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The Medicine Cabinet-Ask the Harvard Experts: Restless legs might improve with nutritional changes

May 28th, 2014 Raquel Rothe

By Robert Shmerling. M.D., Tribune Content AgencyPremium Health News Service

4:30 a.m. CDT, April 30, 2014

Q: I have restless legs syndrome. Can diet help?

A: We don’t know what causes restless legs syndrome, but we do know that it causes unpleasant or painful sensations in the legs. This could include tingling, pulling, or crawling, along with an urge to move the legs.

A number of medications can help. However, treatment recommendations do not usually include changes in diet. Therefore, many doctors would answer “no” to your question. However, there are some associations that might be considered.

Iron deficiency is a risk factor for restless legs syndrome. So if blood tests show iron deficiency, eating iron-rich foods might help. Examples include red meat, leafy green vegetables and iron-fortified cereals. But most doctors would simply recommend an iron supplement. (And your doctor may recommend testing to determine the cause of iron deficiency.)

A few studies have found that celiac disease is more common among people with restless legs syndrome. For people with both celiac disease and restless legs syndrome, eliminating gluten from the diet might improve symptoms of both conditions. However, this possibility has not been well-studied.

A study of more than 18,000 men found no connection between restless legs syndrome and an “unhealthy diet.” (This would be a diet that increases the risk of diabetes, heart disease and other chronic illness.) But this study did not include a detailed analysis of the impact of specific foods on restless legs syndrome.

Caffeine and alcohol may affect sleep quality. Poor sleep quality can make symptoms of restless legs syndrome worse. If you’re willing, it may be worth a trial of cutting back and then eliminating both from your diet.

If you have restless legs syndrome, current evidence suggests that dietary changes are unlikely to have a major impact on your symptoms. But research regarding the connection is limited. Future research could change that.

Until then, watch your caffeine and alcohol intake. And talk with your doctor about getting a blood test for iron deficiency and perhaps for celiac disease.

(Robert H. Shmerling, M.D. is a practicing physician in rheumatology at Beth Israel Deaconess Medical Center, Boston, Mass., and an Associate Professor in Medicine at Harvard Medical School.)

(For additional consumer health information, please visit http://www.health.harvard.edu.)

(c) 2014 PRESIDENT AND FELLOWS OF HARVARD COLLEGE. ALL RIGHTS RESERVED. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.

If You Sleep Less Than 6 Hours, You Must Read This…

February 28th, 2014 Raquel Rothe

I haven’t talked a great deal about sleep deprivation, so when I came across this articleon Medscape, I thought the overview of the various epidemiologic findings related to sleeping less than 6 hours was worth reviewing:

“Sleep deprivation has a profound impact on multiple disease states. For example, if you sleep less than 6 hours, epidemiologic studies show the following:

Stroke is increased by a factor of 4 times.

Obesity is increased by an increase in ghrelin, which is a hunger hormone.

Diabetes is increased because sleep deprivation increases insulin resistance.

Memory loss is accelerated. Epidemiologic studies show that there is not only permanent cognitive loss but also evidence of early brain deterioration.

Osteoporosis is increased, at least in an animal model, with changes in bone mineral density. Even changes in bone marrow are evident within 3 months of a study in a rat model.

Cardiac disease is increased. There is a 48% increase in early cardiac death, as well as increased cardiac-related mortality.

A 4-fold overall increase in mortality.

As it relates to gastrointestinal disease, there is an increased risk for colon cancer, and at least 1 epidemiologic study shows an association between sleep deprivation (or lack of sleep) and an increase in the likelihood of precancerous (adenomatous) polyps.”

The author also summarized the results of this finding that sleep deprived mice had higher rates of tumor growth.

More and more studies are linking sleep deprivation and obstructive sleep apnea with numerous medical conditions, including cancer.

If you sleep less than 6 hours, something else to sleep on…

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Eat to Dream: Study Shows Dietary Nutrients Associated with Certain Sleep Patterns

April 18th, 2013 Raquel Rothe

Eat to Dream: Study Shows Dietary Nutrients Associated with Certain Sleep Patterns

First Nationally-Representative Analysis Reveals People Who Eat a Varied Diet Have Healthier Sleep Duration

Newswise — PHILADELPHIA — “You are what you eat,” the saying goes, but is what you eat playing a role in how much you sleep? Sleep, like nutrition and physical activity, is a critical determinant of health and well-being. With the increasing prevalence of obesity and its consequences, sleep researchers have begun to explore the factors that predispose individuals to weight gain and ultimately obesity. Now, a new study from the Perelman School of Medicine at the University of Pennsylvania shows for the first time that certain nutrients may play an underlying role in short and long sleep duration and that people who report eating a large variety of foods – an indicator of an overall healthy diet – had the healthiest sleep patterns. The new research is published online, ahead-of-print in the journal Appetite.

“Although many of us inherently recognize that there is a relationship between what we eat and how we sleep, there have been very few scientific studies that have explored this connection, especially in a real-world situation,” saidMichael A. Grandner, PhD, instructor in Psychiatry and member of the Center for Sleep and Circadian Neurobiology at Penn. “ In general, we know that those who report between 7 – 8 hours of sleep each night are most likely to experience better overall health and well being, so we simply asked the question “Are there differences in the diet of those who report shorter sleep, longer sleep, or standard sleep patterns?”

To answer this question, the research team analyzed data from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) sponsored by the Centers for Disease Control and Prevention. NHANES includes demographic, socioeconomic, dietary, and health-related questions. The sample for the survey is selected to represent the U.S. population of all ages and demographics. For the current study, researchers used the survey question regarding how much sleep each participant reported getting each night to separate the sample into groups of different sleep patterns. Sleep patterns were broken out as “Very Short’’ (<5 h per night), ‘‘Short’’ (5–6 h per night), ‘‘Standard’ (7–8h per night), and ‘‘Long’’ (9 h or more per night). NHANES participants also sat down with specially trained staff who went over, in great detail, a full day’s dietary intake. This included everything from the occasional glass of water to complete, detailed records of every part of each meal. With this data, the Penn research team analyzed whether each group differed from the 7-8 hour “standard” group on any nutrients and total caloric intake. They also looked at these associations after controlling for overall diet, demographics, socioeconomics, physical activity, obesity, and other factors that could have explained this relationship.

The authors found that total caloric intake varied across groups. Short sleepers consumed the most calories, followed by normal sleepers, followed by very short sleepers, followed by long sleepers. Food variety was highest in normal sleepers, and lowest in very short sleepers. Differences across groups were found for many types of nutrients, including proteins, carbohydrates, vitamins and minerals.

In a statistical analysis, the research team found that there were a number of dietary differences, but these were largely driven by a few key nutrients. They found that very short sleep was associated with less intake of tap water, lycopene (found in red- and orange-colored foods), and total carbohydrates, short sleep was associated with less vitamin C, tap water, selenium (found in nuts, meat and shellfish), and more lutein/zeaxanthin (found in green, leafy vegetables), and long sleep was associated with less intake of theobromine (found in chocolate and tea), dodecanoic acid (a saturated fat) choline (found in eggs and fatty meats), total carbohydrates, and more alcohol.

“Overall, people who sleep 7 – 8 hours each night differ in terms of their diet, compared to people who sleep less or more. We also found that short and long sleep are associated with lower food variety,” said Dr. Grandner. “What we still don’t know is if people altered their diets, would they be able to change their overall sleep pattern? This will be an important area to explore going forward as we know that short sleep duration is associated with weight gain and obesity, diabetes, and cardiovascular disease. Likewise, we know that people who sleep too long also experience negative health consequences. If we can pinpoint the ideal mix of nutrients and calories to promote healthy sleep, the healthcare community has the potential to make a major dent in obesity and other cardiometabolic risk factors.”

Other authors for Penn include Nicholas J. Jackson and Jason R. Gerstner, PhD.
This research was supported grants from National Institutes of Health (T32HL007713, 12SDG9180007 and P30HL101859)

14 Little Changes for a Healthier Life

November 17th, 2011 Raquel Rothe

http://health.yahoo.net/experts/menshealth/14-little-changes-healthier-life

That’s pretty much it. Small changes, big results. It’s my mantra. And it should be yours, too. Fact is, it’s hard to make big changes in life. That’s why so many of us struggle with our weight and health. The problem isn’t knowing what to do; it’s doing it. So forget grand, life-changing goals and start small instead.

New Guidelines for Exercise in Type 2 Diabetes

September 2nd, 2011 Raquel Rothe

It is now well established that participation in regular physical activity improves blood glucose control and can prevent or delay type 2 diabetes mellitus, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life.

http://www.medscape.com/viewarticle/734020?src=emailthis

5 Ways to Live With Your CPAP Machine Adjusting to CPAP can help people with sleep apnea sleep better. Here’s how to do it.

May 2nd, 2011 Raquel Rothe

Focus on the health benefits of your CPAP.   Adjusting to CPAP can make your sleep — and life – better, especially if you have severe sleep apnea. Read on to get sleep specialists’ top five tips on how you can make peace with the device.

http://www.webmd.com/sleep-disorders/sleep-apnea/features/cpap-machine?ecd=wnl_slw_021011

10 States With the Deadliest Eating Habits

February 27th, 2011 Raquel Rothe

10 States With the Deadliest Eating Habits

by Charles B. Stockdale, Douglas A. McIntyre and Michael B. Sauter
Wednesday, February 9, 2011

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Americans are fat and getting fatter by the year. Recent data reported in medical journal Lancet showed that BMI (Body Mass Index), a recognized measurement of obesity, is higher on average in America than in any other nation.

The obesity problem, however, is international. The report in Lancet states that “In 2008, 9.8 percent of the world’s male population were obese, as were 13.8 percent of women. In 1980, these rates were 4.8 percent and 7.9 percent.” U.S. eating habits and diets have been exported, many experts say. Nations which before had relatively lean diets which were high in grains and fruits now consume many more soft drinks and hamburgers.

More from 24/7 Wall St.:

Companies Running Out of American Customers

Housing Markets Where Prices Rose During the Recession

The States Running Out of Smart People

This trend toward poorer diets has caused obesity to be the most written-about health problem in the United States. Fat Americans are more likely to have diabetes, coronary artery disease, strokes and certain forms of cancer. Less well reported are links between obesity and dementia, obesity and postmenopausal estrogen receptors, and obesity and social status. Thin people, apparently, are more likely to be chief executives and billionaires. The problem of obesity is so acute that the number of studies about its causes and solutions grows by the day. The journal Health Affairs reported last year that overall obesity-related health spending reached $147 billion in the U.S., about double what it was a decade earlier.

Like so many other issues where data are collected in the public sector and the information is used to solve problems nationwide, the problems are local. 24/7 Wall St. looked at a number of factors which cause unhealthy diets and resulting obesity. These include income, access to healthy food sources, the ability to pay for healthy food, the concentration of fast food outlets, and the consumption of fruits, vegetables, sugar, fat and soft drinks. The levels of healthy eating defined with these parameters varies wildly from state-to-state. That means there is not likely to be any one set of solutions created and funded at the federal level to solve the problem. Just as education results and their causes are hyper-local, so are the habits that cause unhealthy diets and their results. That makes the problem harder to solve. Congress cannot mandate how many McDonald’s can be built within any hundred square mile area, or, if it could, McDonald’s would object.

The data on poor eating habits and obesity are abundant and unusually well-researched. Congress funded a nationwide report which was called “Access to Affordable and Nutritious Food — Measuring and Understanding Food Desserts and Their Consequences.” The information contained in this report includes the number of households who do not have access to cars and probably find it difficult to go to grocery stores frequently. The USDA keeps in-depth statistics on concentration of grocery stores. The Census Bureau tracks fast food expenditures per capita. The U.S. Department of Health and Human Services follows consumption of fruits and vegetables. 24/7 made its state rankings based on grocery stores per 1,000 residents, amount spent on fast food per capita, gallons of soft drinks purchased per capita and pounds of sweet snacks purchased per capita. We also took into account information provided about poverty levels, obesity and other factors directly related to unhealthy diets.

It is worth mentioning again how complex and local the obesity and eating habit problem is. This does not mean that the problems are insoluble, but nearly so. The issue of fat Americans is one that almost needs to be addressed house-to-house.

10. New Mexico

Grocery Stores Per 1,000 Residents: 0.26 (23rd)
Amount Spent on Fast Food Per Capita: $737 (8th most)
Gallons of Soft Drinks Purchased Per Capita: 58 (12th least)
Pounds of Sweet Snacks Purchased Per Capita: 111 (13th least)

New Mexico’s worst rankings occur in two metrics. It has the 44th-greatest percentage of households without a car that are more than 10 miles from a supermarket or grocery store and the 44th-greatest percentage of population that has low income and is more than 10 miles from a supermarket or grocery store, according to the United States Department of Ag1riculture. These metrics are significant because they suggest a lack of access to affordable and nutritious food. Residents may rely on fast food restaurants and convenience stores instead. New Mexico has the eighth-greatest amount of money spent on fast food per capita among all the states considered.

9. Arizona

Grocery Stores Per 1,000 Residents: 0.17 (47th)
Amount Spent on Fast Food Per Capita: $761 (4th most)
Gallons of Soft Drinks Purchased Per Capita: 60 (21st least)
Pounds of Sweet Snacks Purchased Per Capita: 109 (11th least)

Arizona has the second-fewest grocery stores per person, with only 0.17 for every 1,000 people. This illustrates a major restriction on healthy food access for one of the country’s fastest growing states. One of the ways in which residents of Arizona are supplementing their diets is with fast food. Arizonans spent an average of $760.50 each on fast food in 2007, the fourth-greatest amount among the states.

8. Ohio

Grocery Stores Per 1,000 Residents: 0.18 (45th)
Amount Spent on Fast Food Per Capita: $622 (20th least)
Gallons of Soft Drinks Purchased Per Capita: 70 (11th most)
Pounds of Sweet Snacks Purchased Per Capita: 122 (10th most)

Because a large part of Ohio’s poor population is located in major urban centers like Cleveland and Cincinnati, the state ranks well in regards to access to grocery stores among the poor. However, the state ranks third-worst in store availability across all income classes at 0.18 locations per 1,000 people, compared to 0.6 in first place North Dakota. Ohio’s population has the 11th-greatest consumption of soft drinks, and top-10 highest consumption of both sweet snacks and solid fats. As a result of these poor diets, Ohio has an adult diabetes occurrence of over 10%, which is the 11th-worst rate in the country.

7. South Dakota

Grocery Stores Per 1,000 Residents: 0.5 (4th)
Amount Spent on Fast Food Per Capita: $547 (9th least)
Gallons of Soft Drinks Purchased Per Capita: 64 (23rd least)
Pounds of Sweet Snacks Purchased Per Capita: 122 (8th most)

South Dakota has the fifth-smallest population in the country, and yet, it is the 17th-largest state in terms of geographic area. As a result, many residents have limited access to affordable and nutritious food. In fact, South Dakota has the greatest percentage of households with no car and which are more than 10 miles from a supermarket or grocery store, as well as the greatest percentage of low-income households which are more than 10 miles from a supermarket or grocery store. Only 10.1% of adults in South Dakota consume the U.S. Department of Health and Human Services’ recommended two or more fruits and three or more vegetables per day, compared to the national average of 14%. This is the fifth-worst rate in the nation.

6. Nevada

Grocery Stores Per 1,000 Residents: 0.23 (29th)
Amount Spent on Fast Food Per Capita: $939 (most)
Gallons of Soft Drinks Purchased Per Capita: 58 (10th least)
Pounds of Sweet Snacks Purchased Per Capita: 114 (19th least)

Nevada spends the most per capita on fast food — nearly $940 per person per year. This is roughly 25% more than Texas, the second-worst state, and well more than twice what Vermont residents spend. As might be expected, the state ranks in the bottom 10 for both households with no cars and low-income populations, defined as people with income less than 200 percent of the federal poverty thresholds, and proximity to grocery stores. Nevada’s obesity and diabetes rates, are above average.

5. Oklahoma

Grocery Stores Per 1,000 Residents: 0.25 (24th)
Amount Spent on Fast Food Per Capita: $676 (15th most)
Gallons of Soft Drinks Purchased Per Capita: 69.8 (8th most)
Pounds of Sweet Snacks Purchased Per Capita: 103.2 (3rd least)

The rate of household-level food insecurity, including households with food access problems as well as households that experience disruptions in their food intake patterns due to inadequate resources for food, is 15.2% in Oklahoma. The national rate is 13.5%. Oklahoma also has the third-lowest rate of adults who meet the recommended two fruit/three vegetable daily intake, with only 9.3% of adults doing so. Perhaps this is part of the reason Oklahoma’s obesity rate is 31.4%, the fifth-worst in the country.

4. Kansas

Grocery Stores Per 1,000 Residents: 0.35 (7th)
Amount Spent on Fast Food Per Capita: $610 (19th least)
Gallons of Soft Drinks Purchased Per Capita: 64 (23rd most)
Pounds of Sweet Snacks Purchased Per Capita: 121 (12th most)

Kansas has some of the easiest access (seventh-best) to stores where cheap and healthy food is available. It is clear, however, that most residents do not take advantage of this, as the state has one of the worst diets in the country. Residents consume the 12th-most sweet snacks per person as well as the 12th-most solid fats — more than 20 pounds per person. The state ranks 28th in adult diabetes and 31st in obesity — 28% of the state’s adults are considered overweight.

3. Missouri

Grocery Stores Per 1,000 Residents: 0.26 (22nd)
Amount Spent on Fast Food Per Capita: $623 (21st least)
Gallons of Soft Drinks Purchased Per Capita: 65 (18th highest)
Pounds of Sweet Snacks Purchased Per Capita: 121 (17th most)

Missouri does not rank especially poor in any of the metrics considered, however it does rank badly in about almost every one. It has the 11th-lowest rates of adults eating the recommended amount of fruits and vegetables, the eighth-greatest rate of food insecurity, and relatively high rates of soft drink, sweet snack and solid fats consumption. Missouri has the ninth-worst rate of obesity among adults, with 30% having a body mass index greater than 30.

2. Alabama

Grocery Stores Per 1,000 Residents: 0.21 (37th)
Amount Spent on Fast Food Per Capita: $649 (23rd most)
Gallons of Soft Drinks Purchased Per Capita: 77 (4th most)
Pounds of Sweet Snacks Purchased Per Capita: 113 (16th least)

Alabama residents consume 77 gallons of soft drinks per capita per year, the fourth-highest amount in the country. This is roughly 33% more than Oregon, which consumes the least. Soft drinks like cola have more sugar per ounce than nearly any other food we regularly consume, and it is clear that soda has helped contribute to Alabama’s poor health outcomes. The state has the seventh-highest obesity rate and, predictably, the second-worst diabetes rate. More than 12% of the state’s adult population has the disease.

1. Mississippi

Grocery Stores Per 1,000 Residents: 0.21 (34th)
Amount Spent on Fast Food Per Capita: $588 (17th least)
Gallons of Soft Drinks Purchased Per Capita: 82 (most)
Pounds of Sweet Snacks Purchased Per Capita: 113 (17th least)

Mississippi has the worst eating habits in the country. Only 8.8% of the adult population eats the recommended amount of daily fruits and vegetables, the lowest rate in the country. Residents consumed just under 82 gallons of soft drinks per capita in 2006, the greatest amount reported. Furthermore, the state has the third-highest rate of household-level food insecurity, with 17.1% of households being affected. It is perhaps unsurprising, then, that the state has the highest rates of both adult diabetes (12.8%) and adult obesity (34.4%).

Take Time for Your Fitness and Health

January 14th, 2011 Raquel Rothe
 

 

 

Whether you work in the hospital or home care, you and I know how to scavenge for food. We learned it during our student clinical rotations. By the time we graduated, we were experts in respiratory therapy and feeding ourselves. 

There is the ubiquitous break room birthday cake, vendor-supplied lunches, and even hospital food looks pretty good when you are working long hours and rotating shifts. These calories add up, putting us at high risk for declining fitness. If you do not take time for proper diet and exercise, you could wind up in a hospital bed suffering from similar ailments to those you treat every day. Weight control and exercise are excellent low cost methods of preventative medicine. They can help reduce the risk of heart disease, stroke, diabetes, hypertension, and a variety of sleep disorders. 

A good diet is easier than it seems. Count your caloric intake, and measure it against your daily caloric burn. It only takes a deficit of 3,500 calories per week to lose one pound per week. Once you have cut out chips, candy, ice cream, and fast food, you will find you feel better. Of course, you also will find excuses to skip the run and grab a burger through the drive-thru window. But, remember, everything comes with a price.

A patient recently said to me, “I am here for a good time, not a long time.” He is getting his wish. He is 48-years-old, has had both hips replaced, smokes, drinks excessively, is obese, has obstructive sleep apnea, high blood pressure, and the list goes on. I expect he will get his wish – he will mostly likely be here a short time. He has been a hospital patient more times than I can recall. Where is the fun in that? 

Making time to exercise should be paramount on your list of daily living activities. I travel every week, which means I must plan my triathlete training in advance. There is a YMCA at nearly all my destinations. If not, I pay a daily fee for a health club that has a pool so I can swim. Running is easier; it is always available and cheap. Cycling is more demanding. If I’m traveling by car, I bring a bike. Beforehand, I search Map My Ride for courses other cyclists have downloaded. I call the local bike shop to see if they have a scheduled ride from the shop while I am in town.

Over the years, I have created a network of friends across the globe with whom I train. Seek a physician in your hospital who is extremely fit as a mentor who can help you choose a fitness program that appeals to you. Oftentimes, this physician knows more about sports medicine and fitness than his medical specialty suggests. Of course, do not bypass your own physician who can monitor your exercise regimen and help you set goals.

At your hospital, start your own fitness group. You will have support, and it will promote espirit de corps. In Tennessee, we had pulmonary rehab patients who were very weak, and two of them set a goal of a 5K run. They reached their goal; granted they did not cross the finish line first, but they did cross the finish line.Take time for your fitness and health. You deserve it.

David Lain, PhD, JD, FCCP, RRT, RCP, is chief clinical officer for Oridion Capnography Inc. He is a three-time Ironman finisher and member of the 2007 USA Long Distance Duathlon World Championship Team.

 

 

What is obstructive sleep apnea?

September 12th, 2010 Raquel Rothe

So you never have energy and you are tired most days…..you may have obstructive sleep apnea (OSA).

OSA is a serious, potentially life-threatening disorder that occurs during sleep, and that may lead to life-threatening conditions. The upper airway repeatedly collapses, causing cessation of breathing (apnea-air flow is blocked) or inadequate breathing (hypopnea) and sleep fragmentation. The sleep fragmentation results in chronic daytime sleepiness.

Identifications:

Are you sleepy during the day?
Do you have disruptive snoring at night?
Do you have pauses in breathing during the night?
Do you have pauses in breathing during the night?
Do you wake yourself up choking or gasping?
Obesity
Large neck (less than 17″-men, less than 16″-women)
Restless sleep
Diagnosis: If you have these signs and symptoms, they could be indicative of sleep apnea. Report these signs and symptoms to your healthcare professional as you may need to undergo a diagnostic sleep study. This test is painless and provides information about how a patient breathes during sleep. The data that is collected will enable the physician to determine the type and severity of sleep apnea, along with your treatment options.

Potential Consequences if OSA is left untreated: Now you know you have sleep apnea but not sure you want it treated? “I think I will be fine without wearing that mask. I’ve slept this way most of my life”.
Decreased quality of life
OSA patients, prior to diagnosis and treatment, consume 2 1/2 times more health care resources that patients without OSA
Hypertension (high blood pressure)
Cardiac arrhythmias (irregularities in heart rate/rhythm)
Stroke
Heart Attack
Diabetes
Increased risk of motor vehicle and work-related accidents due to sleepiness
Interventions could include Positive Airway Pressure (PAP) therapy, surgery, body position modification, oral appliances, lifestyle changes such as weight loss (if needed), good sleep hygiene, and avoidance of alcohol, sedatives and hypnotics. Your health depends on your intervention to improve your quality of life. At Sleep EZ, we provide a home-like environment that is relaxing so if you need to undergo diagnostic testing for sleep apnea your experience is more comfortable. Remember, it’s your insurance, it’s your choice where to be tested. Sleep EZ “Diagnostic excellence in a serene setting”

Diet, Exercise and Sleep

July 8th, 2010 admin

For years your mom/dad and your friends go to the gym multiple times a week and they have probably been telling you to eat better and exercise more. It’s all you hear on television, in the newspapers and on talk radio. New doctors and dieticians usher in new diets, new fads, and so you’ve made some lifestyle changes – cutting back on your fat and sweets intake, and doing some cardiovascular exercise a few days a week. Despite all this, you still feel burned out, can’t drop those extra pounds, and don’t have the energy to greet each day with enthusiasm. What are you missing?

The third piece of the puzzle: sleep
Though the exact mechanisms of how sleep works, how sleep rejuvenates the body and mind is still mysterious, one thing sleep specialists and scientists do know is that adequate sleep is necessary for healthy functioning. Research shows that all mammals need sleep, and that sleep regulates mood and is related to learning and memory functions. Not only will getting your zzz’s help you perform on a test, learn a new skill or help you stay on task, but it may also be a critical factor in your health, weight and energy level.

Sleep deprivation may also inhibit one’s ability to lose weight – even while exercising and eating well! A 1999 study at the University of Chicago showed that restricting sleep to just 4 hours per night for a week brought healthy young adults to the point that some had the glucose and insulin characteristics of diabetics. Such sleep restriction may have been a bit extreme, but it is also not altogether uncommon in our society and is a pattern deemed the “royal route to obesity” by Eve Van Cauter, PhD, who conducted the Chicago study.
Food is also related to sleep by appetite and metabolism. Research by Dr. Van Cauter shows that people who don’t get enough sleep are more likely to have bigger appetites due to the fact that their leptin levels (leptin is an appetite regulating hormone) fall, promoting appetite increase. This link between appetite and sleep provides further evidence that sleep and obesity are linked. To top it off, the psychological manifestations of fatigue, sleep and hunger are similar. Thus, when you’re feeling sleepy you might feel like you need to head for the fridge instead of bed.

What it all means: how diet, sleep and exercise affect you
By now you probably realize that health is complex – if one part of the body system suffers, you’re likely to see consequences in other areas of your life. Though diet and exercise are critical components of healthy lifestyles, it’s also important to remember that sleep is inherently linked with how we eat (and how much), how we exercise (and whether or not we lose weight), and how we function on a daily basis. Getting the proper amount of sleep each night is necessary to face the world with your best foot forward. Sleep will help you on the road to good fitness, good eating and good health!

All men whilst they are awake are in one common world: but each of them, when he is asleep, is in a world of his own. ~Plutarch