How to sleep better.

Sleep hygiene:

 

Sleep is critical in the well being of all animals, such that animals deprived entirely of sleep lose immune function and die in just a matter of weeks. Further, many of the major restorative functions in the body like muscle growth, tissue repair, protein synthesis, and growth hormone release occur mostly, or in some cases only, during sleep. The National Highway Traffic Safety Administration conservatively estimates 100,000 police-reported crashes are the direct result of driver fatigue each year. The Institute of Medicine estimates that drowsy driving is responsible for fully 20 percent of all motor vehicle crashes. That would mean that drowsy driving causes approximately 1 million crashes, 500,000 injuries, and 8,000 deaths each year in the U.S. Lack of sleep exacts a toll on perception and judgment. In the workplace, its effects can be seen in reduced efficiency and productivity, errors, and accidents. Just one week of sleeping fewer than six hours a night resulted in changes to more than 700 genes, and even one night of sleep deprivation is linked with brain tissue loss.

 

Sleep hygiene’ is the term used to describe good sleep habits. Sleep hygiene guidelines are designed to enhance good sleeping, and provide long-term solutions to sleep difficulties, without the use of medications. Medications used to treat insomnia tend to be effective in the short-term. Ongoing use of sleeping pills may lead to dependence and interfere with developing good sleep habits, prolonging sleep difficulties. Most sleep medications simply make the patient amnestic to their poor sleep, and do not result in restful or restorative sleep. Restorative sleep is essential in hormone production, stress control, cardiometabolic health and treatment of obesity.

 

Sleep Hygiene Tips

  • Have a bedtime. One of the best ways to train your body to sleep well is to go to bed and get up at more or less the same time every day, even on weekends and days off! This regular rhythm will make you feel better and will give your body something to work from.

 

  • Sleep when sleepy. Only try to sleep when you actually feel tired or sleepy, rather than spending too much time awake in bed. Do not nap outside the sleep time.

 

  • Get up & try again. If you haven’t been able to get to sleep after about 20 minutes or more, get up and do something calming or boring until you feel sleepy, then return to bed and try again. Sit quietly on the couch with the lights off (bright light will tell your brain that it is time to wake up), or read something boring like the phone book. Avoid doing anything that is too stimulating or interesting, as this will wake you up even more. Don’t turn on the television, get on the phone or computer, or listen to the radio.

 

  • Avoid caffeine & nicotine. It is best to avoid consuming any caffeine (in coffee, tea, cola drinks, chocolate, and some medications) or nicotine (cigarettes) for at least 4-6 hours before going to bed. These substances act as stimulants and interfere with the ability to fall asleep. Do not exercise 3 hours before bedtime.

 

  • Avoid alcohol. It is also best to avoid alcohol for at least 4-6 hours before going to bed. Many people believe that alcohol is relaxing and helps them to get to sleep at first, but it actually interrupts the quality of sleep.

 

  • The bed is for sleeping. Try not to use your bed for anything other than sleeping and sex, so that your body comes to associate bed with sleep. If you use bed as a place to watch TV, eat, read, work on your laptop, pay bills, and other things, your body will not learn this connection.

 

  • No naps. It is best to avoid taking naps during the day, to make sure that you are tired at bedtime. If you can’t make it through the day without a nap, make sure it is for less than an hour and before 3pm.

 

  • Sleep rituals. You can develop your own rituals of things to remind your body that it is time to sleep – some people find it useful to do relaxing stretches or breathing exercises for 15 minutes before bed each night, or sit calmly with a cup of caffeine-free tea.

 

  • Having a hot bath 1-2 hours before bedtime can be useful, as it will raise your body temperature, causing you to feel sleepy as your body temperature drops again. Research shows that sleepiness is associated with a drop in body temperature.

 

  • No clock-watching. Many people who struggle with sleep tend to watch the clock too much. Frequently checking the clock during the night can wake you up (especially if you turn on the light to read the time) and reinforces negative thoughts such as “Oh no, look how late it is, I’ll never get to sleep” or “it’s so early, I have only slept for 5 hours, this is terrible. ”

 

  • Use a sleep diary. This worksheet can be a useful way of making sure you have the right facts about your sleep, rather than making assumptions. Because a diary involves watching the clock (see point 10) it is a good idea to only use it for two weeks to get an idea of what is going and then perhaps two months down the track to see how you are progressing. The point of the sleep diary is NOT to create a log of complaints to share.

 

  • Regular exercise is a good idea to help with good sleep, but try not to do strenuous exercise in the 3 hours before bedtime. Morning walks are a great way to start the day feeling refreshed!

 

  • Eat right. A healthy, balanced diet will help you to sleep well, but timing is important. Some people find that a very empty stomach at bedtime is distracting, so it can be useful to have a light snack, but a heavy meal soon before bed can also interrupt sleep. Some people recommend a warm glass of milk, which contains tryptophan, which acts as a natural sleep inducer.

 

  • The right space. It is very important that your bed and bedroom are quiet and comfortable for sleeping. A cooler room with enough blankets to stay warm is best, and make sure you have curtains or an eyemask to block out early morning light and earplugs if there is noise outside your room. Background noise or white noise improves the ambiance and will reduce wake cycles.

 

  • Keep daytime routine the same. Even if you have a bad night sleep and are tired, it is important that you try to keep your daytime activities the same as you had planned. That is, don’t avoid activities because you feel tired. This can reinforce the insomnia.

 

  • Get regular exposure to outdoor or bright lights, especially in the late afternoon.  Use blackout curtains in the bedroom to eliminate light in the bedroom during bedtime.   Turn off or cover all sources of light in the bedroom.

 

  • Don’t take another person’s sleeping pills or over-the-counter pills. Taking over-the-counter sleeping pills causes rapid development of tolerance. Diphenhydramine (an ingredient commonly found in over-the-counter sleep meds) can have serious side effects for elderly patients.

 

 

  • Designate another time to write down problems & possible solutions in the late afternoon or early evening, not close to bedtime. Do not dwell on any one thought or idea—merely jot something down and put the idea aside.

Carbs are an addiction.

Serotonin release in the brain controls functions such as sleep onset, pain sensitivity, blood pressure regulation, and control of mood.  Serotonin-releasing neurons are unique in that the amount of neurotransmitter they release is normally controlled by food intake: Carbohydrate consumption–acting via insulin secretion and the “plasma tryptophan ratio”–increases serotonin release dramatically (by enhancing the brain uptake of its precursor, tryptophan).  Elevated serotonin causes significant mood enhancement and a generalized sense of contentedness.  Patients learn to overeat carbohydrates (particularly snack foods and drinks, like soda, potato chips or pastries, which are rich in carbohydrates) to make themselves feel better.

Self-medication with carbohydrate rich foods as though they were drugs is a frequent cause of weight gain, and is often seen:

  • In patients who become fat when exposed to stress
  • In women with premenstrual syndrome (PMS)
  • In patients with “winter depression” (Seasonal Affective Disorder)
  • In patient’s who are experiencing chronic pain (ingestion analgesia)
  • In people who are attempting to give up smoking. (Nicotine increases brain serotonin secretion; nicotine withdrawal has the opposite effect causing cravings.)
  • As a consequence of chronic patterned carbohydrate consumption causing hardwired changes in neurons, such that there are cravings and feelings of withdrawal when carbohydrates are withheld

Carbohydrate load is so closely linked to addiction, that the Glycemic Index (GI) of specific carbohydrates correlates closely with their relative addictive strength  and activates addiction neural pathways.

The take home message, carbohydrates are an addiction.  Carbohydrate consumption promotes neurochemical changes, which reinforce additional carbohydrate consumption.  There is now evidence that carbohydrate binging is akin to heroin addiction, with the cravings for carbohydrates reduced by opiates and more interestingly, carbohydrate cravings dramatically increased during opiate withdrawal.  Unfortunately, carbohydrate addiction will definitely make you fat.

The addictive power of carbohydrates.

Your brain and obesity.

Obese people have, on average, eight percent less brain tissue than people of normal weight, according to a new study published in the journal Human Brain Mapping.  Even overweight people have four percent less brain tissue than their normal-weight peers.   Obesity is independently associated with poor educational attainment and may be responsible for the cognitive deficiency manifested in lower intelligence test scores (IQ).  Excessive body weight gain has a shrinking and aging effect on the brain with a reduction in measureable IQ, in addition to the previously recognized increased risk of diabetes, high blood pressure, heart disease and stroke.  The terminology of obesity and ever weight is defined by using weight and height to calculate a number called the Body Mass Index (BMI).  Obesity is defined as a BMI greater than 30, and overweight is defined as a BMI of 25 to 29.9.

 

 

The new study showed that age, gender, and race don’t matter. MRI brain scans of obese people revealed that their brains are smaller (atrophy) and appeared to be 16 years older than brains of lean people. The brains of overweight people appeared to be 8 years older. The presence of brain shrinkage is associated with dementia and depletes cognitive reserves in later years, which puts you at greater risk of Alzheimer’s and other diseases that attack the brain.

Atrophy or shrinkage of brain tissue associated with obesity and Alzheimer's

 

The primary areas of the brain affected include the frontal and temporal lobes, which are responsible for planning and memory.

 

The mechanisms which links obesity to gray matter atrophy (brain shrinkage) include:

  • Reduced blood flow to brain due to blood vessel shrinkage
  • Reduced perfusion due to hypertension and loss of vessel elasticity
  • Toxic xenoestrogens released from excessive adipose tissue
  • Insulin resistance with chronically elevated blood glucose, leading to glycation, inflammation, and protein degradation
  • Expansion of the penumbra zones (enlargement of the stroke zone), possibly even with micro strokes or silent strokes.

 

 

This lack of blood flow to the brain causes cell and tissue death resulting in brain shrinkage. Interestingly, the research also showed that regular, vigorous exercise has the reverse effect. Physical activity can actually conserve brain tissue, which further supports the idea that blood flow is at least partly responsible for the maintenance or shrinkage of our brains. Of course, exercise also helps greatly in preventing obesity and its related conditions and risks.

 

According to the World Health Organization, a poor dietary habit with reliance on convenience and processed foods significantly contributes to obesity.  The lack of portion size control is a particular problem in the United States, where “Super Sizing” every restaurant meal has contributed to our expanding waistlines.  Additionally, food engineering and tremendous food diversity titillates our taste buds into over consumption.

 

These new study results highlight the importance of exercising regularly, eating a balanced diet of fresh, whole foods and limiting your portion sizes. Not only will these healthy habits go a long way towards maintaining your weight and reducing the risks associated with obesity, they can help you maintain a healthy brain – which will end up affecting much more than how you look.

Brain shrinkage and reduced IQ is associated with obesity. It may be reversible with appropriate diet and nutrition.

The effects of smoking on your brain.

If you thought the only dangers of smoking were chronic obstructive pulmonary disease (COPD), emphysema and lung cancer, think again. New studies now link the expensive (financially and health-wise) habit with new concerns.

One recent paper, “Smoking History and Cognitive Function in Middle Age From the Whitehall II Study,” appeared in the Archives of Internal Medicine. Head investigator, Séverine Sabia, MSc—from the Institut National de la Santé and de la Recherche Médicale in Villejuif, France— looked at recent discussions linking smoking with dementia, considered related through the effect smoking has on vascular disease.

 

The Whitehall II study evaluated over 10,000 participants, aged 35-55 (at baseline, phase 1, 1985-1988). Assessments were made on smoking history at both phase 1 and phase 5 (1997-1999). Among the group, 25% were light smokers (≤ 5 cigarettes per day) and 25% were heavy smokers (1-2 packs per day). Smokers had an average of 14 cigarettes daily; only 27 participants smoked over two packs a day.

Cognitive data (memory, reasoning, vocabulary and semantic/phonemic fluency) were available for 5,388 study subjects at phase 5—when participants were 45-68 years old/mean age 55.5. Of those, 4,659 were retested 5 years later for phase 7, when study subjects were 50-74 years old/mean age 61

• Smoking was associated with greater risk of poor memory.
• After adjustments at phase 5, smokers had a 37% higher risk for cognitive decline.
• Long-term ex-smokers (stopped prior to study) demonstrated a 30% lower risk for poor cognition (vocabulary decline and reduced verbal fluency)—possibly due to health behavior improvements.
• Positive midlife health changes (better nutrition, exercise, alcohol consumption, etc.) and smoking cessation were linked.
• Middle-aged smokers are more likely to be lost to follow-up by death or through nonparticipation in cognitive tests. Therefore, the smoking-decline cognition link could be undervalued.
• Additional research indicates that mild cognitive decline continues at an accelerated rate to clinically diagnosed dementia.
• A 2007 meta-analysis of 19 studies of over 26,000 elderly (mean age 74) demonstrated that current smoking increased risk for dementia and cognitive decline by 40%-80%, depending upon measure employed.
• A ten-year study of over 3,600 Australians demonstrated a four-fold increased risk of age-related macular degeneration compared to non-smokers.
• A June 2008 study showed that smokers have higher all-cause mortality, equivalent to a non-smoker 5-10 years older.

 

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The excuse of weight gain:
One objection smokers often give for not quitting is weight gain. That may be true for light smokers (less than one pack per day), but heavy smokers (greater than one pack per day) tend to have other associated health habits, such as weighing more and having an increased risk for metabolic syndrome and diabetes. The bottom line: Smoking shows no benefits on any level.

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Smoking is counterproductive to healthy aging. You can stay active, alert, lean and healthy with established protocols, shown to improve cognitive function and physical/sexual energy as well as enhance libido and body composition (lean muscle mass, reduced body fat), strengthen your immune system and ability to manage stress.

Smoking makes you stupid.

Exercise as if your life depended upon it! It really does.

Exercise as if your life depends upon it, it really does.  Men who achieved >7 METs (highly to very highly fit) level demonstrated a 50%-70% lower mortality risk than “low fit” subjects.

In a study published in the Journal Circulation, researchers assessed “the association between exercise capacity and mortality” in over 14,000 men—subjects whose average age was 60, who did or didn’t have cardiovascular disease and who successfully completed a treadmill test.  Men who achieved >7 METs (highly to very highly fit) level demonstrated a 50%-70% lower mortality risk than “low fit” subjects.

The highest-intensity aspect of exercise, the hardest part. is the 15 seconds of sprinting at the end of a long run, or the most difficult 10 seconds of pumping during a peak level on an exercise bike, or the last few repetitions when exercising muscles to failure.   One “metabolic equivalent” [MET] is the amount of oxygen used by an average person at rest  and increases proportionally with the intensity of exercise.

A MET is used as a practical means of expressing the intensity and energy expenditure of physical activities in a way comparable among persons of different weight; but actual energy expenditure (e.g., in calories or joules) during a physical activity depends on the person’s body mass, therefore the energy cost of the same physical activity will be different for persons of different weight.  In other words, METs as defined by most exercise equipment cannot be used to determine metabolic rate directly.  Never the less, a physical activity with a MET value of 2, such as walking at a slow pace (e.g., 3 km/h) would require for a specific person twice the energy that person consumes at rest (e.g., sitting quietly), a MET value of 1.

In this study, fitness categories based on METs achieved are were:

  • low                              [5 METs]
  • moderate                   [5-7 METs]
  • highly                         [7.1 to 10METs]
  • very highly fit            [over 10 METs]

Subjects exercised until tired; with follow-ups done for 7.5 years on average.  Men who achieved >7 METs (highly to very highly fit)—demonstrated a 50%-70% lower mortality risk than “low fit” subjects.  The chances of staying alive increased by 12 to 13 percent with each increase of a single metabolic equivalent [MET] when exercising as hard as possible on a treadmill.  Peak MET achieved is a better predictor of how long someone will live than other factors – including health risk factors like high cholesterol, diabetes, smoking, high blood pressure, and even heart disease.

The risk of death was reduced by 50% with an improved exercise capacity attained of just  30 minutes per session, 5-6 days per week.   And even if  30 minutes was too much , splitting the routine into 10-15 minute segments (morning/evening) gives the same benefit. Additionally, even moderate intensity exercise, greater then 7 METs offers significant health benefits.

  • Increased health span: A study following Harvard grads for 30 years showed those moderately active were at substantially decreased risk of death.
  • Decreased health risks: Strengthening the heart muscle for good circulation, decreased blood pressure and reduced stroke risk.
  • Reduced stress and significantly improved mood: With a moderate intensity workout of 20 minutes or more.
  • Increased muscle endurance: Making daily activities easier.
  • Improved sleep quality: Researchers at Stanford, Emory and the University of Oklahoma reported older people doing brisk walking and/or low-impact aerobics four times a week went to sleep faster and slept an hour longer than before (Harvard Health Letter, March 1997).

Many of these benefits accrue due to the improved endocrine profile; with resultant elevated Thyroid Hormone, Testosterone, and Growth Hormone.  Insulin sensitivity also seems to be enhanced with improved glucose control, resulting in less fat deposition, increased fat mobilization as usable energy, and reduced total Insulin levels and elevated Glucagon levels.

The key element in obtaining health benefits is the high intensity nature of the exercise, and the relatively short duration of the exercise.  MET capacity is even more important than the traditionally measured BMI or waist hip ratio.

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What’s so wrong with a fat belly?

There are three types of fat commonly seen observed in the abdomen

  1. Subcutaneous Fat, which is fat immediately below the skin but outside the abdominal cavity.
  2. Retroperitoneal or Structural Fat separating organ and providing cushioning during movement.
  3. Visceral abdominal fat (found inside the abdominal cavity). Most of that fat is found on the greater omentum—a large apron-like sheet that drapes over all the organs. Some people are prone to storing their body fat in their abdomen as part of this greater omentum. As a result, large, globule clumps of fat attach to the omentum, where they release toxic materials into the venous drainage and onto the bloodstream, ultimately causing adverse effects. This kind of fat releases adipokines, harmful chemicals that can cause Alzheimer’s, type 2 diabetes, insulin resistance, high blood pressure, and increased risk of cancer.

Reports have demonstrated that being overweight or obese (particular with a centralized distribution of adiposity) puts you in a higher-risk category for chronic conditions, from insulin resistance, type 2 diabetes, high blood pressure, high cholesterol, stroke, heart attack, congestive heart failure, gallstones, gout, osteoarthritis, sleep apnea and a liver disease called nonalcoholic fatty liver disease (NAFLD).

It is interesting to note that the middle-age bulge increase your chances of having

Alzheimer’s or other types of dementia in your senior years by nearly three times, even though it’s not your brain that stores the fat.  This may be related to:

  1. Toxic metabolites produced by the visceral abdominal fat, such as xenoestrogens which suppress testosterone formation, leading to poor blood vessel elasticity and high blood pressure
  2. Storage of fat soluble toxins, such as food borne pesticides and herbicides, acquired from the environment which then slowly leach out.
  3. Toxic belly fat is thought to promote amyloid accumulation by increasing chronic inflammation. Amyloid is an abnormal protein, which deposits in the body’s tissues or in more organ-specific areas, such as in the pancreas (type 2 diabetes) or central nervous system (Alzheimer’s, Parkinson’s, Huntington disease).

Visceral abdominal fat (belly fat) is the last reservoir people get rid of when they’re losing body fat—and it’s the first place they store it when they gain back body fat.

To date, there are no ways to specifically target that fat, but there are things you can do to work your way down to healthier body fat levels (16% for men, under 22% for women).

A low-glycemic nutrition eating plan with specific nutritional supplementation can help you optimize your health potential and reduce belly fat. Consistent high intensity interval exercise can increase metabolic rates, lower heart disease risk and improve body composition, muscle endurance, flexibility, cardiovascular endurance, core strength/stability and posture.  These effects are not purely related to the energy burned due to exercise, but also due to the significant endocrine [hormonal changes] induced by resistance exercise leading to increased Growth Hormone, Thyroid Hormone, and Testosterone production.

More specifically, resistance training helps you lose abdominal fat and overall body fat while lowering cholesterol: Weight training is the best way to burn fat; it’s more effective for losing weight than aerobic activity because it burns calories while you’re exercising and later at rest due to the hormonal changes and muscular regeneration.

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