Your Personal Paleo Code: The 3-Step Plan to Lose Weight, Reverse Disease, and Stay Fit and Healthy for Life (27 page)

Perhaps the most immediately noticeable effects of sleep loss are the changes that occur in stress tolerance, cognitive function, and mood. If you have children, you might recall how you felt during those early months when the baby wasn’t sleeping through the night. You may have been more emotionally reactive, less tolerant of stress, and less able to focus and think clearly than normal. Numerous studies support this connection between sleep loss and emotional, cognitive, and neurological functions:

Perhaps the best way to think about sleep loss in this context is as a chronic stressor. The body is constantly working to maintain a state of internal balance, or homeostasis, in which it functions optimally. Sleep deprivation overloads the body’s capacity to maintain homeostasis, which results in the numerous changes and increased risk of disease and death we’ve reviewed in this section. This is why getting a good night’s sleep is so crucial to maintaining health.

Now that we understand why sleep is so important, let’s take a look at what to do if you’re not getting enough.

If you don’t allow adequate time for sleep, the rest of the suggestions I’m going to make below won’t help much. The amount of sleep that’s required for optimal function varies from person to person and throughout a given individual’s life, but research suggests that most adults need between seven and nine hours each night.

As a starting place, I recommend allowing eight hours for sleep. For many of you, this will mean going to bed earlier, as you may have less control over when you wake up due to your work schedule. Patients often tell me they’re naturally night owls, and they’ve always preferred to stay up late and sleep in. But in truth, there’s nothing natural about this. For millions of years of human history, sleep patterns likely were synced with the daily variation in exposure to daylight and darkness. This is what our bodies are adapted for. Having a lot of energy late at night and being excessively tired in the morning is often a sign that your circadian rhythm is out of whack. In most cases, if you follow the suggestions here, you’ll start to get tired earlier and wake up with more energy.

Light is the primary determinant of our circadian rhythm and sleep/wake cycles. Exposure to light at night suppresses melatonin production (which impairs sleep), and exposure to light in the morning resets the internal biological clock and improves sleep at night. It follows, then, that controlling exposure to light is a powerful tool for regulating sleep. The first step would be to reduce your exposure to artificial light at night. This can be done by:

Of course, unless you want to go back to living by candlelight, you will inevitably be exposed to some artificial light at night. One way to mitigate the impact of that is to wear specialized orange-tinted glasses that block out the spectrum of light that suppresses melatonin. These glasses are remarkably effective in reversing artificial light’s melatonin-suppressing effects in clinical studies, and they’ve been shown to improve sleep quality as well as mood. My patients with sleep difficulties have had great improvements in sleep from wearing them after dark. Simply put them on after the sun goes down and wear them until you go to bed. They’re especially important to wear if you’re using electronic media (such as computers, tablets, smartphones, or the TV) after dark. See my website to learn the brands that I recommend and where to buy them.

The next step would be to increase your exposure to light in the morning and during the day. Again, this mimics humans’ natural evolutionary pattern and has been shown in studies to regulate the circadian rhythm and sleep/wake cycle. The circadian system evolved in order to synchronize human physiology and behavior to the natural periods of day and night imposed by the earth’s rotation. Because the cycle length
of the earth’s rotation is close to—but not exactly—twenty-four hours, the circadian rhythm must be retrained to the twenty-four-hour day on a regular basis. This would have happened without conscious effort in our ancestors who lived outdoors and in harmony with the natural cycles of light and darkness. However, in modern society, exposure to light and darkness can be much less regular.

In these circumstances, purposely exposing yourself to bright light first thing in the morning can help reset your circadian rhythm and thus improve your sleep at night. If it’s bright outside in the morning when you wake up, going outside (without sunglasses) and perhaps taking a walk for fifteen to thirty minutes is the best choice. If you have to rise before it gets light, another option is to buy a light machine that emits ten thousand lux of light and sit in front of it for fifteen to twenty minutes after rising. These machines have been studied extensively for seasonal affective disorder (SAD) and depression, but research suggests they can also be effective in resetting the circadian rhythm. Please see my website for a specific recommendation.

Physical activity is positively associated with sufficient sleep, as extensive research shows. In one study of roughly fifteen thousand ninth-to twelfth-graders, students who engaged in more than sixty minutes of daily physical activity had significantly higher odds of getting adequate sleep than students who got less than sixty minutes of daily activity. Studies also suggest that too much sedentary time (that is, sitting) may decrease the quality and duration of sleep. For optimal sleep, follow the recommendations I made in
chapter 12
for movement. This means not only getting enough exercise but also, and even more important, reducing sedentary time and increasing non-exercise physical activity.

Some people sleep better after eating only a light dinner. This is especially true for those with digestive issues. Others—such as people with a tendency toward hypoglycemia—do better with a snack before bed (and
possibly even during the night). In general, it’s best to be neither overly full nor hungry when you go to bed.

I haven’t seen any research on this, but in my experience working with patients, I’ve found that both low-fat and low-carbohydrate diets can cause insomnia. Long-chain saturated and monounsaturated fats such as butter, lard, tallow, olive oil, and palm oil contribute to satiety and help prevent hunger throughout the night. Carbohydrates increase the ability of the amino acid tryptophan to enter the pineal gland; tryptophan is the precursor to serotonin and melatonin, both of which are crucial for sleep. If you’re on a low-carb diet and you’re experiencing insomnia, try adding a little carbohydrate back in—especially at night.

Certain amino acids that are found in muscle meats and eggs compete with tryptophan for transport across the blood-brain barrier and entry into the pineal gland. However, gelatinous animal products like skin, cartilage, and bones don’t have this effect because they aren’t rich in the amino acids that compete with tryptophan. Balancing your intake of muscle meats and eggs with fattier cuts of meat and bone broth can promote the uptake of tryptophan and production of serotonin and melatonin in your brain.

Many people can drink a cup of coffee or two a day without any adverse effects on their sleep. But if you’re having trouble sleeping, one of the first things you should do is stop all caffeine intake for at least thirty days. In some cases this single change alone can completely cure insomnia. However, if your sleep doesn’t improve while you’re off it and doesn’t worsen when you start again, it’s probably safe to assume that caffeine isn’t an issue for you.

Remember, caffeine is a drug, and like all drugs, stopping cold turkey is not easy. If you’ve been consuming large amounts of caffeine for many years, you may need to cut back slowly instead of stopping all at once to reduce the potential for withdrawal symptoms. For example, you might reduce your intake by 25 percent each week over four weeks, meaning that it will take you a month to stop entirely.

Many people run around all day like chickens with their heads cut off and then wonder why they can’t fall right to sleep as soon as their heads hit the pillows. If your nervous system has been in overdrive for sixteen hours, it’s unrealistic to assume that it can switch into low gear in a matter of minutes simply because you want it to. This is why sleeping pills are growing in popularity each year.

One of the keys to getting a good night’s sleep is managing your stress levels throughout the day. See
chapter 14
for specific tips on how to do that.

In addition to taking the steps above aimed at optimizing your physiology for sleep, you also need to optimize your environment for sleep. This includes:

Let’s say you’ve incorporated all of the sleep-hygiene tips in the last section, but you’re still having trouble sleeping. Perhaps you toss and turn for hours before you fall asleep, or maybe you have no trouble falling asleep but you wake frequently through the night or don’t feel refreshed when you get up in the morning. In these cases, you may need some additional support. See
chapter 14
for tips on managing stress (a key step to improving sleep), and visit my website for a list of natural supplements and stress-management techniques that are especially helpful for sleep.

Notes for this chapter may be found at ChrisKresser.com/ppcnotes/#ch13.

Complete the quiz below and use the answer key to determine your stress score.

I actively pursue a hobby.

Points
: 1

I belong to a social or activity group that meets at least twice a month.

Points
: 1

I practice some form of relaxation exercise at least five times a week

Points
: 1

I have a place in my home to which I can go to relax or be by myself.

Points
: 1

I practice time-management techniques daily.

Points
: 1

I do not bring work home with me.

Points
: 1

I know exactly which situations make me feel stressed.

Points
: 1

My average day always includes time for exercise and fun.

Points
: 1

I rarely have a hard time coping with stress.

Points
: 1

I feel that I’m able to control my anger.

Points
: 1

I can forgive people after they’ve hurt or angered me.

Points
: 1

I have an activity, a hobby, or a routine I use to release my feelings of stress.

Points
: 2

I avoid unnecessary conflict and stress (such as Internet debating with strangers)

Points
: 1

I get seven to eight hours of sleep every night.

Points
: 1

I have an income adequate to meet basic expenses.

Points
: 2

TOTAL

Total Points
: 10+

What Your Points Mean
: You are likely controlling your stress well.

Your Personal Paleo Code
: Complete the
Your Personal Paleo Code
3-Step program. No additional personalization is required.

Total Points
: 4–9

What Your Points Mean
: You may benefit from additional stress-relieving efforts/activities.

Your Personal Paleo Code
: Complete the
Your Personal Paleo Code
3-Step program, and add the recommendations in this chapter.

Total Points
: 0–3

What Your Points Mean
: You may be dealing with serious or uncontrolled stress.

Your Personal Paleo Code
: Complete both steps above and see a health-care provider for additional assistance. This should be a major focus for you, and ignoring this area may stand in the way of improvement elsewhere.

I believe stress management is one of the most important—and also most neglected—steps you can take to improve your health. Why?
Because no matter what diet you follow, how much you exercise, and what supplements you take, if you’re not managing your stress, you will still be at risk for modern conditions like heart disease, diabetes, hypothyroidism, and autoimmunity.

I see this every day in my practice. I have a lot of patients that are following a “perfect” diet, and yet they are still sick. Stress is often the cause. (I’ll define stress more clearly in a moment.) Yet as pervasive as stress is, many people don’t do anything to mitigate its harmful effects. The truth is, it’s a lot easier to make dietary changes and pop some pills—whether drugs or supplements—than it is to manage stress. Stress management bumps you up against core patterns of belief and behaviors that are difficult to change. It also forces you to slow down, to step back, to disengage—if only for a brief time—from the electric current of modern life and to prioritize self-care in a culture that does not value it.

Not surprisingly, those who are the most stressed out and in the greatest need of stress management are also the least likely to carve out the time for it. While I empathize with the difficulty of managing stress in such a hectic and crazy world and still struggle to find the time for it myself on occasion, I won’t sugarcoat this:
If you’re not doing some form of regular stress management, you will sabotage all of your best efforts with diet, exercise, and supplements
.

In this chapter I’m going to teach you how to effectively manage stress and reduce its harmful effects. Before I do that, though, I’m going to define stress more clearly, discuss its evolutionary purpose, and describe how too much of the wrong type of stress causes disease.

Stress isn’t all bad. In fact, we couldn’t survive without it. Stress helps us adapt to our environment and meet and overcome challenges. When the body experiences acute stress, a range of physiological responses occur to prepare us for fight or flight: heart rate and respiration increase, nutrients are mobilized, the immune system is activated, and awareness heightens. At the same time, resources are diverted from processes that aren’t
needed for immediate survival, such as digestion and reproduction. This exquisitely regulated response to stress provided our ancestors with the energy and wherewithal they needed to survive in a dangerous natural environment.

Exercise is another example of the adaptive effects of stress. During exercise you stress your muscles and cardiovascular system. In response, your body will build larger muscles and increase the capacity of your heart and lungs so you can meet the same challenge (the same distance on a run or the same amount of weight lifted) more effectively in the future.

This beneficial type of stress is referred to as eustress, or positive stress, by some researchers. It motivates, focuses energy, improves performance, and enhances your ability to thrive in whatever environment you live in. It is typically short-term, and it is perceived to be within an individual’s coping abilities. But what happens when stress exceeds your capacity to adapt? It becomes
dis
tress, or negative stress. In contrast to eustress, distress feels unpleasant, decreases performance, and can lead to mental, emotional, and physical problems. It can be both short-and long-term, but it is more commonly chronic stress that causes distress.

Why does distress cause disease? The human body is constantly working to keep critical physiological variables, like blood pressure, glucose, pH, and hormones, within the narrow range required for optimal health. This delicate and dynamic state of internal balance is called homeostasis. Under conditions of eustress, the body is able to maintain homeostasis, or return to homeostasis fairly quickly if it’s disturbed. For example, if you go to the gym and lift weights, you’re placing stress on your muscles and cardiovascular system, but your body will recover fairly quickly after you finish your workout (assuming you’re not overtraining; see
here
in
chapter 12
). However, with distress, your body cannot maintain homeostasis because the intensity or frequency of the stressor exceeds its capacity to cope. This might occur with the death of a loved one, a divorce, legal or financial problems, or chronic injury or illness. In these cases stress is no longer adaptive—it’s destructive.

But what determines whether you experience something as distress?
What makes stress stressful? When a person is faced with a potential stressor, he (consciously or unconsciously) asks himself the following questions:

A stressor caused by something that is important and that exceeds the capacity to cope will be perceived as negative, while a stressor that is relatively trivial and is well within one’s capacity to cope may be experienced as positive or may not be experienced as stress at all. This suggests that the same stressor could be perceived differently depending on the circumstance or the meaning assigned to stressor. For example, a flood would be a direct threat (and therefore a stressor) for a human being, but not necessarily for a bird. The loss of a job for a single, young professional who was ready to quit is much less of a stressor than the loss of a job for a salaried employee whose family depends on his or her income. A pregnancy for a woman in her midthirties with a strong social and financial support system would be far less stressful than it would be for a teenager with limited resources and no desire to have a child. In other words, how one experiences stress is subjective and depends a lot on internal resources and perspective. This is important to understand, because it suggests that strengthening those resources and changing your perspective can buffer you against the effects of stressors that can’t be avoided. (I’ll discuss this in more detail shortly.)

When the body perceives a stressor, the hypothalamic-pituitary-adrenal (HPA) axis is activated. This axis consists of the hypothalamus and pituitary gland, located in the brain, and the adrenal glands, located on top of the kidneys. This axis causes the release of several different hormones, such as cortisol and epinephrine (aka adrenaline), that orchestrate and govern the stress response.

The first stage of the stress response is called the alarm reaction. It includes the following changes:

Cortisol is the hormone responsible for many of these changes. It’s a diurnal hormone, which means it is not secreted uniformly throughout the day. Cortisol levels are highest at about 8:00 a.m. and then decline throughout the rest of the day and into the evening. When cortisol is produced in appropriate amounts at the right times, it protects the body from excessive stress. However, when cortisol production is too high for too long or when it is secreted at the wrong time (like at night), numerous problems ensue. These include:

As you can see, the negative effects of stress affect nearly every system of the body. This explains why chronic stress is associated with a wide range of diseases and health conditions. Chronic stress has been shown to:

This is by no means a complete list. In fact, there are few chronic inflammatory diseases that stress is
not
associated with.

There are two different approaches to minimizing the impact of stress, and both are important.

Reducing stress means just what it sounds like: reducing your total exposure to all forms of stress, whether psychological or physiological. Of course, it’s never possible (or even desirable) to
completely
remove stress from your life, but even in the most pressure-packed circumstances, it’s still possible to reduce it.