By Clive Lindley-Jones | May 5, 2020 4:53 pm
"Understanding which factors affect your clock will help you make small changes that will add years of good health to your life”.
Prof. S. Panda
This month we want to quickly touch on two things.
• Your general health during lock down,
• A way of sleeping better, getting more energy and losing weight you may not have known about, that is all about day and night.
But first, a big thank you to all of you who are out there on the front line right now, in whatever capacity. I am sure I speak for all of us at Helix House who wish to express our thanks and appreciation for what you are doing.
We were very sad to have to temporarily close the physical Helix House practice. Until it is safe to see you face to face again, we may be able to help you, in some ways, through an online consultation which we are doing for some of our patients and clients. For more information on how to contact us please go here.
Health impacts of lockdown
According to the Institute for Employment Studies (IES) two-thirds of people surveyed said that anxiety was keeping them awake at night while half reported new neck, shoulder and back pain. Was this the result of home workers having to hunch over their laptops for too long?
How are you living in lockdown? Are you working flat out as a key worker, working from home as best you can, or are you busy trying to entertain and/or educate your children at home? Perhaps you are enjoying newfound time to sort out your home and get on with long side-lined projects?
The Week, (18/4/2020) also reported the IES survey saying that 60% of respondents said they are getting less exercise and one-third reporting they are eating less healthily, with 20% saying they are drinking more alcohol.
The search goes on to better understand the Covid 19 virus. Accepting that we all know very little, and most ideas about how to defend ourselves from the virus from Trump and other sources are clearly off the wall, there are things we can do, at least to gain locus of control and look at how modifiable lifestyle factors can make our immune system more or less robust. The Institute of Functional Medicine has some excellent, evidence-based ideas on how we can improve our general health and make ourselves less fragile and reduce risk from all sorts of health challenges now and in the future.
Never let a crisis go to waste
There is no doubt that this is a tragic and damaging time for the world.
It's a wake up call for the far more damaging changes we have set in motion through the climate crisis and that are just around the corner for us all, unless we can use this time to take stock and make big changes in our political choices that may, eventually and with sufficient attention to the science, heal the planet we have trashed.
But as they say, never let a crisis go to waste. We can all think of so many ways that this time could lead to great improvements, and we might also use it now, if we are lucky enough to have the opportunity, to start to make changes in our life and to encourage new good habits for us and our families, both in terms of how we live on the planet, and how we live with ourselves and our loved ones. Then, when this crisis eventually ends, we can make sure we do not go back to life as normal. That normal was unsustainable for our fragile earth. What an opportunity - don't miss it!
Understanding which factors affect your clock
Like everything in our world, as we go around the sun and the earth rotates, we live in a diurnal world. The term circadian comes from the Latin circa meaning "around" (or "approximately"), and diēm, meaning day. Around every 24 hours, we experience two phases of light and darkness. Unlike all our ancestors up until around one hundred years ago, for us, this is such a self-evident fact we can, thanks to electric light, easily ignore it.
Most of us spend up to 90% of our days inside, living in a novel world of our own making. It is likely that the present lockdown is aggravating this for most of us. Thanks to advances in technology, this world is increasingly distant from what is happening outside. However, almost every gene, cell, and organ in our body is still keeping score, watching the ‘clock’.
At this time of pandemic, when all the normal rules of operation have had to be jettisoned, perhaps it is not a bad time to consider what effect this loss of connection to the daily light/dark cycle has on our health, in ways we may not have guessed. I hope this blog might make you look again at your own health and consider what ways your sleep wake cycle might be impacting on your health.
All life, on this rotating earth
All life, on this rotating earth, is put under pressure to accommodate, as best it can, to this inalienable fact. Science is increasingly uncovering the mechanisms through which we pay a high price in our mental and physical well-being, to the extent that we ignore this.
At birth, we are largely unaware of this cycle. However, at around six months we start to entrain with it. From then on, our internal biological clock, deep in our brain (the super chiasmic nucleus) and linked to thousands of micro-clocks embedded in a most of our body systems, keeps in touch with the diurnal, or Circadian Rhythm, via a few tiny blue light sensing cells (melanopsin) in our eyes, helping us know what time of day or night it is and adapting our body systems accordingly.
Dr. Satchin Panda
Recently I have had the pleasure of reading Professor Panda's interesting book The Circadian Code, as well as listening to him on podcasts and watching him lecture on line.
Our bodies respond to this ‘time stamp’ by adapting us for our major activities throughout the 24 hours by a complex series of hormonal signals and adaptations to all our organs, even our own microbiome - the three trillion bacterial cells in our gut.
When we need to sleep, ideally the sleep hormone melatonin is released to prepare us, when we wake it should be turned off and the stress hormone cortisol rises and gets us active. Later still, our muscles reach their peak for physical activity. These three key activity homeostats each effect the other and all are conducted by the small blue light sensors in our eyes that tell our brain clock what time it is. From waking to sleeping, a cascade of preparatory signals cue up the various systems in our body to best complete their tasks and then to rest and repair.
When you eat can be almost as important as what you eat
The greater our shift away from the natural diurnal cycles through shift work, staying up/getting up late, and living a largely indoor life away from the key light signals of the natural world, the more we mis-align these important circadian rhythms from our day to our night cycle, and the more our alertness, performance and mental health is affected negatively.
As long as our eyes are open, our mouths are open
One of Dr. Panda’s teams most interesting and, potentially, impactful findings from mice and later human studies, found 50% of adults eat for up to fifteen hours a day or longer. This had a surprisingly detrimental effect on weight gain in mice and human subjects.
The Virtual world has no day or night
Now we have infinite virtual distractions, it is easy to stay up late and watch one more episode or play another game. People who sleep less may eat and drink alcohol more. Conversely, both mice and human subjects lost more than 3-4% of body weight when they practice Time Restricted Eating (TRE). Best results were achieved when all food and drinks, outside of water and medication, were consumed within an 8-12-hour window, using the digestive system at times when its own clock was ready for its task of digestion, and allowing plenty of down-time for repair. Human subjects also reported that inflammation was reduced and so they experienced less joint pain along with other improved symptoms (the mice never mentioned it) and both mice and humans experienced an increase in endurance capacity.
I have written extensively in these blogs about the dysfunctional food environment that is the number one cause of death for us humans and the planet. Dr. Panda’s research adds another, non-food related, aspect to the path to a long and healthy life.
We are all shift workers at some point
The science clearly shows that in our modern lives, even if it is just that we are (or were) parents of young children or are frequent flyers and regularly suffered jet lag, our erratic lifestyle itself, is driving us to more dysfunction and disease and a shorter life. Certainly, mice that eat even in the 12-13-hour window lived longer than mice who could eat all the time.
Already our devices can be turned down to a ‘night-time’ mode so that we stop giving our brains the wrong blue light cues that lead to metabolic confusion. Imagine if quite soon, we will be able to equip ourselves with sensors to more effectively regulate us to the health-giving harmony of the rhythms that our ancestors took for granted. But don't forget you may have one clever device already. On your wrist. It tells you when it's bed time.
This is just a very brief summary of an exciting and important new window into ways we make ourselves sick and how we can all change this even if we are shift workers.
The longer your circadian rhythm is out of sync, the greater the risk of developing serious disease
This is an area of such profound, and often overlooked, potential effect to just about all the workings of our body and mind having some influence on many of today’s non-communicable or lifestyle diseases, it is really worth us all taking seriously.
Circadian rhythms out of sync, effects more than you might think!
The effects range from sleep, obesity, digestion, anxiety, depression, ADHD, metabolic syndrome cancer and many more. The longer your circadian rhythm is out of sync, the greater the risk of developing serious disease.
Testing your Circadian Code
As Professor Panda says, in The Circadian Code:
"If you are living with a medical condition, it is important to know if your condition may be disrupting your daily rhythms... If you would like to test yourself on these two quizzes to see if the quality of your circadian code is affecting your health you can try them out below.
The first quiz focuses on the way you think and feel right now. The second offers an opportunity for you to track how far off you are from living within an optimal rhythm. The first test represents various symptoms and conditions you may be suffering from. These symptoms or conditions might affect your sleep or eating cycles. Or they may be a response to a poorly operating circadian code. Either way, recognizing that you have these issues, and that they may be affecting you more than you realise, is the first step to addressing them.
If your work requires you to stay awake for at least 3 hours between 10:00 p.m. and 5:a.m. for more than 50 days a year (once a week), you are a shift worker and at risk of suffering from shift-work-related diseases. Many of us do not sleep enough, eat randomly, do not participate in significant physical activity, or do high-intensity physical activity at the wrong time. Understanding which factors affect your clock will help you make small changes that will add years of good health to your life.
Answer the following questions truthfully, noting the ones you say yes to... There are no right or wrong answers. However, if you answer "yes" to any of these questions, it is likely that optimising your circadian system will benefit your health. Don't worry if you aren't perfect; almost everyone has room for improvement."
Have a go. Hopefully you will be able to see how this, possibly overlooked aspect of you life may have health implications for you, or your family, that you may not have looked at so deeply before.
Good luck and good health.
TRACK AND TEST: IS YOUR CIRCADIAN CODE IN SYNC?
Has your doctor told you that you are overweight? Y/N
Have you been diagnosed with either pre-diabetes or diabetes? Y/N
Are you taking prescription medication for a chronic disease, such as heart disease, blood pressure, cholesterol, asthma, acid reflux, joint pain, or insomnia? Y/N
Are you taking over-the-counter remedies for acid reflux, pain, allergies, or insomnia? Y/N
Do you have an irregular menstrual cycle? Y/N
Do you have hot flashes or disrupted sleep related to menopause? Y/N
Do you have a decreased libido? Y/N
Have you been diagnosed with a disease linked to chronic inflammation, such as multiple sclerosis or inflammatory bowel disease? Y/N
Do you have frequent lower back pain? Y/N
Have you been diagnosed with sleep apnea? Y/N
Do you snore? Y/N
Do you wake up feeling congested or with a stuffy nose? Y/N
Do you have frequent abdominal pain, heartburn, or indigestion? Y/N
Do you have frequent headaches or migraines? Y/N
Do your eyes feel tired at the end of the day? Y/N
Do you feel anxious? Y/N
Do you feel low or have frequent blue moods? Y/N
Do you struggle with attention and focus? Y/N
Do you experience brain fog or poor concentration? Y/N
Do you frequently lose items, like your glasses, a charging cable or keys? Y/N
Do you rely on a calendar or to-do lists? Y/N
Do you wake feeling tired? Y/N
Have you been diagnosed with post-traumatic stress disorder (PTSD)? Y/N
Have you been diagnosed with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) or bipolar disorder? Y/N
Do you have food cravings? Y/N
Do you feel like you have a lack of willpower over food? Y/N
Have you been told that you are irritable? Y/N
Do you have trouble making decisions? Y/N
Do you take less than 5,000 steps a day? Y/N
Do you spend less than an hour outdoors under daylight each day? Y/N
Do you exercise after 9pm? Y/N
Do you spend more than an hour on the computer, your phone or watching TV before bedtime? Y/N
Do you have one or more alcoholic drinks (cocktails, wine, or beer) after dinner? Y/N
Do you forget to drink water throughout the day? Y/N
Do you drink coffee, tea, or caffeinated soda in the afternoon or evening? Y/N
Do you consume chocolates, high-carb foods (doughnuts, pizza) or energy drinks to improve your energy level? Y/N
Do you binge on foods late in the day regardless of hunger? Y/N
Do you drink or eat anything (other than water) after 7.00pm? Y/N
Do you sleep with the light on? Y/N
Do you need an alarm clock to wake up in the morning? Y/N
Do you set aside less than 7 hours for sleep and rest every day? Y/N
Do you typically catch up on sleep on the weekends? Y/N
Do you eat whatever food is presented to you, even if you are not hungry? Y/N
Assessing Your Responses
Most of us will have a few “yes” answers to the above questions. It is common (but not normal) as we are all shift workers and we do have some circadian disruption in our lives. In the physical and mental health sections, many of us may answer yes to one or two questions, but answering three or more in each section is a sign that your circadian rhythms may not be optimal. You may also assume that some of the symptoms may be benign and negligible because many people of your age or your peers may have the same symptoms. But what is common is not always normal.
In the behavioural habits section, any yes answer is a potential disruption to your circadian clock. Many people typically have five or more yes answers, which means they have many different ways to optimize their rhythm and stay healthy.