If you are having difficulty seeing the results from a new diet, take this five question quiz.

1. Do you avoid processed foods? Here’s why you should.

2. Have you stopped eating fast carbs (sugar, wheat, and fruit juice etc.)? Here’s why that’s important.

3. Are you physically active? If, not read Dr. Jason Valadao’s tips for geting started.

4. Do you engage in some form of time restricted eating, intermittent fasting, or longer fasting? This is why we all probably should.

5. Have you signed up for email alerts for DrJimmyWestbrook.com?

If you answered “no” to any of the above questions, then that may be the issue, but if you answered “yes” to all and are still having trouble achieving your ideal weight, then it’s possible that chronic stress is holding you back. While this occurs in men, I see this much more commonly in my female patient population for reasons I do not fully understand.

Chronic stress activates our “fight or flight mode”, but for most of us, it never gets turned off. This is bad. Cortisol is our body’s chemical response to stress. Cortisol raises our blood sugar levels, and causes a host of other problems (see diagram below). Cortisol also causes us to hold onto our body fat when dieting or fasting, and our body’s only recourse is to slow our metabolism (fatigue) and burn protein (muscle) as fuel, both of which are bad. Chronic stress often leads to poor sleep, which leads to even higher levels of cortisol. I wrote about this here. To make matters worse, stress and lack of sleep both encourage stress eating. This makes stress a triple or even quadruple whammy (I lost track of whammies) in regards to our weight.

So why do we have chronic stress?

Our stress response evolved to help us survive when we were running from sabretooth tigers. We don’t have many sabretooth tiger encounters today, so why are we so stressed? My theory is that during ancient times the tiger encounters served to calibrate people’s internal stress meter. Stress levels were high when tigers were near, and stress levels were much lower when they weren’t. Also, before lightbulbs, we had not choice but to relax, socialize, and rest when it got dark outside. Today many of us have a 24-7 bombardment of stressors from our jobs, our kids, cable news networks, and baseless criminal investigations. None of our stressors today are as dangerous as sabretooth tigers, but today’s stressors are more constant, more numerous, and therefore overwhelming. This is the problem. Our stress response is locked in the “On” position. Add on the facts that most of us aren’t getting enough sleep, and we have access to an unlimited supply of processed foods, and it’s not surprising that America is over-stressed and overweight.

So how do we reduce chronic stress?
As tempting as it sounds to quit our jobs, enroll our kids in boarding school, and move to a naked hot yoga commune, in a non-extradition country, we really just need to adjust our response to stress. A Man’s Search For Meaning, by Victor Frankl proposes that we choose our responses to stressors, but most of us react instinctively, effectively giving up the power to choose. He discovered this truth while being a prisoner at Auschwitz. While his guards had the power to hurt him, only he had the ultimate power to choose his own response to their actions. This is literally the most empowering concept I’ve learned in 25 years of self-improvement reading. That’s a little deep for this space, and I promise a meme or penis joke is forthcoming, but first here is a model of his theory I made, no big deal.

That space between stimulus and response is our opportunity to choose to not stress and to let it go, like Elsa from Frozen. Just fucking let it go. The choice is ours. I just want us to realize that it is a choice. When I hear someone say, “He made me so mad…” I want to say is, “Karen, what really happened was he did something, and you chose to get mad, and then you asked to speak to the manager.” We all choose. If Victor Frankl can choose not to hate his guards, then I can choose not to get mad at the guy who cuts me off in traffic, and therefore I choose not to stress in the first place. Also, we need to de-stress. Here’s a few things I recommend.

1. Get a lot of D. The catch is that the D has to be natural D, the kind of vitamin D you get from sunlight and a healthy diet and not from a pill. People with naturally normal vitamin D levels are less stressed and maintain better body weight, but studies show that this does not apply to people who are taking oral D supplements. Lab mice when deprived of sunlight will get elevated cortisol levels, and even show drug addiction withdrawal symptoms, which all stems from a lack of sufficient D.
2. Sauna. Not everyone enjoys 20 minutes in the sauna as much as I do. Perhaps the sweating, extreme heat, spicy odors, and naked men aren’t your thing. Try it anyway. If you do an honest self-assessment 30 minutes after, you will feel more relaxed, less stressed, and signifiantly happier. The body releases natural endorphins during and after a sauna, similar to exercise and sex. Also, don’t exercise or have sex in a sauna. I will write an article about sauna soon, but it’s my go-to stress reliever that just happens to make us live longer too. I distract myself during my sauna with crossword puzzles to get through the whole session. I bring water with electrolytes and a towel to cover my private areas, and you should too, especially if you go to my gym. Please and thank you.
3. Exercise. You already know this. I won’t go into details, but exercise helps stress. Thanks, Captain Obvious.
4. Mindfulness AKA meditation. This really works but unfortunately, it often takes 2 or 3 consecutive days to feel the results, but the results are ridiculously good. I feel so good after a few days that I often forget to do it and then rebound. I (and probably you) just need to make it a regular daily habit like flossing, manscaping, or messing with your spouse’s toothbrush. Initially, I recommend committing to two weeks of a daily practice. If you don’t feel 50% better at the end then maybe it’s not for you, but trust me, it’s for you. I’ve used and enjoy the Calm, Headspace, and Brain FM apps for my guided mindfulness. My favorite is the Calm 10 minute loving kindness practice.
5. Bath with Epsom’s Salts or transdermal magnesium. Baths can relax us but adding Epsom’s salt is a whole different level of relaxing. Why? The salts contain magnesium. Magnesium is a natural relaxant and is best absorbed through the skin. This allows it to go straight to our nervous system and skips some of the GI side effects. This is also great for sleep. If you don’t want to bathe, just apply transdermal magnesium in the evening.
6. Sleep. This is huge. Check out my article if you haven’t already.
7. Yoga. If mindfulness and exercise had a child, it would be called “Yoga.” And if sauna, exercise, and mindfulness had a threesome their baby would be “hot yoga.” PS I don’t do yoga in front of people. I do room temperature yoga, at home, at least once per week to prevent back pain and improve my core strength, but also as a substitute for mindfulness. Despite not being flexible at all and having very poor balance, I’m super good at yoga, because yoga isn’t a competition. It’s like soccer for six year olds, if you just get out there and try, you get orange slices and a trophy. In yoga, we’re all winners. I’m going to buy a yoga trophy for myself and display it proudly on my mantle. I use the BeachBody.com app for my yoga, but there are a lot of good apps and YouTube channels out there for home yoga. Message me with your favorite, and I’ll update this post.
8. Lavender or Sage oil. I add lavender or sage oil (depending on my mood) to activities #2,4,5,6,7, and 10 as a way to bombard my senses with anti-stress messages and to disengage from the flight or fight mode.
9. Wine*. I’m not suggesting getting drunk in order to de-stress and forget about our problems. For legal reasons, I ask that you re-read the previous sentence. Often when we are dieting, we stop our evening glass or two of wine because it’s an extra 80 calories per glass. If that’s your way of unwinding after a long day, then I think you should keep doing it*, especially if stress is an issue for you. Also, red wine has a lot of benefits, and a glass can overall help your metabolism.
10. The 5 Minute Journal.** I do this every day and it has significantly decreased the amount of time I spend crying in the shower. It’s amazing. I previously used the hard copy version but have switched to the app because I was misplacing the book, and the app allows me to upload pictures. Here’s a screenshot from one day’s entry. There’s also a great daily quote and a part where you recap what could have been better.
    

The journal is also great to do with your kids as well. The process teaches gratitude and helps ground us and reminds us that we aren’t being chased by tigers and also sets intentions for the day. The recap at night helps me relax before bed. The app is only 5 bucks. Get one for yourself and someone you care about. You’ll be glad you did.

This was supposed to be a short article, but I ramble. If you are on the path to wellness and feel that you are stalling out, consider addressing chronic stress. We don’t need to run from our stressors but instead learn to address how we respond to them and use positive tools to let go of stress once it has affected us. Also, we need lots of D. I know this is a little touchy feely, but stress is a serious medical problem that doesn’t just cause weight issues, but also cancer, chronic inflammation, depression, anxiety, and Netflix bingewatching. If you aren’t affected, you know someone who is. Forward this article to them and encourage them to sign up for my email alerts.

*Don’t start drinking if you are a non-drinker, as this is a slippery slope, moderation can be difficult, and excess alcohol is bad. This should be self-explanatory.
**This was a Tim Ferris recommendation.

Maybe this title was misleading. To be clear, this is your one stop guide for getting great sleep. If you came to this article looking for something else, I apologize, for nothing. Fixing broken sleep has been transformative, in terms of my health but also my mood, attitude, and overall life satisfaction. I didn’t even know my sleep was that bad, until I fixed it, and I’m pissed I didn’t fix it sooner. To put things in perspective, here are the top three things I have done to improve my health in the past ten years.

3 Minimized/eliminated processed foods, sugar, and wheat. Here’s why.

2 Engaged in regular time restricted eating and periodic longer fasts. Here’s the article.

1 Prioritized getting 8 hours of quality sleep. Here’s why.

That’s right, sleep is numero uno. If you take my advice, it can be life changing for you as well. Here are some unbelievable sleep facts followed by my best recommendations for getting great sleep.

Amazing fact #1. Did you know that when we set our clocks forward in the spring and collectively lose an hour of sleep for daylight savings time, the rates of car crashes doubles? You did? Damn. But did you know that the rates of heart attacks, suicides, strokes, hospital admissions, coffee consumption, and people being late to work all skyrocket on that day as well. All this, from just one hour of collective sleep loss. What’s even crazier is that when we turn the clocks back and get an extra hour of sleep, the heart attacks, strokes, suicides, crashes, and work tardiness collectively hit all-time lows. This daylight savings example shows the far-reaching and devastating effects of just one hour of sleep loss.

Amazing fact #2. All animals sleep, even sharks. As a kid, I loved shark week on the Discovery Channel. I was told that sharks don’t sleep because they’ll die if they stop swimming. False. In actuality, they sleep and swim at the same time. #sharkfacts.

Amazing fact #3. When scientists completely deprive rats of sleep, they die, after only 7 or 8 days. What’s most interesting is how they die. I would have guessed car crashes or drug overdose, but in actuality these rats suffer a breakdown of their immune system and get terrible intestinal infections leading to septic shock and eventually death. Our immune systems fail when we don’t get enough quality sleep as well. One study showed that cancer fighting cells (NKC’s) decreased by 70% after patients were limited to just four hours of sleep. Another study gave rats tumors and then cut their sleep by half. The sleep starved rats’ tumors grew 2-3 times faster than rested rats, and experienced metastasis (spreading to other parts of the body) whereas the normal sleeping rats had small tumors that didn’t spread. These studies show how poor sleep lowers our immune defenses, and not just for colds and flu, but also for cancer.

Amazing Fact#4. Sleeping pills can kill you. Taking sleeping pills is shown (in 24 different large studies) to greatly increase our risk of all cause mortality AKA death, which should be put on the label, but isn’t. Here are the studies, and here’s another one. Death is one of the worst side effects I can think of, right up there with hair loss, anal leakage, and the gum disease gingivitis. Exactly zero studies show any measurable health benefits from taking these meds. Even the best sleep medications don’t provide quality sleep and only beat placebo (sugar pill) by a few minutes in terms of how fast they get you to sleep, and that is using big pharma’s own data, which is likely bullshit.

So what are sleeping pills good for? Making big pharma rich. Ambien made 4 billion dollars in profits in just two years. There are 61 countries in the world who’s entire gross domestic product is less than Ambien, and that’s just one of many lucrative drugs. Here are some other big pharma stats that are ridiculous. In conclusion, sleep meds are dangerous, habit-forming, incredibly profitable, and they don’t work. Here are some things that do work and don’t require a prescription from someone like me.

1. Get more light in the day and more dark at night. Our bodies are continually looking for cues about whether it’s night or day, in order to set our internal clock and control the release of melatonin, our natural sleep hormone. Before Edison’s lightbulb, our bodies knew what time it was.  Now, not so much.  Daylight has 50 times more lux (unit of light) than even our most brightly lit cubicles, offices, and Walmart Superstores. So even in a well lit room, our bodies are very confused.   At night, the blue light from our smartphones and computers tricks our brain into thinking it’s daytime, because the blue light they emit suppresses our sleep hormone melatonin.  I encourage my patients to get morning sun (without sunglasses) to help establish our circadian rhythm and to get outside periodically throughout the day. In the evening, I keep my rooms dimly lit, wear blue light blocking glasses (it’s a thing), and have night shade mode on the screens of my electronic devices, to increase my natural melatonin release.  Also, I use an app call F.lux that will block blue light from my computer screen.  
2. Get Cold. Our core body temp must drop a couple degrees in order for us to go from light to deep sleep, and going to bed a little cold can also help us get to sleep faster. I use a dip in a cold pool or a cool shower to help achieve this. One study showed cooling down patients with terrible insomnia (using cooling headcaps) got them to sleep faster than people without insomnia, and no drugs were required.  I also keep my AC on high most of the year in my bedroom to help me get to sleep and stay asleep. I aim for mid 60’s in my room.
3. Don’t sleep completely naked. This really only applies to people who spend the night on my couch. I’m looking at you Handsome Eric. So feel free to sleep in the buck at your own house, however soft gloves and socks encourages blood flow to extremities and can help lower your temp, which is a good thing.  
4. Use your bedroom for sleeping and sex. Don’t use your bedroom for arguing, watching TV, studying, social media trolling, or blog writing. Sex can help us relax and also make us quite sleepy, even if you’re alone. If your sexual activities involve torture devices, cattle prods, or more than three people, then consider taking it to a basement, windowless van, or your local LaQuinta Inn and Suites and be sure to have a “safe word”.  No judging.  Did you know that “LaQuinta” literally translates to “next to Denny’s”?
5. No clock-watching. Take the clock faces out of your bedroom, as this can lead to increased angst regarding sleep and set your phone to “Do not disturb”, unless you get a lot of late night “you up?” texts.
6. Listen to an “Adult Sleep Story”. This is not porn. I hate that the porn industry has stolen the word “adult”. Not all adults are into porn, and frankly that implication is disgusting. Statistically there are literally hundreds of men in the U.S. who don’t regularly look at porn. I use the “Calm” app (not porn) for these adult sleep stories and for my mindfulness practice, which is also good for sleep. This app has hundreds of stories that are just stimulating enough to hold your attention but soothing enough to put your sweet ass to sleep. They even have celeb guest readers like Matthew McConaughey, Bob Ross, and Sam Smith. My favorite stories are “Blue Gold”, “A Magical Winter’s Night”, or anything involving trains. Once again, this isn’t  porn. The app is free, but has a premium membership as well.  Also, there are sleep stories for kids on the app that are good as well. Here’s the link.
7. Magnesium + Apple cider vinegar + Honey + Melatonin (5mg). This elixir is the go-to of Tim Ferris. I pretty much try whatever he suggests and this stuff really works. Magnesium is a natural relaxant and something your body needs anyway.  Sometimes magnesium can cause you to poop too much, if this is an issue, try the more bioavailable topical magnesium, and you will be spared this side effect.  I added the melatonin to this combination.  It really will help, but most people are taking it incorrectly. The key is the timing.  A lot of patients have told me it doesn’t work for them, but when I get them to take it earlier (like 2-4 hours before bedtime) then it works. The rest of us only need to take it 30 minutes to an hour before bed.  
8. Sleep Mask + Ear plugs + Lavender oil.  I have turned my bed area into a sleep sanctuary.  It’s important to get your room quiet and dark for sleep. My room is pretty dark, but sometimes road noise, cat fights, or my oldest child’s night screaming can disrupt my slumber. I use “Mack” ear plugs and a sleep mask with adjustable eye cups (GoZheek brand) as double protection against sleep disruptions. Lavender oil helps relax me.  It’s been used for thousands of years for sleep and has some data behind it*.  My brain has permanently linked the scent of lavender with sleep, not unlike how Guy Fieri associates the smell of bacon with intense sexual arousal.  
9. Alcohol. Alcohol is used by many of us to get to sleep, but drunk sleep isn’t restorative for a number of reasons.  Just because we lose consciousness, doesn’t mean we are getting real sleep. A 2×4 applied with enough force to the side of our heads will induce sleep, but that isn’t quality sleep either. When I told my mother about alcohol’s negative effects on our sleep, the anger, desperation, and fear in her eyes told me that quitting Nana-juice was going to be a multi-step process, probably 12 or so. So instead of recommending abstinence to you and The Betty Ford Center to my Mom, I came up with some mitigation strategies. Here is Dr. Jimmy’s 5 point plan for boozing and still getting good sleep.
   
   1. Start early. Happy hour drinks are much less likely to mess with your sleep as compared with a night cap. So start your drinking earlier and stop well before bed with a goal of being soberish, by night-night time.
   2. Avoid beer, especially close to bedtime. Beer is mostly water and it irritates our bladder and that makes us pee a lot. Getting up to go pee in the middle of the night isn’t great for your sleep.
   3. Get colder than cold. Alcohol raises our core body temp a bit because its a vasodilator. As I mentioned, lower body temp is needed for deep sleep. To fight the warming effects of alcohol, keep your room extra cold and consider a cold shower or bath immediately before bed.
   4. Afrin + Nasal “Breathe Right” Strips + CPAP. Alcohol can induce snoring and worsen sleep apnea. If you have sleep apnea, be sure to wear your CPAP mask, especially when you’ve been drinking. For the rest of us, Afrin (OTC nasal spray) and the Breathe Right nasal strips can help keep our airway open and increase the oxygen to our brain. Don’t use Afrin too frequently, it can be habit forming, once a week is fine though.
   5. Don’t over do it. Too much alcohol stops us from getting into REM (dream) sleep which over time, leads to early dementia, and a host of mental health problems.  Also, you know how upset your mom gets when you get puke on your Yoda pajamas.
      
10. Make a Caffeine Adjustment. I love coffee. I wrote about why it’s good for us (here is the link) but if abused, it can screw up our sleep. I used to drink an espresso after dinner and be asleep in an hour, but I’ve stopped drinking caffeine past noon. Let me tell you why. Caffeine has a half-life of 6 hours and a quarter life of 12 hours. So if you have a Starbucks grande drip coffee (350mg) at 2PM, it’s like having a regular coffee at 8PM (175mg) or a shot of espresso at 2AM (87mg). Anyone with even a hint of insomnia really needs to consider these facts and stop the afternoon caffeine.  But Dr. Jimmy you just said that you can fall asleep after an espresso, so what’s the big deal? I’ll tell you. Even if we can fall asleep with caffeine, the sleep we get is seriously degraded. That espresso ages me by 20 years, in terms of my sleep. This poor sleep makes us tired the following day, which encourages us to drink more coffee later in the day, which makes our sleep worse, and now we are in a vicious caffeine cycle.
11. Workout in the AM. Even just five minutes can help set your body clock. I admittedly hate morning workouts, but I begrudgingly acknowledge that this helps. Also, avoid workouts within 4 hours of bedtime. 
12. Track your sleep. There are lots of sleep trackers out there (Fitbit, Apple Watch, Oura Ring). I suggest using one to monitor what helps your sleep and what doesn’t. I try to be in bed 8.5 hours prior to my wake up time. I don’t sweat it if I’m not asleep the whole time. I think this takes some of the pressure off, which helps me relax.  My in-bed mantra is to relax and let go.  When we try too hard to fall asleep, there’s increased stress and pressure which can make sleep elusive.
13. Have a regular bedtime and wake time. This is impossible for many of us due to our work schedules. When I get very little sleep because of a night shift in the emergency department, I try to give myself at least one 90 minute nap in the daytime. 90 minutes is the length of one sleep cycle. While this situation isn’t optimal, it helps me to be more functional in the day while still being sleepy enough to not have insomnia at night.  One of the downsides is that a 90 minute nap can cause something called sleep inertia where you feel groggy for a period of time, but once that is over, you will be better off, because 90 minutes allows your body to get into both REM and deep sleep.  The shorter 20-30 minute “power nap” can be refreshing, spare you any sleep inertia, and can help you function later into the evening but it’s not a replacement for your night time sleep, the way a longer 90 minute nap can be.  Also, if you have trouble falling asleep at night, try not to nap in the daytime.  

Thanks for checking this out. Let me know what you think or if you have any questions. Also, sign up for my email list on the right side of the screen. It will alert you when a new article, video, or recipe is posted. I’m also going to start giving away free stuff to my email subscribers. I won’t share your email address with anyone and I won’t try to sell you anything or ask for any personal information.

*Author’s rant: Many studies involving natural products are not taken seriously by the scientific community and I think that’s a mistake. They’re generally disregarded because the studies are small and often underfunded. They’re underfunded because the stuff they are testing aren’t billion dollar prescription medications or procedures. I am in favor of evidenced based medicine, however the bar for evidence should be raised and lowered based on the risk of the product being tested. If a study shows that carrots are helpful for weight loss but the study was only involving a few hundred people and only lasted a few years, this doesn’t mean we shouldn’t recommend eating carrots for weight loss because there’s not enough high quality data. We can say that there is some evidence for carrots We know carrots are good for us and the risk of the intervention (carrots) is low, so go ahead and give it a try. Instead, we disregard these small studies of benign interventions but freely prescribe sleep medications that have a high risk associated with them (and an FDA label) when in reality they need more high quality evidence showing benefit to be safely recommended.

Every year hundreds of new books are published about how to lose weight and get healthy. New gyms open. More and more research is done on the ideal diet and exercise program. Well-meaning medical doctors write life-changing, meme-filled, snarky blogs. Despite all these efforts, America’s waistline continues to increase. Why are these diets and exercise programs failing? Could it be that we are missing a huge piece of the health and weight loss equation? Yeah, we are missing something really big and I’m not just talking about fasting.  America is chronically underslept. This lack of sleep is making us overweight, diabetic, and also quite sleepy. I will explain…

Below are obesity rates in the U.S. by year as compared to our average sleep amount. As we get less sleep, our weight increases. Why does this happen? There are lots of reasons, but first, a couple disclaimers. First, I don’t believe that sleep deprivation is the only cause of our obesity epidemic. Second, the graph below only shows a correlation which doesn’t prove that insufficient sleep causes obesity. In the next few paragraphs, I will make the case that sleep plays a much bigger role in our health and fitness than most of us think, in the hopes of motivating you to stay in bed longer. I know “stay in bed longer to lose weight” sounds like clickbait, but just keep reading. That also sounds like clickbait.

While the above graph shows a strong correlation between sleep and obesity, it’s still just a correlation, and better studies are needed to show if poor sleep is actually causing obesity. The fictitious lower graph shows that as pirate prevalence goes down, global population goes up. This is also a correlation, but probably mostly coincidental. So, we shouldn’t be fooled by statements solely based on a correlation, that’s bad science.

Fortunately, in recent years there have been many scientific studies showing a causal relationship between lack of sleep and obesity even after adjusting for factors like exercise, age, sex, and proximity to a Cinnabon. Here is the link. Why does insufficient sleep causes weight gain? Great question. One important and often overlooked cause is hormonal. When we don’t get the proper amount of quality sleep, a stress hormone called cortisol goes up. High cortisol causes us to lose muscle and gain fat, regardless of what we eat!  Cushing’s syndrome is a disease characterized by too much cortisol and the effects (shown on the right) are devastating and very similar to persistent lack of sleep. High cortisol from lack of sleep or Cushing’s syndrome makes getting healthy as f**k impossible.

Incidentally, Addison’s disease is when cortisol levels are too low (opposite of Cushing’s syndrome). JFK had this disease. The symptoms are tan skin, thin appearance, extra confidence, and frequent, aggressive episodes of coitus.*

Sleep loss just doesn’t cause obesity, but it can also lead to type 2 diabetes. Rates of type 2 diabetes are much higher in under-slept adults, but like the pirates and global population, this was just a correlation, until one study took a group of healthy fit young people and limited half of them to just four hours of sleep per night. The researchers fed both groups the same healthful food. After just one week, the under-slept group’s blood sugar levels were so high, they qualified as “pre-diabetic”! WTF? I’ve been taking care of diabetics and pre-diabetics for years. Why am I just learning this? This has been repeated in different studies with even less severe sleep disruptions. Type 2 diabetes will take an average of 10 years off of your life, but even just having slightly high blood sugar triggers high insulin, increased body fat, and a host of other bad stuff. Here’s my article about insulin and blood sugar.

Lack of sleep makes us hungry as f**k. Pro-satiety hormones (leptin) and pro-hunger hormones (ghrelin and endocannabinoids) all go in the wrong direction after just two nights of poor sleep (6 hours or less). This is a double or even triple whammy for weight gain, because these hormones cause us to be persistently hungry but also not fully satisfied by eating. In one well controlled experiment done at a sleep study hotel, patients ate an average of 340 calories more per day when they were restricted to six hours sleep as compared to when they were allowed 8 hours sleep. Additionally, those sleep deprived subjects tended to choose more junk food (cookies, pretzels, chips, Chili Lime Cheetos, etc) and they reported excessive cravings for high carb foods. Basically, not sleeping enough gives us the munchies.

Poor sleep crushes dieting efforts and causes muscle loss. One study took a group of dieters and let half of the subjects sleep normally and sleep restricted the other half to just 5.5 hours per night. While both groups lost weight, the low sleep group lost mostly muscle while the group that got good sleep, lost mostly fat. Losing muscle while retaining fat lowers our metabolism and makes us less sexified, technically speaking. This is the opposite of bueno, I might even dare to say it’s no bueno. If you haven’t noticed, the theme of this article is that good sleep helps us lose weight.

How did one group or researchers turn a group of virile, strapping men in their 20’s (think shirtless Abercrombie and Fitch models spraying each other with water from a hose) into a bunch of middle aged dad-bods with jean shorts on riding lawnmowers? They limited their sleep to only 5.5 hours. This sleep restriction aged these young men by 15 years in terms of their testosterone levels. Testosterone is important for weight because it promotes muscle building while simultaneously decreasing body fat and low testosterone in men is linked to truncal obesity. Sufficient, restorative sleep boosts testosterone and also growth hormone which is responsible for injury repair, muscle growth, resurfacing the lining of blood vessels, and essential for healthy cardiac function and blood pressure. Growth hormone is also the number one reason NFL players visit doctors in Mexico, so you know it must be good.

While there is some evidence that exercise improves sleep, more research is needed in this area. What has been repeatedly shown is that great sleep boosts your exercise performance and poor sleep greatly decreases your ability and likelihood of exercising. Shawn Stevenson’s book, Sleep Smarter recommends morning exercise as a key for better sleep at night.  Don’t worry, I’ll go into my recommendations for getting great sleep in my next post.

Many of us are trying so hard to get thin and healthy that we are waking up at 4 AM to go to the gym, spending tons of money on powders, pills, food scales, and Lululemon apparel and not getting the results we could get from simply staying in bed and getting a great night’s sleep. This should come as great news because sleep is free and it feels amazing.

In conclusion, poor sleep makes us gain weight by screwing up our hormones, spiking blood sugar, lowering our metabolism, shrinking our muscles, holding onto body fat, increasing our cravings, and sabotaging our workouts. Clearly, getting sufficient quality sleep should be a priority of anyone who is trying to get healthy as f**k or maintain their healthy as f**k status. It’s ridiculous that this is not more emphasized by the health community. It’s clear from my research that not getting enough quality sleep is the perfect activity, if your goal is to become obese, diabetic, and sleepy. I will put out my best sleep improvement tips in the next few days. Thanks for reading.

*Addison’s disease is a rare autoimmune disease that is characterized by low cortisol. Symptoms include fatigue, weight loss, low blood sugar, hyperpigmentation of the skin, and depression. JFK had this disease. I’m not kidding. I was kidding about the coitus part.

One of the primary resources for this article was the amazing book, Why We Sleep by Dr. Mathew Walker. I highly recommend it.

 

 

 

Fasting is the forgotten pillar of great health. Everyone talks about diet and exercise because there’s money to be made there. We don’t talk about fasting because it’s free and you can’t sell free things and expect to make money. Fasting is actually better than free because you save both time and money on food when you fast. Fasting is far more effective than any pill, health shake, or wart-removing cream and the only side effect is a little hunger and looser fitting pants. Effective at what you ask? All the things, more to come on this. I’ve written about time restricted eating, AKA short fasts of 12-24 hours. This is the why and the how of a longer fast (48-96 hours). The good news is that we don’t have to do these fasts very often (monthly or quarterly is sufficient) and the benefits of such fasts are long lasting, miraculous, and sometimes weird. Before we get to the details, here is Cliff Clavin (from the 80’s Sitcom Cheers) and his buffalo theory…

“Well ya see, Norm, it’s like this… A herd of buffalo can only move as fast as the slowest buffalo. And when the herd is hunted, it is the slowest and weakest ones at the back that are killed first. This natural selection is good for the herd as a whole, because the general speed and health of the whole group keeps improving by the regular killing of the weakest members. In much the same way, the human brain can only operate as fast as the slowest brain cells. Excessive intake of alcohol, as we know, kills brain cells. But naturally, it attacks the slowest and weakest brain cells first. In this way, regular consumption of beer eliminates the weaker brain cells, making the brain a faster and more efficient machine. That’s why you always feel smarter after a few beers“.
-Cliff Claven (John Ratzenberger)

Cliff Claven’s buffalo theory is actually a metaphor for fasting and autophagy (pronounced “uh tof Oh Gee.”) Autophagy is when the body intentionally kills off its own cells that are damaged, too old, or no longer working properly. What does this have to do with fasting? I’ll tell you. Ideally we would be cleaning house at the cellular level constantly (with autophagy) but unfortunately our bodies don’t really do much autophagy in our normal fed state. So these useless cells just hang around in a state called “senescence”. They get in the way, they turn into cancer, and are a major reason why our organs don’t work as well as we get older. It’s only when our bodies sense fasting or an extreme caloric restriction, do we start to get rid of these old, useless cells, AKA the slow buffalo. This herd thinning improves our body’s function, appearance, and efficiency. But wait, here’s the best part, after getting rid of the old saggy cells, the body generates new taught, sexy cells. This happens all over the body including our liver, brain, kidneys, skin, and muscles. Fasting induced autophagy and cell regeneration literally reverses the aging process on the cellular level. Scientifically speaking, that is fucking awesome.

Our bodies were meant to fast. Our ancestors lived for 7 million years without reliable food sources. For almost all of human history; fasting was a regular occurrence. Only recently, have we had refrigerators stocked with food and drive-thru’s open 24 hours per day. And while continuous access to Crunch Wrap Supremes and Seven Layer Burritos is convenient, it’s not what nature intended. On an unrelated note, I have woken up and found a Taco Bell receipt for 90 dollars. I was in college.

The effects of fasting last a long time. One study involving diabetics showed greatly improved glucose control in the subjects who did a 72 hour fast in the days following the experiment. What fascinated researchers, was how these effects lasted more than three months after the fast, despite no other dietary changes. Dr. Jason Fung, a nephrologist and author of the Obesity Code (great book), is literally curing type 2 diabetes in a matter of weeks with these longer fasts.

Fasting is simple. I have written over 70 thousand words about what to eat. Clearly, the ideal diet is kind of complicated, nuanced, and controversial. Fasting is simple. Just don’t fucking eat. That’s it. I will give some more details in a bit. I used to get frustrated after explaining my dietary theories to a patient only for them to come back two weeks later and happily report that they switched to whole grain pasta and margarine because that’s what they thought I recommended. To be clear, whole grain pasta and margarine go against everything I believe in. Just seeing it in the store hurts my soul, but my communication skills weren’t strong enough to overcome my patient’s 65 years of whole grain/saturated fat brainwashing. So, I tried the new approach of recommending fasting to my patient, and I was totally understood. Of course, there were the obligatory questions like, Can I have tea? Yes. Can I drink diet coke? No. Can I have fat free fig Newtons? Fuck No.

Weird benefits from fasting. If you’ve lost weight in the past, you may have some extra loose skin and connective tissue hanging about causing such conditions as “Lunch Lady Arms” or in my case “Old man Butt”. When we fast, these conditions improve, not just because we lose weight, but the process of autophagy, takes in those useless cells that are just hurting our self-esteem, slowing our buffalo herd, and not serving any other purpose. When morbidly obese people lose massive amounts of weight using conventional means, they usually have to get surgery to get rid of that extra skin, but those who fast to lose massive amounts of weight have no such issues, because of autophagy.

Another weird thing that happens when you do a long fast, is that you keep pooping. You can be two days since your last meal, but still having poops! Who knew? This can be very beneficial for cleaning out your digestive plumbing and will help your digestive health for months after your fast.

Fasting can lower total body inflammation and is a tool used in combating autoimmune diseases like rheumatoid arthritis and many others. Fasting has shown to improve the effectiveness of chemotherapy and greatly reduce its terrible side effects, specifically fatigue, hair loss, and nausea. Finally and most notably, fasting induced autophagy can help get rid of some of the pre-cancerous cells that could lead to tumors down the road. Fasting is free, simple, natural, and an amazing tool for living longer and better. So now that you’re onboard, here are some tips for completing a long fast.

1. The first rule of fasting is that we don’t talk about fasting.
2. The second rule of fasting is that we don’t talk about fasting. It’s annoying when people go into great detail about their diets (I’m looking at you vegans), their pets, or their bowel movements. Refer them to my website and be done.
3. Eat a high fat, low carb meal in the evening prior to starting a fast. This will help keep your insulin low and allow you to go immediately into ketosis (fat burning) and avoid a metabolic slowdown. If you ignore this advice and binge on pizza and cookies, you will have elevated insulin (from eating carbs) and are therefore unable to access your fat stores for several hours. Your body’s only option is to slow down it’s burn rate, plus you will get crazy hungry. All of this is bad.
4. Avoid strenuous workouts during a long fast, but brisk walking, yoga, and aggressive hanky-panks are all encouraged.
5. Stay hydrated and replace electrolytes. Eating normally covers your electrolyte needs, but since you aren’t doing that, replacing your sodium, magnesium, and potassium are important for keeping you feeling good. If you get a headache, it’s probably because your electrolytes are off. Drink some tea with salt and lemon added.
6. Prioritize Sleep. If you are sleep deprived, fasting is not a good idea. We will actually hold onto fat and burn muscle in a fasted and sleep deprived state. This is obviously bad. Get sleep. Sometimes, fasting can make sleep more difficult. If this is the case for you, add more magnesium (400mg) and melatonin (5-10mg) at bedtime.
7. Avoid Temptation. Try not to schedule barbecues, parties, or fancy dinners whilst fasting. I even avoid cooking for my kids because just being around food can be difficult. Instead, I reheat some frozen food for them. Don’t judge. They love it. Getting buy-in from your partner and friends can be a big help as well.
8. Have Some Rescue Foods. I allow myself up to 5 tablespoons of MCT oil or coconut oil (per day) that I mix with coffee or tea if I’m getting hangry. Sometimes I also have a cup or two of bone broth to keep me happy if I have to see patients during my fasts. Coffee and tea can be satiating, and I add a little salt in my tea and coffee when fasting. While the MCT oil and bone broth are technically not allowed on a strict fast, for my purposes it still counts as a fast. I try to keep this type of thing to the minimum, however. Lemon water, sparkling water, pickle juice, apple cider vinegar, plain tea, and coffee can all help, and are fasting approved beverages.
9. Schedule Non-Eating Activities, especially during meal times. A Netflix marathon, video games, extra naps, or other distractions can help get you through a long fast. Be self-indulgent. You’ve earned it.
10. Break your Fast. Weigh yourself later. As long as it’s not an excessively long fast (more than five days), it’s not dangerous to eat whatever. I recommend eating a smallish meal at first to avoid having an upset tum-tum and/or bum-bum. You will probably notice a pretty substantial weight loss after allowing for a day to normalize. I find that this weight stays off too. I often do a long fast following a weeklong vacation of overeating and debauchery to lose whatever weight I gained whilst being bad.

I use the free app “Zero” to keep track and to help me stay motivated during my long fasts, that I do once or twice a quarter. I get hungry initially during the fast but after the first 14 hours or so, I generally feel good. I feel a lot better in the days and weeks following the fast. It’s actually very empowering to know that you can go without food whenever you choose. My patients are super proud of themselves after finishing their first long fast and I bet you will be too.

In conclusion, the occasional long fast can be an empowering tool for weight loss, longevity, and to keep your buffalo herd moving at healthy pace.