien affect women significantly more than men so their doses may need to be decreased. Ambien takes 8 hours to clear the body which is why it results in grogginess in many people. It also impacts on REM sleep (the dream stage) to a much greater degree. There are many examples of people acting out on their dreams or even committing various crimes as a result of the effects of Ambien on their sleep.
Benzodiazepine sedative hypnotic drugs are the oldest class of sleep medications. They act on specific gamma-aminobutyric acid-A (GABA-A) receptors. As mentioned above, GABA is a neuropeptide which induces relaxation and helps with sleep but it’s production decreases with age which is why older people have more trouble with sleep. Benzodiazepines as a group are thought to have a higher risk of dependence than other insomnia sedative hypnotics and are classified as controlled substances. Primarily used to treat anxiety disorders, benzodiazepines that have been approved to treat insomnia include:
- Estazolam (ProSom),
- Flurazepam (Dalmane)
- Quazepam (Doral)
- Temazepam (Restoril)
- Triazolam (Halcion)
- Diazepam (Valium)
- Alprazolam (Xanax)
- Chlordiazepoxide (Librium)
- Clonazepam (Klonepin)
- Lorazepam (Ativan)
- Midazolam (Versed)
Drawbacks to benzodiazepines:
- You can become both physically and psychologically dependent on benzodiazepines. When you’re on the pills for a period of time, you may believe that you can’t sleep without them, and once you stop taking them, you may actually experience physical withdrawal symptoms like anxiety and rebound insomnia.
- Sleeping pills can lose their effectiveness if used on a nightly basis, because the brain receptors become less sensitive to their effects. In as little as three to four weeks, benzodiazepines can become no more effective than a sugar pill.
- The overall quality of your sleep can be reduced, with less restorative deep sleep and REM sleep. You may experience next day cognitive slowing and drowsiness (the hangover effect), which may be even worse than the sluggishness you feel from actual sleep deprivation.
- Insomnia returns once you stop, even if the medication is effective while taking it. As with the use of all sleeping pills, rather than dealing with your insomnia, you’re merely postponing the problem.
- There may be a link to dementia. While it’s currently under investigation, there is concern that using benzodiazepines may contribute to the development of dementia.
Non-benzodiazepine sedative hypnotic sleeping pills
Some newer medications don’t have the same chemical structure as a benzodiazepine, but act on the same area in the brain. They are thought to have fewer side effects, and less risk of dependency, but are still considered controlled substances. They include:
- Zalepon (Sonata)
- Zolpidem (Ambien)
- Eszopiclone (Lunesta)
Drawbacks to non-benzodiazepine sleeping pills:
- Generally, non-benzodiazepines have fewer drawbacks than benzodiazepines, but that doesn’t make them suitable for everyone. Some may find this type of sleep medication ineffective at helping them sleep, while the long-term effects remain unknown. The U.S. Food and Drug Administration (FDA) recently directed the manufacturers of Ambien and similar sleeping pills to lower the standard dosage due to the serious risk of morning grogginess while driving, especially in women patients.
- Long half life.
- Drug tolerance
- Rebound insomnia
- Side effects like headaches, dizziness, nausea, difficulty swallowing or breathing
- Dangerous sleep-related behaviors such as sleep-walking, sleep-driving, and sleep-eating
- New or worsening depression and suicidal thoughts or actions
“SLEEPY” Foods and Supplements. Many foods contain compounds which help us relax and can improve sleep. Here are a few.
- Melatonin meal. There are only a few foods which actually contain melatonin. Tart cherry juice and pistachios are the most common. In fact, pistachios have the highest concentration and only 2 pistachios contain the normal physiological dose. Although melatonin is mostly available as a supplement, there are foods which contain it’s precursor, the amino acid tryptophan. It’s actually the precursor to serotonin, the relaxing and happy neuropeptide, which itself is the precursor to melatonin. Both help with sleep however. Turkey is perhaps the best known tryptophan containing food, but other foods also contain significant amounts. Other animal sources like poultry in general as well as dairy contain it which is why some people find a warm glass of milk helpful for sleep. Plant sources include nuts, bananas, broccoli, spinach, oats, chickpeas and chocolate.
- Vitamin B6, found in avocados, beans and seeds, and magnesium, found in leafy greens. These two nutrients, B6 and melatonin, increase levels of GABA, gamma-aminobutyric acis, a relaxing neurotransmitter.
- Phosphatidylserine (PS). This compound has been sown to increase melatonin and decrease elevated cortisol levels, leading to improved circadian rhythms and better sleep. Although small amounts are available from animal products, supplementing can also be helpful. A reportedly help regimen is 100mg of PS, along with an omega3 fatty acid, 3 times a day. It can take a few weeks to change your rhythms.
- L-theanine. This is an immune-boosting compound found in black and green tea and can promote relaxation and sleep. Although those beverages do contain caffeine, L-theanine impacts on how caffeine is metabolized. In fact, people who consume equal amounts of caffeine from teas as opposed to other caffeinated beverages like soda and coffee report significantly lower levels of caffeine-related side effects.
- Glycine. This amino acid is one of the building blocks of serotonin. It lowers core body temperature, a known factor in improving quality sleep. It also stimulates the release of GABA. This is the same neurotransmitter mimicked by prescription sleep drugs such as Ambien (zolpidem). GABA is also used by the body to make glutathione, the most potent antioxidant our bodies can produce which aids in cell protection and repair
- Magnesium. This is another compound with a variety of relaxing benefits, also assisting in sleep. It can be consumed in water (except for reverse osmosis water which has everything removed), as well as green vegetables, nuts, cereals , fruit, especially apples, and some meat and fish. But even if plenty of such foods are consumed, magnesium deficiency is still common. For example, the magnesium content of apples, even organic ones, has dropped by 70% because of not only modern agricultural practices, but also because this important mineral is decreasing in our soil. There are various forms of supplements but for sleep, magnesium glycinate is best.
- Reishi mushrooms. Mushrooms in general have numerous health benefits but as far as sleep goes, reishi induce relaxation overall, and has been shown to be quite beneficial for good sleep.
- Chamomile tea. The “weed” contains numerous relaxing compounds, as well as antioxidants.
- Valerian root. Valerian is an herb but it’s root has been used for hundreds of years to alleviate anxiety and it also helps to improve sleep.
Nutrients which impact negatively on sleep:
- SUGAR. Added sugars, either from processed foods or sugar-sweetened-beverages, reduce your sleep by s minimum of 1 hour a night. Over the course of just one week, that is the equivalent of an entire night’s sleep.
- ALCOHOL. Although alcohol can help you fall asleep faster, it impacts negatively on the duration and the quality of your sleep. Moderate alcohol consumption (~ 2-3 drinks) lower restorative sleep by 24%. Higher amounts impair sleep by 40%. Alcohol also causes a “REM rebound effect”, with REM sleep being delayed and shortened leading to insufficient brain recovery. If you choose to drink, try not to consume anything within 3 hours and drink polenta of water to keep hydrated and to help flush out waste.
- COFFEE. Coffee has numerous beneficial compounds and in fact is the biggest source of antioxidants for most Americans (that’s not a good thing since they drink too much coffee and eat too few fruits and vegetables). The issue with sleep is really the caffeine which causes delayed sleep onset and impacts on sleep quality. Although teas like green tea also have caffeine, they also contain compounds, particularly L-Theonine mentioned above, which help with sleep, basically nullifying the detrimental effects.
TOO MUCH SLEEP. Although most people don’t get enough quality sleep, there is evidence that too much sleep can lead to poor quality and fragmented sleep. This tends to occur once you start to regularly go past 10 hours. Although not clearly understood, the is an association between too much sleep and obesity, cardiovascular disease and early death. When studied in closed, naturally lit environments following the solar rhythms of light exposure, people would tend towards going to sleep earlier (and getting up earlier with the sun) and edge towards 9 hours of natural sleep but no more.
MELATONIN. Known as the “sleep” hormone, melatonin does a lot more than just help up sleep properly. It controls the activity of over 500 genes, many associated with circadian rhythms which are mostly based on light exposure. Remember that we evolved, and our activities were based on the rising and falling of the sun. It also however impacts on immune function inflammation as well as antioxidant activity. Although primarily made by the pineal gland in the brain, melatonin is also produced by cells in the gastrointestinal tract, retina as well as white blood cells, both in the peripheral blood and bone marrow. It’s production, especially in the pineal gland, decreases after 40. Many cells involved in immune function like NK (Natural Killer) cells, Mast cells as well as T cells contain melatonin receptors. Melatonin acts as both an activator of the immune system and an inhibitor of the inflammatory response. Produced primarily by the pineal gland in your brain, this sleep hormone is extremely important for proper sleep function. It gets secreted in the evening and shuts off, usually in the morning when the sun comes up, but ANY light can shut it off, hence the recommendations to avoid any screens within an hour of sleep. It can help with sleep wake cycles, especially with jet lag or shift work, but supplement doses are too high (adults only need 1-1.5 mg, taken ~90 minutes before sleep). Even a 3 mg over the counter dose is more than 50x the normal circulating amount of naturally occurring melatonin in the body. At higher doses, it actually can worsen sleep partly by blocking natural melatonin production. In addition, melatonin acts as a contraceptive and is actually prescribed as such in some countries. I was first called the “anti-gonad” hormone since it shrunk the sex organs of animals it was tested on. It can impact on not only fertility but other hormone-related issues. There are some studies suggesting that high doses of melatonin can help treat cancer but this is obviously a unique situation. It is the 4th most popular natural supplement in adults and 2nd in kids (first is fish oil in both age groups). About 1.5% of adults and 1% of kids take it as a sleep aid. Although melatonin can help restore sleep patterns if you travel and cross time zones, there is little evidence that it helps when taken regularly. The effect seems to be a placebo effect. If you do use melatonin, make sure it is from a reputable, third-party verified source since supplements are not regulated. A recent review showed that the range of actual melatonin in the 35 most popular brands varied by 400%, most of them having much less melatonin than advertised. They had anywhere from 0 (none) melatonin in it and up to 150x more than indicated on the bottle. The highest level was in a chew-able pediatric formulation. In addition, 66% of melatonin samples tested contained unidentifiable impurities. The companies making them are not required to and therefore don’t do purity tests. An independent firm however identified molecular similarities between the melatonin contaminant and a contaminant that killed 30 people and sickened 1500 in the 1990’s found in a tryptophan supplement, sold as a sleep aid as well since its molecular structure and effects are similar to those of melatonin.
Melatonin is a hormone produced by the pineal gland in the brain. The pineal gland starts to produce melatonin as the light starts to go down in the evening and production shuts off with light exposure. As mentioned in other locations on this site, even brief glances at your cellphone is enough to turn off melatonin production which is why you want to stop looking at screens at least an hour before sleep. Even if you are able to fall asleep, lower melatonin levels (by as much as 50% with screen use) impacts on sleep quality. Although known as the “sleep” hormone, helping us fall and stay asleep, it is now known to have other functions like turning off oxidation which generates damaging free radicals as well as dampening down inflammation. Melatonin also slows digestion since we were not meant to be eating and digesting before bed. This is why people have more reflux at night, in addition to the obvious changes in positions.
Melatonin is also made by the cells lining the intestines, the enterocytes. The gut actually produces 400x more melatonin than the brain does. The gut also produces 80-90% of the serotonin, the “happy” neurochemical as well as 50% of the dopamine in the body.
Keep in mind that the more and the more often you take melatonin, the less effective it becomes. Regular use downregulates melatonin receptors leading to the need for higher and higher doses to get achieve the same effect.
SUNGLASSES and melatonin. There is more on this below but n a nutshell, when you wear sunglasses first thing in the morning on your way to work, you trick the brain into thinking that it is still dark and you need to sleep, in addition to many other hormones, melatonin production is disrupted which keep your tired and impacts on sleep-wake cycles. Don’t wear sunglasses the first 30 minutes of the day. Let the sun hit your eyes so melatonin production stops.
There are melatonin rich foods as well. There are many examples but the most potent are pistachios (only 2 nuts give you the normal circulating amount) and cherries (whole, not dried or in juice form which destroys the melatonin). Other examples are bananas, oranges and pineapple. the highest animal source of melatonin is salmon but you would need to eat 200 lbs. to get adequate levels.
Although the pineal gland in the brain produces most of the light-sensitive melatonin our sleep cycles rely on, the gut bacteria as well as the thyroid gland also produce melatonin. This is another example of how integrated all our organs are and how important it is to keep your gut microbiome and your thyroid healthy. An additional interesting point is that melatonin is also an antioxidant adding to its importance for good health.
Blue light theory. Why are we so sensitive to blue light? There are a few theories but the most supported one simply has to do how we evolved. All life emanated from the oceans. The reason the oceans are blue is that water refracts out yellow and red making it look blue. The rising of the sun brought with it a very potent blue stimulus resulting in the evolution of blue light sensitive tissues, especially the cells in the back of the eye called photo receptors.
The idea that some people are naturally inclined to stay up later or wake up earlier is a myth. When allowed to fall asleep and wake up according to the natural patterns of the sun, the difference between “night owls” and “morning larks” was a mere 30-60 minutes. The artificial light we are exposed to changes our sleep wake cycles unnaturally. Today, we are exposed to 10,000x more light at night than we were in the 1700’s. This additional light exposure can shift the body clock by 3 hours.
Abnormal brain patterns seen when a person is severely stressed are the same as those seen in people who have loss of sleep.
The most important part of getting proper circadian rhythms going in the body is getting the right kind of light at the right time. In a nutshell, you want as much exposure to light, particularly sunlight in the morning and as little light as possible after the sun goes down. Morning light has more blue wavelengths and evening light has more red wavelengths. The physics and explanations if this are complicated but it has been this way as long as man has been on the earth. This explains why a clock radio with red light is the most soothing and that blue light in the morning is the most energizing and uplifting. A great example of how blue light affects mood is demonstrated by what happened in Japan when they installed blue light LEDs in subway stations and had them running during the morning commute. The incidence of subway-related suicides (the most common form in Japan which has the highest suicide rate of all developed countries) fell by an amazing 84%. In the morning, let your eye be exposed to the sunlight. Don’t block the sun’s beneficial effects with sunglasses.
THE 6 “WHYS” of SLEEP (From Dr. Rangan Chattergee’s book “The Stress Solution”)
- WHY DO WE SLEEP? Although many of the reasons we need sleep and processes which occur during sleep are not clear, we do know sleep is critical for clearing the waste which occurs during the day.
- WHY DO WE DREAM? There are many theories as to the benefits or purpose of dreaming but overall, we just don’t know the answers. We do know that dreaming improves our ability to be creative and improves problem solving.
- WHY DO WE FEEL SNAPPY WHEN WE’RE TIRED? Sleep deprivation, even a little, put the amygdala, the emotional part of the brain, into overdrive. The amygdala is responsible for triggering emotions such as fear, sadness, anger and rage.
- WHY DO WE STRUGGLE TO CONCENTRATE WHEN WE’RE TIRED? The prefrontal cortex, the part of the brain responsible for administrative tasks and decisions making, is less able to function when sleep deprived. The Amygdala is more assertive. We become more reactive and less thought out.
- WHY DOES LACK OF SLEEP RESULT IN WEIGHT GAIN? Simply put, the balance between the satiety hormone leptin and the hunger hormone ghrelin is thrown off, with the former decreasing and the latter increasing. Fatigue also impairs judgment and makes you more impulsive.
- WHY IS IT HARD TO SLEEP IN HOTEL ROOMS? From an evolutionary standpoint, when we are in unfamiliar surroundings, our autonomic nervous systems are on high alert for unexpected threats. One response if for the brain to not allow us to go into the deeper, more restful stages of sleep, just in case we need to get up quickly to defend ourselves.
INSOMNIA. Insomnia is not just the inability to fall asleep. It is also difficulty returning to sleep if you wake up or waking up to early and not being able to return to sleep. It’s the most common sleep disorder, affecting almost 40 million American adults annually. It is defined as having difficulties at least 3 nights a week for at least 3 months in a row. It tends to affect more women than men. You can get it at any age, but older adults are more likely to have it. You are also at higher risk of insomnia if you:
- Have a lot of stress.
- Are depressed or have other emotional distress, such as divorce or death of a spouse.
- Have a lower income.
- Work at night or have frequent major shifts in your work hours.
- Travel long distances with time changes.
- Have an inactive lifestyle.
- Have poor sleep habits or known lifestyle habits which affect sleep. These include:
- Caffeine consumption after noon or in excessive amounts.
- Alcohol consumption. Even 1 drink can affect sleep quality.
- Medications such as sleep aids, steroids, decongestants or psychiatric medications.
- Lack of exercise or exercising too close to bedtime.
- Excessive use of devices such as computers, tablets or smartphones, especially with an hour or 2 of sleep.
- Are African American. Research shows that African Americans take longer to fall asleep, don’t sleep as well, and have more sleep-related breathing problems than Caucasians.
Symptoms of insomnia include:
- Lying awake for a long time before you fall asleep.
- Sleeping for only short periods.
- Being awake for much of the night.
- Feeling as if you haven’t slept at all.
- Waking up too early.
- Drowsiness most of the day.
- Memory problems.
Recommendations for insomnia:
- Address all the modifiable lifestyle/risk factors like:
- Medical problems like thyroid disease.
- Reduce caffeine and alcohol consumption.
- Adding routine exercising but avoiding it late in the day.
- Maximize your bedroom environment. Keep it quiet, dark and cool and do not do anything else like work or watch TV since the brain learns to associate location with activities.
- Cut out the screens and dim the lights 1-2 hours before planning to go to sleep.
- Stress reduction…
- Avoid sleeping pills. These do not help and actually make things worse. There is a nominal benefit over placebo (sugar pill) and the downsides are too great.
- First line treatment is cognitive behavioral therapy for insomnia (CBTI). The benefits are a little better than medications but without any risk and much longer lasting effects (up to 5 years) whereas with medications, when you stop, there is a rebound worsening of sleep disruption and then you go back to the regular poor patterns.
Oddly enough, spending less time in bed when you can’t sleep may help with your sleep efficiency. If the brain “learns” that the bed is where you lay around and not just sleep, it may be harder to fall asleep. Only go to bed when you are really tired and ready for bed. By falling asleep faster, your brain learns that the bed is only for sleep and you sleep efficiency will improve. Remember that a little less but better quality sleep is better than more but poorer quality sleep.
Get a sleep study. This is a test where your sleep is analyzed professionally by a doctor. Although snoring and sleep apnea as well as insomnia are the most common sleep disorders, there are about 10 sleep disorders that doctors are aware of. This includes something like restless leg syndrome. A sleep study may help diagnose your sleep problem and you will be able to fix it more efficiently. There are sleep monitoring and analyzing devices like rings (Oura or Motiv), wrist bands (Apple watch, Whoop, or Fitbit) or even headbands (Muse or Dream 2) which can track sleep and give you information but they are not as thorough as a professional study, nor do they offer the professional analysis of the data.
“Sleep Smarter” Shawn Stevenson
“Why We Sleep“. Matthew Walker, PhD
As important as sleep is, how you wake up can be just as important. It sets the tone for the day.
The vast majority (85%) of Americans wake up to the jarring sound of an alarm clock. The main problem with alarms is that they might wake you up in the middle of part of the the sleep cycle during which you should not be waking up. This can cause more drowsiness. Waking up naturally ensures that you wake up when you are supposed to during the cycle.
More and more, the alarm clock of choice is a smartphone. In addition to the jarring sound, there is an almost immediate insult on the eyes and the brain. 25% of people look at their phone within 1 minute of waking up and 50% are checking email or social media within 10 minutes. This is imply not healthy. Hitting the central nervous system like this day after day is quite stressful.
As far as hitting the “snooze” button goes, this causes more damage than good. It’s much better to just get up. Snoozing never allows the full 4 phases of sleep to occur so you will likely wake up even more drowsy than when you were first startled out of sleep.
Money and work are the first things on the minds of most Americans (56% of men and 48% of women) when they wake up in the morning. This also contributes to the immediate, get up and go effect on the brain. Although the brain is more active when you are asleep than when you are awake, it is busy doing it’s own thing rather than being forced to think about what we want.
It is also very important to get plenty of sunlight first thing in the morning. I discuss this a bit more in the section on sunglasses. It’s important to trigger those photo-receoptors in our eyes as much as possible first thing in the morning.
Early bright light exposure sets the biological clock. It tells us that “this is when the day starts”. The circadian clock controls 20% of our genome, many of which are involved in metabolism and inflammation.
When humans were exposed to 10,000 lux, approximately what the sun provides, first thing in the morning and for 7 hours, cortisol levels were reduced by 25% during the next day. Translation, GET OUTSIDE. Cortisol is an important stress hormone but chronic cortisol elevation turns on all kinds of inflammatory genes. It causes muscle and brain atrophy, weight gain, chronic inflammation…
SUNGLASSES, HORMONES and SLEEP
Although fashionable to wear and they may provide some protection to the eyes from the sun’s rays, these staples of daily life may be causing more damage than good. Humans did not evolve wearing sunglasses. In 1913, Crookes lenses were introduced, made from glass containing cerium, which block ultraviolet light. In the early 1920’s, the use of sunglasses started to become more widespread, especially among movie stars. Inexpensive mass-produced sunglasses made from celluloid were first produced by Sam Foster in 1929.
Humans also did not evolve with a depleted ozone layer. The amount of UV rays from the sun has increased significantly in the last 50 years. Cataracts, retinal melanomas and skin cancer occur to a much greater degree. Sunglasses can protect the eyes but it’s all a matter of degree. If you are out in the sun for a short time, you don’t need sunglasses. Spending the day at the beach or on a hike may be another issue.
Also keep in mind that the more you wear sunglasses, the more sensitive your eyes become to the sun’s rays. Light (sun) sensitivity is a trained condition.
Sunglasses trick your eyes and brain into thinking that it is still dark. In doing so, one of the myriad of effects is continued melatonin production. In essence, this tricks the brain into thinking you still need to sleep. Melatonin disruption impacts not only sleep-wake cycles but many aspects of our bodies circadian rhythm.
In addition, serotonin, the “happy” neurotransmitter levels are inhibited. Diminished serotonin is seen in Seasonal Affective Disorder, the depression which occurs in the winter in some people. Wearing sunglasses all the time leads to chronic diminished serotonin production and is implicated in generalized depression.
Melatonin also impacts on the pineal glands production of melanotropin stimulating hormones, known collectively as MSH, also known as melanotropins or intermedins. These protect the skin. Commonly known as the skin pigment hormone, its production is stimulated by UV light from the sun. It’s responsible for the skin darkening (tanning) which is a protective mechanism against the damaging effects of the sun’s ultraviolet waves. It also thickens the skin a bit adding to the protection. When melanin production is inhibited, these protective mechanisms do not occur and skin sensitivity increases leading to easier burning and skin cancer rates. Morning light in the eyes helps to prepare the skin against burning. Diminished melanocytes also impact on vitamin D production which impacts on our immune function overall.
If you must wear sunglasses, at least keep the first 30 minutes of the day sunglass free. Let your body get used to the fact that you are awake and that the sun is up. Let the day begin.
EYES – THE VISIBLE PART OF THE BRAIN
The eyes are the most ancient biological system which, at its most fundamental level tells the brain when to be awake and when to sleep. The original purpose of the brain is not to perceive things around us but to set the alertness and sleepiness of the brain.
There is a saying that the eyes are a “window to our souls”. Assuming that the brain, the soul and consciousness in general are all related, that statement is certainly true. The eyes are actually a physical part of the brain which has been squeezed out during development in the uterus. The eyes are the only part of the central nervous system (CNS) which is outside of the skull. The retina is actual CNS tissue.
The FOVEA is a very small part of the retina, the back of the eye, where the highest concentration of photoreceptors is located. About 90% of all the photoreceptors are located in this area. It’s the “high-resolution” part of the eye. In humans, it’s a small circular area in the middle of the retina, providing very high central visual acuity. Our peripheral acuity is much poorer. In elephants, the area is a “J” shaped area so it can see the tip of its trunk better. In the sloth, their fovea is towards the top of the retina since they tend to hang upside down and need to see the jungle floor better. Diving birds have a horizontal “visual streak”. This allows them to scan the horizon better. In addition, they are capable of adjusting their vision to make up for the refractive index of the water. Because of how light bends when it goes from air to water, refraction, the fish we see are not exactly where we see them. Birds can make up for this and adjust their dive trajectory to hit their target more accurately.
The nerve cells on the retina of the eye are called ganglion cells and they connect the eye to the rest of the brain. There are different kinds of ganglion cells. Some are high acuity cells. Some are responsible for picking up movement. Some respond to color. There are a set of ganglion cells called melanopsin cells which pick up the ultraviolet light from the sun and are sensitive to specific colors, or bandwidths. These are the ones responsible for telling the brain to wake up or go to sleep by stimulating the pineal gland to either make or stop making melatonin, the “sleep hormone”. This is why it is very important to get as much sunlight as possible first thing in the morning and limit light after the sun goes down. Although they do respond mostly to the blue light, they also respond to yellow and orange. As the sun rises, the blues get darker and the yellow orange wavelengths get brighter. The opposite happens as the sun goes down. This phenomenon is present in every animal and it impacts on numerous things such as:
- Melatonin production and hence sleep/wake cycles and all the things that go on during sleep.
- Production of cortisol, the stress hormone.
- Heart rate.
- Melanin production. This hormone leads to protection of the skin by tanning. See the section about sun protection.
Ideally, you want to get 10 minutes of sun within the first 30 minutes of getting up, or at some time in the morning as soon as possible. Also, limit earring sunglasses in general, especially in the morning. Sunglasses trick the brain into thinking it’s time to go to sleep.
Many disorders are associated with lack of sunlight. For example, these cells connect to a part of the brain known as the habenula. It is located very near the pineal gland, which makes melatonin among other hormones, and has various functions itself. One of the connections it makes is to the pancreas, which makes insulin. Lack of sunlight stimulation has been shown to result in impaired insulin function, insulin resistance, leading to blood sugar abnormalities and eventually diabetes. Interestingly, smoking also impairs this habenula-pancreas pathway and explains why smokers are also at increased risk for diabetes.
All cells in the body have their own internal clock which responds not only to the sunlight, but the timing and duration of the sunlight. The daily rhythms of the body are called circadian rhythms but they also have monthly and yearly rhythms called circannual rhythms. These are associated with the changes of the seasons which are impacted by changes in duration as well as the angle of sunlight.
Neuroplasticity is the term describing the brain’s ability to change based on experience. A simple example of this is how people who stop consuming added sugar or salt, have changes in their perception of those tastes within 2-3 weeks. When you cut back on sugar, fruits taste sweeter, closer to their natural state. Vegetables like celery taste saltier, again, they way they are supposed to taste because of naturally occurring salts.
Alertness and focus on a subject produce the compound acetylcholine which “marks” new neuronal connections but at night, when we sleep, consolidation of those connections occurs. This is when the growth hormone BDNF, Brain Derived Neurotropic Factor, also known as abrineurin, acts.
More focus = more plasticity
More rest (meaning more and better sleep) = more reinforcement and recovery.
Other things which impact on sleep and neuroplasticity include exercise and foods. Exercise increases IgF-1 in the brain which increases neurogenesis, growth of new nerve tissue.
Whatever increases dopamine in the brain, also helps with neuroplasticity. Dopamine is the neuropeptide produced as a reward, but not only as a response to some stimulus, the “win”, but also as a response to the process of moving towards the “win”. There is benefit in the work itself.
The Mucuna prurien bean, also known as broad beans and velvet beans, contains a significant amount of the compound L-dopa in its skin. Parkinson’s Disease is a neurodegenerative condition highlighted by a gradual decrease in dopamine in the brain and one of the pharmacologic treatments is to take L-dopa in a synthetic form. Mucuna prurien has long been used in traditional Ayurvedic Indian medicine in an attempt to treat diseases including Parkinson’s disease. It has been investigated in low income regions of the world as an alternative treatment for Parkinson’s disease due to its high content of L-dopa. Mucuna prurien seeds have been recognized for their ability to significantly alleviate neurotoxicity induced by Parkinson’s disease. Other foods such as bananas, nuts and dark chocolate contain significant levels of dopamine.
SNORING and SLEEP APNEA
When it comes to sleep quality and duration, a really important thing to be aware of is the presence of snoring and/or sleep apnea. These conditions are part of a continuum of “upper airway resistance” but both can have a significant impact on sleep duration and, more importantly, sleep quality, not only for the patient but all those around them whose sleep can be affected.
SNORING is basically noisy breathing while you sleep. It’s a common condition affecting as many as 40% of Americans who experience it regularly and 25% who do it all the time. It can affect anyone at any age, although it happens more often in men and people who are overweight. Snoring tends to get worse with age. It worsens with fatigue, things like allergies and nasal polyps which impact on nasal breathing and anything which relaxes muscles like alcohol and excessive fatigue.
Occasional snoring may not be a serious problem to the individual, but it can be a nuisance for your bed partner or others in your household. But if you’re a long-term snorer, you not only disrupt the sleep patterns of those close to you, you hurt your own sleep quality. It becomes more than a nuisance and can be unhealthy. On average the person who sleeps with someone who snores, loses 1 hour of sleep a night!
Snoring can itself be a symptom of a health problem like obstructive sleep apnea which is where the airway resistance is so bad that you can stop breathing and oxygen levels start to drop significantly. If you snore often or very loudly, you might need medical help so you (and your loved ones) can get a good night’s sleep.
Snoring happens when the flow of air through your mouth and nose is blocked. Several things can interfere with air flow, including:
- Blocked nasal airways. Some people snore only during allergy season or when they have a sinus infection. Anatomic problems such as a deviated septum (when the wall that separates one nostril from the other is off-center) or nasal polyps, often caused by allergies, can also block your airways. Studies show that mouth breathing can increase snoring by as much as 5000% as compared with nasal breathing.
- Poor muscle tone in your throat and tongue. Throat and tongue muscles can be too relaxed, which allows them to collapse into your airway. Tone decreases with anything which relaxes muscles like alcohol but don’t overlook lack of exercise! When you lift weights, you also increase core muscles, which include those of the throat.
- Retrognathia. When the chin is small or positioned behind the middle of the face (retro-positioned), all the tissues attached to your chin, primarily your tongue, are also positioned further back, crowding the back of the throat. The smaller and the more retro-positioned the chin, the worse it can be. In extreme cases, the jaw needs to be broken, advanced and wired shut for 6 weeks, although this is rare.
- Bulky throat tissue. Being overweight can certainly contribute to this. Some children, and adults, have enlarged tonsils and adenoids that make them snore.
- Long soft palate and/or uvula. A long soft palate or a long uvula (the tissue in the back of your mouth in the middle of the soft palate which looks like a punching bag) can narrow the opening of your throat. When you breathe, the palate and tonsils vibrate and bump against one another..
- Alcohol and drug use. Drinking alcohol or taking muscle relaxers can also make your tongue and throat muscles relax too much.
- Sleep position. Sleeping on your back can make you snore since everything flops back.
- Sleep deprivation. Your throat muscles might relax too much if you’re not getting enough sleep.
Snoring Diagnosis is usually made by the experiences of family members or partners. Your partner might be the person who tells you that you snore. If there is concern about sleep apnea, a sleep study may be ordered which looks at how often you stop breathing and how low your oxygen goes. Keep in mind that everyone stops breathing at night during sleep. There are periods during the sleep cycle where muscles are temporarily paralyzed. This is normal. Stopping for up to 10 seconds for up to 5 times an hour is considered normal.
Treatments for snoring include:
- Lifestyle changes. Lose weight, stop drinking alcohol before bed, improve your diet.
- Exercise is important not only because it helps you lose weight but it also helps tone up all your muscles, including the ones which support your upper airway.
- Oral appliances. You wear a small plastic device in your mouth while you sleep. It keeps your airways open by moving your jaw or tongue.
- Chin support straps which use stretchy material and Velcro to keep the mouth closed, forcing you to breathe through the nose which is more natural than mouth breathing.
- Surgery. Several kinds of procedures can help stop snoring by shrinking tissues in your throat, or make your soft palate stiffer.
- CPAP. A continuous positive airway pressure machine treats sleep apnea and might reduce snoring by blowing air into your airways while you sleep.
Try these other home remedies to get a good night’s sleep. Many are outlined above.
- Sleep on your side, not your back. When you’re on your back, everything flops back and blocks the airway.
- Raise the head of your bed a few inches. It’s better to elevate the bed than use more pillows which can actually make things worse by flexing the neck and blocking things. Also, reflux is worsened when you use pillows and flex your torso.
- Use elastic strips (Breathright Strips) that stick to the bridge of your nose to widen your nostrils. These open the “nasal valve”.
- Nasal stents accomplish the same thing. They are silicone baskets with holes in them that you stick in your nostrils and keep the valve open from the inside. They sound a little wacky, but they work. Check out Sinus cones or Max Air Cones.
- Use decongestant sprays to open your nasal passages. Don’t use them for more than 3 days without talking to your doctor as they are addictive and can actually cause sinus infections.
- Stick to a sleep schedule. Regularity, especially when you wake up, is crucial to good quality sleep.
- Lose weight.
- Limit alcohol consumption. Alcohol might help you fall asleep but it relaxes muscles allowing soft tissues to flop around more. Alcohol also impairs proper sleep function by changing the various sleep stages.
- Sleep medications similarly can help you fall asleep but do not provide quality sleep.
- Change sleep positions to improve breathing. Don’t sleep on your back.
- Stop smoking. Smoking can increase swelling in your upper airway, which may make both snoring and apnea worse.
SLEEP APNEA is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep enough that oxygen levels drop. Obstructive sleep apnea (OSAS) is estimated to affect as many as 31% of men and 21% of women. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times a night. This means the brain,and the rest of the body, may not get enough oxygen. In response to lower oxygen levels, the heart is forced to pump harder and more frequently to accommodate which, night after night, month after month, leads to major heart problems.
There are two types of sleep apnea:
- Obstructive sleep apnea syndrome(OSAS). The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep. Contributing to this collapse can be a small chin, narrow jaw, blocked nose and simply excessive weight and fat deposits.
- Central sleep apnea. Unlike OSAS, the airway is not blocked, but the brain fails to signal the muscles to breathe, due to instability in the respiratory control center. People with severe enough OSAS do develop central apnea and this is usually a sign of lack of oxygen to the brain.
Sleep apnea can affect anyone at any age, even children. Risk factors include:
- Being male.
- Being overweight. Although plenty of thin people have apnea, there is a direct correlation between weight and severity of OSAS.
- Being over age 40, although kids can have it as well, Although traditionally related to enlarged tonsils and adenoids, given the obesity crisis in our kids with 20% being obese, they are now subject to the same risks that adults face.
- Having a large neck size (17 inches or greater in men and 16 inches or greater in women), also associated with weight and obesity.
- Having large tonsils, a large tongue, or a small jaw bone.
- Nasal obstruction due to a deviated septum, allergies, or polyps
HEALTH EFFECTS OF SLEEP APNEA. If left untreated, sleep apnea can increase the risk of health problems, including:
- High blood pressure.
- Heart failure, irregular heart beats like atrial fibrillation, and heart attacks.
- Diabetes. Poor sleep disrupts Insulin sensitivity, the cause of diabetes.
- Depression. Poor sleep impacts on brain function and emotions.
- Worsening of ADHD.
- Headaches. Chronic low oxygen causes inflammation.
- Chronic fatigue. OSAS is thought to account for the majority of road accidents in the US.
In addition, untreated sleep apnea may be responsible for poor performance in everyday activities, such as at work and school, motor vehicle crashes, and academic underachievement in children and adolescents.
DIAGNOSIS. Diagnosing snoring does not take complex detective work. Either you make sounds, usually pretty awful sounds heard by a bed partner, or you aren’t. The question is whether or not your sleep is being disrupted enough to impact on health. As mentioned above, stopping breathing during sleep is normal but if it happens for too long or too often or if your oxygen levels drop too low, that can be dangerous. The general rule of thumb for adults is 10 seconds of not breathing for up to 5 times an hour is considered normal. Any more than that and you may have sleep apnea.
If you have symptoms of sleep apnea, your doctor may ask you to have a polysomnogram, a sleep apnea test. This may be done in a sleep disorder center or, more commonly these days, at home. Although there is a smartphone app (Snorelab) which can help with diagnosis, usually, you need some specialized equipment prescribed by a sleep specialist. A sleep study is a multiple-component test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have sleep apnea or another type of sleep disorder. If sleep apnea is determined, you may be asked to do further sleep testing in order to determine the best treatment option.
During a sleep study, surface electrodes will be put on your face and scalp and will send recorded electrical signals to the measuring equipment. These signals, which are generated by your brain and muscle activity, are then recorded digitally. Belts will be placed around your chest and abdomen to measure your breathing. A bandage-like oximeter probe will be put on your finger to measure the amount of oxygen in your blood.
Other Tests also done during a formal sleep study may include:
- EEG (electroencephalogram) to measure and record brain wave activity.
- EMG (electromyogram) to record muscle activity such as face twitches, teeth grinding, and leg movements, and to determine the presence of REM stage sleep. During REM sleep, intense dreams often occur as the brain undergoes heightened activity.
- EOG (electro-oculogram) to record eye movements. These movements are important in determining the different sleep stages, particularly REM stage sleep.
- ECG (electrocardiogram) to record heart rate and rhythm.
- Nasal airflow sensor to record airflow.
- Snore microphone to record snoring activity.
TREATMENTS FOR SLEEP APNEA. Similar to snoring, treatments can include lifestyle changes, such as losing weight or changing sleep positions, medical devices like CPAP machines, or surgery. You may be able to treat mild sleep apnea with some lifestyle changes. Your doctor may recommend that you:
Continuous Positive Airway Pressure (CPAP). With continuous positive airway pressure, CPAP, you wear a mask over your nose and/or mouth while you sleep. The mask is hooked up to a machine that delivers a constant flow of air into your nose. This airflow helps keep your airways open so you can breathe the way you should. CPAP is the most common treatment for sleep apnea. Bi-level positive airway pressure, or BiPAP, is similar to CPAP except that the airflow changes when you breathe in and out.
Oral Appliances for Sleep Apnea. Dental devices can help keep your airway open while you sleep. Dentists with special expertise in treating sleep apnea can design them for you. There are some devices that are effective and are available online. A few companies include Zyppah and SnoreEase.
Surgery for Sleep Apnea. You might need surgery if you have a medical condition that makes your throat or nose too narrow. These conditions include enlarged tonsils, a small lower jaw with an overbite, or a deviated nasal septum (when the wall between your nostrils is off-center).
The most common types of surgery for sleep apnea include:
- Nasal surgery: This fixes nasal problems such as a deviated septum, enlarged nasal turbinates or removal of polyps or other lesions.
- Uvulopalatopharyngoplasty (UPPP): This takes out soft tissue from the back of your throat and palate, making your airway wider at the opening of your throat.
- Tonsillectomy and/or adenoidectomy if enlarged.
- Mandibular maxillomandibular advancement surgery: This fixes certain facial problems or throat blockages that play a role in sleep apnea.
- Somnoplasty. Procedures done in your doctor’s office can shrink and stiffen the tissue of your soft palate.
- Upper airway stimulation (UAS). If you can’t use a CPAP, you might get a device called Inspire. It’s an upper airway stimulator. Your doctor puts a small pulse generator under the skin on your upper chest. A wire that goes to your lung detects your natural breathing pattern. Another wire up to your neck sends mild signals to the nerves that control your airway muscles, keeping them open. You can use a handheld remote control to turn it on before bed and turn it off after you wake up.
When a baby is born, if the baby can’t breathe through its nose for some reason, it will suffocate unless it develops the ability to breathe through its mouth. This ability is encouraged by using something called a McGovern nipple, a bottle nipple with slits and holes cut into the tip. While sucking on the jerry rigged nipple, the baby is able to breathe through its mouth. That is how powerful the drive to breathe through our noses is.
The air we breathe is first processed through the nose. The nose is a miraculous filter lined with tiny hairs called cilia. The cilia have many functions. They move the mucus produced by the nose and sinus lining, which can be as much as ½ a gallon a day! They also filter, humidify and warm or cool the air before it enters the lungs. It is estimated that cilia protect our bodies against about 20 billion particles of foreign matter every day! By the time the air you breathe in through the nose hits the back of the nose, it’s 100% humidified, body temperature and cleaned of almost all the particulate matter suspended in it.
Once it exits the nose, air passes through the mucus-lined windpipe. This is another avenue to trap unwanted residual particles before they enter the lungs. The air then enters the lungs, where the oxygen (O2) is pumped into the bloodstream and circulated through the body. In exchange, the air leaving the body carries with it carbon dioxide (CO2) from the cells, a waste material that is expelled through exhalation.
Breathing through the nose is the way our bodies were designed. In fact, it’s been said that breathing through your mouth is about as practical as trying to eat through your nose! Most people breathe at 10-20% of their full capacity. Restricted breathing greatly decreases respiratory function, which in turn decreases energy levels in the body. Since oxygen is our main source of life, and exhalation is the main way to expel toxins from our bodies, poor breathing can contribute to a multitude of health problems, from high blood pressure to insomnia.
Many of us feel stressed out, overworked, and overstimulated during our daily lives, which leaves us in a chronic state of sympathetic (fight or flight) response. Breathing in and out through the nose helps us take fuller, deeper breaths, which stimulates the lower lung to distribute greater amounts of oxygen throughout the body. The lower lung is rich with the parasympathetic (rest and digest) nerve receptors associated with calming the body and mind, whereas the upper lungs, which are stimulated by chest and mouth breathing, prompt us to hyperventilate and trigger sympathetic nerve receptors.
Another reason to embrace proper nasal breathing? It can enhance your workout! Not only does breathing through the nose improve respiration overall, the nose and sinuses are a vital source of Nitric Oxide (NO), a gas produced by the endothelial cells which line all blood vessels, as well as an enzyme located in the lining of the nose. NO relaxes arteries, improving blood flow and has been shown to improve athletic performance. The nose and sinuses generate as much as 25% of the NO in our bodies so nasal health is critical. Keep it moit and healthy. NO also comes from foods like beets and greens, and the nitrites they contain are converted into NO in the stomach. Beet juice has become a staple of many endurance athletes for this reason.
You can get NO also by eating foods rich in the amino acids Arginine and Citrulline, which are the precursors to NO. Some foods rich in these amino acids include:
- Pumpkin seeds
- Soy beans
- Pine nuts
Here are a few more of the benefits of nasal breathing:
- The lungs actually extract oxygen from the air during exhalation, in addition to inhalation. Because the nostrils are smaller than the mouth, air exhaled through the nose creates a back flow of air (and oxygen) into the lungs. Because we exhale more slowly through the nose than we do through the mouth, the lungs have more time to extract oxygen from the air we’ve already taken in.
- When there is proper oxygen-carbon dioxide exchange during respiration, the blood will maintain a balanced pH. If carbon dioxide is lost too quickly, as in mouth breathing, oxygen absorption is decreased, which can result in dizziness or even fainting. It’s harder to get light headed hyperventilating through the nose than through the mouth.
- Air that we inhale through the nose passes through the nasal mucosa, which stimulates the reflex nerves that control breathing. Mouth breathing bypasses the nasal mucosa and makes regular breathing difficult, which can lead to snoring, breath irregularities and sleep apnea.
- Breathing through the nose forces us to slow down until proper breath is trained. Proper nose breathing reduces hypertension and stress. It also helps prevent us from overexerting ourselves during a workout.
- Our nostrils and sinuses filter and warm/cool air as it enters our bodies.
- Our sinuses produce nitric oxide, which, when carried into the body through the breath, combats harmful bacteria and viruses in our bodies, regulates blood pressure and boosts the immune system.
- Mouth breathing accelerates water loss, contributing to dehydration. Mouth breathers lose 40% more water while sleeping than nasal breathers do.
- Mouth breathers have significantly more dental cavities.
- Mouth breathing increases snoring by as much as 5,000%.
- The nose houses olfactory bulbs, which are direct extensions of part of the brain called the hypothalamus. The hypothalamus is responsible for many functions in our bodies, particularly those that are automatic, such as heartbeat, blood pressure, thirst, appetite and sleep cycles. The hypothalamus is also responsible for generating chemicals that influence memory and emotion.
- The increased oxygen we get through nasal breath increases energy and vitality.
Belly breathing rather than chest breathing, in conjunction with nasal breathing, is the most efficient way to achieve optimal health. Many people who breath through the mouth too much are also shallow chest breathers. Poor posture and a sedentary lifestyle contribute to this ineffective and unhealthy way of breathing. Instead, focus on breathing through the nose and into the belly. The breathing muscle is the diaphragm, which should rise and fall with each breath, producing a belly movement. This movement massages the stomach and vital organs of digestion, promoting good elimination, another way to remove toxins from the body. This type of breathing also stimulates the vagus nerve, a cranial nerve that starts in the brain stem and extends, down below the head to the neck, chest and abdomen, where it contributes to the innervation of many organs of the body. Besides output to the various organs in the body, the vagus nerve conveys sensory information about the state of the body’s organs to the central nervous system. 80% of the traffic along this nerve is to the brain.
Nasal irrigation is one way to remove nasal mucus, which has all the debris you breathe in trapped in it. If you have seasonal allergies and have been out or if you are ill, doing a nasal rinse once or twice a day can be helpful. Overdoing it on the saline however can actually dry out the nose. Saline and water are thin and evaporate quickly and in so doing, dry out the nasal lining. So don’t overdo it.
Clues that you may be a mouth breather include:
- Getting up at night to urinate more than once or twice.
- Restless sleep.
- Bad breath in the morning.
- Gingivitis or bleeding gums.
- Teeth grinding.
- Excessive numbers of cavities, a result of increased acidity and dryness of the mouth leading to improper bacterial balance.
- Drooling on the pillow.
- Dry mouth and drinking water through the night.
- Worsening allergies and nasal stuffiness. Many people report improved nasal breathing within only a few days of practicing nasal breathing.
One simple way to improve nasal breathing at night is to use tape to seal the mouth. Although this sounds dangerous and should be avoided in infants, small children and cognitively impaired adults, for everyone else, they are perfectly safe. Just a few weeks of using them often changes breathing patterns, establish new nasal breathing habits and improves nasal breathing overall. 2 products are helpful. Micropore Tape by 3M and Somnifix (more expensive). Alternatively, there are chin straps which help to keep the mouth closed.
Two great references about the importance of breathing and specifically nasal breathing are:
“BREATH: The New Science of a Lost Art” by James Nestor and
MANAGE STRESS and PMA (Positive Mental Attitude)
“Stress is not what happens to you. Stress is how you respond to what happens to you”.
The term “stress”, as it is currently used was coined by French Endocrinologist Hans Selye in 1936, who defined it as “the non-specific response of the body to any demand for change”. He also stated the the absence of stress = death. To be alive is to be stressed but modern society puts us under a constant type of unhealthy stress. The WHO (World Health Organization) states that “Stress is the health care epidemic of the 21st century”. 90% of doctors office visits are related to stress and stress induced issues.
Although some argue that today we are not under any more overall stress than humans were exposed to during any other era, how we deal with it is certainly much worse. Stress, more specifically poor stress management, is at toxic levels in society and is arguably the most significant health-related issue after poor nutrition and lack of movement and exercise. 90% of all doctor visits are stress-related. Stress is known to contribute to hypertension, immune dysfunction, impaired cognitive and emotional development and anxiety. And stress starts early. A recent survey of 2nd graders revealed that almost 100% of them felt that they were stressed and anxious and at least half of them slept poorly. The average human makes between 30 and 60 thousand decisions a day. In developed countries, preoccupied with things like technology, making money, failing health, toxic relationships…, we are on the upper end of that estimate. That continuous mental chatter results in a lot of unnecessary stress. Stress has a huge impact on health and longevity. In addition, stress-related issues cost US businesses upwards of $300 billion a year.
When mammals, including humans, are in an acutely stressful situation, like being chased by a lion or being in a dangerous situation, the sympathetic nervous system, is stimulated and the adrenal gland produces stress hormones like cortisol and catecholamines like epinephrine. This is a normal response. These compounds lead to protective physiologic responses (see below). The sympathetic system is the “fight or flight” response system. The sympathetic nervous system is one half of our autonomic (or automatic) nervous system. The other, opposite half is the parasympathetic, or “rest and digest” system. Some of the sympathetic nervous systems effects include:
- Increase heart rate to improve acute blood flow to the brain for mental clarity and muscles for improved power.
- Increase clotting by making platelets clumpier. This it stop any bleeding which may have been caused by acute physical trauma.
- Widening of lung airways to improve oxygenation.
- Increase in muscle tone to improve performance and response.
- Helps release energy from muscles.
- Blood sugar increases to provide more sugar for energy. The brain uses up 25% of our sugar normally. This increases dramatically when the sympathetic nervous system is activated so more sugar helps.
- The part of the brain known as the amygdala, responsible for emotional control and hypervigilance, becomes more active so one becomes more aware of the surroundings. The “antennas go up”.
- Dilation of pupils to improve light sensitivity and vision.
- Diverting blood flow to muscles, the heart and lungs from acutely unnecessary functions like:
- digestion which gets shut off to reserve energy for other more acute needs.
- immune system function which becomes less efficient and responsive.
- the skin, which becomes cool and clammy.
- Sex drive goes down. Who is thinking about sex when you are in a dangerous situation?
- It also uses up the majority of our antioxidant stores (within 2 hours of a stressful event) to combat the oxidative stress caused by such events. That’s why it’s important to boost your consumption of fruits and vegetables when you are sick since these are the only sources of antioxidants. None is found in animal products.
In nature, the switch from a sympathetic nervous state to a parasympathetic state can be quite fast. One second a zebra is eating grass, the next he is in full sprint running away from a lion. Almost as quickly, assuming he is no caught, the zebra relaxes and resumes grazing. There is a saying (and a book title the same by Robert Sapolsky) that “Zebras Don’t Get Ulcers”. Humans, for the most part, have lost that ability to switch quickly from one state to the other and rather stay in a sympathetic state most of the time. Although these stress hormones can be helpful, they, along with many other helpful neuropeptides drop off quickly if the stress does not abate. Within an hour of continued increased stress, those compound levels are back to baseline. within only 2 hours, they are actually below the normal rested state. Within only a few short weeks, the hormones responsible for well being, like serotonin, are severely diminished, which is partly why chronic stress contributes significantly to depression and anxiety.
Stress also stimulates the Hypothalamic-Pituitary-Adrenal (HPA) axis. Starting with the stress-response center of the the brain, the hypothalamus, the compound Corticotropin Releasing Factor (CRF) is secreted which then triggers the pituitary gland in the brain to produce a hormone, Adrenocorticotropic Hormone (ACTH) which then triggers the adrenal glands, sitting on top o your kidneys, to produce the primary stress hormone cortisol. Cortisol, increases sugars (glucose) in the bloodstream, enhances your brain’s use of glucose and increases the availability of substances that repair tissues. Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex natural alarm system also communicates with the brain regions that control mood, motivation and fear.
More recently, the HPA axis has been renamed the HPAT axis (Hypothalamic-Pituitary-Adrenal-Thyroid) acknowledging how important the thyroid is in hormonal and metabolic health and the interplay of all these organs.
These physiologic responses are normal but only for acute situations. After the threat is gone, it takes between 20 to 60 minutes for the body to return to its pre-arousal levels. If continuous stress with the resultant, continuous responses are allowed to go on and on, continuously, bad things start to happen!
There is also the concept of “challenge stress” vs “threat stress”. When we perceive a stressful event as a challenge, our physiologic responses are much different, and are healthier, that the responses which occur to chronic “threat stress”. Again, how we perceive and thus respond to stress is the key. Turning a ‘threat” into a “challenge” is the goal.
With chronic stress, the body thinks it is under constant attack and all the above sympathetic responses occur continuously. That is not good and can lead to obvious problems like poor digestion, elevated blood pressure, weight gain and a slew of issues dealing with a poorly functioning immune system like infections and autoimmune diseases. Stress is stress and your body can’t distinguish between the stress of being attacked by a lion, emotional stress from an unhappy marriage or work or the physical stress of physical injuries. To be alive is to be stressed but there is too much additional societal and self-imposed stress. Work, kids, relationships, ambition, retirement, health, the environment… the issues contributing to stress are endless.
Cortisol also signals the body to store energy as fat, the idea being that fat can be used as an energy source when all the glucose is used up and you need more energy. Chronic stress causes continuous cortisol production resulting in excess energy storage leading to weight gain. Chronically elevated cortisol levels also suppress the production of the brain neuropeptide serotonin, responsible for mood, resulting in depression. Sleep deprivation, caffeine, and alcohol all also lead to increase cortisol levels. Chronic cortisol production shuts off the hippocampus, the part of the brain responsible for memory formation. It also down-regulates the prefrontal cortex which is like the CEO of the brain. It is responsible for coordinating activity in the rest of the brain. This why chronically stressed people seem to have poor memory and can’t cope with complex tasks. Meditation has been shown to improve functionality of both areas.
ALL hormones are made from LDL cholesterol. If your hormones are in good balance, there is usually enough LDL to produce all the hormones including cortisol, estrogen and testosterone. When you are under constant stress, the body thinks you need cortisol all the time and it “steals” the LDL making it more available for the cortisol and less available for other hormones. This partly why there is an epidemic of low testosterone in men.
It is up to us how we deal with and react to stress. Ambien for sleep, Xanax to calm nerves and anxiety, Adderall to enhance focus and concentration… just like with all other diseases, these over prescribed medications are band-aids and do not address the root causes of the underlying stress. One in six Americans are on an antidepressant or other psychiatric medication. Suicide rates have gone up by 30% since 2000. We need to get the stress under control. Exercise, yoga, caring for a loved one or a pet, meditation, mindfulness and breathing practices help a lot. Just petting an animal for 5 minutes releases the hormone and neuropeptide oxytocin which helps you relax and relieves stress. Remember that “Stress is not what happens to you. Stress is how you respond to what happens to you”.
There are studies showing that how we perceive stress is just as injurious to our physiology as the stress itself. Anticipating that a daily activity is stressful rather than having a more relaxed and positive attitude makes a huge difference in our mental and physical health.
BREATHING. The average person takes about 16 breaths a minute, or 23,000 breaths a day. Each one is an opportunity to impact on your physiology and stress response. The term “breath” has been synonymous with spirit a life since in many cultures. The Greek word for breath is “Pneuma”, which is synonymous for “spirit” or “soul”. The Hawaiian word for hello is “Aloha“, which also means “to share breath“. Interestingly, the Hawaiian term for main-lander is “haole” which also means “one without breath“. Even in our own culture, “take a deep breath” or “I need a breather” are common terms indicating how important breathing is to emotions and rest. The parts of the brain known as the Amygdala and Medulla are responsible for how we think and feel. They are both also exquisite CO2 sensors and as such, are both greatly influenced by and impact on how we breathe. This shows you how important breathing is for emotional well-being. Focusing on the breath is a great way to focus your mind but there are also real physiologic changes which occur depending on how you breath. When you exhale longer than when you inhale, the parasympathetic (rest and digest) nervous system is activated and the sympathetic (fight or flight) nervous system is down-regulated. There are many of these types of exercises but a simple one is exhale for twice as long as you inhale. Another is “3-4-5”. Breathe in slowly for a count of 3, hold your breath for a count of 4 and then exhale slowly for a count of 5.
Another great simple breathing exercise is the 4-7-8 technique as described by integrative health guru Dr. Andrew Weil. In short, the technique involves breathing in for a count of 4, holding your breath for a count of 7 and then exhaling for a count of 8. Click here for more on this and other breathing techniques.
MEDITATION is an extremely beneficial habit to develop. Meditation rests the body and mind 5x more than even a good nights sleep. Both are really important but this highlights how valuable meditation is. The science is clear on the benefits of meditation on many conditions including stress, PTSD, anxiety, ADD… It optimizes gene expression, regulated the immune system, increases neuroplasticity, re-grows brain cell cells and stem cells. Meditation decreases levels of cortisol (the stress hormone) by up to 50% (20% more than a good night of sleep). Drug addicts have a 60% reduction in relapse rate if they meditate (as opposed to nearly 100% relapse in non-mediators). The same positive trends are seen in prisoners with respect to repeat criminal offenses after their release. Studies on the impact of meditation and guided imagery on post-operative pain result in a 50% decrease in need for pain medications. Some other things meditation has shown to improve include:
- Lowering inflammation throughout the body.
- Decreasing the effect of viruses.
- It increases the length of our telomeres by increasing levels of the telomere repair enzyme telomerase. Telomeres are the protective “end caps” on our genes which deteriorate with age and poor lifestyle choices.
- It lowers cortisol levels. This is the “stress” hormone which also does things like increase weight and raise blood pressure.
- It relieves symptoms of depression and anxiety.
- 10 minutes of meditation has been shown to reduce lactic acid buildup in muscles after exercise to a greater degree than a full nigh of sleep and rest.
There are various types of meditation. Some include:
- LOVING-KINDNESS MEDITATION
- BODY SCAN OR PROGRESSIVE RELAXATION
- MINDFULNESS MEDITATION
- BREATH AWARENESS MEDITATION
- KUNDALINI YOGA
- ZEN MEDITATION
- TRANSCENDENTAL MEDITATION
You need to find what works for you. There are many smart phone apps that are out there to help along the way. Calm, Headspace, Insight Timer… Also consider taking a class in Transcendental Meditation. A less expensive but very similar program is called Ziva. Another great resource is Mindfulness.Com. They all work equally effectively but the key is consistency. You can combine them but one form should be done fairly regularly. Research shows that, although any amount of meditation is great and you have to start somewhere, a threshold effect is seen when you meditate for 12 minutes or more. In addition, more practice = more improvement.
“You should meditate once a day. If you don’t have time to meditate once a day, you should do it twice a day“.
For more information about meditation, click here: MEDITATION
Chronic stress leads to chronic over-stimulation of the sympathetic nervous system. This leads to increased inflammation in the brain contributing to depression which then impacts on proper immune function. As an example, people infected with HIV who are depressed have double the risks of dying of AIDS as compared with those who are not depressed.
Stress shortens telomeres, the “end caps” on our DNA, leading to faster aging. It also adversely affects gene expression, has a harmful impact on the gut microbiome and negatively impacts on important cellular effects like apoptosis (pre-programmed cell death) and angiogenesis (new blood vessel growth), both of which are very important in how cancer forms, grows and spreads. A long-term study of women who were the principle care-givers to loved ones with Alzheimer’s Dementia or kids with Autism showed up to a 17 year shortening of life expectancy with significant shortening of telomere length. These effects were diminished however if those caregivers routinely practiced stress management skills or had a positive outlook on life.
Meditation alone can change your gene expression and affect emotions. It causes a part of your brain, the left prefrontal cortex (the “thinking” part), to send inhibitory signals to your amygdala (the emotional part) decreasing anger and fear. As a result, we have more control of those emotions. Regular meditation has also been shown to increase the size of the hippocampus leading to improved memory and shrink the amygdala, leading to a reduction of anger and fear.
“There is no failure in meditation. There is either DO or DON’T DO. Just begin.”
Laughter is very important in reducing stress. Laughing has numerous beneficial side effects, not only for the individual but for everyone around them. Laughter releases serotonin, leading to less depression. It can increase blood flow throughout the body by 20%. It relaxes the lining of blood vessels. It also releases endorphins reducing pain, controlling emotions and providing an overall sense of well-being.
Gratitude is associated with significantly lower levels of stress by decrease in cortisol by as much as 23%. Grateful people have 10% lower blood pressure measurements, 10% improved sleeping patterns and 19% lower levels of depression.
ONE LAST IMPORTANT FACT: people who work 55+ hours a week (compared with less than 40 hours a week) have a 33% greater risk of having a stroke and 13% greater risk of developing coronary heart disease (link). You need downtime and as much as possible, do what you love. Work to live, don’t live to work!
THE RELAXATION RESPONSE. The term, “Relaxation Response’” was coined by Dr. Herbert Benson, professor, author, cardiologist, and founder of Harvard’s Mind/Body Medical Institute. The response is defined as your personal ability to encourage your body to release chemicals and brain signals that make your muscles and organs slow down and increase blood flow to the brain. In his book “The Relaxation Response”, Dr. Benson describes the scientific benefits of relaxation, explaining that regular practice of the Relaxation Response can be an effective treatment for a wide range of stress-related disorders. This is essential the same thing as Transcendental Meditation (without the cost or training).
Steps to Elicit the Relaxation Response
- Sit quietly in a comfortable position.
- Close your eyes.
- Deeply relax all your muscles, beginning at your feet and progressing up to your face. Keep them relaxed.
- Breathe through your nose. Become aware of your breathing. As you breathe out, say the word “one” silently to yourself. For example, breathe in, and then out, and say “one”, in and out, and repeat “one.” Breathe easily and naturally. If you don’t like the word “one”, choose any soothing, mellifluous sounding word, preferably with no meaning or association, in order to avoid stimulation of unnecessary thoughts. For example, don’t use “flower” or “apple” since those will generate thoughts of nature or food.
- Continue for 10 to 20 minutes. You may open your eyes to check the time, but do not use an alarm. When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes opened. Do not stand up for a few minutes.
- Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace. When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating “one.”
- With practice, the response should come with little effort. Practice the technique once or twice daily, but not within two hours after any meal, since the digestive processes seem to interfere with the elicitation of the Relaxation Response.
While many people think of yoga as just a series of postures, it is actually a combination of breathing exercises (pranayama), postures (asanas), and meditation together. (See figure 1 on the previous page.) The poses typically utilize isometrics, building muscles by holding a pose to cause muscle contraction while not bending at the joint as you would with free weights. The movement from one pose to another can provide a terrific cardiovascular workout.
Yoga has been shown in numerous studies to decrease :
- Cortisol levels (the stress hormone)
- Blood pressure
- Heart attack rate
- Insulin resistance (the cause of diabetes).
Yoga has been shown to improve levels of growth hormone and improve:
- Muscle mass
- Endothelial function (your arteries)
- Cholesterol levels
- Heart and breathing rate
There are many different types of yoga. As many as 53 are reported. Some common ones include:
- Hatha – General term for using poses with breath
- Power – Continuous sequences of poses
- Isengard/Anusara – Emphasis on proper alignment
- Krupa luck – Encourages mind/body alignment
- Kundalini – Encourages self empowerment also using chanting
- Ashtanga – Scripted poses with a focus on rhythmic breathing
- Bikram – Scripted poses in artificial heat
- Yoga Nidra – stationary pose focusing on one body part at a time
“Good Morning, I Love You” Shauna Shapiro, PhD. Mindfulness and self-compassion practices to rewire your brain for calm, clarity, and joy.
Other techniques to help manage stress include (click on the item for more information):
- Diaphragmatic Breathing
- Mindfulness Meditation
- Guided Imagery
- Autogenic Training
- Personal Biofeedback
- Progressive Muscle Relaxation
- Emotional Freedom Technique (Tapping)
- Enjoyable Pastimes
- Green Tea (Instead of Coffee)
MULTITASKING and STRESS
Our modern, fast-paced culture encourages us to multi-task. The simple fact is that the brain can’t multitask. It’s impossible. When you try to do more than one thing at a time, what the brain is actually doing is jumping back and forth between the tasks you are doing. The transition happens at a fraction of a second but make no mistake that it is happening continuously. As a result, the quality of each task is diminished. How diminished depends on many variables but they are diminished. You may be able to chew gum and dribble a basketball at the same time but without question, you can dribble better if you are not chewing gum.
Only 2% or people can really multitask effectively and even that is with relatively simple tasks.
The constant fragmentation of attention erodes our ability to focus and remember, even when we want to single-task. There is a direct correlation between IN-tension and RE-tension. When you do something with intention, focusing on a single task, you do the task more effectively and you remember better. That is why, regardless of what they may think, students remember and retain information better when they focus on what they are reading, without music or having the TV on in the background. Retention is reinforced when you add an action like taking notes and writing down what you are studying.
In addition, multi-tasking adds greatly to our overall stress level. We don’t need more things to stress us out.
That’s not to say that you shouldn’t do housework while listening to music or talk to your spouse while you are eating. But if you are speaking about something really meaningful or important, it’s best to focus 100% on the conversation. If you are navigating complex traffic, maybe you should turn down the music. When I am operating, I don’t think about what’s for dinner.
The more you single-task and give 100% of your attention, even to mundane tasks like washing dishes, the better you get at it and your ability to focus and remember will improve overall.
MAINTAIN THE HEALTHIEST WEIGHT POSSIBLE
The fact is simple. We are becoming a heavier and heavier species. 75% of Americans are at least overweight with 42% being obese (up from only 15% in 1980 and 3% in 1900). At the current rate of increase, the number of overweight or obese Americans is expected to reach 95% by 2035. 20% of kids under 20 are obese already and this is directly related to midlife mortality. Keep in mind that those statistics are based on the upper limit of normal weight. If you consider the healthiest weight to be in the middle of the normal category only 12% of Americans have a healthy weight. If you then factor in the fact that many people who have a healthy weight are that way because of some disease like cancer, GI problems or smoking, only 2.4% of Americans achieve a healthy weight because of a healthy lifestyle!
Police departments and our military are having trouble getting recruits because many of them are too overweight to be eligible. New labor and delivery guidelines are being developed with earlier induction of delivery and increased, earlier and more difficult C-sections because of how many pregnant women are obese. Surgical risks and complications are on the rise because patients are just fatter and sicker and there is a correlation between the two.
40,000 people die a month, almost half a million a year, in the US alone from complications of obesity. And that is only looking at the top 3 causes: cancer, diabetes and heart disease. Only 50 a month die from gunshots and that gets significantly more attention.
Though you can be thin and unhealthy (40% of Americans with normal BMIs have metabolic abnormalities consistent with Metabolic Syndrome), excess weight is directly related to risk of disease and risk of death. There is a direct correlation between body mass index or BMI (weight to height ratio) and rates of chronic disease. The average American has a BMI of 29, which is at the borderline between being overweight and obese. Simply put, the more excess weight you carry, the greater the risk of various chronic diseases. Just looking at diabetes and pre-diabetes alone, 90% of people who are overweight or obese will develop these conditions. The more overweight you are, the greater the risk of breast cancer as well as colorectal cancer in addition to all the other chronic diseases. Being overweight puts you at greater risk of various vitamin deficiencies since some of them, like A, D, E and K are fat soluble. They get taken up and are made unavailable for their metabolic functions the fat cells. With the Covid-19 crisis, just being 20 lbs. overweight increases the risks of complications 6x. Under the age of 55, obesity is the greatest risk factor. Just for reference, for the average American male, only ~ 30 lbs. over ideal weight puts you in the obese category.
Being thin is not by itself an indicator of health either. Being somewhat overweight but physically fit is better than being thin and not fit. But being obese is just not good. In my office, people are always shocked when I show them a graph which shows their weight and what they would need to lose just to get to the upper end of the “healthy weight ” category on the BMI scale.
Unfortunately, our perception of what is a normal weight has become distorted. Today, it is basically “normal for people to be overweight. 75% of Americans are overweight or obese with 35% being overweight, 32% being obese, up from only 15% in 1980, and 8% being morbidly obese. People don’t even appreciate how overweight they really are. When 1/3rd of overweight people felt they were of normal weight and more than 2/3rd s of obese people thought they were just a little overweight, we have a real image problem! Of significant concern is the rapidly rising rate of childhood and teenage obesity (now at 19%, triple the percentage in 1970). 75% of military recruits 17-24 years of age we ineligible to join the military for a number of reasons but the #1 reason was obesity. Of the 25% who were eligible, 60% could not complete the basic physical fitness test. Willing, matched organ donors (both living and Gift of Life donors) are not able to donate their desperately needed organs because their BMI is too high.
Fat cells can divide and become more numerous but once they form you can’t get rid of them without surgically removing them. They do however grow and shrink. When you gain weight, you accumulate more fat cells and the fat cells you have get bigger. When you lose weight, these fat cells just shrink. A fat cell can grow 1,000x its original size.
ADIPOSE TISSUE. What we traditionally think of as “fat” on an in a person’s body is not as simple as what sits around your belly. There are different kinds of fat and where it is located impacts on it’s function.
There are a variety of forms of fat.
- Subcutaneous fat. This is the traditional “fat: we think of which sits just under the skin. It has numerous functions primarily:
- Storing extra caloric energy. We are evolutionarily hard-wired to store extra energy as fat, because our bodies are always getting ready for the next famine.
- Padding muscles and bones
- Regulating body temperature
- Acting as a passageway for blood vessels and nerves.
- Visceral fat (aka omentum fat). This is the fat kept inside the body and in between our organs. This is the bad fat which mostly contributes to development of insulin resistance, diabetes and heart disease. You can have a concerning amount of visceral fat without much external subcutaneous fat. Visceral fat is now the #1 cause of liver transplants in the US since it causes NAFLD, Non Alcoholic Fatty Liver Disease.
- Intramuscular fat. Used primarily as an energy source by our muscle cells, excess amounts also contribute to insulin resistance and diabetes.
- Brown fat. Located primarily in the region of the neck, collar bones and upper back, this fat actually burns energy, releases heat and increases metabolism. It does so through the control of a protein called thermogenin. Babies have a much greater proportion of brown fat than adults do. It’s brown because of very high concentrations of mitochondria.
- Beige fat. This type of fat also plays a role in thermoregulation but is much less well understood. Whereas brown fat cells arise from stem cells which also generate muscle cells, beige fat cells form with deposits of white fat cells beige cell precursor stem cells.
The fat under the skin is called subcutaneous fat. In general, it doesn’t do a lot other than store calories. The fat in between and in organs is called visceral fat. The visceral fat, along with the fat inside cells, or intracellular fat, it what creates most of the metabolic problems like diabetes, through insulin resistance, and vascular disease. In addition to the 73% of Americans who are overweight or obese based on body mass index, another 20% are thought to be “skinny-fat”, meaning that they have a normal BMI but increased fat in their cells and organs. It also generates inflammation by producing inflammatory compounds known as cytokines. Interestingly, a high animal fat diet impacts to a greater degree on visceral and intracellular fat than subcutaneous fat, with levels going up as much as 54% in only 1 week of increasing fat consumption. Diets higher in plant-based fats do not exhibit this same effect. In addition, diets high in animal protein, even when there is significant weight loss, do not have the same benefits when it comes to improving insulin function as do diets higher in plant based protein. Specifically, proteins known as Branched Chain Amino Acids (BCAAs), found in higher concentrations in animal protein sources, are particularly problematic when it comes to impacting on reduction in metabolic problems. These are popular in the bodybuilding and exercise communities.
Fat can also be divided into white fat (WAD or white adipose tissue) and brown fat (BAD or brown adipose tissue).
- White Adipose Tissue (WAT).
- This can be thought of as fat which stores energy and generates hormones and inflammatory compounds.
- They consist of a single lipid droplet.
- Located mostly around the waist, thighs and legs.
- It basically stores excess calories. When you eat too many calories, the extra gets stored as fat.
- The fat around the abdomen is associated with increased metabolic disease but the fat around the hips and thighs a lot less.
- Brown Adipose Tissue (BAT).
- This type of fat is essentially thermoregulatory. It burns energy. Brown fat cells are unique in that they do not need insulin to transport sugar from the blood into the cells.
- Brown fat cells are made up of many lipid droplets.
- They also contain higher concentrations of iron-containing mitochondria (cellular powerhouses) accounting for their browner color.
- It also contains more capillaries because of higher oxygen consumption.
- It contains more myelinated nerve fibers providing sympathetic (fight or flight response) stimulation to the fat cells.
- It’s main function is to produce heat by burning calories.
Thinner people in general have a higher proportion of brown vs white fat.
Fat is not all bad and in fact, we need it for proper health. As mentioned above, brown fat is involved in thermoregulation and maintains body heat by burning calories. White, more commonly known as yellow fat, is more involved in whole body energy and energy storage. The white fat is also involved in immune regulation. The visceral adipose tissue (VAT), the fat around the belly and internal organs, is laced with immune cells filtering the fluid which leaves our digestive tract, filtering microbes, damaged cells and assists in controlling inflammation. Fat cells also are an important storage site of immune memory cells. Fat cells also make hormones like estrogen, which is why breast cancer rates increase along with weight.. The immune system also controls how fat cells work. They work together. But just like any balance, excessive amounts of either one, throw the other off. Excess fat impacts on inflammation and immune function and an overactive immune system impacts on how fat works.
So how much fat is too much fat? In addition to such measures as body mass index and hip to waist ratio, there is body fat percentage. For men, a healthy fat % is 10-20. For women, it is 18-28%.
OBESITY itself must be looked at as a chronic disease. No one should be discriminated against or shamed because of their weight but that does not mean that we should sit back and do nothing about it. Blaming genetics and inheritance is also not a valid excuse although of all chronic diseases, genetics plays a much more significant role. Most chronic diseases, even cancer, have at most a 10% genetic predisposition with the other 90% being attributed to lifestyle choices. With excessive weight and obesity, the genetic predisposition is closer to 60-70%. That still leaves a significant amount of control lifestyle has over our weight, the most important component being diet. You may have inherited some “obesity genes” but you also inherited and learned lifestyle habits from your parents and families. Being overweight is simply unhealthy and all of the extra external and internal (visceral) fat contributes to just about every chronic condition including cancer, diabetes, depression, arthritis and heart disease.
Fat (technically called adipose tissue) is not passive extra tissue hanging around doing nothing. It is an interactive organ, producing hormones, especially estrogen, and impacting on various physiologic activities in the body. Leptin is a hormone secreted by fat cells that signals the body to stop eating more fat since the body has enough stores of energy for any emergency. Its activity is disrupted by excess fat. This is called leptin resistance and that “I’m full, stop eating” signal doesn’t occur and you keep eating and gaining weight. It’s a vicious cycle. You can overcome leptin resistance by eating a healthier diet. First, remove as much processed food and sugar from your diet as you can. Both contribute significantly to your brain becoming unresponsive to leptin leading to overeating and snacking because you feel like you are always hungry. Adding foods high in omega 3 fatty acids such as flax, hemp and pumpkin seeds, nuts, especially walnuts, algae and some cold-water fish like salmon and herring (just keep them clean) help improve leptin function. Also adding whole fruits and vegetable helps a lot. Fat cells also produce cytokines known as adipokines which cause inflammation and directly damage joint cartilage leading to joint pain and arthritis. The inflammation is further increased by the standard American diet, full of pro-inflammatory fats. Just switching to a plant-based diet improves joint pain by 60-80%, even before weight loss starts.
Being overweight increases The risks of developing The autoimmune disease Rheumatoid Arthritis (RA) by almost 50%. If you take medications for RA, their efficacy decreases by as much as 50% if you are overweight as well.
People who are overweight or obese also have less of a response to vaccines since their immune systems are also compromised. Specifically, their T-cells, crucial to immune reactions and developing antibodies, don’t function as well. In addition, people who are overweight or obese are also more prone to complications from various vaccines.
Another compound fat cells produce is Insulin Like Growth Factor 1 (IgF1). This is a growth hormone which promotes cell growth and is important when we are goring but in adulthood, it stimulates cancer cell production and growth. It is also found in high levels of people who eat meat, dairy fish and eggs. In addition, adipose tissue converts a hormone androstenedione into estrogen and testosterone. Excess amounts of estrogen in the body promotes and stimulates various hormonal cancers including breast and prostate cancer. The more fat in your body, the more estrogen and testosterone gets produced. In addition, the estrogen in your body continuously circulates through the liver, enters the bile ducts and ends up back in your intestines where it gets re-absorbed or gets removed by fiber in the diet. A low fiber diet prevents absorption of estrogen from the gut leading to its re-absorption and re-circulation in the body. Lastly, a compound called Sex Binding Hormone Globulin or SBHG, which as the name suggests binds circulating sex hormones like estrogen and testosterone, is inhibited by body fat. This also leads to increased circulating levels of the hormones. They are normal hormones, just not in excessive amounts.
There is more on Obesity on my DISEASES page.
MEDICATIONS, FOOD CRAVINGS AND FOOD ADDICTION. Food addiction is estimated to affect 5-7% of our population. People with addictions, be they drugs, sex or gambling, have fewer dopamine receptors in the brain. It’s the brains way of down regulating these overwhelming stimuli. Addicts need to feed their addictions just to feel normal. The same is true of food addicts. Sugar, salt and fat stimulate the same reward (dopamine) as well as mood (serotonin) and brain regulation (GABA) receptors as opioids (Percocet, Vicodin and morphine) and benzodiazepines (Valium and Xanax). Their dopamine receptors are decreased and down regulated in the same way. As that occurs, the drive for more food, just like with drugs, increases. There are a number of medications out on the market now that help control cravings which are the hallmark of addiction. These medications are similar to drugs that people addicted to opioids and other narcotics take to help control their addictions. They can be effective, resulting in significant weight loss. That loss can result in getting rid of other medications like diabetes, blood pressure and cholesterol medications but they are still drugs that you have to keep taking unless you address the underlying problem. As with all other medications for all other chronic diseases, the drugs are just a band-aid. For some a necessary band-aid but the goal should always be to address the eating/craving addiction and not just dull the cravings with another medication.
Unfortunately, the food industry is without question partly to blame for the state of our health. They intentionally add unhealthy substances to our foods to create the “bliss point”, making them as addictive as possible. They have chemists whose sole job is to create foods and additives that will keep people coming back for more. I have more on this on another page but in short, people can’t be completely to blame for their weight because they have been made addicted to the foods that they eat. It’s like the drug dealer on the corner offering school kids free drugs to get them hooked, and then they keep coming back for more like an annuity. If you think you have a food addiction, or struggle with cravings, consider looking at an online program like Bright Line Eating (click the link), developed by Susan Pierce Thompson, PhD. She also has an online food addiction quiz: FoodFreedomQuiz.com.
YOUR FAMILY AND FRIENDS MATTER. Our environment, both personal and living, also impact greatly on obesity rates. Studies show that if your friend is obese, you have a 50% greater chance of being obese yourself. If your friends friend is obese, your risk is 20% greater. If your friends, friends friend is obese, even if you have never met them, your chance of becoming obese is 10% greater! That’s how interconnected we are. Although genetics plays a role, your friends are more important. If your family members are overweight, your chances of being overweight are 40% greater. If your friends are overweight however, your chances of being overweight is 170% greater! If there are 6 fast food restaurants within 1/2 a mile of your home, your chance if becoming obese are 40% greater than if there were only 3 or less. If there is a billboard advertising any kind of junk food, your chances of becoming obese is 10% greater.
BARIATRIC (WEIGHT LOSS) SURGERY. There are a number of surgical procedures that help quite a bit with weight loss, however just like with medications, we are treating the numbers and not necessarily the disease. These procedures work primarily because they decrease how much you can eat. In the case of procedures on the stomach itself, parts of the stomach are removed where cells that produce a hormone called Ghrelin is located. This hormone does many things including controlling hunger and stimulating growth hormone production. However, unless you simultaneously make lifestyle changes, including improving your diet, in many cases, the weight just comes right back on. The statistics range quite a bit. Anywhere from 25% to 70 % regain their original weight within 5 years! Although removing the ghrelin producing cells may sound like a good idea for weight loss, this hormone also regulates bone formation, prevents muscle wasting, regulates insulin secretion and is involved in cancer development and cancer spread. Its metabolic activity is complex and it is important. Eating turns off ghrelin production but fat shuts it off to a lesser degree than carbohydrates and protein which might explain why higher fat diets without carbohydrates contribute more to weight gain than higher carb, lower fat diets in the long-term.
There is also some evidence that bariatric surgery alters the gut microbiome in a healthy way. This may be because of better food choices or possibly to less volume of food, but it’s probably a combination of things.
The good news is that by adopting a healthy diet along with more movement and exercise along with incorporating many of the other lifestyle habits mentioned below, you can lose weight. For your own information, the following downloadable form is a great way to calculate what your body mass index (BMI) is and what your target weight goals should be. It also gives some weight loss tips. Weight Loss Tip Sheet and BMI Calculator
Don’t be discouraged by how much weight you may have to lose to get into a healthy BMI range. A journey of a thousand miles starts with one step.
Losing only 1 pound has a significant impact on total daily load on your joints, equal to 20 tons on the knees. When you lose 10% of your body weight, you’ll have to consume an average of 25% less calories to maintain your weight. 25% is one fourth of the calories that somebody else can eat. This is an enormous amount.
This is what happens when you lose just 10 lbs.:
- Lower Cholesterol Level
- Lower Blood Pressure
- Reduced Risk for Heart Attacks
- Reduced Risk for Dementia
- Reduced Risk for Sleep Apnea, which is improved with a plant-based diet, even if your weight stays the same.
- Reduced Joint Pain
- Reduced Risk for Cancer
- Reduced Risk for Diabetes
- Improved Sex Life
- Taking Less Medications
- BONUS: You’ll Feel better!
Click this link to see more detailed information about what happens when you lose 10 pounds.
Eat Less and Eat less often. Your body and pancreas need to rest. Small meals more often don’t work and keep your body always working on digestion and producing insulin which leads to fat storage. DO NOT SNACK! Even if it is “healthy” food. Nuts are healthy but add 18 gm of fat per small handful. The same with avocado and coconut, 2 very popular “healthy” fats. It adds up. It’s also OK to fast or skip meals occasionally. There is nothing supporting the thought that we need “3 square meals a day”. Look into intermittent fasting and time-restricted eating. Also look up Fasting Mimicking Diets. A specific program called Prolon (Prolonfmd.com) is a program the “tricks” your body into thinking that you are fasting without actually not eating.
Keep food quality front and center when thinking about what to eat. If you follow a whole-foods, plant-based, low fat, low salt and low sugar diet, you do not, ever have to think about how much or how often you eat. This type of diet is full of all the nutrients you need including fiber which is very filling. You can’t eat too much. It’s a very freeing, wonderful, healthful way to live. It’s also more compassionate and saves the environment all at the same time. It’s ALL GOOD!
Food timing is also important. People who eat earlier and finish eating earlier lose more weight than those who eat later. Also, people who skip breakfast gain more weight than those who eat breakfast. This is because eating breakfast starts and ramps up your metabolism and improves insulin secretion and function the rest of the day. Blood sugar remains elevated the whole day to a greater extent in breakfast skippers. In fact, type 2 diabetics who skip breakfast experience a 20% increase in blood sugar the rest of the day compared with those who don’t skip breakfast. Skipping meals is fine as long the meal you skip is dinner.
A quick list of tips for weight loss include:
- Avoid animal products. By doing so, you avoid all the animal fat and naturally gravitate to healthier, more fiber rich foods.
- Keep vegetable oils to a minimum. Also limit nuts, seeds, avocados and full fat soy products. They’re Ok, but not too much.
- Cut out the fat. Fat makes you fat. Read labels. Try to keep fat consumption to less than 30 grams a day.
- Favor high fiber foods like beans, fruit, vegetables and whole grains.
- Cut out all sugar from your diet.
- Watch the salt. Salt increases over-consumption of fat by 11%.
- Cut out all processed food from your diet. These are addictive and add empty, unhealthy calories.
- Eat less. We simply eat too much. If you eat more slowly, you will naturally eat less since your brain will get proper signaling telling it you are full.
- Eat less often. It is simply habit and availability that supports the “three meals a day” idea. Consider intermittent fasting or time restricted eating.
- Don’t eat distracted. Watching TV or looking at a device or computer while eating leads to more calorie consumption since the brain is overwhelmed and does not send the signals that you are full properly.
- Don’t snack. Let your digestive system rest. Constant snacking leads to constant insulin production and subsequent weight gain.
- SPICES AND WEIGHT LOSS. Turmeric, actually a member of the ginger family, zingiberaceae, is a root from which the spice comes from. Although it contains many micronutrients, the best well known, most studies and most potent is curcumin. In addition to it’s known anti-inflammatory effects, it also upregulates the activity of adiponectin, a satiety hormone, decreasing appetite. It also improves insulin sensitivity, reducing blood fats and preventing fat storage. Ginger, the main member of the zingiberaceae family, contains a micronutrient called zingerone which has been shown to stimulate the activity of hormone sensitive lipase, the enzyme responsible for ushering fat out of cells and increases the breakdown of that stored fat.
- Move more. Take the stairs, walk more, park farther away from storefronts, garden…
- Exercise daily. Both cardio (run, bike, elliptical…) but more importantly, lift weights and do resistance training. If you only do one form of exercise, lift weights.
- take cold showers. Sounds whacky but exposure to cold increases a type of fat in the body called “brown fat”. Mostly concentrated in the back, this type of fat is metabolically very active. Many studies have shown that cold, especially cold water, exposure increases the percentage and amounts of this brown fat.
- Cut out use of plastics. As mentioned in many areas on my website, plastics leach out chemicals which disrupt hormonal regulation, including weight gain and loss. The chemicals are actually called “obesogens”, chemicals which increase obesity. Tiny amounts are actually more problematic than larger amounts so avoid as much plastic as you can. No bottle or cans. Most cans are lined with plastics. NEVER cook or heat in plastics. Don’t store food in plastic. Read the labels on you beauty care products. The ALL have plastic in them or come stored in plastic. It all matters.
- Stay well hydrated with water.
- CHECK BLOODWORK
- Make sure your thyroid (your metabolic thermostat) is working properly.
- Check your vitamin D levels. Low levels impact on a variety of functions leading to weigh control.
FAT LOSS ESSENTIAL #1 – support your microbiome.
75% of the world’s food is produced from the same 12 plant species and the same 5 animal species. Our gut craves a variety of plants. Primary Prebiotics are the foods which feed the healthy bacteria in our intestines. Apples are a great example. Rich in the compound pectin, bacteria love apples and produce more of the short chain fatty acid (SCFA) butyrate, critically important in gut health. Other great prebiotic foods include:
- Garlic and Onions.
- Chicory root.
- Artichokes, specifically Jerusalem artichokes.
Many of these foods have high levels of the prebiotic fiber inulin which has been shown to impact positively on some of the hormones which help with weight loss and appetite suppression. White rice and potatoes, much maligned and labeled as “unhealthy carbs” are actually quite good for you. When cooked, refrigerated and then reheated, they become very high in microbiome-supportive resistant starch.
WATER AND WEIGHT LOSS.
The importance of clean water and proper hydration cannot be understated. A very short list of some of it’s responsibilities include:
- DNA maintenance.
- Mitochondrial (energy organelles in your cells) function.
- Blood, lymph and CSF (cerebrospinal fluid) integrity.
- Digestive fluids and digestion itself.
- Regulating body temperature.
- Brain activity (contrary to popular belief, the brain is mostly water, not fat.)
From a weight loss perspective, water not only fills you up and can impact on satiety, it is crucial to all metabolic processes in the body, including fat metabolism. Proper hydration impacts on the function of such hormones as glucagon and human growth hormone (HGH) but it also increases your metabolic rate through a process known as water-induced thermogenesis. Within 10 minutes of drinking just 17 ounces of water, metabolic rate is increased by as much as 30% reaching a maximum after 30-40 minutes. The caloric burn is not huge, about 25 calories, but do this a few times a day and it builds up.
“The Secret to Ultimate Weight Loss“. Chef AJ shares her personal experience, weight loss plan and many success stories.
“The Hungry Brain: Outsmarting the Instincts That Make Us Overeat“. Stephan Guyenet, Ph.D. Excellent analysis and discussion about why we overeat and gain weight.
KEEP IN MIND THAT ALTHOUGH WEIGHT LOSS MAY BE SLOW, THE HEALTH BENEFITS YOU WILL EXPERIENCE START IMMEDIATELY.
You may not be as thin as you want as quickly as you want, but you will be healthier so be patient and keep improving your lifestyle.
WEIGHT LOSS BASICS
70% of Americans are overweight. Nearly 40% of adults and 19% of teens and children are obese. In 1980, only 15% of Americans were obese. This is astounding and certainly an indication that whatever we are doing in our country, it ain’t workin’! Being overweight puts you at significant risk for many medical problems including diabetes, dementia, hypertension, coronary artery disease, arthritis, sleep apnea and many cancers. Although body mass index (BMI), basically height to weight ratio, is not a perfect measure, it is a good guide. Don’t be discouraged by how much weight you should lose. Every little bit helps. Losing only 1-pound results in a 4 lb. load reduction on your knees which is equal to 20 tons of pressure a day off your joints. By dropping your weight by only 10 lbs., cholesterol levels improve by 10%, your risks of heart attack and diabetes go down by 50% and 60% respectively. Sleep apnea and cancer risk decrease. Lose Just 10 Lbs. and THIS happens
Even with a normal BMI, if you carry most of the fat on and in your body centrally, there could be disease simmering, increasing risk of diabetes and heart disease. This abdominal weight is called, central adiposity, and is more concerning than excess weight in other parts of the body, like the hips.
Waist circumference is important but not perfect. For a woman, waist circumference greater than 35 inches is concerning. For men, it’s 40 inches. Above these numbers, central adiposity is more likely.
Another measure of excess, central adiposity is waist to hip ratio. Measured at the belly button and the widest part of the hips, a ratio more than 0.85 in women and 0.9 in men is a risk factor for intranasal-abdominal adiposity.
Here are some helpful tips to help you lose weight:
Eliminate processed food. If it comes in a package, has more than 5 ingredients or if you can’t pronounce an ingredient, avoid it. The more processed and refined it is, the more it causes blood sugar to spike which results in excess insulin production leading to a variety of problems including weight gain. Keep food as whole and unprocessed as possible. For example, olives have fat, but they also come with a variety of phytonutrients (plant-based nutrients) not to mention lots of fiber. Olive oil on the other hand is just pressed olives. All the fiber and nutrients are stripped away leaving you with 14 grams of fat per tablespoon with no nutrients.
Eliminate all sugar. Even the “healthy” or “low calorie” versions. Whole fruit is OK but limit fruit juices. Processed, refined sugar rapidly raises blood glucose levels resulting in large spikes in insulin. Repeated overproduction of insulin contributes to insulin resistance resulting in a cycle of high sugar and high insulin levels eventually contributing to storage of fat in tissues meant to store fat.
Eat Less and Eat less often. Your body and pancreas need to rest. Small meals more often don’t work and keep your body always working on digestion and producing insulin which leads to fat storage. DO NOT SNACK! Even if it is “healthy” food. Nuts are healthy but add 18 gm of fat per small handful. The same with avocado and coconut, 2 very popular “healthy” fats. It adds up. It’s also OK to fast or skip meals occasionally. There is nothing supporting the thought that we need “3 square meals a day”. Look into intermittent fasting and time-restricted eating. Also look up Fasting Mimicking Diets. A specific program called Prolon (Prolonfmd.com) is a program the “tricks” your body into thinking that you are fasting without actually not eating.
Make dinner your smallest meal. Eating at night makes little sense since we spend the night resting and regenerating anyway. You don’t want your body spending energy digesting when It should be cleaning and regenerating. Skipping breakfast on the other hand has been shown to contribute to poorer blood sugar control all day and leads to weight gain.
Eat less fat. Whether from plants or animals, too much fat consumption causes insulin resistance leading to diabetes, heart disease and weight gain. Some healthy fats are necessary but it’s easy to get enough fat but easier to over-do it. Fat has 9 calories per gram while carbohydrates (only found in fruits, vegetables, legumes…) have only 4 calories per gram. If you are really struggling with weight loss, really look closely at the fat you consume. Even healthy fats are still fats. Common foods where fats can be eliminated include:
- Nuts and seeds, including nut butters.
- Coconut and coconut oil. It’s 90% saturated fat.
- ALL oils, even extra virgin olive oil.
Eliminate dairy and minimize animal products (meat, fish, eggs, poultry). Meat and dairy are not necessary for good health and they do contribute to obesity to a much greater degree than whole plant-based diets. What you think are “low-fat” sources like fish and chicken are really not. Chicken is actually the highest meat source of fat and cholesterol in the American diet followed by dairy products. Chicken has the same amount of cholesterol as red meat and only slightly less fat as a percentage (23% for chicken vs 29% with the leanest cut of red meat). Dairy and calcium supplements are also linked to MORE osteoporosis.
Why do whole food, plant-based diets lead to weight loss?
- FIBER. Only plants have fiber which, in addition to being extremely protective against colon cancer, makes you feel fuller, faster leading to less food consumption overall. The food you eat is, in addition, more nutrient dense and healthier. Fiber also leads to the production of short chain fatty acids which have a slew of health benefits including healing the gut.
- When we eat, our bodies have to metabolize (work) to break down the food. Plant based foods increase the post-meal metabolism by 16% over animal-product based meals.
Move more and Exercise daily. We simply don’t move enough. We evolved moving, not taking elevators, sitting and staring at screens and driving cars. Take the stairs. Park farther away from stores to walk more. Don’t eat dinner and sit down right away to watch TV. Instead, go for a walk. There are many ways to increase movement and activity. Any exercise is great but resistance training (weights) is particularly helpful. If you only do one form of exercise, lift weights. Weightlifting leads to the greatest post-exercise oxygen consumption, which is a measure of how long after exercise your body continues to stay metabolically active and burn fat. We lose 0.5% of our muscle mass every year after 30. Weight lifting is the best way to maintain bone health, not calcium supplements.
Eliminate plastics. This may sound like an unusual recommendation but all plastics, even “BPA-free” products leach chemicals which mimic our own hormones, especially estrogen. These chemicals are also called “obesogens” since they contribute significantly to obesity. There are many studies now showing how plastic use and subsequent exposure to these chemicals, even tiny amounts over long periods of time, can disrupt our hormonal signaling and one of the major side effects is weight gain. Just eliminate them. No plastic bottle. NEVER heat food in plastic. Minimize storage in plastics. There are studies that exercise clothing, often marketed as “sweat-wicking” are made from plastics which can get absorbed through the skin. There is much more about hormone disruptors if you click here.
SLEEP WELL. Poor sleep is a significant contributor to weight gain. The hunger hormone ghrelin and the satiety (I’m full) hormone work in opposite directions with poor sleep. Those who sleep poorly have been shown to consume 200-300 additional calories a day. It adds up fast. Poor sleep also impacts on poor decision making leading to poor food choices. The stress of poor sleep also leads to “stress eating” as well as chronic cortisol production, leading to weight gain. Poor sleep also leads to poor exercise efficiency and output, not to mention the decision whether to exercise at all or not.
Weight Loss Tip Sheet and BMI Calculator – Downloadable Excel Spreadsheet
TAKE CARE OF YOUR MOUTH, TEETH and GUMS
Your mouth is full of all sorts of microbes, and they are supposed to be there! There are millions of them in your mouth which normally include many varieties of bacteria, yeast and even viruses. They serve many purposes including helping to start the process of digestion along with the digestive enzyme amylase which is produced in our saliva. You don’t want to remove these microbes. You do want a healthy balance however so it is vital to properly take care of your mouth. Bad teeth and gums cause inflammation which is linked to cancer, heart disease and dementia, not to mention the fact that dental infections are the most common cause of neck abscesses and lymph node swelling, which I see a lot in my ENT practice. It’s estimated that 90% of Americans have some degree of dental or gum inflammation.
Dr. Robert Ostfeld, director of the Cardiac Wellness Program at Montefiore Medical Center in NYC, lists dental hygiene a close second (just ahead of daily exercise) in importance behind a plant-based diet when it comes to promotion of cardiac health.
- Floss and brush twice a day. Use natural floss and bristles. Many commercial brands of floss use plastics to make them smooth and slippery. These chemicals dissolve in your saliva and get into your body.
- Visit the dentist regularly for cleanings (just avoid all the X Rays).
- Try to use a natural toothpaste. All the chemicals in commercial toothpaste are not healthy. If you want to be really geeky, it’s pretty easy to make your own toothpaste. Here is one link: DIY Toothpaste.
- Fluoride. Avoid it if you can. Although from a public health perspective, it has some benefits with regards to overall dental health, if you take care of your teeth by brushing, flossing and visiting the dentist and dental hygienist regularly you don’t need it. It’s an aluminum byproduct which is linked to dementia and liver damage. In addition, fluoride is a an antimicrobial and impacts on the healthy bacteria in your mouth with help to make nitric oxide, the gas which keeps blood vessels healthy.
- Do NOT use mouthwashes. 200 million Americans, 2/3rds of the country, wake up every morning and use these products. They kill the healthy bacteria in your mouth that start the digestive process, improve blood vessel relaxation and their destruction adversely impacts on the gut microbiome (balance of microbes in your intestines). There are studies that show that chronic use of “antibacterial” mouthwashes increase the risk of developing type 2 diabetes by 50% because they kill beneficial bacteria which help with blood sugar metabolism. Also, mouthwashes negate the beneficial blood pressure effects of high nitric oxide from foods high in nitrates like beets and greens whose effects can be measured within an hour of consumption. When you chew and consume foods high in nitrates, the bacteria in the grooves of your tongue convert the nitrates into nitrite which then gets converted into nitric oxide by the acids in your stomach (which is why antacids are bad for you by the way!). Nitric oxide is an important arterial wall relaxant, improving blood pressure. The only exception to the “non-rinsing” rule is if you use asthma or COPD inhalers that have steroids (Symbicort, Advair, Dulera…). These do increase the risk of developing thrush (an overgrowth of yeast) so it is important to rinse and gargle with plain water (not any other concoction) after using your inhaler.
- I am not a fan of other dental practices like tongue scrubbing either. Some people are obsessed with how their tongue looks. Tongue appearance is only partly related to the balance of the microbes in the mouth. It is also a function of what we eat and drink as well as tobacco use.
- Breath issues (halitosis). I see this issue a lot in my practice and the fact is that most people’s breath isn’t as bad as they think it is. They are just obsessed with it! There are some people with true halitosis and some common issues like bad teeth and gums, reflux and even sometimes sinus infections and cancers need to be addressed but these are the minority.
- Although things like red wine and coffee can stain your teeth, another forgotten cause are antibiotics. Another reason to avoid them.
After a lifetime of brainwashing by commercial toothpaste companies, we now understand that plaque is not the enemy. We just need the right kind of plaque on our teeth to protect them. We need bacteria in our mouths to protect our gums from inflammation. We need beneficial oral species to produce compounds, nutrients, and brain-signaling molecules that support our health.
Many toothpastes contain more chemicals than you can read or pronounce. Here are some of the poisons in commercial toothpaste. Check your tube’s label; then throw it away.
- Sodium Lauryl/Laureth Sulfate. This surfactant (detergent) strips all bacteria off the teeth and gums.
- Sodium Saccharin. Suspected of causing cancer, it is also a glucose metabolic disrupter that causes weight gain.
- Stannous Fluoride & Sodium Fluoride. Fluoride is banned in many countries because it’s a thyroid disruptor, and linked with low intelligence. A toxic by-product of the aluminum industry, it’s being filtered through human bodies (municipal water, mouthwashes, and toothpastes) instead of being dumped into a to die.
- Colgate Triclosan. This is a powerful, non-biodegrading antibiotic that is a thyroid hormone disruptor and is forcing bacterial-adaptations in the body to become more virulent thus increasing inflammation. Now it’s being found in municipal water supplies, rivers, lakes, and newborn babies bodies.
- Microbeads. Tiny plastic spheres to help scrubbing. They are an environmental hazard in the waste waster system where they accumulate toxins and then come back to you via tap water since they are too small for municipal water to filter out. They are linked with gum disease because they harbor bad bacteria and become trapped between the teeth and gums.
- Red, Blue, Yellow Food Dyes . These are also banned in most of the rest of the world. They contain compounds including benzidine and 4-aminobiphenyl, that research has linked with cancer and behavioral disorders in children.
- Propylene Glycol, aka antifreeze. A solvent, humectant, and surfactant, it is linked with eye, lung, and liver toxicity. It penetrates easily through the gum tissue into the body.
- Diethanolamine (DEA). This is a foaming agent that is a powerful hormone disruptor. It combines with other compounds to cause esophageal and stomach cancer.
- Carrageenan. A derivative of red sea weed, which sounds natural, but in this case it’s linked to gut inflammation, colon ulceration, ulcerative colitis, disrupted insulin/glucose metabolism, fetal toxicity, and cancer.
- Artificial Flavors. These are known to cause: depression, dizziness, chest pain, headaches, fatigue, allergies, brain damage, seizures, genetic defects, tumors, bladder cancer, nausea, etc.
- Tea Tree Oil. An antimicrobial that disturbs the beneficial oral microbiome.
- Neem Oil. Another antimicrobial that disturbs the beneficial oral microbiome.
- Xylitol / Sorbitol. These are alcohol sugars. Although they come from plants, they are often from genetically-modified corn. It disturbs the oral and gut microbiomes; kills beneficial species. It is often fatal for dogs. It also causes gas.
- Whitening Agents. Usually a form of hydrogen peroxide, this is an oxidative agent that kills bacteria indiscriminately and damages gums with free radicals that can lead to oral cancer.
- Preservatives. These are linked with cancer and skin reactions. These do not belong in your mouth! Some examples are:
- Diazolidinyl urea,
- DMDM hydantoin,
- Imidazolidinyl urea,
- Polyoxymethylene urea,
- Sodium hydroxymethylglycinate.
- Parabens. These are also preservatives and have been shown to be estrogen mimickers and disruptors. They include:
- Methylparaben, and
- Genetically-Modified Ingredients like Glycerin & Lecithin. These come from GMO soy or canola oil. The contain the the deadly pesticide, RoundUp which supports destruction of agricultural soil, and introduces xenobiotic DNA to the body. It’s turning up in breast milk.
LISTERINE vs VEGETABLES
Dr. Robert Osfeld, a prominent cardiologist at Montefiore Medical Center in the Bronx, who founded and runs the Montefiore CardiacWellness Program, lists dental health as the third most important thing after improving the diet, stressing plants, and exercise. Tobacco cessation is a given.
The inflammation from bad oral hygiene contributes significantly to inflammation and cardiovascular disease.
- Visit the dentist. Obviously, taking care of any bad teeth is important.
- Brush twice a day with as chemical-free toothpaste as you can.
- Floss twice a day to get all the junk out of the nooks and crannies.
Do NOT use mouthwashes. They are not necessary and in fact make things worse. They essentially kill off the beneficial bacteria in your mouth allowing unhealthy bacteria which cause dental decay to flourish. These good bacteria start the digestive process, particularly converting nitrates from plants, especially leafy greens, into nitric oxide (NO) which has numerous beneficial effects, not the least of which is that it is a potent vasodilator, meaning it opens up arteries, by relaxing their walls. The inner lining of our arteries, the endothelium, actually generates this compound, but the amount wanes with age and progressive cardiovascular disease. As an aside, NO is also generated in the nose which is why nasal breathing, as opposed to mouth breathing, is crucial. Another important role of NO is to improve glucose uptake and metabolism, reducing the risk of developing pre-diabetes and diabetes.
With respect to oral hygiene, nitrates from fruits and vegetables have the following effects:
- It positively impacts on our oral biofilm, aka plaque. This is the film of material, mostly bacteria, which leads to tooth decay and gingivitis. Nitrates inhibit its formation.
- When you eat, the pH, the measure of acidity, in your mouth goes down, meaning, more acidity. Although this helps the digestive process, an unhealthy diet full of sugar and processed food causes excessive acidity which contributes to tooth decay. Nitrates prevent this from happening, improving the pH of the mouth and thus preventing tooth decay.
- Nitrates inhibit the growth of unhealthy bacteria associated with tooth decay and gingivitis. Nitrates promote a healthy oral microbiome.
Brush your teeth with a chemical free toothpaste, floss twice a day, eat lots of fruit and veggies, and you are well on your way to a healthy mouth.
IMMUNE SUPPORT vs IMMUNE REJUVENATION
Although supporting a healthy immune system and minimizing additional inflammation in our bodies is crucial, we should also remember that our immune cells are constantly forming and our immune system can rejuvenate. If your immune system is not functioning optimally, do you want to continue supporting that or have your immune system rejuvenate, starting from scratch with healthier cells?
It all goes back to our Bone Marrow.
All of the cells floating around in your blood as well as those involved in inflammation and immune response in our tissues are derived from hematopoietic stem cells, cells which can be turned into ANYTHING our body needs. These cells sit there in the bone marrow, not designated for any particular purpose, and then get called upon to fill in any gaps in our immune defenses that are needed. So if you are depleted, whether it is nutritionally depleted, sleep depleted, overstressed or overloaded with toxins, the immune cells which come out of your bone marrow come out imprinted with what is going on in your body. The cytokine storm is a manifestation of an already stressed body with immune cells predisposed to over-reaction. There is a reason that it is seen mostly in people with any chronic disease, such as diabetes, hypertension and heart disease, any autoimmune disease but also, simply being overweight and obese, which puts a stress on the body in many ways. Although many of these conditions are diseases of excess, there are some deficiencies which also contribute.
What is rejuvenation? Every 10 seconds, our bone marrow produces 1 million new white blood cells, 23 million red blood cells and 50 million new platelets, the ones responsible for proper blood clotting. Older cells floating around in your body, imprinted with your present life experiences, are ones you want to get rid of and replace with fresh, healthier cells.
Immunophenotyping is an evolving field of study looking at how specific immune cells get imprinted with specific messages to become what they are. Their phenotype. Genotypes are the genes. Phenotypes are the expression of the genes, how a cell works, looks and acts. To solve those answers, one could try to re-learn everything or simply study those cultures and populations where people don’t have chronic diseases or frequent infections. One could simply look to the “Blue Zones” (check out the book by Dan Buettner), areas in the world where today, people routinely live well into their 90’s and even 100’s, healthy, mentaly clear and with limited chronic diseases. These are all places that did not have immediate access to modern medicine or antibiotics and still did great. What did they do? They were, among other things, sleeping well, moving a lot, managing stress and eating certain diets. Although 4 out of 5 Blue Zones eat some animal products, they constitute 5-10% of their diet, which mostly consists of unprocessed fruits, vegetables, beans and nuts and seeds. The group that did the best however was 100% vegan and they are in Loma Linda, California. ALL of them had one food in common though, beans!
The most important component we can benefit from in plants are the PHYTOCHEMICALS. These compounds are basically the immune defense mechanisms (their immune system) of plants and there are 1000’s of them. They are generated when the plants are under stress. When a plant is stressed, it can’t run away. They have developed complex compounds to defend themselves.
We evolved in concert with all the plants and animals around. This is called co-evolution. An example of how reliant we are the world around us is vitamin C. Humans and Guinea Pigs are not able to generate vitamin C. All other animals can. We probably used to but because we can get it abundantly from the environment, we probably bred this ability out of the human gene pool.
The orchestration of all the different phytochemicals from all the different plants we eat, plays a unique role in how our bodies get rid of the older, damaged immune cells and stimulate production of the newer, healthier cells, produced in a healthier environment. Autophagy is a term which describes digestion of our own cells in a process that accomplishes just that. Older, damaged cells are “auto” consumed and this process is stimulated by phytochemicals. It is a natural process which is hampered by inflammation in the body and stimulated by healthier lifestyle habits, particularly a diet rich in plant phytochemicals. This is not an “anti-viral” effect. It is an “immune-rejuvenating” effect, allowing the healthier immune system to fight off infection better, rather than respond to an overwhelming infection or inflammation.
The bottom line is that the dietary pattern which has the most positive impact on human health is one which focuses on a varied, whole-food, plant-based diet. The factor which supports the healthiest gut flora, where 80% of our immune function is located, is the variety of plants you consume. Not animal products, all of which are pro-inflammatory, especially in the amounts most people consume.
Food can either heal disease or act as a slow poison. You can continue to eat pro-inflammatory foods like processed food, added sugars and animal products. Or you can consume foods which improve health and support decreasing inflammation and rejuvenating your immune system like fruits and vegetables. The big ones are:
- Fruit, all of them. Eat a varied mount. The big players are berries, apples, citrus like oranges but anything is great. The sugar in fruit, assuming the fruit is whole, is not an issue. I am diabetic and eat a ton of fruit.
- Greens. Eat as many as you can, as often as you can. I eat them for breakfast with my morning oatmeal. The big players are kale, spinach, chard and my favorite, dandelion greens, which has 10x the antioxidants of the next most potent green, spinach.
- Cruciferous vegetables. Especially broccoli, Brussels sprouts and cauliflower.
- Nuts and seeds. Keep them raw and unsalted but don’t overdo it. 1 handful has 18ish grams of fat. Better fat, but the more you eat, the more fat you consume. And FAT, not sugar, is what causes insulin resistance, the precursor to pre-diabetes and diabetes.
- All other veggies are great. Eat many, many different types and eat them often.
- If you choose to eat animal products, keep them clean, not factory-farmed, free range, wild caught and NOT factory farmed.
In addition to diet, all the other things are important:
- Move as much as you can.
- Manage stress as best as you can.
- Sleep as well as you can.
- Stay connected with friends and loved ones as much as you can.
SOCIALIZE MORE (SOCIAL MEDIA DOES NOT COUNT!)
For the vast majority of human evolution and history, we lived in small, gatherer-hunter groups. We evolved not only physically but also socially. We were incredibly reliant on one another for survival. Over the last 10,000 years (a blink of an eye from an evolutionary standpoint), we started living in larger and larger groups but this really took a steep increase only in the last few hundred years (a “microblink”). Today, according to the UN, around 55% of the world’s population is thought to be living in an urban area or city, with that figure set to rise to 68 percent over the coming decades. In North America, 82% of people were found to live in cities, compared to 74% in Europe. In Asia, around 50% of people were based in metropolitan areas, while Africa was thought to be the least urban-populated continent with only 43% of its population situated in cities. To date, there are 33 urban centers with populations of more than 10 million people, although this is expected to rise to 43 by 2030, mostly in developing countries. In 1990, there were just 10 megacities worldwide. Tokyo is the world’s largest city with a population of approximately 37 million people, followed by New Delhi with around 29 million and Shanghai with 26 million.
Despite the explosion of social media and the incredible ability for humans to stay connected electronically, we are more isolated and depressed than ever before. 20 years ago, people reported that they had on average 5 friends they would consider close and on whom they could rely on in a crisis. Today, that number is 0. Yet we have on average 338 Facebook “friends” and 707 followers on Twitter. Constant exposure to social media has made our brains hyperactive. That is insane. Most people have ZERO close human connections. It’s no wonder that worldwide depression and suicide rates are epidemic. 50 years ago, depression rates were 1:100. Today, 1:2 people report some degree of regular depression.
People who actively maintain relationships with family and friends live longer and are happier. Isolation and depression triple the rate of premature death from all causes by 3-10x. Cancer patients with a support system have longer survival and higher cure rates than those who don’t. Caring for another person or animal is therapeutic. Join a club. Practice religion. Volunteer. Visit with family and friends often. It is also important to take care of our elders. It may seem like a burden, but the societies who live the longest (Blue Zones) revere and respect their elders and keep them involved in day-to-day life. A study of genetically identical rabbits showed that those who had human interaction and love had a 60% rate of development of cardiovascular disease. Another study showed a direct linear relationship between using Facebook and depression. The more you use it, the more depressed you were likely to be. The negative impact of loneliness is equivalent to smoking 15 cigarettes a day. Numerous cancer and surgery survival studies show significant increased survival in those who had a social network, especially immediately at home. There was a cancer survival study nicknamed the “Russian Bride” study because it included men who had married women who came from foreign countries. They all had improved survival.
Being socially supported and having faith makes you 7x more likely to survive major heart surgery. Patients facing heart surgery were asked the following 2 questions:
- Do you participate in regular social groups?
- Do you draw strength and comfort from your religion or spiritual faith?
If you answered “yes” to both, your chances of being dead 6 months after surgery was less than 5%. If answered “no” to both, your chances of being dead were 25%!
Altruism, the selfless concern for the well-being of others, stimulates the same parts of the brain as heroin. In other words, behaviors like doing things for others, being kind, being generous, makes you feel good and is addicting.
Put down the phone or tablet! We have de-evolved into a “heads-down” society, too interested in the latest tweet, post or “like”. In 2018, mobile phone subscriptions topped 6.8 billion which is almost 1 for every person on the planet! 25% of Americans reach for their phones within a minute of of waking up and 50% are checking their emails within 10 minutes. In Britain, the average person looks at their phone 221 times a day. Americans do a little better in this area only looking at our phones 46 times per day on average but that’s up from 33 looks per day in 2014. Those between the ages of 18 and 24 look at their phones most often, with an average of 74 checks per day. Americans in the 25-34 age bracket look at their devices 50 times per day, and those 35-44 do so 35 times each day. Most look at their phones within five minutes of waking up. But 26% of those in the 18-24 age range said they look at their phones immediately upon waking up. The first thing most people do on their phones in the morning is now text messaging, not checking email. In the US, 6x more car accidents are now caused by cellphone related distracted driving than drunk driving in the. Another alarming statistic is that the average American touches their phone 2,600 times a day with “super users” topping 5000 touches a day. 10% of Americans check their phones DURING sex and 35% check them immediately after sex. A UK study showed that the average woman spends 30 days a year (entire days) playing games on their phones and the makers of a tracking app called Moment estimate that the average person will spend 11 years looking at their phone! 86% of smartphone users check their phones immediately upon waking up.
A 2014 study estimated about 10% of all pedestrian injuries are due to cell phone distraction. It seems obvious but when you’re looking down at your phone and in motion you may not see obstacles that are right in front of you. Thanks to cell phones, distracted walking has doubled emergency room visits in 5 years.
PUT DOWN THE PHONE AND FOCUS ON WHAT YOU ARE DOING!
Nothing is more disturbing than seeing a family out to dinner, supposedly to spend time together, with each member staring down at their device. 81% of Americans look at their phones while dining out. We no longer communicate with seeing and talking, just typing and posting. Social media (Facebook, Twitter, Snapchat, Instagram, Texting…) is anything but social. It is anti-social. We don’t know how to communicate like normal human beings anymore. An analysis of millions of Twitter posts correlated angry posts with coronary artery disease.
The most valuable social trait to learn and develop s how to listen and communicate with each other. Studies have shown that exercising your mind like playing card games is great for brain health but the effect is significantly greater if those games are in a social context. Solitaire is good but poker with a group of friends is 10x better. People who are social isolated and depressed have a 10x greater risk of all-cause mortality.
From an environmental perspective, cell phones are a disaster. American alone discard 125 million cell phones a year generating 65,000 tons of waste. Cell phones are the fastest growing form of manufactured garbage in the nation. Our phones are made with various toxic chemicals like lead, mercury, cadmium, arsenic and flame retardants, all of which make their way into the soil, water and eventually the food chain. Look at this website for more information about the dangers of cell phone use. Recent research has also linked blue light exposure to retinal deterioration leading to macular degeneration and even glaucoma. For more on this, look at this summary: Blue Light and Vision.
The “Happiness” Study. The Harvard Study of Adult Development, dubbed “The Happiness Study” is the longest running study in the United states. The project has followed 724 men since they were teenagers in 1938. It is now following the third generation of men and is on its 4th study coordinator. Approximately 60 of the original men, now in their 90’s, are still left. The group consisted of men from various economic and social backgrounds, from Boston’s poorest neighborhoods to Harvard undergrads. President John F. Kennedy was even part of the original group. Over the years, the researchers have collected all kinds of health information, and every two years they ask members questions about their lives and their mental and emotional wellness. They even interview family members. They found that specific traits and behaviors were linked with increased levels of happiness across the entire group. The 2 major findings were:
- Stay connected. The study has found a strong association between happiness and close relationships like spouses, family, friends, and social circles. Personal connection creates mental and emotional stimulation, which are automatic mood boosters, while isolation is a mood buster. This is also an opportunity to focus on positive relationships and let go of negative people in your life, or at least minimize your interactions with them. However, even apparently volatile relationships were better than no relationships.
- Knowing when to let go. As the people got older, they tended to focus more on what’s important to them, and didn’t sweat the small stuff to the degree they did when they were younger. Other research supports this mindset, and has found that older adults are better about letting go of past failures. “They tend to realize how life is short and they are more likely to pay more attention on what makes them happy now,” says Dr. Waldinger, the present study coordinator.
SOCIAL CONNECTION, the VAGUS NERVE and HEALTH
When we experience feelings of love and connection, our brains release a cocktail of hormones and chemicals. These include dopamine (mostly known as the one released when we engage in addictive behavior including consuming sugar), testosterone, estrogen and most importantly oxytocin. Known as the “love hormone” released when mothers nurse their babies, it’s both activated by and helps to create connection, attraction, feelings of love and bonding. Oxytocin is also an anti-stress tonic, counteracting the effects of the fight or flight response and the stress hormones which drive it.
Control of many of these hormones, especially oxytocin, is the vagus nerve. Latin for “wandering”, the vagus nerve is the most complex nerve in our body, impacting on every organ. It is key to both sending information out to such organs as the gut and heart, but 80% of the electrical traffic travels from these organs to the brain. We don’t just have one brain; we have 3, the head brain, gut brain and heart brain, which contains 40,000 neurons, third most in the body behind the brain and the gut. It’s responsible for the “gut feeling” (instinct) or “butterflies in your stomach” (nervousness or anticipation) and it is what causes your heart to “pitter patter” (love). One of the organs the vagus nerve stimulates is the diaphragm, a sheet of internal skeletal muscle that separates the chest cavity, containing the heart and lungs, from the abdominal cavity. It performs an important function in respiration: as the diaphragm contracts, the volume of the chest cavity increases, creating a negative pressure there, which draws air into the lungs. Signals from the brain stimulate the diaphragm to contract, assisting with breathing. However, deep abdominal breathing, done with certain types of meditation, stimulates the vagus nerve, triggering secretion of all those relaxation hormones which help with calming the body and mind. Activation of the vagus nerve also occurs with inflammation in the body. Information is sent to the brain which in turn turns on our immune system, dampening inflammatory damage.
Just like your muscles, the vagus nerve can be exercised and its function improved and fine tuned. That’s why things like meditation, stress management and social interaction are crucial. Vagal tone refers to the ability to rapidly activate the parasympathetic (rest and digest) nervous system. Positive emotions, like love, tone the vagus. Every little “micro moment” of emotional connection is valuable and contributes to improved vagal tone. All moments of micro-connection are meaningful and with improved vagal tone, we are more open to feeling the positive emotions of love, compassion and empathy. In a nutshell, the more you love, the more you appreciate and benefit from love.
A form of meditation called loving-kindness meditation or LKM, emphasizes cultivating feelings of love, compassion and goodwill towards oneself as well as others. Studies have shown that this form of meditation improved social interactions. As these emotions and interactions improved, so did vagal tone. By shifting the “fight or flight” (sympathetic) stress response to the “rest and digest” (parasympathetic) anti-stress response, your body allows you to have and benefit from those important moments of connections, feelings of love and improve your ability to bond with others. The “fight or flight” response, stiffens your body, inhibits your genuine emotions like the warmth of your gaze, genuineness of your smile and overall inhibits your ability to make connections. It also decreases libido since when you are under threat, you do not need to be thinking about sex. The chronic perception of threat contributes to less sex drive.
Social interaction and connection is so crucial. Studies have shown that loneliness and social isolation increase the risks of heart attack and stroke by 30%. Sleep is disrupted. Inflammation increases. Your immune system malfunctions. Cancer rates are higher. Premature death increases by 20%. The impact on memory, cognitive changes and dementia is also significantly higher in socially isolated people.
Although virtual connections like phone calls and video and on-line interactions are great, nothing beats in-person interactions. Live interactions stimulate the vagus nerve the most. We are social creatures. We evolved that way. Supporting this is the fact that the “lizard brain”, the part which controls the sympathetic, fight or flight, response is much older than the part which controls the parasympathetic, rest and digest, part which evolved much later. This part is only seen in higher order mammals like humans and primates but also is found in such animals like cows, pigs, chickens and even fish.
FOOD and EXERCISE vs SOCIAL and MIND.
WHICH IS MOST IMPORTANT?
Below are some takeaway notes from journalist Marta Zaraska’s book “Growing Young”
The simple answer is that all of these lifestyle habits and practices are important. However, improving social interactions, having purpose, having a positive attitude and peace psychological well being are the most important. Here are a few examples of how lifestyle changes impact positively on mortality risk:
- Exercise – 33% reduction
- Fruits and vegetables (6 or more servings a day) – 26% reduction
- Whole grain intake (3 servings a day) – 23% reduction
- Cruciferous vegetable intake (min 5.8 oz. a day) – 20% reduction
- At least 4 healthy lifestyle changes combined – 66% reduction
(alcohol consumption, smoking, diet, exercise)
As compared with social/mental qualities/behaviors:
- Happy marriage – 49% reduction
- Large social network – 45% reduction
- Knowing you have friends you can count on – 35% reduction
- Being an extravert – 24% reduction
- Volunteering – 22% reduction
- Agreeableness – 20% reduction
- Having a purpose in life – 17% reduction
- Good social integration – 65% reduction
Some examples of how lifestyle changes and habits impact negatively on mortality include:
- Red meat intake – 29% increase
- Obesity – 29% increase
- Vitamin A supplementation (not from food) – 16% increase
- Beta carotene supplementation (not from food) – 7% increase
As compared with social/mental qualities/behaviors:
- Loneliness – 26% increase
- Pessimism – 14% increase
- Unhappiness – 14% increase
- Neuroticism – 14% increase
The point is that although diet and some basic physical lifestyle habits do have a significant impact on early mortality and longevity, the social and mental aspects of wellbeing are just as, if not more important.
Social interaction is crucial for wellbeing. A study showed that loners had a 45% higher risk of developing a cold than did more gregarious people, even though everyone was exposed to the exact same dose of the cold virus. In other words: hanging out with your friends can protect you from sniffles.
The biological links between our social connections and health are largely due to the interplay of neuropeptides such as oxytocin, dopamine, endorphins, and serotonin, as well as the HPA (hypothalamic-pituitary-adrenal) axis.
What matters almost as much as the status of our social lives is how we perceive it.
Loneliness and social isolation are two distinct concepts. The first one is subjective (you feel like there is no one out there for you). The second one is objective (there really is no one out there for you). You may be surrounded by family and friends, and yet feel lonely. On the flip side, you may be truly alone and not experience loneliness. But just as is social isolation, loneliness is prevalent in the Western world. 20% of Canadians claim to be lonely, while in the US, the number of people reporting loneliness is around 17%. Western Europe is a bit better off, with rates of loneliness around 10%. With old age, loneliness rates climb almost everywhere across the globe. In Canada, approximately 50% of seniors over the age of 80 say they are lonely.
There may be some evolutionary explanations as to why loneliness impacts on immune function. When we feel lonely, our immune systems switch away from fighting viruses, much more common organisms our bodies have to contend with, toward a better antibacterial response. In a tribe, viral infections spread easily, so the body has to be ready to take them on. But once a person is secluded, the risk of a virus goes down, while the risk of “lion-induced” wounds, teeming with bacteria, goes up, and that’s what the body focuses on. Just as the feeling of hunger turns on your search for food and puts your body in an energy-saving mode, your feeling of loneliness switches on your “alone on a savanna survival mode.” Such a turn away from an antiviral response toward an antibacterial one means that when you feel lonely, inflammatory activity in your body goes up. When we were hunter-gatherers, it could have prevented you from losing limbs, or your life, to gangrene, but in 2020 it just raises your risk of metabolic syndrome.
Loneliness also impacts on sleep quality. If you are all alone on the savanna, falling asleep alone is not a good idea (it makes it too easy for lions to creep up on you). Studies show that lonely people experience more fragmented and restless sleep, even if they sleep for as many hours as those who don’t feel all alone in the world. Poor sleep can mean heart disease, diabetes, and cancer, and ultimately result in a shorter life.
A lot of research has found that simply living together as a couple is not as good for your physical well-being as is getting married. A 2015 Finnish study showed that those who cohabited without getting married had higher risk of heart attacks than did married people. For women, living out of wedlock was actually worse than being single. Cohabitation meant 69% higher risk of a heart attack than being married, while those living on their own had that risk elevated only by 8%. Neither is good, but “living in sin” seems to be far worse.
The longest married couple has been together for 79 years, as of 2018. “We never hold grudges. Most arguments are about food,” John said. To which Ann replied: “Yeah, like, ‘You bought the wrong kind of cucumber!’ ” In a more serious moment, Ann admitted that the key to their success is respect for each other. “We are not arguing; we are listening. And we’ve always listened,” she said.
Humans are not the only species to form friendships. Horses, monkeys, giraffes, chimpanzees, spotted hyenas, donkeys, elephants, and even guppies form plutonic bonds with other animals, and not only even their own species. Male dolphins enjoy synchronous swimming with their mates, while horse “girlfriends” gently bite hard-to-reach spots on each other’s necks to remove dead skin and untangle hair. Cows stand close to their friends and exchange licks. And just like with humans, they do not do well when their social connections are severed. When such animals are isolated, their longevity suffers. Lonely horses live shorter lives, and so do lonely fruit flies. Mice get fat, develop type 2 diabetes, and even sleep poorly when they are alone.
If you can do just one single thing for your health and longevity, that thing should be finding a great partner and committing to the relationship. Marriage, and in particular a happy one, can stave off cancer, diabetes, heart disease and even the flu. Not only does it calm our stress response and the HPA axis, it can also boost the release of health-relevant social hormones. The effects are so large that if a pack-a-day smoker found lasting love, their mortality risk would be the same as if they didn’t smoke at all.
And then there is friendship, the second most important determinant of health and longevity. Personal connections are the key, not those made on social media. A Facebook friend does not have the same impact on your health as a live, in-person friend. In fact, social media friendships probably hurt more than they help. Studies have shown that the more social media friends you have, the lonelier you are.
To live long, you need strong social relationships. You need a committed romantic partner, a few best friends, and caring neighbors.
WORDS, THOUGHTS and ACTIONS MATTER
“Your beliefs become your thoughts,
Your thoughts become your words,
Your words become your actions,
Your actions become your habits,
Your habits become your values,
Your values become your destiny.”
Experts estimate that the mind thinks between 60,000 and 80,000 thoughts a day. That’s an average of 2500 to 3,300 thoughts per hour. Most of these thoughts are fleeting things that come and go over which we have no control. To make matters more complicated, you can have what appear to be multiple thoughts simultaneously, or, they are occurring so fast, it is hard to separate them out. Many thoughts, however, and arguably the most important ones, we can control. How and what we think impacts on everything we do and how we interact with the world and all those around us. Our thoughts and beliefs dictate our actions and interactions. Although we may think of our thoughts as our own individual property, they impact on not only our mental and physical health, but on the health of everything around us; people, animals, plants, the planet…
In a world so connected through our devices, social media platforms and media, human beings are more isolated and depressed than ever. People are losing the ability to interact personally and it is sad how most people interact only digitally. The danger is that these types of communications are impersonal and run the risk of being misconstrued and are easily escalated. In addition, the temptation to REACT immediately, rather than take time to think and ACT, is too great. Something as simple as typing in capitals or using punctuation can be misconstrued as anger. Because there is no personal interaction or immediate consequence, people feel emboldened to say, or rather type, things that they would not ordinarily say. They are quick to criticize without knowing all the facts or the other person’s perspective or situation. In many cases, social posts are extremely hurtful and they can have tremendous consequences. A British survey of 2000 people found that 25% of them admitted to making personal remarks to others online they would never say if they were standing in front of them in real life.
For every hurtful interaction, it takes 5 positive ones to offset the harm to our mood and drain on ones energy. One person with toxic behavior in a group diminishes the entire group’s performance by 30-40%. It just brings everyone down.
13th-century Persian Muslim poet and theologian Rumi said that, before speaking or reacting, ask yourself 2 questions:
“Is it true? and “Is it kind?”
We need to be more compassionate, kind and thoughtful in our actions and interactions.
Kindness matters. There is nothing as rewarding as giving back to others. Giving back can take many forms but it can be as simple as a smile. Kindness is the best medicine, and being generous can change the world.
KINDNESS MAKES YOU HAPPY. A simple act of kindness can turn a bad day into a good day. Not just for the receiver, but also the giver. Researchers at the University of British Columbia found that being generous leads to a significant increase in positive moods. Happiness is spread through each and every one of us. By taking the time to help others, we not only give them a better day, but their satisfaction and gratitude can make ours better as well. We connect with people through kindness. Being kind is the first step to real human connection.
KINDNESS IS GOOD FOR YOUR HEALTH. Worry, fear and stress all contribute to aging. Being kind slows down this process. Spreading kindness decreases anxiety in social situations. When we are kind towards others our bond with them grows. Scientifically, when we are kind, a hormone called oxytocin is released in our bodies. Oxytocin triggers a release of nitric oxide from the lining of our arteries leading more relaxed, responsive blood vessels, lower blood pressure and lowers the rate of heart attacks and strokes.
KINDNESS IS CONTAGIOUS. Kindness has a domino effect. When one person stops to do something kind for another, those who witnessed the act are inspired to do the same. In 2014, an act of kindness by a single woman in a Starbucks drive-thru sparked a 378 person long chain of paying-it forward. Acts can be as small as smiling at a stranger, paying for someone’s coffee or even donating to a good cause. It’s these moments that spark a chain reaction of compassion in people. Kindness is an easy habit to pick up, but an even harder one to let go of.
KINDNESS SPARKS HOPE. Giving back to those in need not only makes them feel better, but it can also give them hope. The greatest thing we can do for another human being is to make them feel less alone, and what better way to do that by simply being kind. One small act of compassion can make a huge impact on someone’s life. It only takes one person to trigger an entire movement. Showing kindness to others is the first step to creating happier, healthier, and more hopeful people.
TOUCH – THE MOST NEGLECTED SENSE
“Touch is not just a sentimental, human indulgence. It’s a human necessity. ”
Professor Francis McGlone, human touch researcher.
All mammals evolved with physical touch as an important part of social interaction Indeed, the first of the senses to develop in a fetus is the sense of touch. A simple touch can ease stress, raise mood and solidify bonds. Unfortunately, we are living in a world which is becoming more disconnected and in fact, averse to touch. People are afraid of touching each other for fear of it being misconstrued as a violation of personal privacy and space. It’s gone too far.
Studies on rats and dogs has shown that pups liked and cared for by their mothers were much calmer later in life than those who were isolated from their mother. The same has been shown with primates. All these animals demonstrated better stress responses and behavior if their mothers interacted with them with frequent touch and licking when they were babies. Studies of professional sports teams, basketball in particular, show that those teams where there was a lot of tactile interaction between players early on in their seasons did better than those which had less touch. Touch impacts on even unconscious behavior: if a waiter at a restaurant touches a patrons should when bringing the bill, the patron is more likely to give a more generous tip. Our children’s physical interactions have been slowly decreasing over time. Less play time. More paranoia about “inappropriate” touch. A classic example of how important touch is is shown by what was seen by 1000’s of children in orphanages in Eastern Europe. Those kids who were not touched often early in life had significantly higher rates of autism and a variety of other emotional and cognitive problems including much higher rates of ADHD and anxiety. Even those who were touched a little bit did much better later in life than those who were never touched, all of whom had serious psychological issues later in life. Human touch has a profound impact on childhood development.
From a basic scientific perspective, we are understanding more about the biology of touch. Interaction between species is only initially mediated through a mechanical sense called touch. All social mammals have evolved sensory nerve fibers called C fibers (also known as CT, or C Touch fibers), which respond to filial (friendly) contact between one animal and another. These are different from simple touch fibers called Fast Touch (FT) fibers, which let you now that something actually touched you. These fast fibers transmit messages to the brain in milliseconds travelling at almost 180 miles/second. An example would be when you touch something hot and you immediately feel pain and retract your hand. These speeds are achieved partly because of the insulation, called myelin, which helps with conduction. This myelin, by the way is what breaks down in certain neurological conditions like Multiple Sclerosis and Lou Gehrig’s Disease (ALS). CT fibers are different in that they conduct very slowly, sending a signal to the brain in 1-2 seconds so they have no immediate discriminative function. They aren’t myelinated in the same way. These fibers respond to gentle, stroking touch. They are the ones responsible for the emotional response to pain. As mentioned above, when you touch something that burns, the fast fibers cause you to retract your hand because of the pain but what makes you cry, delayed by a few seconds, is transmitted through the CT, slower and un-myelinated fibers. When stimulated in a gentle way, there is a resulting drop in the stress hormone cortisol, a lowering of blood pressure and heart rate as a measurable improvement in the levels of NK (Natural Killer) immune cells which, as their name suggests, kill targeted inflamed or infected cells. Human touch improves heart and immune health directly!
These CT fibers play a fundamental role in nurturing, bonding and affinitive touch and is present in every social mammal that has been studied. They C fibers are most concentrated on the upper back and shoulders areas. These are the areas where people tend to contact each other when trying to console or reassure one another. When measured, there also is a specific rate of stimulation which, not surprisingly, corresponds to typical human contact. These nerves are stimulated the most when there is a rubbing motion at a rate of 2-5 inches a second. Just a mere touch however is beneficial. There is a famous study in which children were offered a marshmallow but if they waited for a longer period of time, they would get 2 marshmallos. When followed for years, the kids who were able to withstand the urge and waited for the double reward were better adjusted as adults. In a different version of this study, if the children were given a supportive pat on the shoulder or the back, they were more able to withstand the urges. It’s thought that the supportive touch resulted in some reward/relaxation response making them better able to withstand the stress and wait for the reward later.
We also know that there is a relaxing and rewarding response not only in the receiver of the touch, but also the giver. Both have a significant increase in their parasympathetic nervous system tone. This is the one responsible for rest and relaxation. This is why stress is reduced when you pet your dog, cat or any other pet. Touch increases levels of serotonin, the “feel-good” neuropeptide as well as oxytocin, the “cuddle” neuropeptide. It also results in the release of naturally occurring opioids, reliving pain and stress.
Although they are located all over the body, the highest concentration of fast touch FT (fast touch) fibers are in the hands, specifically the digits and palms, where we interact with the outside world. The soles of the feet and to a lesser degree the lips also have very high concentrations of these fibers. These areas have a skin type known as glabrous (smooth and hairless) skin. These surfaces are about exploring the outside world. They are covered with low-pressure mechanoreceptors. The hand is exquisitely constructed to feel minute differences. A person blind from birth can read and understand braille faster than a non-blind person can read text. The skin of the rest of the body, mostly hair covered, is different in that they contain FT fibers, which are not present in the palms of the hands.
The US has the worst track record when it comes to maternal benefits as compared with the rest of the developed world. Whereas in most countries, mother’s are given many months if not over a year or even 2 years to spend with their newborn, it is not unusual in the US for a working mom to be back to work even as early as 2 weeks after delivery. Her newborn is handed off to a nursery and that is simply sad. Working, often single moms, along with their infants, are not given the support they need.
INTIMACY and TOUCH
The average American is having 15% less sex than in the 1990’s. In the UK, the rate has dropped by 20% in the last 15 years alone. Our phones have become the third member of our relationships. The romantic model of relationships, promoted by pop culture, is an impossible standard to meet long term. Rather than focusing on romance, we should focus on intimacy, and this is not necessarily sex. In a similar way that touch has diminished in human culture, so has intimacy. Intimacy has several important components:
- Feeling like two members of a team. It’s not 50:50. You don’t give a half effort. It has to be 100:100.
- Being responsive to each other’s needs.
- Being present with each other, not distracted by thoughts or devices.
- A deep level of caring for the other person.
- Sharing profound information. Thoughts, desires, wishes… things you don’t share with anyone else.
Here are 5 ways to nurture intimacy (and remember that it’s not just about sex) with a loved one:
- Schedule regular time to connect and be intimate without the distraction of technology.
- Give your partner a massage.
- Steal intimate moments together whenever you have time.
- Smile when your partner walks through the front door, even if you don’tt feel like it.
- Remember the 3D greeting (see below)
The 3D greeting. This concept was developed and popularized by Dr. Rangan Chatterjee, MD. It’s described in his book, “The Stress Solution“. The 3 components of the 3D greeting include:
- Eye. Look the person directly in the eye. It’s important to make eye contact.
- Touch. A handshake, a hug, a shoulder rub… it all helps make meaningful contact.
- Voice. A big “Hellooo” or “It’s great to see you”. Vocal communication is just as important.
The majority of human evolution was spent outside, in nature, under the sun, moon and stars, in fresh air. Not indoors, under artificial lighting with air conditioning, mostly stale and “scented’ air. Today, the average American spends 87% of their time indoors and an additional 6% in their cars. That’s a total of 93% of their day spent out of nature. The average American will spend a total of 9 years in front of the television! No one watches TV outdoors. That is insane.
Indoor air quality is often worse than what is outside. The air conditioning, scented candles, chemical sprays, cleaning products, cologne and perfumes as well as off-gassing furniture and carpeting all adds to the toxic compound load we breathe in. To that list, add things like formaldehyde from new clothing, chemicals from the dry cleaning process and all the Fe-breeze people use because they have to have something to smell. Get rid of the chemicals and the scent. Consider an indoor air filer But get outside more.
Artificial light also doesn’t equal sunshine. Lux is the unit of illuminance. In photometry, this is used as a measure of the intensity, as perceived by the human eye, of light that hits or passes through a surface. The average indoor lux level is between 200-300u. On a fully cloudy, dreary day, outdoor lux is ~ 5000u. In full sunshine, it’s ~ 100,000u! In addition, the quality of indoor lighting, not to mention the light coming from all our devices is significantly better. It’s natural! Here is a short list of the benefits of being outdoors and getting natural light:
- Saves energy and money.
- Increases focus.
- Reduces blood pressure.
- Reduces stress and anxiety.
- Boost your immune system.
- Increases happiness.
- Helps to prevent SAD (Seasonal Affective Disorder)
- Natural lighting is the only source of Vitamin D.
- It benefits your vision.
- It’s better for indoor plants.
- It can help you lose weight.
- It improves cognitive functions. It makes you smarter!
- Improves energy.
- It helps you sleep better.
Our bodies evolved based on various circadian patterns. All are based on the sun and it’s position relative to the earth. The rise and fall along with the sun exposure is what drives how our bodies function, primarily occurring during daylight our and how our bodies repair and consolidate, primarily occurring when the sun goes down and we go to sleep. It’s not just the daily cycles which are important. The seasons are based on the position and exposure to the sun.
Being outdoors connects us with nature which is where we evolved to be. In Japan, there is a ritual known as Shinrin-yoku, or “Forest Bathing”. Quite simply, it’s the act of going out and spending time in forests, looking around, touching the trees, breathing in the air and just being in nature. Trees emit phytoncides, or essential oils, which are their natural protection attacking microbes and insects. They may also be ways that trees communicate with each other. When administered separately, these phytoncides have has similar results to what happens when people spend time among the trees. The health benefits significant are measurable and include:
- Reduced blood pressure.
- Lowered stress levels.
- Improved sleep quality.
- Lower level of stress hormones cortisol and adrenaline.
- Improved symptoms of depression.
- Improved memory and concentration.
- Enhanced immune system function.
- Lower blood sugar levels.
- Improved heart rate variability (HRV), a sign of better heart function and lower stress.
Another odd-sounding practice is tree hugging. Hugging a tree increases levels of the hormone oxytocin. This hormone is responsible for feeling calm and emotional bonding. When hugging a tree, the hormones serotonin and dopamine make you feel happier.
Earthing is a fast-growing movement based on the notion that connecting to the Earth’s natural energy is essential for vibrant health. Connecting to the Earth is easy and can be done outdoors by walking barefoot on the Earth’s natural surfaces. Even though they many people spend time outdoors, their feet never touch the ground. It may sound a little hokey but I do think there is something to being in direct contact with the earth as often as possible.
A fractal is a pattern that the laws of nature repeat at different scales. Examples are everywhere in the forest. Trees are natural fractals, patterns that repeat smaller and smaller copies of themselves to create the biodiversity of a forest. Another source of fractals in nature are the patterns which are seen when sunlight comes through the clouds or between the leaves of trees. We are hardwired to respond to these patterns. Looking at a picture of these patterns does not have the same impact as seeing the same patterns out in nature.
An additional benefit of getting outside is that you breathe in air, filled with all kinds of beneficial things like pollen, microbes and compounds which various plants secrete, just like human pheromones. There is mounting evidence that all of these compounds keep you nasal and sinus microbiome healthy. The microbiome doesn’t just exist in the intestines, it it on every surface exposed to the outside world, including the skin, nose and mouth. Technically, the gut is exposed to the outside world since from the nose and mouth all the way to the anus is one tube. Now, if you have chemicals or pollution in your outside air, that’s no good so minimize those but otherwise, breathe in natural air.
All in all, anything you can do to get outside is great. Walk, garden, clean leaves, weed, hike, meditate… It’s all good.
Nothing is more important to us on Earth than the Sun. Without the Sun’s heat and light, the Earth would be a lifeless ball of ice-coated rock. The Sun warms our seas, stirs our atmosphere, generates our weather patterns, and gives energy to the growing green plants that provide the food and oxygen for life on Earth. Lack of sun exposure results in various medical problems including depression as well as vitamin D deficiency. Lack of sun exposure is associated with an increased rate of at least 15 different cancers as well as increased sun exposure decreases the mortality rate of some cancers, especially colorectal cancer, by 1/2. In today’s modern society, the average American spends 87% of their time indoors and another 6% in their cars. That’s 93% of our time out of the sun.
It’s important to avoid overexposure to the sun and sunburns but, because of our lack of sun exposure and our sedentary indoor lifestyle, most people (70% of adults) are Vitamin D deficient. Vitamin D is made on the surface of the skin from cholesterol but only with adequate sun exposure. It has many important roles and deficiency in this important hormone (it’s not actually a vitamin) can lead to osteoporosis, heart disease, diabetes, autoimmune diseases, high blood pressure, fertility issues and even cancer. Some studies indicate that vitamin D deficiency poses a greater cancer risk than smoking. Symptoms of vitamin D deficiency are very non-specific (like fatigue). Another interesting fact about vitamin D is that deficiency leads to abnormal function of a hormone called leptin which is responsible for fat metabolism. This is why vitamin D deficiency also contributes to weight gain. It takes 20 minutes of unprotected sun to start to burn but that is also all you need to make enough Vitamin D for a week (assuming you don’t wash it off right away since the reaction occurs in the skin and can take up to 48 hours to get absorbed). Supplements are often necessary but natural production is better.
Sunshine and Vitamin D. About 10% of the sun’s output is UV radiation, necessary to form Vitamin D through a photosynthetic process in the skin. The WHO reports that only 15 minutes of casual sunshine exposure on your hands, arms and face a few times a week is enough to maintain normal levels of Vitamin D. This is also assuming you do not use sunscreen which blocks Vitamin D production. There are a few other factors impacting on vitamin D levels:
- Age. A 70 year-old produces 4x less than a 20 year-old.
- Weight. Since Vitamin D is fat soluble, excess weight results in less Vitamin D available in the circulation.
- Skin tone. Darker skin individuals produce much less Vitamin D than Caucasians.
In addition to assisting in calcium metabolism, it is important for proper immune function.
- It assists in T cell movement throughout the body.
- It helps produce antimicrobial substances in the skin, lungs and gut, preventing infections.
- It suppresses excessive inflammatory responses from cells known to be overactive in many autoimmune disorders.
- It keeps Natural Killer (NK) cells functioning normally. NK cells are vital in cancer cell surveillance.
Independent of Vitamin D, the blue wavelengths of sunlight improve T Cell function and movement. Sunlight also helps to develop Tregs, T regulatory cells, important in proper immune function.
Despite less sun exposure, our immune system is ramped up in the fall and winter months as a protective mechanism against more exposure to microbes like Influenza and the myriad of cold viruses we are more exposed to.
There are many different types of rays present in sunlight however the rays that are most damaging to the skin are called “ultraviolet (UV) rays.” There are two basic types of ultraviolet rays that reach the earth’s surface, UVB and UVA. UVB rays are primarily responsible for sunburns and play the greatest role in causing skin cancers, including the deadly black mole form of skin cancer (malignant melanoma). UVA rays also play a role in skin cancer formation. In addition, the UVA rays penetrate more deeply into the skin and play a greater role in premature skin aging changes including wrinkle formation (photoaging). There are approximately 500 times more UVA rays in sunlight than UVB rays. Therefore, in addition to protecting your skin from the effects of UVB rays, it is also very important to protect from the damaging effects of the more numerous UVA rays. Traditional chemical sunscreen products have been more successful at blocking UVB rays than UVA rays. This is a great safe Sunscreen Guide. In general, avoid the following dangerous chemicals:
- Avobenzone. Avobenzone is a primary agent in commercial sunscreens due to its effectiveness in absorbing a wide range of ultraviolet (UV) rays, specifically the type that is known to cause sunburn (UVA). Avobenzone degrades in the sun, resulting in the release of free radicals that may increase the risk for cancer. Free radicals are also known to accelerate skin aging and research has also tied it to a slew of allergies.
- Oxybenzone. Oxybenzone and avobenzone function in similar ways but oxybenzone is more toxic. Both are found in the majority of commercial sunscreens. This chemical may actually be behind the increased rates of melanoma. Oxybenzone has been found to lower the birth weight of girls whose mothers’ bodies had high exposure levels. It’s also linked to allergies, hormone disruption, and cell damage.
- Fragrance. Sunscreen is often injected with a variety of artificial fragrances as a means of making the product more appealing and tolerable to the senses. The list of aroma-producing chemicals used for this purpose is enormous, over 1,500. You’ll rarely see the actual chemical name of a fragrance on a label as many chemicals are grouped together under the umbrella term “artificial fragrance.” Cancer, nervous system disorders, allergies, and birth defects are some of the shocking concerns that have been linked to artificial fragrance. It shouldn’t be surprising that an increasing number of public places are now banning their use.
- Parabens. Parabens are preservatives in sunscreen as well as a variety of other personal care and beauty products. There are 18 different varieties, and you can easily spot them on most labels because they all contain the word “paraben” in their chemical name. What makes them dangerous is that they’re estrogen disruptors. Parabens have been associated with breast cancer, infertility, abnormal development of the testes, obesity, asthma, allergies and benign tumors of the uterus or digestive tract.
- Vitamin A. Considering that it is a necessary nutrient, it might seem surprising to see vitamin A listed as a concern. When vitamin A is exposed to UV light, it creates free radicals that may cause genetic mutations that actually increase cancer risk. Daily use of retinyl palmitate (another name for Vit. A) by a pregnant woman may also be toxic to the developing fetus. It has been linked to brain swelling, developmental toxicity, cellular changes, and organ toxicity. Retinyl palmitate produces excess reactive oxygen species which can lead to cell death, and the compound may also be involved in cardiovascular disease.
- Other common chemicals to avoid include Octinoxate, Homosalate and Octocrylene.
Although Zinc Oxide and Titanium Dioxide are not perfect, they are the safest commercially used compounds.
Some Sunscreen and Sun Exposure facts:
- You absorb at least 60% of the chemicals you put on your skin.
- With full cloud cover, you still get 60% sunlight transmission.
- When around water, snow or other reflective surfaces, you get double exposure of sunlight because of reflection.
- SPF of 30 blocks 95% of UVA and UVB so anything stronger is overkill.
- SPF of only 9 reduces vitamin D production by 99%.
- Remember that you must re-apply every 2 hours regardless of SPF strength! It all wears off.
- Use non-toxic, organic or natural sunscreens like Zinc Oxide. Most other SPF chemicals have actually been shown to increase cancer rates. They also pollute the oceans, destroy barrier reefs and kill sea animals.
- they do lose potency so if a sunscreen is older than 2 years, replace it.
From an environmental perspective, sunscreens are another disaster. Much of the destruction of our coral reefs are caused by sunscreens which wash off of swimmers. It’s estimated that 6000 metric tons of sunscreen washes off swimmers into our waterways annually. Ultraviolet filters used in some sunscreens have been identified in fish from mountain lakes and rivers.
Here is an article about sunscreens including how you can even easily make your own: Sunscreen Information
SUN, CIRCDIAN RHYTMS and SUNSCREEN
For over 200,000 years, modern man evolved, living outside, in the sun, controlled by its daily pattern of rising and falling. Our internal circadian rhythms are in fact guided by this day and night pattern. Our bodies, including obviously the skin but also our retinas, were almost continuously bathed in it, until we went to sleep.
One of the myriad of benefits from sun exposure is vitamin D production. Although we can supplement with it, the main source of Vitamin D, actually a hormone crucial for proper immune health, was the conversion of cholesterol on the skin into Vitamin D from exposure to the sun’s UV rays.
Skin tone is based on the concentration of a compound known as melanin. Darker skinned people have a permanently elevated level whereas Caucasians have less. Melanin comes in 2 forms. Pheomelanin (red or yellow) or eumelanin (brown or black). We all have the same number of melanocytes in our skin. Skin color differences depend on how productive those cells are and the kind of melanin they produce. For example, Africans produce much more eumelanin than Europeans. Melanin also determines hair and eye color. Melanin builds up with sun exposure which is what results in a “tan”. Melanin is a protective compound. We evolved in equatorial Africa. As we migrated to the colder, northern climates, sun exposure diminished and our skin became lighter. Lighter skin is more sensitive to the sun and is able to produce Vitamin D more easily but as melanin levels rise, Vitamin D production drops off. In fact, even today, darker skin individuals are 2-3x more likely to be Vitamin D deficient. The same is true of regular sunscreen users. The flipside is that Europeans are 40x more likely to develop melanoma than Africans.
Unfortunately, because of the pollution humans have created, our ozone layer, the part of the atmosphere which filters out the damaging rays of the sun, has become thinned out, resulting in a higher incidence of skin cancer. Since banning certain aerosolized chemicals, the ozone layer has improved but the rates are still high and the damage done when people were younger, is coming back to haunt them today. That having been said, we have become obsessed with sunscreens to protect our skin. The problem is that by using these sunscreen, we are also preventing our bodies from developing natural protective mechanisms while also lowering vitamin D production, thus lowering our immune defenses. By absorbing the potent, harmful chemicals in sunscreens many of which act as hormone disruptors, we are also wreaking havoc on our bodies.
Sunscreens have been linked to:
- Lower Vitamin D levels and all the downstream effects that it has like various cancers, increased rates of heart disease and more infectious illness.
- Increased rates of diabetes.
- Increased all cause mortality
As mentioned above, some of the most common chemicals used in sunscreens are: Oxybenzone, Avobenzone, Octisalate, Octocrylene, Homosalate, Octinoxate.
These are dangerous compounds, most of which have been found to be endocrine disruptors also linked to cancer and you definitely absorb these compounds into your body. An FDA study showed that after only one application of a sunscreen which contains Oxybenzone, blood levels were 180x above what the FDA indicated was safe. After a second application, levels were 500x higher than the safety limit.
Zinc Oxide and Titanium Dioxide on the other hand are safe. However, they still block the sun and lead to Vitamin D and NO (see below) production deficiencies.
The other advantage of unblocked sun exposure is increased levels of Nitric Oxide, NO. This compound is also made by our arterial endothelium and the bacteria in our mouth from nitrates and relaxes the smooth muscles of our arteries, improving blood pressure. This may account for the increased rates of heart disease in regular sunscreen users.
A 20 year Swedish study of 30,000 women, comparing sun worshipers to sunscreen users revealed that the sun worshipers had a significantly reduced risk of blood clots and diabetes. Although they did have a higher rate of developing melanoma, they were 8x less likely to die from it. This difference probably is a result of the improved immune surveillance provided by the elevated Vitamin D levels. In addition,, the sun screen users had a doubling of all cause premature mortality compared with those who did not use sunscreens. The risks were similar to smoking.
Although sun exposure is important, care must also be taken. Burning is NOT a good thing. If you have a personal or family history of skin cancer, you must protect yourself, just don’t use sunscreens. Cover up, especially after 20 minutes of exposure and avoid those times when the sun’s rays are the strongest.
Although the internet, email, our cell phones, Siri, Google, Alexa, Facebook, Netflix and all other manner of digital devices and services have made our lives “easier” in many ways, we have also become slaves to all this technology. The average American’s attention span has decreased from 12 seconds to 8, less than that of a goldfish! ADD, Migraines, Stress, depression not to mention the link to various cancers have all been attributed to this technology. The average office worker fields 122 email messages a day. 86% of smart phone users check their phones when they wake up before their feet even hit the bedroom floor. The average American touches their smartphone more than 2500 times a day with “super users” topping 5000 x a day! People can spend as much as 4 hours a day on their phones. The average 8-12-year-old spends more than 4 hours a day looking at some kind of screen. ALL of this did not even exist one generation ago and our bodies certainly did not evolve with the digital age in mind.
Microsoft did a study which revealed that since the advent of smartphones, human attention spans have decreased from 12 seconds to 8 seconds, less than that of a goldfish!
The notion of “detoxing” or in other words, taking a break from a bad habit is like an alcoholic or drug addict saying, i am only going to not drink or use 1 day a week. The addict has to quit, and stay quit. It’s impossible to quit our technology but we can alter our behavior and relationship with technology to be lees of a slave to it. Here are some ways to do that:
- Turn off push notifications on cell phones and computers. All those dings and beeps are a distraction and draw us to our devices when we’re not even planning to do so.
- Convert from color to black and white. One reason we find our devices so alluring is they are vibrant and we are attracted to colorful things.
- Make mealtime digital free. At least keep the phones off the table. Turning the TV off would also help. In addition to being a distraction it contributes to obesity. A study looking at meal-time habits and obesity revealed that some people will use a TV show ending as the point at which they stop eating!
- Schedule “tech-free” hours. You don’t need to be checking email every 10 minutes.
- Limit screen time. ALL screens including the TV. We don’t need to be glued to every new award-winning television series.
- Make the bedroom “tech-free”. The bedroom is for sleeping. Also keep it dark and quiet.
- Rediscover paper. Having a notepad or journal slows you down and can also be therapeutic.
- Stick to ONE screen. This limits multitasking, not to mention less screen radiation exposure and brain stimulation.
- To relieve eye strain from staring at screens continuously, take occasional breaks from your screen and look outside.
Information overload (also known as infobesity, infoxication, information anxiety, and information explosion) is the difficulty understanding an issue and effectively being able to make decisions when one has too much information. We consume information the same way we consume food. Too many calories and too much information. Up until the last 75 years, people used to die of undernourishment. Today, people die primarily from over nourishment. Information is the same. One edition of the New York Times contains more information than what the average person 100 years ago was exposed to in an entire lifetime. And most of the information we take in is either negative or useless.
We are addicted to information. It is available 24 hours a day, 7 days a week from multiple sources such as newsprint (there is a magazine for everything these days), TVs, streaming services, smartphones, iPads, billboards, even monitors in supermarkets and other stores. People can’t stand in line for 30 seconds at the supermarket without pulling out their phones to consume more information. The average American spends 10 hours a day looking at a screen. And touches their phone 1000s of times a day.
We don’t even have to be reminded to look. Our devices remind us and let us know with constant notifications and information streams.
There are plenty of studies showing how negative news impacts negatively on stress and emotions. On the other side, there are plenty of studies showing how just sitting in silence and doing nothing, has tremendous beneficial impact on mental wellbeing.
As someone who unfortunately is now reliant on devices, I can appreciate these pressures. One of the biggest patient complaints about health care these days is that doctors spend more time looking at their tablet or laptop entering or looking up data rather than interacting with the patient. Medical information is also available at a much faster rate than before. I have patients calling the same day as a test, asking for the result. PATIENCE GRASSHOPPER (that’s a 1970’s reference to a TV show called Kung Fu).
We all need a little more down and quiet time and a little more patients. We are in too much of a hurry and the only place it’s getting us fast to is the grave!
“Without the right food, the medicine won’t work. With the right food, you won’t need the medicine”
MEDICATIONS – AVOID THEM IF POSSIBLE
More than 4 billion prescriptions are written in the US yearly. That’s 13 prescriptions for every man, woman and child. Every year. The sale of prescription drugs has gone up 300% since 1999. Despite only representing about 4% of the worlds population, the US takes 50% of all antidepressant medications prescribed and almost 100% of Vicodin prescriptions. Half of Americans are taking one prescription drug for something monthly, 21% are taking 3 or more and 10% of are taking more than 5 a month and we pay twice as much for drugs as any other country. If you take 5 or more medications (and that includes supplements and all over-the-counter medications), there is a dramatic increase in chances of having some kind of drug interaction or side effect. The average American over the age of 70 takes 7 or more prescription medications.
For every dollar we spend on medications, we spend one dollar on treating side effects of all those medications. These reactions are much more common as we age since our ability to metabolize drugs starts to slow down. Dying from a drug reaction is the 4th leading cause of death int he US. Drug reactions account for 7% of US hospital admissions. More than 20 million Americans over 12 years old have some sort of drug addiction. 75% of overdoses are caused by prescription drugs, more than heroin and cocaine combined.
Opioid addiction affects more than 10 million Americans. 25% of them started off by being prescribed opioids from chronic pain. The problem exploded in the 1990’s when the companies making these drugs began heavily marketing them to physicians, providing false assurances of low rates of addictive potential, despite evidence to the contrary. 130 people die every day from opioid overdose and 80% of heroin addicts started their spiral into drug addiction with opioids. The costs of dealing with this crisis is more than $78 billion a year in the US alone.
Advertising certainly does not help. Only 2 countries on Earth allow direct-to-consumer marketing: The United States and New Zealand. Just count how many television commercials or magazine adds you see which promote some kind of drug for depressant, reflux, impotence, constipation, cancer treatment or who knows whatever disease we must be struggling with. It’s really quite an avalanche of in-your-face marketing.
The whole medication approval system is corrupted as well. The FDA drug approval rate is 96%. How is it possible that 96% of the drugs submitted to the FDA can have been scrutinized enough to be considered safe? It’s not. In addition, drugs are rarely re-called. Usually, if some adverse or side effects are identified, a “black box” warning is simply put in the drug profile. The pharmaceutical industry pays the FDA over $1 billion dollars in user fees. The pressures are enormous not to “rock the boat”.
Medications do not treat disease. They treat symptoms and lab values. They give people a false sense of security. “I can eat more sugar or cholesterol since the statin or diabetes medication I’m taking will take care of that!”. It’s an illusion. Here are just a few examples:
- DIABETES. Diabetics who take oral medications, even if their lab-work is good, have the same mortality rate from heart attacks and strokes as those who do not take medications and have worse blood sugar control. Why? because the underlying disease is not fixed.
- STATINS. All else being equal, studies have shown that those taking statins gain more weight over time as those who do not. They will help lower serum cholesterol but long term studies show only a minimal reduction in risks of cardiovascular events (96% of patients on statins who already had a cardiovascular event had no reduction on subsequent events). You can however prevent such events with lifestyle modifications and avoid the complications of drugs. 20% of people have side effects from statins.
- ANTIHYPERTENSIVES. Just like with cholesterol, they may help get things under control but they do not treat the underlying disease. As a head and neck surgeon, I have done more emergency tracheotomies on patients because of side effects from some blood pressure meds than for any other reason!
- ACID REDUCERS for REFLUX. These medications do NOT treat reflux. They reduce the amount of stomach acid from being produced and do nothing to stop the stomach contents (food, acids and digestive enzymes) from refluxing up into the esophagus, throat and even sinuses where they are not supposed to be. These medications actually cause a lot of harm in the long term. Problems include bone loss, malabsorption, dementia and even cancer of the stomach. For more on this, click here.
- IMMUNE-MODULATING DRUGS. These are medications which decrease inflammation. 30 million Americans, almost 10% of the population, are some kind of drug chronically which suppresses the immune system. Although drugs like those used to treat autoimmune diseases like Rheumatoid Arthritis, Psoriasis and Lupus are in this category, so are commonly used medications like steroids and even ibuprofen (Motrin), also known as a Non-Steroidal Anti-Inflammatory Drugs (NSAID). These may help the symptoms but they also increase the risk of infection but suppressing your own immune response and some even increased risks for cancer.
- ACETAMINOPHEN, FOOD DYES and PHTHALATES – A COMMON LINK. Although considered the safest analgesic, including during pregnancy, there are some flags being raised about this commonly used drug. Acetaminophen, aka Tylenol, and phthalates have similar chemical structures. Animal studies on acetaminophen result in various congenital abnormalities and human studies have revealed a higher rate of undescended testes (cryptorchidism) in male babies born to women who took acetaminophen during pregnancy, particularly in the second trimester. Dyes in food and clothing containing the compound aniline can be converted into acetaminophen in the human body. In addition to the link to ADHD and other behavioral issues in kids, here is another reason to avoid food dyes, which are banned in most of the world, but not the US. Additionally, babies given Tylenol just once a month are 5x more likely to develop asthma when they are older.
- IBUPROPHEN. Another common analgesic, ibuprofen (Advil), has been linked to a condition known as compensated hypogonadism. In this condition, luteinizing hormone (LH), which stimulates testosterone production, is increased leading to normal testosterone levels. Unfortunately, compensated hypogonadism is also associated with reduced libido, reduced fertility, arthritis, cardiovascular disease and diabetes. Commonly used for arthritis, there is lots of evidence that in the long term, they actually make arthritis worse. By masking the pain, the conditions which cause arthritis go untreated. In addition they also become less effective
- NSAIDS. In patients with cardiovascular disease, within a week of taking NSAIDS daily, risks of heart attack and stroke go up. In addition they do nothing for chronic inflammation and actually contribute to worsening conditions like arthritis.
- ASPIRIN. Although this medication can be a miracle drug and certainty reduces the risks of heart attacks and strokes, it only does so in those at significant risk. Aspirin is the drug which results in the most complications and deaths worldwide. In those who take aspirin regularly, 1 in 15 (7%) will have a complication and 1 in 556 will die.
Our medical system and our approach to disease management is broken. Rather than try to correct an underlying disease process, physicians are too quick to recommend a medication to “fix the problem” and do not spend enough time explaining what causes their disease in the first place and how they can reverse it or cure themselves of it. Again, 80% of chronic disease like diabetes, hypertension and hypercholesterolemia is reversible and curable with simple lifestyle changes. Medicines can be lifesaving and are sometimes necessary for infections or major medical issues initially, but we are impatient and too reliant on them. Even aspirin, thought of as some kind of shield against heart attacks and strokes, in fact doesn’t prevent much of anything from a cardiovascular standpoint. In fact, aspirin is the most common drug, prescription and over-the-counter, causing complications and side effects, including drug-related death, of all the drugs used worldwide. If you have had a heart attack or stroke or if you have significant risk factors, there is some benefit but the risks are still significant. There are some studies showing that a daily baby aspirin might prevent cancer-related mortality but this effect is much more dramatic when one consumes fruits and vegetables high in salicylates (the active ingredient in aspirin).
We have used so many drugs that many can be measured in our drinking water. Between peeing small amounts out and flushing unused drugs down the toilet, we can measure drugs like antibiotics, hormones, epilepsy drugs, mood stabilizers, and blood pressure medications. It’s well-known by now that pharmaceuticals are affecting fish, frogs and lobsters. Small amounts of estrogen cause male fish to develop eggs, for instance. The contamination is amplified by the drugs which are excreted by livestock which are fed things like growth hormones and antibiotics. It’s estimated that 75% of the antibiotics given to livestock get excreted unchanged, making their way into the waterways and eventually into our drinking water.
Oral diabetes medications lower blood sugar values but have not been shown to decrease long-term complications or increase lifespan. The same is true of blood pressure medications. Antibiotics kill on third (33%) of normal healthy gut bacteria which has a slew of secondary side effects like malabsorption and breakdown of the intestinal wall allowing foreign proteins into your bloodstream leading to autoimmune reactions. Most infections clear themselves without treatment. anti-depressants, Anti-Anxiety and ADD medications are addictive, over-prescribed and mask the underlying causes of these conditions. Blood pressure medications have a slew of side effects. Anti-inflammatory drugs impact on immune function, decrease cancer cell surveillance and promote infections. Some immune modulators like those used for Rheumatoid Arthritis or Psoriasis actually increase your risk for various cancers.
Acid reducing medications are the most purchased drugs in US pharmacies. Proton Pump Inhibitors (antacid medications like Nexium, Prevacid, Omeprazole, Protonix…), medications taken for reflux, essentially stop acid production. In doing so, they cause malabsorption and have been linked to Vitamin B12 deficiency and well as osteoporosis. Some studies link it to dementia and kidney damage. There is much more information about reflux and drugs in the section about reflux on my Common Diseases page.
Drugs to treat dementia have been universally disappointing. Not only do they not work, some recent studies in 2018 showed that they can actually accelerate progression of dementia. The huge drug company Pfizer announced in 2018 that they were suspending all research and development into dementia drugs given their lack of efficacy.
Medications aren’t a cure; they’re a Band-Aid and don’t fix the underlying causes of disease. Medications like those prescribed for diabetes, elevated cholesterol and hypertension only decrease risks of adverse complications by at most 30%. Lifestyle changes however decrease risks by 80-90%! Overall drugs for conditions like diabetes, depression and asthma only help 60% of people and those which “treat” Alzheimer’s Dementia, arthritis and cancer only help 25% of people. The FDA only requires that drug companies show “some benefit” and don’t have many side effects. They do require that companies address why other patients do not get any benefit.
Another reason to avoid medications and try to fix the disease with lifestyle changes is that lifestyle changes, although they appear harder, are more successful and much easier to maintain. Many studies have shown that patients stop taking their medications at a rate that approaches 30-40% on their own within 6 months and almost 20% of prescriptions are not even filled in the first place. On the other hand, lifestyle modification programs like those run by Dr. Dean Ornish, have a 95% success, compliance and continuation rate even after 1 year.
Improve your lifestyle, treat the disease (not just the symptoms) and you can get rid of many medications. Diabetes, Coronary and Peripheral Artery Disease, Hypertension, High Cholesterol, Arthritis… All curable!
Another important issue is the opioid crisis in the US. More Americans died of opioid overdose in 2017 than died during the entire Vietnam conflict! The number of prescriptions for opioids (like hydrocodone and oxycodone products) have escalated from around 76 million in 1991 to nearly 207 million in 2013 (almost tripled). The United States is the biggest consumer globally of opioid prescription medications accounting for almost 100% of the world total for hydrocodone (e.g., Vicodin) and 81% for oxycodone (e.g., Percocet). Approximately 25% of patients prescribed opioids for chronic pain misuse them and about 10% become addicted. About 80% of heroin addicts started by misusing opioids. We are so addicted that we now have commercials on TV for medications to counteract the side effects (severe constipation) of using these addictive medications. We obviously prescribe too many drugs. People expect too many drugs and we need to re-evaluate how we practice medicine in our society. Again, we do not practice “health” care. We practice “sick” care. Less stress needs to be put on just managing illness and more stress on improving and preventing illness.
Antibiotics have added about 20 years to worldwide life expectancy since their introduction 75 years ago Before the advent of antibiotics, ~40% of deaths were attributed to out of control infections. Overuse of antibiotics has resulted in the antibiotic-resistance crisis we are facing. There are over 2 million cases of serious resistant infections a year in the US with over 30,000 deaths directly related to antibiotic resistance. Globally, more than 700,000 deaths are a direct result of drug resistant infections. The incidence of antibiotic resistant illness is increasing at a rate of 20% a year and today costs $2.1 trillion to treat. The CDC estimates that more than 50% of the antibiotic prescriptions written in the US are inappropriately prescribed. In addition, when people don’t take them the correct way, resistance is promoted. Adding to the problem are the antibiotics we consume on meat products. 82% of the antibiotics used in the US actually got to animals to promote their growth and prevent infections. Between the antibiotics prescribed by doctors and those consumed through our foods, the average American gets about 30 courses of antibiotics during a lifetime. This constant consumption of antibiotics also contributes to resistance. 30% of animal farm workers are colonized (permanently infected) with MRSA. For more on antibiotic resistance, read this article. Some natural alternatives to drugs to treat infections include garlic, ginger, honey and oregano.
For more on the history of antibiotics including their origins, use in agriculture and the development of resistance in humans, read this PDF: ANTIBIOTICS and AGRICULTURE – THE HISTORY and the DOWNFALL
There is a link between both chronic tonsillitis and chronic bladder and urinary tract infections in younger people and subsequent increased cancer rates, especially breast cancer. It is felt that the chronic use of antibiotics to treat these infections has resulted in damage to the gut lining and such a change in the microbiome that other systemic inflammatory changes occur leading to the increased risk of cancer. Antibiotics have also been linked to anxiety and depression. Just 1 course of antibiotics increases the risks of having a major depressive disorder by 24% and general anxiety disorder by 17%. 2 courses increases the risks by 54% and 44% respectively!
The gastrointestinal tract is referred to as the “second brain”. Upwards of 80% of the serotonin (the neurotransmitter responsible for feeling happy) and melatonin (the sleep hormone) is made in the gut. 70% of our immune function occurs in the gut. A standard course of antibiotics wipes out 60% of the healthy gut bacteria and it can take months to recover. In addition, only 1 course of antibiotics results in a 25% greater incidence of a major depression episode in the subsequent year and a 19% increased risk for anxiety disorder or panic attacks. 2 courses of antibiotic increase the incidence of a depression episode by 60%.
A class of very commonly used antibiotics known as fluoroquinolones (FQs) are particularly problematic. These include commonly used antibiotics such as Cipro and Levaquin. 25 million prescriptions for these two drugs are written annually. That represents 25% of all antibiotics prescribed in the US. Another less commonly used FQ is Avelox. In addition to their significant impact on the microbiome, they are known to degrade collagen, the most abundant substance by weight in our bodies. Collagen occurs in elongated fibrils, like scaffolding, and is mostly found in fibrous tissues such as tendon, ligament and skin, and is also abundant in cornea, bone, blood vessels, cartilage, intervertebral disc and the digestive tract. Although previously thought to be non-living tissue, it actually gets broken down and built up just like bone through the action of matrix metallo proteinases (MMPs). Some of the well-known complications of FQs because of the collagen-degrading effects include Achilles tendon rupture (4.5%) and corneal retinal detachment. Recent studies have also shown links to developing aortic aneurysms and aortic dissections (since collagen makes up the walls of arteries) and even aortic and mitral valve diseases, because of their significant collagen content. What’s worse, is that the impact on collagen lasts for many months after the round of antibiotics is competed. You could be treated for a urinary tract infection (which are usually treated with FQs) and then be out for a jog 2 months later and rupture your tendon! AVOID ANTIBIOTICS!
MADE UP DISEASES. Lastly, there is the important issue of invented and exaggerated diseases, often created by the pharmaceutical industry itself. A great example is Late-Onset Hypoandrogenism, also known as “Low T” or the apparent low testosterone crisis in men. Although some men truly have testosterone issues and there are many treatable causes, testosterone levels are quite sensitive and for many men, they are over prescribed testosterone as a prescription. Levels go up when a man holds a gun and go down when he holds a baby. If his sports team is winning, testosterone goes up. If they’re losing, it goes down. It fluctuates throughout the day normally to quite significant degrees.
Some other examples of artificial or exaggerated diagnoses include:
- Hypoactive Sexual Desire Disorder (HSDD). Companies have promoted this diagnosis even if your partner seems to have decreased interest in sexual activity.
- Social Anxiety Disorder. Shyness is not a disease which needs medications.
- Pediatric Bipolar Disorder. Children as young as 18 months have been prescribed anti psychotics with deadly side effects for symptoms that am mount to normal behavior.
- Reflux. Although some people truly have a problem with this, most just eat too much, too late and eat fatty, processed food.
- Excessive Sleepiness. Join the club!
- Osteopenia. It is normal for bones to become less dense with age. We ALL have weaker bones compared with much younger people. It’s called life!
- Menopause. This is a normal part of life. Not a disease.
NUTRIENT DEPLETION. One of the under-appreciated aspects of medications is how they can deplete nutrients from our bodies. Below is a chart showing some examples.
Here are a few more examples of common drugs’ impact on nutrient deficiencies:
- NSAIDs (Non-Steroidal Anti Inflammatory Drugs like Motrin, ibuprofen, Naproxen, Aleve)
- Vitamin D, B6, K, Folic Acid, Calcium, Zinc and iron
- Birth Control Pills
- All B vitamins
- Acid reducers like Zantac, Prevacid, Nexium…
- folic acid
- Vitamin K
- Antibiotics. By killing healthy bacteria, there is a tremendous impact on nutrient absorption and production.
Drugs can save lives and improve health but their over promotion and inappropriate use is dangerous and unethical.
DISPOSING OF MEDICATIONS. Do NOT just throw them out or flush them down the toilet. It may seem like a small amount but it builds up and drug residues end up in our water and food supply, not to mention they poison the wildlife that shares the waterways and the Earth in general. Check with your local pharmacy or township about proper disposal of these drugs.
SPECIAL NOTE. When you adopt a healthy lifestyle, including a plant-based diet, your health improves quickly. Often, so quickly that you may be able to get off of your medications even within weeks. This is particularly true of oral diabetic medications for type 2 diabetes and high blood pressure. This change is particularly important if you are on insulin since you can become hypoglycemic (low blood sugar) which is dangerous so be sure to tell your doctor that you are changing your diet so he or she can monitor you and your sugars. Also, changing your diet can have a radical impact on patients who take blood thinners or have advanced kidney disease so communicate with your doctor about any changes you make.
THE DANGERS of CHRONIC MEDICATION USE
There are many examples where long-term use of common medications, even ones which are over the counter, can have serious implications on the body. Often, the body tries to react to the medications we are taking, in many cases, downregulating those cell receptors the medications target or increasing hormones and chemical triggers to combat what the medications are trying to counteract. The body fights back to what we are trying to do to it. Here are a few examples.:
- Benadryl. This antihistamine, when used chronically, has been linked to dementia. The mechanism is not clear but the fact is that all cells in our bodies have histamine receptors, including the brain. These receptors are downregulated and become less numerous with chronic antihistamine use.
- Antacids. The strongest in this class, the PPIs or proton pump inhibitors, which by the way are the most purchased OTC medications in the country, essentially shut acid production off. The body’s response is to produce more of the enzyme gastrin, which tries to increase acid levels in the stomach because the body senses a shortage. As a result, even worse reflux occurs, especially if you stop them suddenly. In addition, many nutrient deficiencies develop as a result of taking these medications long term, even being linked to cardiac disease and osteoporosis.
- Anti depression medications. Known as serotonin-reuptake inhibitors, these medications prevent the “relaxing, happy” neuro compound serotonin from getting taken up. As a result, long-term use leads to down regulation and decreased number of serotonin receptors, worsening depression.
- Calcium supplements. These do NOT help osteoporosis and have been linked to cardiac arterial calcification and heart attacks.
- Mouthwashes. Although this is not a “drug”, it is a regularly used product with many chemicals in it. Especially the alcohol-based ones, these chemicals destroy healthy bacteria in the mouth and increase the risk of developing diabetes by 50% and heart disease by 30%.
There are many, many other examples of how drugs, as well as chemicals in products we use in and on our bodies, make us unhealthy and should be avoided at all costs. Get healthier and fix the problem. Don’t just put a band aid on it and hope it goes away.
THE POWER OF BELIEF. The PLACEBO and NOCEBO EFFECT
Faith, be it through an organized religion or simple belief in the interconnectedness of everything in the universe, is a powerful healing tool. One of the 9 pillars of the Blue Zone cultures, those people who live the longest with little to no disease, is having some kind of spiritual belief. It allows us to surrender and accept that ultimately, we do not have control over everything. It also gives us a foundation of hope, that something greater than us is in control. We see the power of faith and belief scientifically through the placebo effect.
The roots of the word “placebo” come from Latin, meaning “I shall please”. Healers have known forever that belief can play a significant role in healing however, the modern concept of “the placebo effect” came about in the 17th century. At that time, as “modern medicine” started to evolve, doctor’s started prescribing medications and treatments they knew were of no use, but getting something, satisfied stubborn customers. Doctors did notice that despite their inert, non-medicinal nature, sometimes taking placebo treatment, like sugar water, made them feel better.
Early on, placebos were used to debunk false claims by snake oil salesmen. However, placebos were not without their utility early on either. During WW2, field surgeons who ran out of morphine would hook up simple saline drips, telling the soldiers that they were getting morphine and moving ahead with the necessary procedures. 40% of those soldiers reported that their pain was significantly managed by the “morphine”, or by what it really was, a placebo.
Today, there is an expectation with any treatment study that there is, on average, a 35%placebo effect. The range is from 10-90%. The results of placebos don’t just relate to medications. A study looking at pain relief from knee arthroscopic surgery showed no difference in pain relief in the group receiving actual surgery vs those who had the same incision, but received no actual treatment. The same is true of cardiac stents and chest pain relief. In fact, the group who were told that they had a stent but didn’t, actually had better results in pain than those who actually had a stent placed.
What is the placebo effect? Many feel that it represents the expectation of relief causing a physiologic response that mirrors the expectation. You expect to feel better, so you do. Studies have shown that placebos can lead to measurable changes in the body, including heart rate, blood pressure, brain biochemistry and even reduce the symptoms of such conditions like Parkinson’s Disease.
One of the craziest aspects of studies using placebos has to do with the fact that even when patients know they are getting a placebo, some of them actually get better anyway. This speaks to a deeper, unconscious belief in caring and healing.
The flip-side to the placebo effect is the ”nocebo effect”. This is simply the phenomenon of expecting to continue to feel bad, so you do. Test patients, who had known reactions to poison ivy, reacted to a completely inert leaf when rubbed on their skin if they were told it was poison ivy. They expected a reaction and it happened. A study of 120 students in the alps showed that the ones who were told that a complication of altitude is migraine headaches had the worst symptoms along with measurably higher inflammatory markers than those who were told nothing.
Another interesting study looked at people who did not have celiac disease but had self-reported gluten sensitivity. 70% of the people who received gluten-free foods had symptoms and a similar percentage of people who received gluten-containing foods had no symptoms. This highlights not only the expectation of symptoms causing them, but how gluten sensitivity is probably not as significant and issues as most people think. It’s probably the chemicals and additives which go along with the gluten.
“It’s better to believe than disbelieve. In so doing, you bring everything into the realm of possibility”
LIMIT TOXIN EXPOSURES
Every person on the planet has measurable amounts of hundreds of chemicals which did not exist prior to the 20th century. These poisons have no role in our bodies and cause all kinds of disease and biochemical dysregulation. We are constantly bombarded with chemical, radiation and electronic toxins. Of the more than 80,000 chemicals currently used in the United States, most haven’t been adequately tested for their effects on human health. Limit exposure to chemicals and unnecessary sources of toxic exposure like cleaning products, scented soaps, metals in fish, smog, perfumes and antiperspirants. No plastic bottles! Limit tests like CTs or X-Rays. One CT of the neck exposes you to the same amount of radiation (~20 severts) as 100-200 chest X-Rays, putting you at the same risk of getting cancer as those exposed to the Hiroshima nuclear explosion. About 0.5% of cancers are thought to be related to radiation exposure from medical tests. Always ask if a test is REALLY necessary. That includes dental X Rays.
Cellphone use has become ubiquitous. Although not definitively proven to be bad, limit cellphone use. There is more on this on my EMF section below. There are known cancer causing agents in many “anti-bacterial” soaps. It’s important to stay clean but we are too clean. The bacteria on your skin also serves a biological purpose. Studies show that women who apply antiperspirants with aluminum onto their armpits after shaving have measurable elevations of aluminum in their blood. Many metals, including aluminum have been implicated in the development of dementia.
Although there is significant toxin exposure from various sources, what we eat is still the greatest source of toxin exposure. There are over 10,000 chemicals added to our foods (the list of new additives grows by 100 or so each year), another reason to keep foods whole, organic and plant-based. Conventionally grown foods are contaminated with dozens of chemicals (as many as 35 on one tomato alone). Even organically grown foods have chemical residues because of how much we have contaminated our environment. The herbicide glyphosate (the main ingredient in Roundup) has been used to such a degree that it can be measured in most municipal water samples and even in the rain! Crops grown near highways have higher levels of the heavy metal cadmium which is in vehicle exhaust. Lead from gasoline in countries where lead is still allowed in gas (like China) contaminates the soil and it also gets into crops. Protein powders, both plant-based and whey (from dairy) have been found to be contaminated with various heavy metals, hormones, and various other environmental contaminants. Know where your food comes from, keep it as clean as possible and wash it, even if its organic. Although water is a good start, adding baking soda or apple cider vinegar helps.
Although some companies will report that their products are tested for heavy metals or other contaminants, they report their findings in units that are ridiculous. These chemicals are shown to be harmful in PPB (parts per billion). These companies report contamination amounts in milligrams!
Most people are exposed to more than 123 different chemicals before they even leave the house. Newborn babies have had as many as 200 different toxins, such as mercury, arsenic, DDT, cadmium, various pesticides and aluminum, measured in their bodies which they absorbed from the maternal circulation during development. See the next section about newborn toxic exposure and watch this video about the study: “10 Americans”. The average woman uses 12 personal care products a day, exposing herself to over 160 different chemicals. Men use approximately half that amount. That’s a lot of mostly unnecessary chemical exposures. Every day children are exposed to an average of 27 personal care products. 77% of the ingredients in more that 1,700 of the products have not been evaluated for safety. The toxic carcinogenic chemical 1,4-dioxane is found in as many as 22 percent of the more than 25,000 cosmetics products and was identified in 55% of baby bubble baths, 57% of baby shampoos and 55% of baby soaps!
THE AIR YOU BREATHE. If you can smell it, it is probably bad for you. Simple as that. Most cases of chronic obstructive pulmonary disease, COPD, are diagnosed today in housewives and house cleaners. All from the inhaled household and cleaning chemicals. Other sources of toxic inhaled chemicals include the “fresh car smell” which consists of off-gassing of plastics. Carpeting and some furniture. Car exhaust, factory fumes, aerosolized excrement from animal farms, glyphosate (the chemical in roundup) in the air around farms… The sources are endless. At home, especially if you live in a city, it is wise to get an air filter (HEPA – High Efficiency Particulate Air filter).
Keep in mind that you absorb into the bloodstream about 60% of what you put on your intact skin. More if the skin integrity is broken. An example of this is how aluminum from deodorants gets measurably increased in the blood if a woman applies it after shaving her armpits.
CLOTHING, BEDDING and FURNITURE. Cotton is the most heavily contaminated crop on the planet, accounting for more than 25% of the pesticides and herbicides used annually world wide. In addition most synthetic clothing is made from petroleum based compounds. Everything you wear, sit on and even sleep on is a potential source for toxins. They do get absorbed through your skin and wreak havoc.
MAKEUP and FRAGRANCES. Not since the 1930’s has the FDA passed any meaningful safely regulations when it comes to cosmetics and personal care products. Only 40 products have been banned in the US, as compared with the thousands that have been banned by the European Union. Furthermore, even if a compound has been identified as toxic to humans, the FDA has no authority to force companies to recall or remove products already in the market. As mentioned above, you absorb 60% of the chemicals you put onto your intact skin. There are hundreds of chemicals in “fragrances” which are among the top 5 allergens in the world. More than 13,000 chemicals are used in cosmetics and less than 10% have been tested for safety. Some of these chemicals include acetone, benzaldehyde, benzyl alcohol along with many others with long complicated names. Lipsticks were tested and a full 1/3rd of them contained hazardous levels of lead. When it comes to other personal care products, be careful of these 3 toxic compounds: Phthalates, Parabens and DEA (diethylanolamine). Also, be cautious of terms like “natural”, “green” and “organic”. They are deceptive and although the products may not contain toxic compounds directly, in the processing of these products, toxic by-products are generated. These do not need to be listed on the product ingredients. There are many cosmetic and fragrance companies which sell healthier options. They include companies like Beauty Counter, Afterglow Cosmetics and Aubrey Organics. For men, a great source is Kiehl’s.
SUNSCREEN are another common source of toxic cancer-causing chemicals. Some of these chemicals are thought to cause skin cancer, not protect us from it. There is a lot on this topic below in the Sun Exposure section.
The top 6 things to avoid:
- Pesticides and herbicides.
- Food additives. See below for more information but the biggies are MSG, trans fats and artificial sweeteners.
- Factory-farmed food. Laden with pesticides and other chemicals (not to mention animal products themselves are not healthy).
- Genetically Modified Food (GMOs).
- Unfiltered tap water. Even municipal water should be filtered.
- Plastics. We have contaminated and polluted our world to the point where most foods we eat are contaminated with plastic. The list of damaging effects is frightening.
Some great resources for a healthy home are:
“Super Natural Home: Improve Your Health, Home, and Planet–One Room at a Time” by Beth Greer.
cleaningservicenewyorkcity.com – Great resource for home made cleaning products, makeup and household products.
12 easy ways to reduce toxic exposures at home (paraphrased from her book)
What goes IN you.
1) Eat as much organic or chemical-free food as possible. Plant a garden or shop at farmer’s markets. Avoid genetically modified foods.
2) Read labels and avoid food additives like MSG, trans fats (partially hydrogenated oils), artificial sweeteners and artificial colors.
3) Choose filtered tap water over bottled water. It has less bacterial and chemical contamination. Choose glass and stainless-steel beverage containers over plastic.
What goes ON you.
4) Use natural, chemical-free body care products and cosmetics. Be careful of parabens and phthalates. Don’t use deodorants or antiperspirants if don’t need them.
5) Be careful of products with a “fragrance” (code word for toxic chemicals) including shampoos, lotions and perfumes.
6) Synthetic fibers used in many clothing products contain chemicals which you do absorb. Especially for exercise apparel, switch to natural fibers like cotton or bamboo.
What surrounds you.
7) Clean your house with non-toxic natural cleaning products like baking soda, vinegar and hydrogen peroxide. Avoid chlorine bleach, ammonia and antibacterial products containing the chemical triclosan (a chemical in many soaps). Avoid scented candles, laundry detergents, dryer sheets and air fresheners.
8) Avoid volatile organic compounds (VOCs), found in vinyl wallpaper, floor coverings, new carpeting, paint and “new car smell”.
9) If you can replace your mattress, do so with one made from natural, untreated non-toxic materials. Otherwise, cover the mattress with a wool or organic cotton mattress cover.
10) Switch to organic cotton or bamboo towels and sheets. Regular cotton is one of the most intensely sprayed crops in the world, accounting for up to 25% of the pesticides used in the US.
11) Get rid of Teflon and other non-stick pans and cooking supplies and tools. They emit toxic gases and leach chemicals into foods. Use stainless-steel, enamel, glass or ceramic. Although cast-iron and copper are better, overuse can cause excess absorption of both metals which can worsen dementia. Teflon has contaminated our environment to the point that 99% of all animals on the planet have Teflon in their bodies.
12) Limit EMF exposure (like cell phones). EMF stands for electromagnetic field which are composed of an electric and a magnetic fields perpendicular to each other, which travel together in an invisible wave form. This is a very controversial area but we clearly did not evolve surrounded by Wi-Fi, Cell signals and Bluetooth devices. There is a whole section on EMF exposure below.
Our natural detoxifiers are:
- SWEAT. Contaminants such as glyphosate, heavy metals and even PCBs and dioxins have been measured in sweat. Get out and move. Use a sauna.
- LIVER. Our bodies main detoxification organ, everything that we ingest passes into the liver. Detoxification goes through 2 pathways. Pathway #1 involves breaking down the chemicals into inactive forms. Pathway #2 is where they are made water soluble so they can be more easily excreted. These broken down toxins are then secreted through the bile into the intestines where they are cleared, another reason to keep your gut healthy.
- KIDNEY. All the blood gets filtered through the kidney. Proper hydration is key so you continue to urinate and get rid of any of the garbage floating around in your blood.
Some detoxifying foods include: Parsley, Cilantro, Milk Thistle and Dandelion Root. These plants help get rid of heavy metals and support kidney and liver health.
We in the US can do better. Most other countries have much more regulation regarding which toxins are allowed to be used to grow food as well as what goes into our food and consumer products. As an example, Europeans have almost 1/10th of the toxic exposure from chemicals than we do in the US. Our government needs to be more concerned about public health rather than financial interests.
A great online resource for natural cleaning products is Grove.
We don’t think much about the notion that our clothing can make us sick, but it can and it does. Think about this: the denim industry is required by law to dispose of unused scraps of material as if they were toxic waste. Denim is considered hazardous material. It can’t just go in regular garbage. Why? Because it IS toxic. The chemicals like dyes used to color the denim and formaldehyde, used to preserve it and prevent insects from eating it during transport, are toxic and you better believe that those chemicals get absorbed through your skin into your body. The dyes contain many chemicals including heavy metals. And washing them, even many, many times, does not wash away all the chemicals.
Just like any other chemicals from personal care products, “if it is on you, it is in you”.
The same goes for all synthetic clothing. Mostly made from plastic compounds, they do leach chemicals, many known to be endocrine (hormone) disruptors which wreak havoc on our hormonal systems. They also increase the risks of various cancers. Also, the more you sweat and the higher the heat, the more chemicals leach out. What do most people work out in? Synthetic materials which are supposed to wick away sweat. They are advertised as being ‘antimicrobial” and thus less prone to body odor but what do you think makes them antibiotic? Chemicals. They kill the bacteria on your skin. That is not good!
Victoria’s Secret, one of the largest women’s lingerie companies, has to date settled over 300 lawsuits brought by women who developed breast cancer thought to at least be partly due to the toxic chemicals found in their bras. There must be enough good evidence for the harm these clothing items pose if they were so willing to settle rather than defend themselves and their toxic products.
Here is a list of 5 toxic fabrics to try to avoid:
- POLYESTER Polyester is one of the most popular and most used synthetic fabrics. Even though it can be produced with a blend of natural components, like cotton, to prevent wrinkles and tears, its effect on our health is still harmful. Polyester does not allow the skin to breathe. In addition, as body temperature rises and you sweat, chemicals from this fabric are released and are absorbed by your skin. This can cause a variety of problems and irritations like rashes, itching, redness, eczema, and dermatitis.
- RAYON (VESCOSE). Rayon is a fiber that is made from cellulose that is chemically converted from wood pulp. Not only is the production of this material dangerous, but wearing it can also be unhealthy. Rayon fabric can emit toxic substances that can cause nausea, headaches, vomiting, chest and muscle pain, and insomnia. In addition to all that, its production is heavily polluting the environment.
- NYLON. Nylon is a synthetic thermoplastic linear polyamide (a large molecule whose components are bound by a particular type of bond) that was first produced in 1935 by DuPont. Socks, lingerie, underwear, pantyhose, and so many different everyday clothes are made from nylon. It is durable and not very expensive to produce, which is why it’s popular. Clothes made from nylon do not absorb sweat from the skin, which can cause bad odors and skin infections. While in its production, the fabric gets bleached or dyed with different chemicals. Wearing it on your skin can cause a variety of irritations as well.
- ACRYLIC. Acrylic fabrics are made of acrylonitrile, which is a carcinogen and a mutagen. Exposure to this substance can cause different problems with your health. Among them are headache, nausea, dizziness, difficulty breathing, limb weakness, and many more. Acrylonitrile does get absorbed into your skin. Also, the manufacturing of acrylic is a huge cause of environmental pollution.
- SPANDEX / LYCRA / ELASTANE. Spandex was developed by chemical megacompany Dupont in 1953. Spandex is made from the synthetic polymer polyurethane. These types of fabrics are extremely stretchy and a lot of tight clothes are made with them like sports bras, leggings, T-shirts, shaping underwear, tights, bikinis, etc. Like other synthetic fabrics, they are made from harmful chemical substances like polyurethane, that is also known to be a carcinogen. Prolonged contact with these fabrics can cause skin irritations like dermatitis.
Clothing companies use attractive terms like “moisture wicking”, “waterproof”, “wrinkle proof” and “stain resistant”. What gives clothing, and furniture for that matter, these qualities are not natural fibers but toxic chemicals. “Gortex” is essentially Teflon. Perfluorooctanoic acid (PFOA) is the chemical which makes teflon so slippery and it is deadly. It has been definitively linked to various neurodegenerative and cancerous diseases and it is used widely in the clothing/textile industry. As I have mentioned before, if it is on you, it is in you and you had better bet that clothing with Gortex leads to increased levels of the PFOA in your blood. This chemical was first developed in the 1940’s and was used quite extensively because of its resistance to stains and heat. It was added to cooking surfaces because it made it easier to cook with since frying foods did not stick and made them very easy to clean.
Other toxic compounds found in textiles, including the clothes we wear, include:
- PHTHALATES, which are added to various plastics. They were banned from baby bottles and baby clothing as well as their toys because of their toxic effect on the developing brain. It is just as toxic to adults.
- FORMALDEHYDE. This is the same stuff morticians use to embalm people who have died, preserving their bodies for years to come. And we are putting it on our clothes? It is sprayed on clothing to minimize insect damage during transport and it also helps to keep clothing from getting wrinkled.
- GLYPHOSATE. This is the most prolific chemical on the planet. It is the active ingredient in Roundup and kills all plants, except those genetically modified to resist it. It also has been proven to cause various diseases including lymphoma in humans. ADHD, depression, cancer… Too many diseases to list. Cotton is the most sprayed agricultural product so make sure your cotton is organic.
- CHLORINE BLEACH. Used to make clothing white, this chemical destroys your natural skin microbiome, and even your internal gut microbiome. Chlorine is also used in drinking water, having a similar effect. Filter your water. Use hydrogen peroxide in your wash. Much safer and better for the environment.
- VOLATILE ORGANIC COMPOUNDS (VOCs). VOCs are a large group of chemicals that are found in many products we use to build and maintain our homes, cars, furniture and even clothing. They are released or “off-gas” into the indoor air we breathe. Although they are “organic”, they are far from safe and in fact are linked to many conditions including lung disease, even cancer, skin rashes and endocrine (hormonal) issues.
- BROMINATED FLAME RETARDANTS. Used also in clothing, furniture and upholstery, these are known to be carcinogenic and have been banned in many places but still show up regularly in clothing from abroad, which is essentially all clothing.
- AMMONIA. This chemical is added to prevent shrinkage. There are various health impacts of this absorbed and inhaled compound.
- WIRES. Although technically not a chemical, the wires used in bras to support the breasts also have been shown to impair lymph flow. Our lymphatic system is crucial to clear debris, dead cells and deliver immune cells to our tissues. They have been implicated, but not proven, in progression of breast cancer.
Choose natural, dye free fibers like cotton, linen or wool. They may be a little warmer but they are certainly healthier. Also, keep in mind that cotton is one of the most chemically sprayed cross so try to get organic cotton.
However, keep in mind that , as crazy as it sounds, clothing companies are not required to disclose which chemicals are used in making their clothes. Furthermore, there is no regulation requiring clothing companies to prove what is on their labels. A company might claim that it uses “100% organic cotton” when in reality, it is a 50:50 blend.
Here is a list of safer fabrics to wear:
- COTTON. It’s breathable, absorbs liquid from the skin, protects against heat in the summer and cold in the winter, and it’s hypoallergenic and durable. It’s one of the best fabrics you can wear to treat your skin to the most comfort.
- MERINO WOOL. It’s an all-natural, temperature and moisture regulating material that doesn’t lose shape or sag with time. Instead, it’s soft, lightweight, and also offers a natural UV protection! Alpaca wool can also be a good alternative.
- CASHMERE: This is a very precious and valuable material. No heavy chemicals are used to create the smooth silky feel of cashmere, and it is amazing and nice to feel on the skin on its own.
- HEMP. This textile has been serving people for thousands of years. It is well-known for its strength and durability. It’s the best natural material when it comes to holding shape and not stretching. Also, the more you wear it, the softer it gets.
- SILK. Not only does this soft fabric have a luxurious texture, but it also has a bunch of health benefits! It can slow down aging, help with eczema and asthma, have an anti-fungal effect, help to avoid allergies, and improve sleep!
- BAMBOO. It’s an interesting new alternative to traditional natural fabrics. Textiles made of bamboo are just as soft and silky as other natural fabrics, but also hypoallergenic, highly breathable, and thermo-regulating. It can absorb moisture from the skin even better than cotton and protect you from UV rays like merino wool. Also, it’s biodegradable.
- LINEN. It’s a highly comfortable and durable material. It is also easy to take care of and is suitable for every season. Like some other natural textiles, it has hypoallergenic properties, will feel extra comfortable, and will allow your skin to breathe.
AIR and WATER QUALITY
Air pollution is obviously toxic. Avoid it if possible. The air is so toxic in cities that it contributes to all kinds of chronic lung problems. Just breathing the air in Beijing, China raises your lung cancer rates the same amount as smoking 1 pack of cigarettes daily. Lest you think American cities are much better, just in 2019, the air quality in Southern California was as poor as smoking 1/2 a pack of cigarettes a day and the air in Salt Lake City, Utah is so bad at certain times of the year, school children are not allowed to go outside for recess because it triggers asthmatic reactions. Indoor air quality is also important. If you have any significant lung issues or allergies, consider getting an indoor filter. Whole home filters are good but the best is to get a HEPA rated air filter directly in your bedroom and keep the door closed. The EPA reports that because of all the chemicals in our homes, the average US home produces 2x as many greenhouse gases as a single car. In addition, the air inside our homes is 5-100x more polluted than the air outside!
Common sources of air pollution in the home include:
- Household cleaners.
- Dry-cleaning chemicals. Although these chemicals do dissipate, it can take weeks. Let them air out for at least a few hours OUT of the plastic before taking them inside OR, clean and iron clothing yourself.
- Synthetic fragrances, air fresheners and aerosol sprays.
- Nonstick cookware (use stainless steel or ceramic).
- Lead glazes in dish-ware.
- Off-gassing from carpets, wall paper and even synthetic mattresses and pillows
- Cotton. Clothing, sheets, towels… Cotton is the most heavily chemical contaminated crop in the world accounting for at least 25% of pesticide use in the US. Stick to organic cotton products.
Spray cleaners are estimated to account for 15% of cases of asthma. The fragrances are particularly toxic. Known to contribute to migraines and respiratory difficulties, 1/3rd of Americans surveyed complained of side effects from chemicals with fragrances and half of them claimed disability because of those health effects. What is worse is that companies who make these common household products do not need to disclose what chemicals and fragrances they contain.
There is an interesting app called “Sh**t I Smoke” which shows you how bad the air quality is in your area and expresses it in terms of the equivalent number of cigarettes you are smoking, if you smoked. The app is available on Apple and Android devices.
Some examples of sources of indoor toxins include:
- Fuel-burning combustion appliances.
- Off gassing from carpeting and even wall paper.
- Toxic fumes from candles.
- Tobacco products. Second hand and even third hand (just the odor which comes off of clothing and furniture can trigger asthma attacks).
- Building materials and furnishings as diverse as:
- Deteriorated asbestos-containing insulation
- Newly installed flooring, upholstery or carpet
- Cabinetry or furniture made of certain pressed wood products
- Products for household cleaning and maintenance, personal care, or hobbies.
- Central heating and cooling systems and humidification devices.
- Excess moisture leading to mold.
- Outdoor sources such as:
- Outdoor air pollution.
How to Improve Air Quality in Your Home
- HEPA filters. These take out 99.97 percent of pollution; often used in hospitals. They can be stand-alone for each room or whole-house systems. They are also good at filtering out allergens like tree and grass pollen.
- Media air cleaners. These are up to 40 times more efficient than a standard air filter.
- Electronic air cleaners—uses electrically charged, washable filters to lower pollutants
- Germicidal UV light systems. These are also available for water filters if you are concerned about microbial contamination.
- Whole-Home Humidifiers and Dehumidifiers.
- House Plants. Plants are natural air purifiers and they generate oxygen. Some examples are:
- Garden Mum.
- Spider Plant.
- Ficus/Weeping Fig.
- Peace Lily.
- Boston Fern.
- Snake Plant/Mother-in-Law’s Tongue.
- Bamboo Palm
WATER QUALITY. From an overall public health perspective, there is no question that adding fluoride and chlorine to municipal water supplies have been beneficial. The chlorine helps to prevent bacterial overgrowth and fluoride helps with dental care since most people can’t afford or won’t go to the dentist and take very poor care of their teeth. Chlorine does however also kill off you healthy gut bacteria and fluoride is an aluminum-based toxin so avoiding them if you can by using a water filter at home is great, assuming you take care for your teeth. In addition, 70% of municipal tap water is contaminated with Roundup as well as a variety of pharmaceutical drugs and other chemicals. Consider a water filter at least for your drinking water. Have your water tested, even if it’s municipal. Our bodies are mostly water (between 78% at birth, dropping to about 50% in adulthood). It makes sense to keep the water we consume as clean as possible. Keep in mind that chlorine is added to municipal water to keep bacterial counts down. That chlorine also kills off the normal bacteria in your gut and affects the microbiome. If you use a reverse osmosis filter (RO) at home, it cleans and filers the water so well that it also strips out all the beneficial minerals like calcium. Add a pinch of sea salt to a pitcher of water to make up the difference.
There is much more about water quality on the “What to Eat” page.
TOXIC EXPOSURE IN NEWBORN BABIES – “10 Americans”
In 2012, the Environmental Working Group (www.ewg.org) published the first study looking at the exposure of newborns to 413 different chemical toxins and environmental pollutants like industrial chemicals and pesticides. Umbilical cord blood was used. At that time, we knew that a baby developing in the uterus still did not have a fully intact blood brain barrier (BBB), the natural “filter” which protects the brain from various natural and chemical compounds (although some scientists feel that the BBB is fully developed well before birth). We also felt that the placenta was also a powerful filter, protecting the developing fetus from harmful chemicals. This turns out NOT to be the case.
A total of 287 chemicals were identified in these 10 babies (one of whom was the infant son of the head of the EWG. If anyone’s pregnant wife and developing child was going to have limited toxic exposure, his certainly would have been). On average, the newborns had about 200 different chemical exposures already. 28 were waste byproducts such as dioxins and 47 were consumer product ingredients such as flame retardants, Teflon and pesticides. Most concerning was the fact that 212 of these chemicals had already been banned more than 30 years before these babies were born! These included PCBs (Poly Chlorinated Bisphenol) and DDT (Dichloro Diphenyl Trichloroethane).
A breakdown of the known effects of these chemicals was as follows (many of the drugs had multiple effects):
- 134 were known to cause cancer
- 151 caused birth defects
- 154 were hormone disruptors
- 186 caused infertility
- 130 were toxic to the immune system
- 158 were neurotoxins
In addition to direct transmission from the mothers circulation, there is a concept of “transgenerational inheritance”. Not only are levels of chemicals and their physiologic impact seen in the children of mothers exposed to chemicals while they were pregnant, but they are seen in the grandchildren and even great grandchildren of these women.
The chemical industry uses the argument that the doses of these chemicals are minute and are measured in “parts per billion (ppb)”. Although this may sound like a negligible exposure, it actually is NOT. As an example, here are a few common drugs and at what dose they are therapeutically active and effective:
- Albuterol (for asthma) – 2.1 ppb
- Paxil (antidepressant) – 30 ppb
- Cialis (erectile dysfunction) – 30 ppb
- Nuvaring (birth control) – 0.035 ppb
In addition, we know that in the case of chemicals called “endocrine disruptors”, tiny doses are much more dangerous than large doses. When the body is exposed to large amounts of these chemicals, it shuts down the hormone receptors, thus protecting itself. With small doses, our system doesn’t notice them as much and the receptors remain active and constantly stimulated.
Between 1975 and 2002, there was an 84% rise in pediatric lymphoid leukemias, a doubling in rate of hypospadias (congenital penile defect) and a 57 % rise in childhood brain cancers. The autism rate rose from about 1 in 150 (today’s rate is estimated at 1 in 35!). Infertility rated has risen by 20%, the majority of which was occurring in women in their 20’s. Male sperm counts decreased significantly, dropping at a rate of 1%/year.
In 1976, congress passed the “Toxic Substances Act” which was supposed to protect the public from chemicals. 62,000 chemicals were grandfathered in and were exempt from this pathetically weak act. The law did not require any safety or health studies to be done before a new chemical was allowed onto the market. 80% of the new chemicals the EPA was reviewing were approved within 3 weeks and only 5 chemicals were banned or restricted. It was such a weak law that the first Bush administration was unable to ban even asbestos. The law did not protect the public. It protected industry and polluters. Although there have been amendments to this act, the Trump administration has reversed some of these, loosening restrictions and opening the door to even more toxic exposure.
Legislation works. Both DDT and PCBs were banned and subsequent blood levels measure in people dropped significantly. However, despite being banned more than almost 40 years ago, these contaminants are still in our environment so the sooner we can stop using these chemicals, the better.
You can’t avoid all exposures. Do what you can to limit what you know.
Watch this video about the study: “10 Americans”
ARE WE TOO CLEAN?
Assuming they are healthy and in good balance, the bacteria and other microbes on and in us play a vital role in maintaining good health. Our constant assault on them however causes significant imbalance and contributes to disease. We’re learning more every day about the benefits of being exposed to different kinds of microbes, especially when we are young. When we are born, our bodies are sterile. As soon as we enter the birth canal, we start getting exposed to microorganisms which start to populate our outsides and insides and our immune system starts to learn about what is friend and foe. It is said that when we are born, we are 100% human but when we die, we are only 10% human, the other 90% representing bacteria, viruses, fungi and many other types of microbes.
A growing body of research has associated being exposed to germs and infections at an early age with a lower risk of developing asthma and allergies. Experts have labeled this theory the “Hygiene Hypothesis.” Living on a farm, for example, or even having dogs in the house seems to reduce the risk of allergies in children. The thinking is that being around pathogens when you’re young, while your immune system is still developing, allows your immune system to fine-tune itself and learn to differentiate between harmful and harmless irritants. Without this learning, your immune system may overreact to harmless substances, like pollen.
Contributing to the Hygiene Hypothesis is the fact that we get numerous immunizations, preventing occasionally serious diseases and we immediately turn to medications like antibiotics rather than allowing our bodies to fight things off naturally. It’s well established that in poorer, undeveloped countries, the balance of what are called T Helper Cells in our immune system favors the cells responsible for defending against infections while in the developed world, our immune system favors those T Cells responsible for allergic reactions, hence the explosion of allergies in the developed world and relative absence of allergy in poorer nations.
That said, regular hygiene serves a purpose and can prevent us from getting sick or even dying. In fact, the biggest contributor to increasing life expectancy in the last 200 years are improvements in sanitation and waste disposal. You should still shower regularly although even skipping a day here or there or skipping washing your hair on occasion is perfectly fine. Shorter showers also save water. Wash your hands before you eat, after you use the bathroom or if you have been around someone who is sick. Public travel, especially airplanes are petri dishes so use wipes there. But there’s a decent case for a little more dirt and grime and a little less hand sanitizer and antibacterial wipes. We may wind up a healthier, less allergy-prone society down the road.
Some of the common sources of exposures which attack our microbiome include:
- CHLORINE in the water. Chlorine is put in our water to prevent bacteria from growing but this same chlorine kills the healthy bacteria in your gut as well. Simple fix: FILTER YOUR WATER!
- ANTIBIOTIC overuse and consumption. Only 1 course of antibiotics kills 60% of the healthy bacteria in your gut and it can take 1-2 months to recuperate. 95% of infections are viral, for which there is no medication, just symptomatic support like hydration and good nutrition. Resist the temptation to take antibiotics. We are too quick to jump to them. Also note that the majority of the antibiotics we take in come from the animal products we eat! 80% of the antibiotics used in the US are given to livestock, often just to promote growth and prevent infection. This makes its way onto our food supply. Drug resistant organisms is a real problem in the animal food industry and 30% of farm workers are colonized with multi-drug resistant bacteria.
- HAND SANITIZER overuse. These chemicals do kill germs and there are situations of course where they are helpful like on planes or public bathrooms but overuse not only kills the healthy bacteria on your skin but the chemicals in them are harmful and they also cause over-drying and cracking of the skin which puts you at greater risk of infection. The same goes for washing our hands too often and with harsh soaps. Just rubbing your hands under running water removes at least 50% of the bacteria. Adding regular soap removes another 25%. Soaps contain surfactants, compounds which break the surface tension of water which helps to loosen up the bacteria on the skin. “Antibacterial soaps” have additional chemicals which kill 99% of microbes, including the healthy ones, but this is overkill if used regularly. Keep in mind that bacteria and viruses do die eventually. For example, the respiratory syncytial virus (RSV), a cold-like virus that can cause serious illness in children, can survive on worktops and door handles for up to 6 hours, on clothing but on tissues for only 30 to 45 minutes and on skin for only 20 minutes. Although overexposure to the sun does cause cancer, there is a growing body of evidence that skin cancer is caused or at least promoted by the chemicals we apply to our skin through sunscreens and soaps. In addition, the imbalance of microbes on our skin also is thought to contribute to skin cancer.
- CLEANING PRODUCTS contain a dizzying array of antibacterial compounds, some of which can damage our health or encourage bacterial resistance to antibiotics. It is just as effective to use more natural cleaners which contain vinegar or citrus. Again, just plain water goes a long way.
- FOOD has a tremendous impact on our microbial composition. For more information read the “Microbiome” section to learn more about how the food we eat impact on the balance of bacteria and other microbes in the gut and how that impacts on health.
Although smoking still kills 1200 Americans a day because of lung, cardiovascular and cancer -related diseased, there has been a steady decrease in the last 20 years. The level has now plateaued. In fact the decrease in smoking in the last 20-30 years is the most important factor in slowing the continuous rise in cancer rates overall (lung cancer rates alone are 30x greater in smokers), which has been occurring since we started tracking cancer mortality. Although in 2017, smoking in the US hit its lowest rate in over 60 years (14% of Americans smoke today), we still smoke too much. In the 50’s, almost 50% of Americans smoked and the average was 1/2 a pack a day. Most doctors smoked and smoking was allowed in hospitals, nurseries, operating areas and even schools. The main reason for the decrease really has to do with what influences changes in any mass behavior, the 3 As: Availability, Affordability and Acceptability. Raising the taxes and overall costs of cigarettes alone probably has had the greatest impact on smoking rates. Legislation regarding public smoking, first in restaurants and bars and now even in outdoor public places has also had an influence. It is now also less socially acceptable to smoke.
The first published scientific study linking smoking to lung cancer was published in 1939, it wasn’t until 25 years later, in 1964, after more than another 7000 (that is correct, 7000) articles were published linking tobacco use to cancer and heart disease, that the Surgeon General finally made a public statement that smoking was bad for you and caused cancer, lung disease and heart disease. He was fired from his job for making such an outlandish claim. It wasn’t until 2 years later that the AMA (American Medical Society) officially accepted the Surgeon General’s report. At that time, the AMA was still receiving support from the tobacco industry, to the tune of $10 million a year ($80 million in today’s dollars). Although we do better in the smoking department than most other countries, we still have a long way to go and the “vaping” phenomenon is not helping much. Vaping is not safe. You are still inhaling a variety of chemicals whose damaging effects are yet to be identified. Tobacco (all forms including chewing tobacco) decreases blood flow in ALL blood vessels to ALL organs. Although many of the bad effects of smoking are dose-dependent (i.e. the more you smoke, the greater the risks) some effects are not. Even ONE cigarette a day or passive smoke exposure can cause big problems with blood vessel endothelial function and circulation. ALL organs age faster when you use tobacco. Even hearing loss progresses faster in smokers! Tobacco impacts on the function of the cells that line the nose and the lungs. Malfunction of these cells results in decreasing mucus clearance contributing to infections because microbes are not properly cleared. This decrease in mucus clearance is also why smokers exposed to certain toxins like radon and asbestos have a 10-fold increase risk of cancer than non-smokers with the same exposures. Smoking causes almost 90% of deaths from lung cancer, around 80% of deaths from COPD, and around 17% of deaths from heart disease. It contributes to Lung disease (COPD, emphysema, asthma and infections), Heart disease (high blood pressure, coronary artery disease, vascular disease in general), Strokes and Cancer in many parts of the body. Some of the known cancers caused by smoking include: mouth, throat, lip, esophagus, lung, stomach, bladder, kidney, pancreas, liver, colon, rectum, cervical, breast and blood (leukemia). Even autoimmune conditions like Rheumatoid Arthritis (RA) occur more frequently when you smoke (as much as a 60% increased risk of developing RA). Smoking causes 87% of all lung cancers and 30% of cancers overall. If you smoke, your chances of developing lung cancer are 23x greater than if you didn’t. People who smoke have more problems with wound healing after any type of surgical procedure. Although smoking itself does not cause LDL cholesterol elevation, it does cause LDL oxidation which makes LDL even more dangerous, causing a greater degree of arterial plaque formation leading to heart attacks and strokes as well as chronic inflammation.
Smoking dulls your taste buds and kills olfactory fibers (the nerve endings responsible for smell and taste) in your nose and sinuses. It also paralyzes and damages the natural movement of the sinus and nasal cilia. These are the finger like structures which move mucus around and clear the nasal and sinus passages.
Although less smoking is better, even a few cigarettes is not good. One cigarette causes a generalized inflammatory response lasting for 6 hours. That means that if you smoke only 4 cigarettes a day every 6 hours, your causing generalized inflammation all day long.
There are an estimated 4000 chemicals inhaled in cigarette smoke, of which 70 have been shown to be carcinogenic, including benzene and arsenic. Tobacco is actually a delicate crop and a tremendous number and amount of chemicals including fertilizers, herbicides and pesticide are applied numerous times during the growing process. These pesticides eventually are inhaled and make it into your body, adding to the chemical burden we have to deal with. There is also a huge environmental impact because of all these chemicals, in addition to the significant danger to all the farm-workers involved in this industry. For more information, check out this Tobacco and the Environment fact sheet.
Also, note that the average cigar has the same amount of disease and cancer-causing chemicals as 1 whole pack of cigarettes! Even if you don’t inhale, chemicals dissolve in your saliva, coat all mucosal surfaces and get absorbed into your bloodstream. Your smoking habit doesn’t only have an impact on you, it affects all those around you. Second hand smoke is as dangerous as first hand smoke and even smoke particles on you clothing is enough to trigger asthma attacks in children. Second hand smoke kills 38,000 Americans a year. Dogs and cats are twice as likely to get cancer if their owner smokes.
When you quit smoking, positive effects start taking effect almost immediately! This is what happens when you quit:
- Within 20 Minutes: Blood pressure drops to normal. Pulse rate drops normal. Body temperature of hands and feet increases (i.e. circulation improves!)
- Within 8 Hours: Carbon monoxide level in blood drops to normal. Oxygen level in blood rises to normal levels
- Within 24 Hours: Chances of heart attack decreases.
- Within 48 Hours: Nerve endings start re-growing. Ability to taste and smell improves.
- Within 72 Hours: Bronchial tubes relax, making breathing easier. Lung capacity increases
- 2 Weeks to 3 months: Coughing, sinus congestion, fatigue, shortness of breath decreases. Cilia re-grow in the lungs increasing the ability to handle mucus, clean the lungs and reduce infection
- 5 Years: Lung cancer death rates for average smoker decreases from 117 per 100,000 to 72 per 100,000
- 10 Years: Lung cancer death rates drop to almost the rate of non-smokers (12 per 100,000). Precancerous cells are replaced.
- 15 Years: Cancer and cardiovascular risks are the same as lifetime non-smokers.
All the benefits of quitting however are erased with just one cigarette per day. That means that even being around second-hand smoke is as damaging as smoking yourself! Sometimes people use the excuse of weight gain which often occurs after quitting smoking. This does occur but your metabolism resets itself pretty quickly. Also, substituting the tobacco habit with other more healthful habits like exercise and a better diet help with weight loss. The impact of the extra few pounds is much less than the impact of continued tobacco use so please quit. “If it’s important enough, you will find a way. If it’s not, you will find an excuse”.
HOW TO QUIT. There are as many ways of quitting smoking as there are smokers. One simple way is to just delay the days first cigarette. Studies show that by just delaying the first cigarette by 5 minutes, chances of quitting permanently go up significantly. Cold turkey (the most common way and click on the link), hypnosis, group therapy, acupuncture, medication… They all work but first of all, you have to want to quit. Statistically, less than 5% of people who want to quit smoking are able to do it the first time. Each time they try, the statistics improve a bit but slowly. If you don’t want to quit, don’t bother trying. You have to want to quit and to do that, you have to identify the WHY. Why do you want to quit? “To feel better”, “to breathe better”, “not to get cancer or heart disease”, “to see my grandkids graduate college and get married”… Whatever it is, find it and keep reminding yourself of it. Keep trying different things. Keep in mind that medications like Chantix and Wellbutrin are basically low-dose antidepressants which substitute what smoking provides for you, a sustained level of serotonin (the “good feeling” brain peptide). While taking the medication, you still have to work on the ‘WHY” and find some alternative substitute to the craving smoking provides. The failure rate 6 months after stopping the medication is 86%! and these drugs all have serious side effects. A great online resource is an online program called “Craving to Quit”. They also have a smartphone app called Craving to Quit. Another great resource is “Why Quit“.
SECOND-HAND SMOKE. Secondhand smoke harms children and adults, and the only way to fully protect non-smokers is to eliminate smoking in all homes, work sites and various public places. Secondhand smoke causes approximately 7,330 deaths from lung cancer and 33,950 deaths from heart disease each year. Between 1964 and 2014, 2.5 million people died from exposure to secondhand smoke, according to the 2014 report from the U.S. Surgeon General. In addition, it contributes to thousands of cases of asthma and various other forms of lung disease.
What Is Second-hand Smoke? It’s smoke from burning tobacco products, such as cigarettes, cigars, cannabis or pipes. It includes the smoke exhaled by the person smoking. Tobacco smoke, both first and secondhand, contains more than 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer.
Exposure to secondhand smoke can be measured by testing saliva, urine, or blood to see if it contains cotinine which is created when the body breaks down the nicotine found in tobacco smoke.
What You Can Do. You can protect yourself and your family from secondhand smoke by:
- Quitting smoking if you are not already a nonsmoker.
- Not allowing anyone to smoke anywhere in or near your home. Separating smokers from nonsmokers, opening windows, or using air filters DOES NOT prevent people from breathing secondhand smoke.
- Not allowing anyone to smoke in your car, even with the windows down.
- Making sure your children’s day care center and schools are tobacco-free.
- Seeking out restaurants and other places that do not allow smoking (if your state still allows smoking in public areas).
- Teaching your children to stay away from secondhand smoke.
- Being a good role model by not smoking or using any other type of tobacco.
Second-hand smoke increases your risk of getting lung alone cancer by 19%. In 1996, in an attempt to downplay the impact of second hand smoke, Phillip Morris, one of the largest tobacco companies in the world, put out an advertising campaign highlighting the risks of other lifestyle factors in some bizarre attempt to make second hand smoke seem “not as bad”. They quoted the following statistics in their ad:
- 1-2 glasses of milk a day increases lung cancer risks by 62%.
- If you cook regularly with oil, your risks are 100% greater (2x).
- Heart disease risks triple by eating too few fruits and vegetables.
- Risks of heart disease go up 6x (500%) by eating meat and dairy daily.
Not surprisingly, since Phillip Morris purchased Kraft Foods company, they no longer acknowledge any harm from meat or dairy!
THIRD-HAND SMOKE. Most people have never heard of this but it is a real toxin. It’s basically what you smell when you are around a smoker or are in an area where people have smoked. Don’t mistake lack of actual smoke for lack of injury. If you can smell it, it’s causing damage to your cells. Maybe it’s not as bad as first hand or second hand smoke, but it’s still bad. In fact, third hand smoke is known to trigger asthmatic reactions in kids whose parents smoke outside the house.
TOBACCO AND WEIGHT. When people quit smoking, they often complain of weight gain. This has often been attributed to changes in metabolism. Although it’s true that nicotine stimulation increases basal metabolic rate, the main effect tobacco has on weight is as an appetite suppressant. In the 1980’s, Americans’ weight started to dramatically go up. This is partly related to our diet and increases in both fat and processed carbohydrate consumption, but it also correlated with a decrease in smoking in the country overall. In the early 70’s, the surgeon general formally announced how unhealthy smoking actually was and in 80’s, senate hearings where the tobacco industry was revealed for their unscrupulous advertising practices and hiding the known health impact smoking actually had woke people up. People realized that smoking was bad and started to cut back or quit. Weight loss is NOT a good reason to continue, or even to start smoking (which I have heard!!!). The downside is much greater than any perceived weight loss benefit.
MARIJUANA. A word about cannabis. As more and more states are legalizing this substance it is important to understand its benefits and clear downsides. Cannabinoids (the hallucinogenic compound in pot) has many benefits we are still learning about but do not think that smoking it is not as bad as smoking tobacco. From the perspective of acute lung injury, smoking one joint does the equivalent amount of damage as smoking 5-7 cigarettes! That’s about 3 joints to 1 pack of cigarettes. On a puff-by-puff basis, cannabis smoke deposits 4 times more tar in the lungs than tobacco smoke. Cannabis smoke also worsens bronchitis and established lung disease. Chronic, significant use is also associated with lung cancer but not to the same degree as smoking cigarettes. Why so much damage? It is felt to be related to: deeper inhalation, keeping the smoke in the lungs longer and more tar exposure. Joints also burn hotter, produce more smoke and are not filtered. Unlike tobacco, they contain fewer carcinogens and are not as contaminated with pesticides like cigarettes are however.
In addition, it is a gateway drug, in some cases leading to the abuse of harder drugs. It is clearly addictive. There is a heated debate between those who believe that marijuana is addictive, can cause violent behavior, psychosis, schizophrenia and other psychiatric and antisocial behaviors. Regardless of which side of the argument you fall on, it is a psychoactive substance, just like alcohol and even nicotine, which changes how you think, react and behave and can blunt judgment. Although some people may not be affected by it in a negative way, if you have any predisposition towards anxiety or other psychiatric issues, it can certainly bring out or magnify those tendencies. Just because it is being legalized does not mean it’s not unhealthy. Cocaine and heroin were at one point legal.
As far as pot is concerned, using it as a teenager raises The risks of psychotic episodes by 450%. These episodes can have permanent effects on behavior. In addition, a recent study showed that adults who smoked pot as teenagers had significantly increased risks for serious anxiety and depression as adults.
As more and more states are legalizing cannabis, more and more is being grown. As with most other commercial crops, we are finding chemical contamination of cannabis with pesticides and herbicides. Not only are you consuming a mind-altering drug, you are contaminating yourself with chemicals as well.
TOBACCO COMPANIES. “Our product is doubt!” This was the topic of a memo sent around to the employees of one of the large tobacco companies during the US Senate hearings investigating how tobacco companies lied about the health implications of smoking and colluded to keep this information from the world. They knew that they did not have to prove smoking was not bad for the public, just spread enough doubt that people will continue to smoke. At one point during the hearings, a tobacco executive had the audacity to state that because smoking led to earlier death, and thus they were saving Medicare and our Government and taxpayers money! Although it may seem like the tobacco companies have been punished for their lies and deceit with regards to making tobacco more addictive and are not as evil as they once were, this is simply not true. They are still having a major impact on public health. In addition to continuing to producing and market a product that is unhealthy in so many ways, many of the largest food companies poisoning the public now are owned by tobacco companies. Phillip Morris owns Kraft. RJ Reynolds owns Nabisco. The tactics they used to produce and peddle tobacco is now used to addict and poison people through processed food. There is much more on this on the page dealing with food issues. As far as tobacco safety goes, they continue to lie and deceive. In 1994, the CEO of every major tobacco company swore under oath in front of a congressional hearing that they did not think that tobacco was addictive nor did it cause cancer! How insane is that. Their lobbies continue to exert influence on our legislators as well. In 2002, a ban on public smoking was passed in Helena, Montana. Within 6 months, there was a 40% absolute decrease in the rate of hospital admissions related to heart attacks! Even passive smoke is well known to cause platelets to clot. The tobacco lobby went to work and the law was repealed. In a very short time, the rates of heart attack related admission returned to its previous levels!
PESTICIDES/CHEMICALS in TOBACCO & MARIJUANA. As if tobacco itself wasn’t bad enough for people, researchers have found at least 3 pesticides in the smoke of cigarettes. More than 20 different pesticides and herbicides are approved for use on tobacco crops. Although it was though that these are burned off by smoking itself, this has proven to be wrong. With a filter, at least 10% of the chemicals still make their way into your lungs. Without filters, at least 50% of the chemicals make it into your circulation.
The chemicals, commonly used in tobacco farming and approved for that use by the EPA, disrupt the human endocrine system, which includes the thyroid and other glands and the hormones they secrete. The substances include:
- Flumetralin, a suspected endocrine disrupter already banned for use on tobacco in Europe.
- Pendimethalin, a known endocrine disrupter that affects the thyroid.
- Trifluralin, an endocrine disrupter that affects the reproductive and metabolic systems.
The latter two compounds are also suspected human carcinogens.
As far as cannabis is concerned, the chemical contamination is horrific. Because it is not a legal crop on a federal level, the FDA does not have any regulations with regards to chemical use. When individual states try to impose regulations, there is so much push-back from the cannabis industry who want no regulation and there is so much tax revenue from this industry that state regulatory bodies bow down. Chemical contamination of cannabis crops has been measured as high as 1000x more than conventional vegetable or fruits crops with as many as 24 different pesticides, herbicides, fungicides… in one sample alone. The amounts of chemicals are especially high in oils and edibles because they are concentrated. As far as “burn-off” is concerned, there is very little with 50% of the chemicals making their way into the users’ circulation.
Nearly 70% smokers say they want to stop. Quitting smoking is one of the best things you can do for your health. Smoking harms nearly every organ in your body, including your heart. Nearly one-third of deaths from heart disease are the result of smoking and secondhand smoke. Turning to electronic cigarettes (e-cigarettes) as a way to ease the transition from traditional cigarettes to not smoking at all is a worthy goal but do not fool yourself into thinking that it is safe. In addition, the companies who make and market these devices have absolutely no interest in your health. This is just another product to addict people and make money. As evidence of its popularity and power, Altria, a giant in the world of tobacco conglomerates, just spent $12.8 billion dollars to purchase a 35 percent minority stake in Juul, a company that currently dominates the e-cigarette market. More and more young people are getting addicted and many have had to seek professional help, even going to rehab, to quit this equally addictive habit.
Here are a few basic facts about vaping:
Vaping Is Less Harmful Than Traditional Smoking. E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create a water vapor that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. While we don’t know exactly what chemicals are in e-cigarettes, there’s almost no doubt that they expose you to fewer toxic chemicals than traditional cigarettes. They STILL contain chemicals though that are known carcinogens and are not safe. Some of these chemicals include:
- Dipropylene glycol and glycerol which, when heated, are converted into many cancer-causing compounds including formaldehyde (embalming fluid).
- Various volatile compounds
- Heavy metals
- Tobacco-Specific Notrosamines (TSNAs)
Vaping Is Still Bad for Your Health. Nicotine is the primary compound in both regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is also a toxic substance. It raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack. There are many unknowns about vaping, including what chemicals make up the vapor and how they affect physical health over the long term.
It has been implicated in causing a form of pneumonia called Eosiniphilic Pneumonia. It also causes coughing and bronchitis.
Electronic Cigarettes Are Just as Addictive as Traditional Ones. Nicotine acts on the same brain receptors as heroin and cocaine and is just as addictive. What’s worse, many e-cigarette users get even more nicotine than they would from a tobacco product. You can buy extra-strength cartridges, which have a higher concentration of nicotine, or you can increase the e-cigarette’s voltage to get a greater hit of the substance.
Electronic Cigarettes Aren’t the Best Smoking Cessation Tool. Although they’ve been marketed as an aid to help you quit smoking, e-cigarettes have not received FDA approval as smoking cessation devices. A recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to smoke both traditional and e-cigarettes.
A New Generation Is Getting Hooked on Nicotine. Among youth, e-cigarettes are more popular than any traditional tobacco product. In 2015, the U.S. surgeon general reported that e-cigarette use among high school students had increased by 900%, and 40% of young e-cigarette users had never smoked regular tobacco.
Vaping products contain higher doses of nicotine than traditional cigarettes. This is partly why it can be so addictive. In addition, nicotine raises heart rate and blood pressure. Some animal studies also show that it contributes to atherosclerosis.
There are three reasons e-cigarettes may be particularly enticing to young people. First, many teens believe that vaping is less harmful than smoking. Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, vape cartridges are often formulated with flavorings such as apple pie and watermelon that appeal to younger users. Both youths and adults find the lack of smoke appealing. With no smell, e-cigarettes reduce the stigma of smoking. What’s most concerning about the rise of vaping is that people who would’ve never smoked otherwise, especially youth, are taking up the habit. It’s one thing if you convert from cigarette smoking to vaping. It’s quite another thing to start up nicotine use with vaping. And, it often leads to using traditional tobacco products down the road.
ELECTROMAGNETIC FIELD (EMF) EXPOSURE
Although hotly debated in the scientific community and on the internet, there are no consistent and definite answers as to EMF effects or toxicity. However, be aware of the fact that the vast majority of the studies showing that there is no harm from the various sources of electromagnetic exposure are done and are financed by the industries which stand to gain by the devices which are the source of the EMFs.
There is no question that our bodies run on electricity. An ECG (electrocardiogram) measure electrical conductivity in the heart leading to a very coordinated contraction. The heart generates an electromagnetic field. An EEG (electroencephalogram) is a test which measures electrical activity in the brain. Our nerves transmit electrical impulses to our muscles which then contract. As “electrical” beings, it stands to reason that outside electrical stimuli would impact on us. Indeed, Pulse magnetic waves are used to treat depression. How it works is not clear. It was preceded by ECT, or electric shock therapy, which was successfully used to treat a variety of psychiatric conditions. It would be naïve to think that electrical and electromagnetic signals around us have no impact on our health.
An electromagnetic field, or EM Field (EMF) is a physical field produced by electrically charged objects. They are areas of energy, often referred to as radiation, that are associated with the use of electrical power and various forms of natural and man-made lighting. They have been around since the beginning of time since we receive natural EMFs from the sun, the earth and even our food and water itself. It wasn’t until mankind learned to generate electricity that we started generating man-made EMFs and today, it is virtually impossible not be exposed to them unless you live off the grid. More than 100 years after the advent of electricity, we have become almost completely dependent on sources of EMFs like high-performing computers, microwave ovens, cell and cordless phones, and many other wireless technologies. Every one of us is now exposed to unprecedented levels of man-made EMFs. The safety of EMF exposure is controversial because the pro-technology advocates believe that these artificially created EMFs are completely safe. These claims are made primarily on the basis that there are no definitive studies showing harm but this is changing. Studies are emerging demonstrating that EMFs, including non-ionizing ones, may be unsafe.
Types of EMFs: The National Institute of Environmental Health Sciences categorized EMFs into two different groups:
- Low frequency EMF radiation which have lower frequencies than visible light and are non-ionizing, meaning that it does not carry enough energy to ionize atoms or molecules (to completely remove an electron from an atom or molecule). Examples include EMFs from microwave ovens, computers, visible light, smart meters, WiFi, cell phones, Bluetooth devices, power lines, and MRIs.
- High frequency EMF radiation. These have higher frequencies than visible light and are ionizing radiation. Examples include ultraviolet (UV) light, X-Rays, and Gamma rays.
5G. This is the newest, most powerful cellular technology being rolled out. It basically stands for 5th Generation of cellular technology. The signal used in this newest technology is ~ 60 Gigahertz, a power level which has been used in the past by the military as an actual weapon! It is strong enough to displace oxygen molecules from hemoglobin in the blood making it harder to deliver oxygen to our tissues. If it’s strong enough for that, it can’t be good to have around you all the time. What is worse is that the communication tech companies are deploying thousands of satellites to provide this technology worldwide. As of the end of 2020, about 700 such satellites have been deployed and the plan is to have as many as 42,000 floating around above the planet in low orbit, blasting us with this powerful energy.
Are EMFs Harmful? There is no question that too much exposure to high frequency radiation can create health problems. Too much sun (UV) exposure leads to sunburns and skin cancer. When women get X-Rays, they are asked about pregnancy because X-Rays can harm the growing baby. Recommendations regarding frequency of mammograms are changing because all these studies may be causing more cancers than they are preventing. This also includes too many higher radiation studies like CT Scans which are linked to cancer formation.
The health effects of low frequency EMF radiation are more controversial however. First, symptoms due to use of microwave ovens, smart meters, Wi-Fi, cell phones, etc. can be imperceptible at first, but they may become noticeable over time. Second, the electronic and telecommunication industries have strong financial interests in consumers not being aware of potential harm from using their products. Third, we are so reliant on these devices that the thought of going without would require considerable convincing evidence and even then, most people would resist not using them (like with smoking).
Why is EMF Exposure a Problem? The human body is a sophisticated electromagnetic system. Our nervous system and our heart run on electricity, which explains why we can shock a dead heart into life using an electric shock machine called a defibrillator. Natural magnetic fields can be detected in the human heart and brain. Other metabolic functions also rely on electrical conductivity like mitochondria, the energy producing organ in our cells, and liver enzyme function. Our own electromagnetic signals are very weak compared to the man-made EMFs which can interfere with the electromagnetic systems inside our bodies, particularly affecting the brain, heart and mitochondria. In addition, because our own biology can get disrupted, EMF exposure can worsen inflammatory problems.
How Much EMF Exposure is Safe? With high-coverage cell phone networks, WiFi signals, and appliances, it is impossible to reduce EMF exposure to zero. Whether a certain EMF is dangerous depends on a few different aspects of the electromagnetic waves, including:
- Frequency: The higher frequency an EMF is, the more energy it carries and the more likely it is to be dangerous.
- Power density: The average energy of the electromagnetic waves in a given area or volume.
- Strength: of the electric and magnetic fields that are present.
- Duration of exposure: prolonged duration is usually worse than acute duration for the same levels of EMF.
The World Health Organization established a guideline for safe EMF exposure but different countries have established their own guidelines. Russia has the strictest requirements while the US allows for more EMF exposure. In fact, the FCC (Federal Communications Commission) established cellphone exposure limits and guidelines but has not amended them since the 1990’s. At that time, cell phones were the size of bricks, were only meant to be used for short periods of time and certainly could not be worn on the body like today’s smartphones. The International Agency for Research on Cancer has already categorized low frequency EMF radiation a class 2B possible carcinogen. This is the same category as vehicle exhaust fumes.
A recent study linked cell phone exposure to both benign and malignant salivary gland tumors. The evidence that cell phone radiation causes brain, specifically acoustic, tumors is also mounting.
Symptoms Thought to be Related to EMF Exposure. Chronic high levels of low frequency EMF exposure can result in:
- Brain fog.
- Dizziness and vertigo.
- Frequent illnesses.
- HPA axis dysfunction (also known as adrenal fatigue).
- Hormone imbalances.
- Cancer or increased in cancer risk.
HOW TO REDUCE EMF EXPOSURE
Avoid Living Near Strong Sources of EMF Radiation. Very strong sources of EMF radiation can present significant health risks. These include smart meters, radio stations, electrical generators, power lines, and electrified train tracks. Although controversial, there are studies suggesting higher leukemia rates, especially in kids, who live near power lines.
Limit EMF Exposure At Home. We can reduce EMF exposure by:
- Avoid Bluetooth headsets, especially ear buds. The science is not clear but many scientists warn of the dangers of long-term exposure.
- Keep appliances and devices off, or on airplane mode as much as possible. Keep in mind however that even when off, they are still drawing power and are creating electrical fields around them if plugged in.
- Hard wire internet connections, rather than using Wi-Fi.
- If Wi-Fi use is necessary, only turn it on when in use and turn off the Wi-Fi router at night.
- Hard wire computer peripherals rather than using wireless or Bluetooth connections.
- Ensure that your homes electrical wiring is done properly to minimize EMFs.
- Keep electronic devices, i.e. cell phones, tablets, and computers away from your body. Use wired head phones to make calls instead of placing the phones near your ear to speak. Bluetooth headsets are better than the phone itself but not as good as hard wired headsets (which also do transmit EMFs by the way). The field created by cellphones drops by 80% at 1 foot and 90% at 2 feet.
- Sleep away from circuit breakers or large appliances that run overnight, including if the appliance is on the other side of the wall.
- Use protection tools such as Defender Pad under your laptop, and EMF shields for cell phone.
- Filter out dirty electricity using dirty electricity filters.
- Minimize use of digital devices when possible. Even better, take regular digital detoxes.
Mitigate Negative Health Effects of EMF Exposure. With high coverage of cell phone and power line networks, it is not possible to completely avoid man-made EMF exposure. In addition to taking steps to reduce EMF exposure, we can mitigate the negative effects by
- Grounding. It sounds a little out there but simply stepping onto bare ground barefoot apparently allows our bodies to neutralize positive ions from electronic devices. Some people swear that it helps them adjust to local environments faster when traveling, especially to different time zones.
- Exposures to negative ions such as being near moving water which can create ozone (O3), Himalayan salt lamps, or a negative ion generators can mitigate negative effects of exposure to EMF radiation. Like grounding, this is a bit controversial and some dismiss the whole concept.
- Eating a nutritious diet high in antioxidants can help mitigate some oxidative stress from EMF exposure.
Is Bluetooth Radiation Dangerous? Bluetooth is basically Wi-Fi designed for individual devices to communicate with each other and share data, rather than to connect you to the internet. Bluetooth is dangerous because like regular Wi-Fi, it transmits using Radio Frequency (RF) Radiation. There are hundreds of peer reviewed scientific studies linking RF Radiation to cancer. Even the World Health Organization classified it as a “possible carcinogenic”, which means “causes cancer”. And Bluetooth operates using the exact same frequency of RF Radiation, 2.45 GHz, as your microwave oven does to cook your food.
A common theme we hear today is that Bluetooth is safe because it is typically a lower powered signal than regular cell phone RF Radiation. This is not true for 2 reasons.
- Within the RF Radiation portion of the electromagnetic spectrum, the higher the frequency, the more dangerous it is to living organisms. Bluetooth is a higher frequency than most cell phones.
- A constant low powered RF Radiation signal is more dangerous than a more powerful short duration RF Radiation signal, like your TV remote. Bluetooth emits RF Radiation constantly as long as it is on, and it is a slightly higher frequency than 4G cell service. (5G is a much higher frequency than Bluetooth.)
Another false Bluetooth claim has to do with ear buds. There is a pint of view that “there are no studies showing that Bluetooth is harmful to humans”. People say this because there are so few studies done specifically on the “Bluetooth” signal. A lack of studies does not prove something is safe. There have been hundreds of peer reviewed scientific studies on RF Radiation in general since the 1960’s. They link RF Radiation to more ailments than just cancer. They also link it to DNA damage (especially in infants and fetuses), crib death, male infertility and other things. The communication industry has a lot of money and a lot of power. This is similar to the tobacco/health relationship where it took over 30 years and 7000 articles linking smoking to cancer, vascular disease and lung disease before our medical establishment made public statements about the dangers of smoking. Similar also to what is going on today with our food supply and chronic health problems.
A great source of EMF-blocking clothing is Lambs.
IMMUNIZATIONS and VACCINES
This is a very important, divisive and unfortunately misunderstood topic. It is extremely important to understand some of the pertinent basic issues. In considering immunization, you can’t just think about your or your child’s individual health. You must also consider public health. Individual health is obviously important but we are not islands. We live in a complex, overpopulated society. We take advantage of all its benefits and must accept the risks of living in large numbers in small quarters as well. Immunization is an invaluable tool to minimize disease and it has done an enormous amount of good from a public health standpoint.
When you get an immunization, you’re injected with (or nasally inhale) a weakened form of a fragment of a bacterium, virus or lab-made particle. This triggers your body’s immune response, causing it to either produce antibodies to that particular particle or induce other processes that enhance immunity against that pathogen. The next time you are exposed to the actual organism, your immune system is prepared to fight the infection more quickly and robustly. A vaccine will usually prevent the onset of a disease altogether or else reduce its severity and duration. This is actually identical to how our bodies react to environmental allergies like grass, dust or animals.
The goal of public health is to prevent disease. It’s much easier and more cost-effective to prevent a disease than to treat it. That’s exactly what immunizations do. They protect us from serious diseases and also prevent the spread of those diseases to others. Over the years, immunizations have thwarted epidemics of once common infectious diseases such as measles, mumps, and whooping cough. Thanks to immunizations we’ve seen the near eradication of others, such as polio and smallpox. This has resulted in saving millions of lives not to mention the amount of disease that has been minimized which also has had a tremendous financial benefit to society as a whole.
Vaccines overall are very effective, in the range of 90-95%. Some vaccines need to be given only once while others require updates or “boosters” to maintain successful immunization and continued protection against disease. Tetanus and hepatitis B are examples of immunizations which need boosters after a number of years.
Immunizations can be less effective in people whose immune system is compromised. This includes people with such diseases like HIV infection (Immune Deficiency Virus) or who are taking medications which suppress the immune system like chemotherapy meds, immune-modulators like Humira for arthritis or even anti-inflammatory medications like Motrin regularly. People who are overweight or obese also have less of a response to vaccine since their immune systems are also compromised. Specifically, their T-cells, crucial to immune reactions and developing antibodies, don’t function as well. In addition, people who are overweight or obese are also more prone to complications from various vaccines.
Getting immunized against something also lowers your risk of getting other diseases since it stimulates your immune system. This has recently been shown specifically with the MMR vaccine which protects against more than just measles. It also prevents longer-term damage to the immune system that can lead to a resurgence of other diseases
For enrollment in most schools or day care facilities, children are required to be up to date on their vaccines. This is to protect all children as well as all the teachers and other school support staff. The recommended immunizations for children 0-6 years of age include: Hepatitis A and B, Rotavirus, Diphtheria, Tetanus and Pertussis (DTP), Haemophilus Influenzae type B, Pneumococcus, Polio virus, Influenza (flu), Measles, Mumps and Rubella (MMR), Varicella (chickenpox) and Meningococcus (causes meningitis).
At one time or another, each of the diseases posed serious health threats to people, especially children, taking their lives by the thousands. Today, most of these diseases are at their lowest levels in decades, thanks to immunizations. In the 70’s, about 100 kids a year died in the US from complications of getting chicken pox. Since we introduced the vaccine, the fatality rate and complication rate has dropped by 99%. At least 10% of mumps cases result in complications such as deafness, meningitis and testicular and ovarian inflammation. In 2018, there was a significant outbreak of chicken pox in a private school in the North Carolina where 68% of the children were not immunized against this common virus. In all cases, the parents refused to immunize their kids.
Unfortunately, because of misinformation and immunization paranoia, there has been a disturbing trend of parents electing not to vaccinate their children resulting in some of these once-rare diseases to make a resurgence. Some adults who should also get immunized have elected not more and more often. The inevitable result has been the rise of once extremely rare diseases like mumps and increased deaths from the flu.
For adults, it is also important to stay on top of vaccinations. The most important ones include hepatitis B, pneumonia, flu and shingles (chicken pox virus) vaccines. In older people, these diseases can be particularly devastating and even life-threatening. Not everyone needs a flu shot but certainly anyone whose immune system may be impaired or if you are in an environment where spread to and from individuals is more likely, you should strongly consider (and may even be required to get) vaccination. Some of these situations include:
- Anyone living or working in any kind of health care setting (hospitals, nursing homes, medical and dental offices, schools…)
- Elderly people, especially if you are in an assisted living or nursing facility. They are usually more deconditioned with weakened immune systems.
- Young children whose immune systems have not fully matured yet.
- If you have any kind of immune or autoimmune disease like Rheumatoid arthritis, Crohn’s disease, Lupus or HIV infection.
- If you have Diabetes, both type 1 and 2 or Cancer
- If you are on any kind of medication which affects the immune system. Some of these include common drugs like steroids and frequently advertised drugs like Stelara and Humira.
The flu vaccine is probably the most controversial vaccine since it is a yearly medication and is significantly less effective than most other vaccines. Although it is true that this specific vaccine, which is made up every year based on an estimate of what the flu bug might look like, is much less effective than most other immunizations, any protection is better than none. In addition, even a little bit of protection might lessen the symptoms and duration of the flu if you get it. The bottom line is that in the US alone, during the 2017-2018 season, 80,000 people died as a direct result of the Influenza virus, the deadliest in more than 40 years both in adults and in children. It was the 8th leading cause of death!
Vaccines are overall extremely safe but as with any medication, they can have side effects and are associated with occasional complications. In most cases side effects are usually mild. Most common minor reactions include temporary soreness or redness around the injection site and low-grade fever. In extremely rare instances a high fever in excess of 104 F can occur with a vaccine. Fevers like this will not harm you or your children, but they can cause discomfort and irritability. Of course, just like ANY medication, both prescribed or taken over-the-counter, there are more serious risks. Even Tylenol can kill people. Children and adults have also been known to have serious allergic reactions to vaccines.
For reasons that are not completely understood, sometimes a child will not become fully immunized against a disease after receiving a vaccine. This is all the more reason to get children vaccinated. Children in whom the vaccine is 100% effective protect those few who have not been completely immunized, lessening everyone’s chance of exposure to the disease.
Children who are vaccinated against meningitis have the added benefit of reduced risk for acute lymphoblastic leukemia, the most common childhood cancer. The measles vaccine helps to protect against other dangerous infectious diseases whereas getting measles “naturally” can have many bad side effects and also makes you more vulnerable to other diseases.
Misconception #1: “We don’t need to vaccinate against rare diseases.” Few parents today have even heard of all of the diseases we vaccinate against, let alone seen a case of the measles, diphtheria, or whooping-cough. It’s the vaccines that keep these diseases so rare. Avoiding having your child immunized because of myths and misinformation about vaccine safety puts your child, and public, at risk. In communities where vaccine rates have dropped, these infectious diseases have quickly returned. Chicken pox is now rare, but that is because of immunization.
Misconception #2: “The preservative thimerosal makes vaccines risky.” Another concern about vaccines involves the use of a mercury-based preservative called thimerosal which has been used as a preserving agent in some vaccines and other products since the 1930s. According to the CDC, no harmful effects have been reported from the amount of thimerosal used in vaccines, other than expected minor reactions like redness and swelling at the injection site.
It’s important to note that since 2001, with the exception of some flu vaccines, no U.S. vaccines used to protect preschool children against infectious disease contain thimerosal as a preservative. A preservative-free version of the inactivated flu vaccine (containing trace amounts of thimerosal) is available.
Misconception #3: “Vaccines cause autism.” Because symptoms of autism spectrum disorder usually occur around the same time as the first measles, mumps, rubella (MMR) and other immunizations in children, some have assumed that there is a link between thimerosal and autism. However, the MMR vaccines have never contained thimerosal, and neither have the vaccines for chickenpox or inactivated polio. In 2004, an Institutes of Medicine report concluded that there is no association between autism and vaccines that contained thimerosal as a preservative. In addition, the physician who first popularized the idea that there was a link between autism and immunization has since been discredited. His articles were based on lies and fictitious data. His papers have been debunked and his behavior was considered so irresponsible that his license to practice medicine has been revoked.
There is no question that the rate of autism and autism-spectrum disorders have gone up dramatically over the years (1:5000 in 1976 and 1:35 now!). However, blaming immunization is not the answer. We should be much more concerned about the pesticides, herbicides and other chemicals in the foods we give our kids as well as other hormonal and toxic exposures rather than worrying about immunizations.
Misconception #4: “Kids get too many vaccines, too quickly and in greater combinations”. Even though children are getting more shots than they used to, the amount of antigen (the protein particles which stimulate our immune response) injected is actually less per shot than it used to be. As a result, the likelihood of adverse reactions and complications is significantly lower with equal effectiveness. The arguments about timing and combinations also follow along the same lines. More shots but even with the combined vaccines, less antigen load is administered with fewer complications and maintained effectiveness of the immunization.
Misconception #5: “I got the flu after I got the flu shot“. Not possible. The virus is dead. A recent study of common side effects from the vaccine including headaches, muscle and joint aches and even fever showed no difference in patients receiving the flu shot vs a placebo (saline injections).
Misconception #6: “Vaccines are contaminated with many other chemicals”. This is extremely over exaggerated. Keep things in perspective. There are contaminants in everything. Arsenic is naturally occurring in rice and apple cores. Too much oxygen or even water is toxic. There is more aluminum in breast milk than what is found in vaccines.
Misconception #7: “I can’t have an immunization because I’m allergic to eggs”. The issue of egg allergy should also be addressed. The simple answer is that regardless the degree of your allergy to eggs, vaccines are safe to be given. The only contraindication to getting a vaccine is a history of a previous severe reaction, regardless of what was thought to be the cause.
Misconception #8: “I don’t want to get an allergic reaction or paralysis”. Other potential complications like severe allergy (anaphylaxis), arthritis and Guillain-Barre Syndrome (a reversible neurological reaction from the vaccine) are exceptionally rare, occurring at a rate of 1:100,000 immunizations.
NOISE POLLUTION, STRESS and HEARING LOSS
Although we don’t hear as well as many of our mammalian relatives, the human ear is still an amazing organ. Our ability to hear is intimately related with survival and socialization. Loss of hearing is estimated to be the most traumatic sensory deficit, even more impactful than the loss of vision.
The relationship between noise pollution, stress and hearing loss has been well known for many years. In 44 BC, Julius Caesar banned wheeled carts from driving in city streets during daylight hours to cut down on noise. The US Surgeon General warned about the health effects of noise pollution in 1978. From an evolutionary standpoint, we obviously evolved to hear things in our surroundings. We have also developed an appropriate stress response to sudden loud noises as a protective mechanism to deal with acute dangers. But just like with chronic physical and emotional stresses, there is an inappropriate chronic cortisol (the stress hormone) response to chronic noise exposure contributing to many health conditions.
Cortisol secretion results in increased heart rate, hyper acute vision, raised blood pressure and increased muscle tone, all to help with escaping the sudden danger which caused the loud noise. With chronic noise, these physiologic effects never stop and it impacts negatively on health. According to the Environmental Protective Agency (EPA), chronic noise pollution exposure contributes to hearing loss, cardiovascular problems and accelerated cognitive decline. People exposed to noise pollution have a 60% greater risk of developing the same degree of hearing loss as someone 20 years older not exposed to noise pollution. Chronic stress from noise pollution has also been associated with increased risks of hypertension, heart attack and even type 2 diabetes. A European study estimated that for every year of chronic noise exposure, 100,000 life years are lost because of the stress impact. Just living near a city street increases your risk of depression by 25%. The converse has also been found. Spending time in a quiet park or library leads to improved biochemical responses to stress.
We have known for a number of years that older adults with hearing loss who should, but don’t wear hearing aids, have a greater incidence of dementia and more rapid memory loss and cognitive decline. A recent study revealed that even mild hearing loss in your 40’s-50’s doubles your risk for developing dementia when you are older. Protect your ears, get tested and get hearing aids if you need them! They might just save your brain!
The World Health Organization (WHO) estimates show that approximately 800 million adults have hearing loss globally and has reported that today more than a billion young people are at risk of hearing loss. According to the US National Institutes of Health, approximately 90% of those with hearing loss are affected by sensorineural hearing loss (SNHL). Noise exposure is difficult to avoid in modern society and, based on our estimates, we believe that 59 million people in the United States alone may have SNHL, based on numbers of diagnosed and undiagnosed.
Obviously, the less noise we expose ourselves to, the better off we are.
ENDOCRINE DISRUPTING CHEMICALS
ENDOCRINE DISRUPTING CHEMICALS (EDCs) are chemical compounds that are very similar in structure with normal human hormones and they interfere, or disrupt, endocrine (hormone) systems in the human body. They are also known as hormone mimickers. These chemicals can come from the foods and beverages we consume, cosmetics and personal care products we use or chemicals we are exposed to in our environment every day. These chemicals should be avoided and although some products and foods may have only tiny amounts of these chemicals, it all adds up. Any system in the body controlled by hormones can be affected by hormone disruptors. Although the doses of these endocrine disrupting chemicals may be small, studies show that small amounts continuously is worse than larger doses which tend to overwhelm our normal receptors, turning them off. So a bottle of water here and there is actually pretty unhealthy.
If you understand where plastics come from, it is not surprising that these chemicals impact on hormone function. Plastics and many other chemicals are generated from petroleum products. Petroleum is a fossil fuel. They are called “fossil” fuels beaus they are generated for the remains of ancient animals like dinosaurs and plants. The remnant of algae and phytoplankton are also prominent contributors. Deep underground, under very high heat and pressure, their tissues are converted into these fuels. Their tissues, which were involved in many biological processes like hormonal signaling, are still present an when we bring them to the surface, manipulate them and use them in products, some of this hormonal activity remains, or is similar enough that our bodies get confused and our hormonal system become disrupted. Early puberty, increased hormonal cancer risks (breast, endometrial, prostate, testicular…), obesity… Many conditions are affected by these hormone mimickers.
There are numerous negative effects that endocrine disruptors can have on our bodies:
- increasing production of certain hormones; decreasing production of others.
- imitating hormones.
- turning one hormone into another.
- interfering with hormone signaling.
- telling cells to die prematurely.
- competing with essential nutrients.
- binding to essential hormones.
- accumulating in organs that produce hormones.
- causing the liver to work harder than normal since it now has to clear these unnatural compounds.
- causing the liver to produce more fat (lipogenesis) and glucose (gluconeogenesis).
- causing direct inflammation in the body.
Hormone related problems are estimated to affect 50% of women. These conditions include:
- PCOS (Poly Cystic Ovarian Syndrome): 1 in 8 women
- Endometriosis: 1 in 10 women
- Infertility: 1 in 8 couples.
Endocrine disruptors have a definite impact on the development of all of these endocrine problems. Endocrine disruptors are also associated with the development of:
- learning disabilities and attention deficit disorder.
- cognitive and brain development problems.
- deformations of the body (including limbs) in newborns.
- cancer, especially ones associated with hormones such as:
- breast cancer
- testicular cancer
- prostate cancer
- uterine cancer
- thyroid cancer
- sexual development problems such as feminizing of males or masculinizing effects on females, etc.
Easy Quick Steps to Reduce Your Exposure to Endocrine Disruptors
- If you must eat fish, eat only wild caught fish. Even they are contaminated but less than farmed fish. Avoid all farmed fish or fish from known contaminated waters.
- Don’t drink from any plastic bottles. Ever. Even if they say they are BPA free (like Nalgene, Camelbak…).
- Don’t heat or cook anything in plastic including avoiding plastic wrap.
- Consider storing food only in glass or stainless steel containers.
- Don’t use Teflon-coated non-stick pans. Use stainless steel like All Clad or ceramic cooking pans like Green Pan. You can often get great deals on these more expensive pans at Marshall’s or Home Goods.
- Eat organic produce whenever possible. Refer to the Dirty Dozen for more tips on which ones.
- Stop using plastic wrap. Switch to silicone covers or beeswax wraps instead.
- Avoid cleaning, personal care and household products that contain chemicals. There are plenty of healthier alternatives. Keep in mind that all these products come out of plastic containers and chemicals do leach out. Until our government does more to limit chemicals in our products, we simply need to be mindful of them. Whereas Europe banned over 1100 chemicals from cosmetics in 2003, the US FDA has only banned 11 thus far.
- Don’t handle cash register receipts, especially if your hands are wet or if you have used hand sanitizer. These receipts use BPA, a known hormone disruptor. Levels of BPA can be measured in the blood after you handle receipts but levels increase 100x when you handle receipts with wet or alcohol treated hands.
- Consider not wearing, or at least not exercising in clothing made from synthetic fibers. These do leach out chemicals, including BPA and levels can be measured as it absorbs through the skin. Choose natural fibers like cotton, hemp or bamboo. Just like other chemicals we put on our skin, IF IT’S ON YOU, IT’S IN YOU.
THE WORST OF THE WORST
ZERANOL (Ralgro) is a potent synthetic estrogen which is fed to all conventionally grown livestock in the US and only cattle in Canada. It is the most potent growth hormone found in all food and its influence on estrogen is 100,000 times greater than BPA. In the lab, exposing normal breast cells to the substance for only 21 days causes them to transform into breast cancer cells. It is so frequently used that 100% of meat from conventionally raised beef, which accounts for 94% and some grass-fed beef as well since it’s allowed to be used with them also, is tainted. After a study was done in Italy revealing that Zeranol was the main contributor to abnormal breast tissue growth in both boys and girls, it, along with ALL other growth-promoting drugs, were banned in Europe. In 1989, they also banned all beef imports from Canada and the US and this ban still stands today because we continue to insist on using it! In the US, a study of 163 girls, aged 9 and 10, identified zeranol in the urine of 78% of them. 100% of those girls ate meat the night before! None of the girls whose urine was negative for zeranol ate meat the night before. In the Boston-area Nurses’ Health Study, there was a 35% increased risk of premenopausal cancer if they regularly ate meat as kids and teenagers.
Here are 12 other very common hormone disruptors, how they do their dirty deeds, and some tips on how to avoid them.
BPA. Bisphenol A (BPA) is a chemical that is used primarily to make polycarbonate plastic and epoxy resins. It was actually developed in the 1930’s as a drug to treat estrogen deficiency but was never actually used as that. It was too valuable as a plastic. It’s known as an estrogen mimicker. Unfortunately, this synthetic hormone can trick the body into thinking it’s the real thing and it has been linked to everything from breast and others cancers to reproductive problems, obesity, early puberty and heart disease. According to government tests, 93% of Americans have BPA in their bodies, whether they use plastics or not. One infertility clinic found significant levels of BPA in 78% of the infertile men.
How to avoid it? Use glass instead of plastic. Avoid plastic beverage bottles. Go fresh instead of canned. Many food cans are lined with BPA. Even BPA-free cans should be avoided since they are lined with BPS which is not much better. Avoid register receipts since thermal paper is coated with BPA. Avoid plastics marked with a “PC,” for polycarbonate, or recycling label #7. Not all of these plastics contain BPA, but many do. For more tips, check out: www.ewg.org/bpa/
DIOXIN. They form during many industrial processes when chlorine or bromine are burned in the presence of carbon and oxygen. Dioxins disrupt ways that both male and female sex hormone signaling occurs in the body. Exposure to low levels of dioxin in the womb and early in life can both permanently affect sperm quality and lower the sperm count in men during their prime reproductive years. Dioxins are very long-lived, build up both in the body and in the food chain, are powerful carcinogens.
How to avoid it? That’s pretty difficult, since the ongoing industrial release of dioxin has meant that the American food supply is widely contaminated. Products including meat, fish, milk, eggs and butter are most likely to be contaminated, but you can cut down on your exposure by eating fewer animal products.
ATRAZINE. This is the second most widely used agricultural chemical in the US and it has been banned on most other countries. It is such a potent estrogen-mimicker, that even low levels of the herbicide atrazine can turn male frogs into females that produce completely viable eggs. Atrazine is widely used on the majority of corn crops in the United States, and consequently it’s a pervasive drinking water contaminant. Atrazine has been linked to breast tumors, delayed puberty and prostate inflammation in animals, and it’s linked it to prostate cancer in people. In addition to it’s estrogen stimulating effects, it turns on the enzyme aromatase which converts testosterone into estrogen. Many breast cancer treatments specifically act to turn this enzyme off, hence it’s connection to breast cancer.
How to avoid it? Buy organic produce and get a drinking water filter certified to remove atrazine. For help finding a suitable filter, check out EWG’s buying guide: www.ewg.org/report/ewgs-water-filter-buying-guide/
PHTHALATES. It’s normal and healthy for 50 billion cells in your body to die every day. Phthalates, chemicals used to soften and increase the flexibility of plastic and vinyl, can trigger what’s known as “death-inducing signaling” in testicular cells, making them die prematurely. Phthalates are also linked to hormone changes, lower sperm count, less mobile sperm, birth defects in the male reproductive system, obesity, diabetes and thyroid irregularities.
How to avoid it? Avoid plastic food containers, children’s toys and plastic wrap made from PVC, which has the recycling label #3. Many personal care products also contain phthalates, so read the labels and avoid products that simply list added “fragrance,” since this catch-all term sometimes means hidden phthalates. Avoid sunscreens containing phthalates. Find phthalate-free personal care products with EWG’s Skin Deep Database: www.ewg.org/skindeep/
ACETAMINOPHEN, FOOD DYES and PHTHALATES – A COMMON LINK.
Although considered the safest analgesic, including during pregnancy, there are some flags being raised about this commonly used drug. Acetaminophen, aka Tylenol, and phthalates have similar chemical structures. Animal studies on acetaminophen result in various congenital abnormalities and human studies have revealed a higher rate of undescended testes (cryptorchidism) in male babies born to women who took acetaminophen during pregnancy, particularly in the second trimester.
Dyes in food and clothing containing the compound aniline can be converted into acetaminophen in the human body. In addition to the link to ADHD and other behavioral issues in kids, here is another reason to avoid food dyes, which are banned in most of the world, but not the US.
Another common analgesic, ibuprofen (Advil), has been linked to a condition known as compensated hypogonadism. In this condition, luteinizing hormone (LH), which stimulates testosterone production, is increased leading to normal testosterone levels. Unfortunately, compensated hypogonadism is also associated with reduced libido, reduced fertility, arthritis, cardiovascular disease and diabetes.
PERCHLORATE. Perchlorate is a component in rocket fuel, fireworks, and fertilizers. It contaminates much of our food, especially dairy products. When perchlorate gets into your body, it competes with the nutrient iodine, which the thyroid gland needs to make thyroid hormones. This alters your thyroid hormone balance. This is important because it’s these hormones that regulate metabolism in adults and are critical for proper brain and organ development in infants and young children.
How to avoid it? You can reduce perchlorate in your drinking water by installing a reverse osmosis filter. As for food, it’s pretty much impossible to avoid perchlorate, but you can reduce its potential effects on you by making sure you are getting enough iodine in your diet. Eating iodized salt is one good way. Sea vegetables (seaweed, nori, dulse…) are also a great source.
FIRE RETARDANTS. What do breast milk and polar bears have in common? In 1999, Swedish scientists studying women’s breast milk identified an endocrine-disrupting chemical found in fire retardants, and the levels had been doubling every five years since 1972! These incredibly persistent chemicals, known as polybrominated diphenyl ethers or PBDEs, have since been found to contaminate the bodies of people and wildlife around the globe, even polar bears. These chemicals can imitate thyroid hormones in our bodies and disrupt their activity. That can lead to lower IQ, among other significant health effects. While several kinds of PBDEs have now been phased out, this doesn’t mean that toxic fire retardants have gone away. PBDEs are incredibly persistent, so they’re going to be contaminating people and wildlife for decades to come.
How to avoid it? It’s virtually impossible, but passing better toxic chemical laws that require chemicals to be tested before they go on the market would help reduce our exposure. A few things that can you can do in the meantime include: use a vacuum cleaner with a HEPA filter, which can cut down on toxic-laden house dust; avoid reupholstering foam furniture; take care when replacing old carpet (the padding underneath may contain PBDEs). Find more tips at: www.ewg.org/pbdefree/
LEAD. It’s well known that lead is toxic, especially to children. Lead harms almost every organ system in the body and has been linked to a staggering array of health effects, including permanent brain damage, lowered IQ, hearing loss, miscarriage, premature birth, increased blood pressure, kidney damage and nervous system problems. Lead also affects your body by disrupting your hormones. Lead has been found to lower sex hormone levels and it can disrupt the hormone signaling that regulates the body’s major stress response system (called the HPA axis).
How to avoid it? Keep your home clean and well maintained. Crumbling old paint is a major source of lead exposure, so get rid of it carefully. A good water filter can also reduce your exposure to lead in drinking water. And if you need another reason to eat better, studies have also shown that children with healthy diets absorb less lead.
ARSENIC. Arsenic is a naturally occurring compound but at high enough concentrations, it is harmful and potentially lethal. Arsenic can interfere with normal hormone functioning in the glucocorticoid system that regulates how our bodies process sugars and carbohydrates. Disrupting the glucocorticoid system has been linked to weight gain/loss, protein wasting, immunosuppression, insulin resistance (which can lead to diabetes), osteoporosis, growth retardation and high blood pressure.
How to avoid it? Reduce your exposure by using a water filter that lowers arsenic levels. Rice, both white and brown, concentrate arsenic. Avoid rice grown in Texas and the southern US states where soil arsenic contamination is extreme. Even organic rice from these regions can contain more arsenic in one serving than the EPA recommends in an entire year of exposure.
MERCURY. Caution: That sushi you are eating could be hazardous to your health. Mercury, a naturally occurring but toxic metal, gets into the air and the oceans primarily though burning coal. Eventually, it can end up on your plate in the form of mercury-contaminated seafood. Pregnant women are the most at risk from the toxic effects of mercury, since the metal is known to concentrate in the fetal brain and can interfere with brain development. Mercury is also known to bind directly to one particular hormone that regulates women’s menstrual cycle and ovulation, interfering with normal signaling pathways. In other words, hormones don’t work so well when they’ve got mercury stuck to them! The metal may also play a role in diabetes, since mercury has been shown to damage cells in the pancreas that produce insulin, which is critical for the body’s ability to metabolize sugar.
How to avoid it? For people who still want to eat (sustainable) seafood with lots of healthy fats but without a side of toxic mercury, wild salmon and farmed trout are good choices.
PERFLUORINATED CHEMICALS (PFCs). The perfluorinated chemicals used to make non-stick cookware can stick to you. Perfluorochemicals are so widespread and extraordinarily persistent that 99 percent of Americans have these chemicals in their bodies. One particularly notorious compound called PFOA has been shown to be “completely resistant to biodegradation.” In other words, PFOA doesn’t break down in the environment – ever. That means that even though the chemical was banned after decades of use, it will be showing up in people’s bodies for countless generations to come. This is worrisome, since PFOA exposure has been linked to decreased sperm quality, low birth weight, kidney disease, thyroid disease and high cholesterol, among other health issues. Scientists are still figuring out how PFOA affects the human body, but animal studies have found that it can affect thyroid and sex hormone levels.
How to avoid it? Skip non-stick pans as well as stain and water-resistant coatings on clothing, furniture and carpets.
ORGANOPHOSPHATE PESTICIDES. Neurotoxic organophosphate compounds that the Nazis produced in huge quantities for chemical warfare during World War II were luckily never used. After the war ended, American scientists used the same chemistry to develop a long line of pesticides that target the nervous systems of insects. Despite many studies linking organophosphate exposure to effects on brain development, behavior and fertility, they are still among the more common pesticides in use today. A few of the many ways that organophosphates can affect the human body include interfering with the way testosterone communicates with cells, lowering testosterone and altering thyroid hormone levels.
How to avoid it? Buy organic produce and use EWG’s Shopper’s Guide to Pesticides in Produce, which can help you find the fruits and vegetables that have the fewest pesticide residues. Check it out at: www.ewg.org/foodnews/
GLYCOL ESTHERS. Shrunken testicles: Do we have your full attention now? This is one thing that can happen to rats exposed to chemicals called glycol ethers, which are common solvents in paints, cleaning products, brake fluid and cosmetics. Worried? You should be. The European Union says that some of these chemicals “may damage fertility or the unborn child.” Studies of painters have linked exposure to certain glycol ethers to blood abnormalities and lower sperm counts. And children who were exposed to glycol ethers from paint in their bedrooms had substantially more asthma and allergies.
How to avoid it? Start by checking out EWG’s Guide to Healthy Cleaning (www.ewg.org/guides/cleaners/) and avoid products with ingredients such as 2-butoxyethanol (EGBE) and methoxydiglycol (DEGME).
Additional Resources on Endocrine Disruptors
IMMUNE DISRUPTING CHEMICALS
Essentially Аляl of the the toxins mentioned in the previous section not only disrupt our hormonal systems, but they also disrupt our immune systems making us more prone to infections and cancer. Our immune system interacts with everything in our environment and protects us from harmful compounds. When disrupted, our immune system can’t recognize friend from foe, allows cancer cells to grow and can result in the destruction of our own bodies, as is seen in many autoimmune diseases like arthritis, MS, Lupus, Diabetes and Thyroid disease.
70% of our immune system resides in our intestinal tract and chemicals and foods we consume can cause serious damage to our immune system. Glyphosate, from Roundup, for example breaks down the tight unctions between cells, making the intestinal walls weaker. This allows foreign material to be exposed to our bloodstream before being broken down and our immune system react to it. At least it causes added inflammation. At worst, it leads to autoimmune diseases because the more foreign material our bodies need to process, the more antibodies are formed and the greater the chance of one of those antibodies mis-recognizes our own tissues as foreign leading to autoimmune disease.
Another common gut barrier disruptor are artificial sweeteners. They also disrupt the cellular tight junctions. These junctions not only are structurally supportive to cell membranes, they act as communication systems between cells. When cells can’t communicate, just like in human populations, disorder ensues.
THE DOSE DOES NOT ALWAYS MAKE THE POISON
Although it is true that, with most chemicals or trauma, the more you are exposed and the more chronic the trauma, the greater the risks of an adverse effect, that is not always the case. The more you smoke, the greater the risk of developing lung cancer. The more alcohol you drink, the greater the risks of getting liver disease. The more unprotected sun exposure you are exposed to the greater the risk of getting skin cancer.
When it comes to the above mentioned endocrine disrupting chemicals (EDCs), dose dependence does not necessarily apply. They cause the most damage at low, continuous levels of exposure. That regular use of plastic bottles or food containers. That daily use of beauty and hygiene products which are loaded with endocrine disrupting chemicals. All that slow, low grade exposure is causing us to get fat and is killing us.
The classic example is what happens in the pancreas, the organ responsible for insulin production. Bisphenols (BPA, BPS…) are ubiquitous in almost all plastic products, including can lining and food packaging as well as on store receipts. The pancreatic beta cells, the ones which produce insulin, have estrogen receptors on their surface, E1 (alpha) and E2 (beta), which are very sensitive to bisphenols, which act as estrogen mimickers. Different levels of levels of Bisphenol have different effects on the beta cells and small amounts are the worst. Small levels of BPA switch on the beta receptors, which increase insulin production through a mechanism involving slowing of the flow of calcium ions into the beta cells. The lack of calcium “jolts” the cells into releasing more and more insulin, independent of blood sugar levels, their usual trigger. Higher levels of BPA stimulate both alpha and beta receptors, so there is a net neutral effect on insulin secretion. That’s not to say higher levels of BPA are good since it has all kinds of other deleterious effects in the body. High levels of insulin, not only wreak havoc on blood sugar control, they also contribute to more and more weight gain. Fat cells produce natural estrogens and the more estrogen you have floating around, the greater the risks of various hormonal diseases including cancer, in both women and men.
This “U-shaped” curve is called a non-monotonic curve.
This same pattern was seen with exposure to the estrogen-mimicking medication DES (Diethylstilbestrol), which used to be prescribed to treat nausea as well as other pregnancy-related issues but was banned in the 70s because it caused birth defects as well as various male and female cancers in the babies. The non-monotonic effect was seen in mice who had prostate enlargement and cancer. Despite being banned in the 70s, DES, which had been widely used since the 40’s, is still showing up in the blood of not only the children of women who took the drug, but also the grand children and even the great grandchildren.
The “low dose” effect has also been noted with organophosphate pesticides used since the 1940’s. The are known to work by inhibiting the enzyme which breaks down the neurotransmitter acetylcholine. It’s the chief neurotransmitter of the parasympathetic nervous system, the part of the autonomic nervous system (a branch of the peripheral nervous system) that contracts smooth muscles, dilates blood vessels, increases bodily secretions, and slows heart rate. It does this in human brains at high doses but in rats, much smaller doses are required and in insects, even smaller doses. Recent studies however have shown that at tiny doses, even those not impacting on rodent brain function, they do impact on other brain activities and also on thyroid function. Thyroid hormone is crucial for the development of babies brains. The scary part is that the EPA allows for tiny doses in humans, assuming they are safe, but they clearly are not.
Other toxic compounds like lead, mercury and organophosphate pesticides also follow such non-monotonic curves when it comes to significant impact on human health.
THE BOTTOM LINE. Minimize your exposure to these chemicals. Refuse receipts. Don’t drink out of plastic bottles. Never cook or heat food in plastic. Don’t use canned food or even drink containers like soda and beer, which are lined with plastic. Read labels on ALL your health and beauty products. MOST are loaded with chemicals which are just not good for you.
Remember, small doses can also be problematic.
METABOLISM and AGING
A slowing metabolism is NOT a consequence of aging! Don’t use it as an excuse!
Your metabolism refers to the continuously occurring chemical and physical processes which keeps us functioning normally in order to stay alive. These include such processes as breathing, nerve conduction, blood circulation, as well as the breakdown of nutrients from food and drink that is then converted to energy.
A measurement of your metabolism is your basal metabolic rate (BMR), which is the amount of energy your body uses just to maintain functioning at rest. Your BMR accounts for 60-70 % of the energy used each day, more than 2/3rds of which is used by our immune system protecting us and cleaning up dead and unhealthy cells, followed by physical activity (20-30%) and digestion (10%). BMR decreases by 1-2% per decade after the age of 20 and up to 10 % per decade after the age of 45. Although metabolism does decrease slightly as a natural result of simple aging (the causes of this are not clear), it decreases more as a result of a few controllable factors:
- Decreased activity and hence energy use. Young kids have a ramped-up metabolism because they are so much more active than older people. This has been changing however with the increase in screen-related activities and decreased physical activity. Childhood obesity along with obesity-related chronic diseases is at epidemic levels.
- Decreased muscle mass. After 30, you lose up to 1% of lean body mass a year and muscle accounts for the largest proportion (20%) of your BMR followed by the liver (19%), brain (17%), digestive system (10%), heart (8%) and kidneys (7%). The only way to avoid muscle loss is to exercise! After 65, you do need a slightly greater amount of of protein intake as well to maintain what you have.
- Increased fat mass. Fat accumulation has a number of negative effects on the body but its main impact on metabolism has to do with mitochondrial function. When we store excess fat in our cells, a signal is sent to the cell to stop producing as much mitochondria, the energy powerhouses if the cells. This signal is felt to be related to trying to protect the body from too high a metabolic rate in the face of impending lack of food. That’s why the fat is being stored as well.
Here are some things we can do to maintain a healthy metabolism:
- EXERCISE MORE. To increase your metabolism through physical activity, any form of cardiovascular exercise is good. High-intensity interval training (HIIT) can be particularly effective, due to the concept of ‘after-burn’ which is, an increase in resting metabolic rate that occurs for up to 24 hours post-exercise. Weight/resistance training to build lean muscle mass is also important for optimal metabolism as muscle is more metabolically active than fat mass. Your BMR is partly determined by the amount of muscle you have because muscle burns a lot more calories compared to fat, so when you lose muscle, your metabolic rate drops and you burn fewer calories. This would suggest that the more muscle you have, the higher your metabolic rate.
- SLEEP BETTER. If you get too little sleep, your metabolism slows down to conserve energy, which then triggers the release of the stress hormone cortisol. Consistent high levels of cortisol increases fat cell growth and storage. This occurs because visceral fat tissue contains a high number of cortisol receptors which respond to the circulating cortisol in the blood negatively affect our metabolism.
- EAT HEALTHIER. As higher levels of fat storage can negatively impact our metabolism, it is important to eat a balanced, nutritious diet. Just as with every other chronic disease, a whole foods, plant based, low fat, low sugar and low salt diet will help the most. Studies show that post-meal metabolism is 16% higher in plant-based eaters vs meat-eaters. It may not sound like much, but meal after meal, that increased metabolism adds up. Many studies have shown that even elite athletes perform better and recover faster when following a healthy vegan diet. There are certain vitamin deficiencies that may contribute to fat metabolism, deposition and storage. These include:
- Vitamin D. Low levels of vitamin D result in your body producing certain hormones that are responsible for fat cells to hoard and store fat rather than burn it.
- Magnesium. Magnesium is a co-factor of many enzymes involved in glucose metabolism. It has an important role in the action of insulin, and insulin stimulates magnesium uptake in insulin-sensitive tissues. Lower levels of magnesium increases the risk of insulin resistance causing fat to accumulate around the abdomen.
- MAINTAIN HORMONE BALANCE. Metabolism is controlled partly by the thyroid gland in the neck, which in turn is governed by a part of the brain called the hypothalamus. The speed of your metabolism depends on complex chemical messages, which are sent to your brain by your body, telling it how much it needs to function optimally. If there is an imbalance with your thyroid hormones, this may slow your metabolism down, so it may be beneficial to get your thyroid hormones tested to make sure they are within optimal ranges. Other organs also impact on thyroid function like the liver and pancreas. We are not individual organs but a complex organ system.
Although, ultimately, we cannot stop aging and our metabolism slowing down, there are some other food and dietary tips that may help boost your metabolism.
- Avoid fad diets. These usually are very low or too low in total calories and eliminate certain food groups, which may place you at risk of nutrient deficiencies.
- Reduce alcohol consumption.
- Increase protein intake after 65, although you don’t need to overdo it. Your body digests protein more slowly than fat or carbohydrates, which makes you feel fuller for longer. A sufficient protein intake will also assist in building and preserving lean muscle mass. Again, you get plenty of protein from plants and, as compared with animal sources, those plant proteins are more efficiently absorbed and better utilized.
- Add spices to your food, for example chili and cayenne pepper.
- Avoid all fats, especially trans fats. Fats bind to fat and liver cells, which may slow metabolism and increase inflammation in the body.
- Drink green tea — the active ingredient catechin found in green tea may boost your metabolism
Bonus fun fact: Hummingbirds have the fastest metabolism in the animal kingdom. They have a wing beat of 60 to 80 stokes per second. Interestingly, most of their diet comes from sugary sources like nectar, and they have a blood sugar level that would be considered diabetic in humans. But they manage to burn through it rapidly to keep their wings fluttering at top speed.
In a world where anything you want, or think you need, is available at a moment’s notice, it is easy to accumulate and get bogged down with too much “stuff”. We often don’t appreciate all we have until we move or downsize to a smaller home, do spring cleaning or collect for seasonal donations. If you really think about it, we can probably do perfectly fine with significantly less material goods than we think. We don’t need the latest gadget or the biggest TV or that nice shirt or blouse just because it is on sale. This notion of over-abundance has led to the popular minimalism movement.
Minimalism is a lifestyle that helps people think about and question what things actually add value to their lives. By removing the unnecessary distracting stuff, we can make room for and focus on the more important aspects of life such as health, relationships, personal growth, and contribution to society.
Some have taken living minimally to an extreme, paring down their belongings to less than 100 total items, including all their clothing. When you consider that monks basically just own the clothes on their backs and the prayer beads in their hands, 100 things actually sounds like a lot. We don’t all need to be monks, or extreme minimalists for that matter, but less stuff is a great idea. Not only would it help us out personally, but buying less would lead to less waste which helps our struggling environment. Try it out. The next time you think you need something or have the urge to buy something, take a moment and think about whether or not you really need it. Chances are that you probably don’t.
Here is a site that looks into minimalism a little deeper: www.theminimalists.com
Click here for help finding ways to de-clutter.
THE BLUE ZONES – Summarized
Dan Buettner, a National Geographic explorer and researcher, noticed during his travels that there were places in the world where people lived not only long, but healthy and vibrant lives free of the chronic diseases which plague most western societies. He and his research team set out to find these places, later named the Blue Zones, and learn about what their secrets were to health and longevity. There are many such areas in the world but the original 5 include:
- Sardinia, Italy. Home of the world’s highest concentration of male centenarians.
- Ikaria, Greece. This area has one of the lowest rates of middle age mortality and the lowest rates of dementia.
- Nicoya Peninsula, Costa Rica. This area in Central America has the world’s lowest rate of middle age mortality and second highest concentration of male centenarians.
- Loma Linda, CA. Right here in the USA is where there is a large concentration of Seventh Day Adventists. Their life expectancy is 10 years longer than their North American counterparts.
- Okinawa, Japan. Females from this island are the longest-lived population in the world.
After considerable research, they came up with 9 lifestyle habits common to all of these groups:
- MOVE NATURALLY. The world’s longest-lived people don’t pump iron, run marathons or join gyms. Instead, they live in environments that constantly nudge them into moving without thinking about it. They grow gardens and don’t have mechanical conveniences for house and yard work. You may not have a garden but you can do simple things like take the stairs rather than the elevator and park your car farther away from store entrances forcing you to walk farther.
- HAVE PURPOSE. The Okinawans call it “Ikigai” and the Nicoyans call it “plan de vida”. For both it translates to “why I wake up in the morning.” Knowing your sense of purpose is worth up to seven years of extra life expectancy. Too many people wake up every day dreading the drudgery of what they need to do that day. It’s easy to say “do what you love, love what you do” but for most, this is not a reality. We must strive to find some purpose to what we do every day. For some, it’s helping people at work, for some it’s raising great kids. Whatever it is, find it.
- DOWN SHIFT. Even people in the Blue Zones experience stress. Stress leads to chronic inflammation, associated with every major age-related disease. What the world’s longest-lived people have that we don’t are routines to shed that stress. Okinawans take a few moments each day to remember their ancestors, Adventists pray, Ikarians take a nap and Sardinians do happy hour.
- 80% RULE. “Hara hachi bu”. The Okinawan, 2500-year old Confucian mantra said before meals reminds them to stop eating when their stomachs are 80 percent full. The 20% gap between not being hungry and feeling full could be the difference between losing weight or gaining it. People in the Blue Zones eat their smallest meal in the late afternoon or early evening and then they don’t eat any more the rest of the day.
- PLANT-BASED DIETS. Beans, including fava, black, soy and lentils, are the cornerstone of most centenarian diets. Meat, mostly pork, is eaten on average only five times per month. Serving sizes are 3-4 oz., about the size of deck or cards. There are 5 pillar components to the all the Blue Zones daily diet:
- Beans. Red, kideney, garbonzo, great northern, lentils… They are all good.
- Whole grains. Oats, rice, barley… Not refines and processed.
- Greens. There are so many different types beyond just spinach, kale and arugula (although those are all awesome). Try Dandelion greens, the most potent on the planet.
- Tubers. 80% of the Okinawan diet is sweet potatoes!
- Nuts and Seeds. Unsalted. Unroasted. They are all good, just be aware that they are all about 15-18 grams of fat per handful. Better fats for sure, but it adds up.
- WINE @ 5. People in all Blue Zones (except Adventists) drink alcohol moderately and regularly. Moderate drinkers outlive non-drinkers. The trick is to drink 1-2 glasses per day (preferably Sardinian Cannonau wine), with friends and/or with food. And no, you can’t save up all weekend and have 14 drinks on Saturday.
- BELONG. All but five of the 263 centenarians interviewed during the Blue Zones research belonged to some faith-based community. Denomination doesn’t seem to matter. Research shows that attending faith-based services four times per month will add 4-14 years of life expectancy.
- LOVED ONES FIRST. Successful centenarians in the Blue Zones put their families first. This means keeping aging parents and grandparents nearby or in the home (It lowers disease and mortality rates of children in the home too.). They commit to a life partner (which can add up to 3 years of life expectancy) and invest in their children with time and love (They’ll be more likely to care for you when the time comes).
- RIGHT TRIBE. The world’s longest-lived people chose, or were born into social circles that supported healthy behaviors. Okinawans create ”moais”, groups of five friends that committed to each other for life. Research from the Framingham Studies shows that smoking, obesity, happiness, and even loneliness are contagious. So the social networks of long-lived people have favorably shaped their health behaviors.
To make it to age 100, you have to have won the genetic lottery. But most of us have the capacity to make it well into our early 90’s and largely without chronic disease. As the Adventists demonstrate, the average person’s life expectancy could increase by 10-12 years by adopting a Blue Zones lifestyle.
THE BLUE ZONES OF HAPPINESS
As a follow up study to The Blue Zones of Longevity, Dan Buettner wrote “The Blue Zones of Happiness“. He looked at where in the world people were the happiness. Spoiler alert, it has nothing to do with money, how much stuff you have, how fancy your car is our how hot your spouse is. The 4 basic key needs to be happy are:
- Someone to love.
- Something to do.
- Something to look forward to.
- Something to give back.
I could elaborate on these 4 points but it seems to be pretty self evident why, as humans, having evolved in tribes, relying on each other for survival, that these are the keys to happiness and satisfaction.
HOW TO INTERPRET RESEARCH STUDIES
“There are three kinds of lies: lies, damned lies, and statistics.”
Whether it was actually acclaimed American author Mark Twain or 1800’s British Prime Minister Benjamin Diraeli who first coined this phrase is up for debate but the fact is that it is absolutely true. Statistics are more often times confusing and contradictory rather than helpful and illuminating. Regardless of your interests and beliefs, you can find support and “proof” for your position somewhere based on some study which in most cases has manipulated and cherry-picked data. This is particularly true of nutritional and lifestyle studies trying to correlate behaviors and disease.
In today’s world of conflicting interests, flawed science, and sensationalized media, it’s important to question new claims and findings, especially when those findings could have serious implications for your health. One of the most important things you can do is to read the scientific literature yourself. The web is a huge resource although this can be a double-edged sword since anyone can put anything up on the web without any scrutiny or oversight whatsoever. Google does have a search engine called Google Scholar that is helpful for finding studies and papers. It pulls results from online journals and databases around the web, and is pretty good about only providing papers from trustworthy sources. PubMed is also a great place to look for trustworthy articles.
For more about interpreting research articles, please check out this link to my other page.
Wellness and Lifestyle Basics Handout – Introduction to general wellness issues, particularly nutrition.