Looking for the reason why you can't I lose weight or why you keep gaining it?

I am a member of quite a few facebook groups and work with people trying to lose weight and this question comes up very often.  To me, it really isn't rocket science and I can typically find at least a couple of things that people do that hold them back from attaining whatever health or weight loss goals they are trying to attain.  More often than not it's because they take an overly myopic attitude towards weight loss.

Over the course of the last couple of weeks I have come up with a checklist that I will be using with my clients to help them troubleshoot their weight loss issues.  The impetus for this is two-fold.  First, I may see someone in a Paleo group say they are sticking to the diet to the T but not losing weight or someone in a Fitbit group say they are getting their steps in but nothing is happening.  More often than not, when I question what they are doing for the other variables they should be paying attention to, they aren't doing anything.  I see the same thing with clients.  They may be getting their steps in every day, eating a proper diet, or getting in 3 weekly workouts but they aren;t doing all of these things consistently.  The second reason for the checklist is that it will gamify the process and provide a measure of accountability for my clients that they didn't have before.  Gained some weight this past week?  Look at the list.  Think you were good on your diet this week but not sure?  Look at the list.

While I am only using the checklist with my clients right now, I think a lot of these, "Why am I not losing weight?" questions can be answered simply by paying attention to the primary lifestyle factors that a person trying to lose weight should be paying attention to and creating a checklist to make sure yo are doing them.  I have my own specific way of dealing with each factor that I won't get in to, but most people will have an answer to that question simply by knowing what is important for weight loss and general guidelines for each.

1)Sleep

If you're not winding down at the end of the day and getting to bed at a reasonable hour, you basically trash your ability to lose weight by messing with hormone signaling, especially insulin.  You should put yourself in bed with the lights off and no distractions at least 8 hours before you need to get up.  This is a bare minimum.

2)Stress

Stress should be managed for the same reason.  One thing that sticks out like a sore thumb to me is that people who manage stress poorly also tend to have a difficult time losing weight.  I don't think there is a single reason why this is the case, there are many.  However, one glaring issue for me is that people who are not "planners" don't typically manage stress well and are the first ones to regress on weight loss when an opportunity presents itself.  I used to be guilty of this myself on numerous occasions.  If I put myself in to a situation where people are eating junk food and I haven't planned for this by having a healthy option for myself, I'll eat junk food.  If I know I am going to have a heavy client load one week and don't attend to it until the last minute, I won't work out that week.  If I am taking a 7 hour car trip and I don't make a point to get some low level physical activity in before and/or after it I won't get any in.  A quote attributed to Benjamin Franklin sums this up nicely, "If you fail to plan you plan to fail."

3)Intense physical activity

Whether it be working out with weights or playing a sport competitively or in a social setting, people really need to get intense physical activity in regularly.  I used to believe that 2 times a week was sufficient, but now believe that 3-4 times a week is significantly more effective.  In order for something to qualify for this factor, it should include the entire body and generate a significant sweat.  Good examples are weight training, flag football, rowing, or rock climbing. More often than not, this activity should also be 45 minutes to an hour long.

4)Daily physical activity

Many people feel that blowing themselves out at the gym 3-4 times a week is enough physical activity to lose weight, but multiple studies show that it can't make up for sitting around all day long.  At a bare minimum, people who wish to lose weight should be taking 10,000 steps a day which equates to 5 miles of walking throughout the day.  If I were to say that any one of these factors is the most underutilized, it's this one.

5)Nutrition

People who are trying to lose weight should be eating a highly diverse diet that is mostly of plant origin by volume and contains little to no processed food.  If most people did this they would have no problem losing weight and would score quite a few weekly points on my checklist.  Where it gets tricky for most is that this requires a lot of preparation and a lot of people shop for convenience.  However, if I had a dollar for everyone who told me that they'd give anything to get to their goal weight I'd be a rich man.  In the grand scheme of things, utilizing 5-10% of your day preparing the proper food is a fairly small price to pay for someone willing to do "anything".

6)The "It" factor

What is the "It" factor and who has "It"?  Some may call it mental toughness, some may call it willpower, but I believe it to be more than that.  The "It" factor is knowing what you need to do to achieve a goal and the willingness to do that to achieve it.  Michael Jordan had the "It" factor.  Michael Phelps has the "It" factor, and many captains of industry and people who have become elite at what they do have "It".  From a weight loss perspective, "It" is preparing lunches for the week on Sundays if that's what you need to do to eat properly at work.  "It" is waking up 20 minutes earlier so that you can take a 20 minute walk after breakfast before your 30 minute commute.  "It" is resisting the inertia holding you down on the couch to watch TV after you eat dinner and going for a walk or work out.  "It" is realizing that the end of the fiscal year is a busy time of year for you at work so you plan your workouts accordingly.  Neglecting these things may seem small, but it adds up over the course of a year.  People with the "It" factor just do "It", and as a result they typically get "It".  The whole reason to develop a checklist for yourself is to determine if you are getting "It" done.  In fact, "It" is exactly what your checklist should measure.

Conclusion

Looking at these 6 factors, it may seem like weight loss is a lot more than burning more calories than you eat, and it is.  However, knowing about these factors and paying attention to them is just part of being successful when it comes to weight loss.  More than any other factor, success in any field is dictated by persistence, or the "It" factor.  Pick a sport and anyone who is highly successful at it can be found practicing while their friends and lesser talented competition are on a beach or hanging with friends.  Look at any successful business person or parent, and you will find that their priorities align with what it is they truly want to be great at.

None of these things just come to people, they have to be worked on and perfected over years of practice, failure, and refinement.  Weight loss is no different.  People who want to be successful at it work at it and prioritize it in their life.  They don't run in to situations every week where they have nothing to eat but food that goes against their goals.  They don't skip workouts because something else comes up or because work or family life is getting busy.  Day in and day out they make sure they get done what needs to get done.  If something pops up and they can't work out at their designated time, they are working out late that night or first thing the next morning.  They get their steps no matter how busy they are.  There are 24 hours in a day, there is plenty of time to work, enjoy your family, AND work on your goals if you truly want to attain them.  The trick is to know yourself and learn the techniques necessary to prioritize your weight loss goal.

Using your Fitbit One data: Sleep

In this blog, we will go over the many ways to use the Fitbit One sleep data.  In a previous blog post found here, I went over the benefits of the Fitbit One Activity Tracker.  Compared to the older Fitbit Ultra, I find the Fitbit One to be a big upgrade.  However, there is also a lower end version of the Fitbit called the Fitbit Zip.

The primary differences between the two are that the One measures flights climbed as well as sleep.  While the flights climbed is a pretty good data point considering the work is more vertical than walking on flat ground, the biggest benefit of the Fitbit One is the sleep data.  This data is useful to help identify issues you may be having with:

• Identifying lifestyle factors that can impact sleep
• Identifying food sensitivities you may have 
• Not getting enough physical activity
• Getting too much physical activity
• How your sleep changes over time
• How your sleep changes over the week

Below is a picture of the data the Fitbit One collects on sleep.  This is from the Fitbit App for the Iphone 4S, the data on the dashboard found at Fitbit.com contains more information.

As you can see, the app gives you data on how long you were asleep, when you went to bed and when you woke up, and when you were restless or awake throughout the night. All of this is good data to have and can illustrate things that you may be doing that aren't particularly good for your health.  However, one of the knocks on the sleep data the Fitbit collects is that it isn't really measuring if you are asleep.  Since it is merely worn on your wrist, all it is measuring is whether or not you are moving.  In other words, you can just lie still and it will measure you as asleep.  This is really isn't a problem if you look at the data.

Anyone can see the difference between these two sleep patterns.  Whether you are attempting to stay as still as possible or not, there is something going on in night 1 that isn't in night 2.  Keep in mind that these are both Thursday's sleep which means they were recorded on Wednesday night in to Thursday morning.  First, we can see that while the first Thursday's sleep was almost 45 minutes longer, it was of much poorer quality.  There was more than likely something going on either on this day or leading up to this day that led to poor sleep.  There are several reasons why this may happen when comparing the same day of the week over time.

1) Hidden food sensitivities

It is possible that something or some things were eaten on the first Thursday that weren't on the second Thursday that negatively impacted sleep.  A common symptom of a food sensitivity is poor sleep, and not all food sensitivities will have overt GI symptoms.  Since the best way to identify a food sensitivity is to make a food journal, you can compare the two.  Luckily, the Fitbit allows you to log all of your food so you can easily enter it in the App or Dashboard and access it from either.  Over time you can narrow down foods you are sensitive to by eliminating foods one at a time and watching how they affect your sleep cycle.

2)Stress

Too much stress can also negatively impact sleep.  Maybe you were approaching a deadline at the end of the week of the first night but not the second.  Obviously you can look at this and see the effect stress has on sleep quality, even if you get to sleep in.  You can also record subjective info like this on your Fitbit Dashboard or in the App.  The benefit in this situation is that you can see that you should take active steps to manage stress or your sleep will suffer.

3)Too little physical activity or too much

You can compare the sleep data from both days to the step data on both days and see if you may have slacked on getting your steps in.  Too little physical activity during the day can lead to a surplus of energy at night and difficulty sleeping.  On the flip side, you could be entering a state of overtraining by overexercising.  This will cause your body to shift in to fight or flight mode which will make it more difficult for you to get in to rest and digest mode.  In this instance you will want to cut back on your exercise for a while until your sleep improves.

4)Whether an intervention is working over time

Most people associate the word intervention with a drug or alcohol problem.  What I am referring to here is a health intervention you apply to a health condition.  If you are having problems and try to remedy the situation, looking at how the intervention affects your sleep can be a huge benefit.  In this instance you wouldn't use just two data points, but if all of the other data points trend in the right direction you know you are on the right path.

You can also look at the data over the course of a week to find trends.

 

As you can see, it appears that this person sleeps better later on in the week.  I've looked at all of the other data throughout the year and this is a pretty standard trend for this person.  In this instance we can identify things that the person may be doing on a weekly basis that negatively impacts sleep.

1)Coffee consumption

Maybe this person drinks more coffee on the weekends.  You would expect coffee consumption to be greater during the work week, but this person could work weekends and have Tuesdays and Wednesdays off.  If they avoid coffee on these days but not the other days that could certainly be an issue as coffee is a stimulant that could potentially impact sleep on days it is consumed.

2)Alcohol consumption

This is actually what is happening in this picture.  This person drinks alcohol on the weekends but abstains during the week.  As a result, not only is their sleep disrupted on Friday and Saturday nights, it carries through in to Sunday night's sleep.  In this instance, the person actually consumed a small amount of alcohol at a celebration on Sunday during the day.  However, this disturbance in the sleep cycle is similar whether they confine alcohol consumption to Friday and Saturday or they allow a little consumption on Sunday as well.

3)Any significant changes that impact sleep

It could also be some other change you make during the weekend that negatively impacts sleep.  Going back to a lack of physical activity, most people don't exercise on the weekends or reduce general physical activity such as walking.  Binging on junk food during the weekends could also negatively impact your sleep.  Tweaking these things and then looking at your sleep data can give you tremendous insight in to what may be causing your sleep to change over the course of a week.

Conclusion

As you can see, the sleep data that the Fitbit One collects is pretty cool and useful.  Whether you are just looking to live a healthy lifestyle or you are working on improving a health condition, using the Fitbit One can give you a little more information that can help you make the right decisions.  You simply wear the Fitbit One in the wrist strap that is provided with it and hold the button until the counter starts when you are ready to go to bed.  When you wake up in the morning, you simply hold the button again until the counter stops.  If you forget to start and/or stop it but wear it anyway, you can enter the time you went to bed and/or the time you woke up in the App or the Dashboard the next day.  The data was collected as long as you wore it.  The best part...the silent alarm doesn't jolt you out of bed.

Conquering Type 2 Diabetes: Lifestyle

When trying to overcome Type 2 diabetes, lifestyle modification trumps medicine most of the time.  If you have done so much damage that there are not enough beta cells in your pancreas to make insulin you may be dependent on insulin for life, but you can still limit the amount of insulin you need via lifestyle modification.  In the previous blog on diet we went over why you should avoid processed foods and eat plenty of fruits and vegetables to help promote good gut bacteria and a healthy intestinal lining.  In this blog we will cover other lifestyle factors that impact blood glucose control.  These factors can be broken down in to three primary categories: Sleep, physical activity, and stress management.

Sleep

Sleep is incredibly important for human health and insufficient sleep duration and/or quality can have a major impact on your health.  A study published in 2013 found that insufficient sleep affected the expression of 711 genes that help modulate the stress response, immune system, and metabolism(1).  The study found that 1 week of sleep restriction of slightly less than 6 hours per night lead to a host of problems at the genetic level including increased oxidative stress, altered circadian rhythm, and altered energy metabolism, three hallmarks of many of the chronic diseases we see today including Type 2 diabetes.  This study is a fairly good representation of the sleep habits of many Americans as a good chunk of the population gets less than 6 hours per night(2).  Other studies have found that restricted sleep lead to changes in glucose regulation, insulin sensitivity, and leptin sensitivity(3, 4).  These changes begin to occur in as little as 2 nights of restricted sleep and a single night of no sleep(Hear that night shifters?).  Typically, the progression of Type 2 diabetes begins with leptin resistance followed by insulin resistance.  Over time, blood glucose regulation becomes permanently affected and Type 2 diabetes ensues.  The research on sleep and Type 2 diabetes is pretty much settled at this point, not getting good quality sleep for 8 hours dramatically increases your risk for Type 2 diabetes(4).

Physical Activity

When most people think of physical activity they think of exercise.  This is a mistake, because an hour of exercise per day cannot make up for prolonged sedentary time in helping prevent Type 2 diabetes and the metabolic syndrome(5, 6, 7).  Even just breaking up prolonged periods of sitting with 2 minutes of physical activity every 20 minutes helps improve glucose metabolism(8).  Most of the data points to spending as little time per day sitting being more important than exercising.  Certainly exercise is also important, but try standing more throughout the day first.

Next, walking more throughout the day is also something that is very beneficial in preventing and reversing Type 2 diabetes.  Aside from the benefits of not being sedentary, taking a 15 minute walk after each meal has been shown to decrease the risk of Type 2 diabetes(9).  Furthermore, people who maintain their daily step count over 5 years have been shown to maintain their insulin sensitivity better than people whose daily step count decreased over that time(10).  A good goal to shoot for and the recommendation by the American Heart Association is 10,000 steps per day.  The average American tends to get about 6600, quite a bit lower than the recommended number.  Just taking a 15 minute walk after each meal will give you 4500 steps, so it's not that difficult to accomplish.

Stress

Physical inactivity can also lead to changes in the brain that can modulate the stress response in a negative way(11).  In addition, sleep restriction can cause an overactive stress response(1).  To complete the circle, sleep restriction in the face of physical inactivity has been shown to negatively impact insulin sensitivity and blood glucose regulation(12).  All three of the factors we have discussed today are interrelated when it comes to the risk of Type 2 diabetes.  While it may be easy to put yourself to bed early or make sure you get enough daily steps in, managing stress is a completely different ballgame. Fortunately, doing the other two usually helps with the third.

It's very easy to see the importance of the stress response when it comes to physical stress.  When you are out in the jungle and about to become a lion's lunch, the stress response springs in to action to partition your resources for fight or flight.  This puts all non-essential processes on hold and floods the body with stress hormones.  The stress response begins and ends in the hypothalamus.  In what is basically a game of hormonal telephone, the hypothalamus tells the pituitary gland to tell the adrenal glands to make stress hormones.  These hormones help mobilize energy, particularly glucose, to provide the body with fast acting energy.  Over time, these hormones act on the hypothalamus and tell it to cools it's jets.  Obviously mobilizing energy is key to fighting or fleeing, the problem is that there is a direct line from the amygdala to the hypothalamus and that can turn on the stress response in the face of a perceived threat.

The amygdala is the emotional center of the brain.  Under the proper circumstances, the amygdala can tell the hypothalamus to initiate the stress response.  The problem is that in today's society, there are so many psychological stressors that can initiate the stress response.  How am I going to pay the mortgage?  What if my wife divorces me?  I have a big deadline that I need to make.  Any sort of situation that we deem as stressful has the potential to initiate the stress response.  The problem is, what do you need energy for to flee an emotional stressor?  Furthermore, can you ever really flee an emotional stressor?  Even if you do, there is typically another one right behind it.  As these stress hormones and glucose enter your bloodstream, there really is no need for them because it's not energy that you need.  What you need is to stop processing this information through your amygdala.  This is the goal of mindfulness.

The reason you have been hearing so much about mindfulness and mindfulness meditation is because mindfulness is a way to alter your thought processing so that you avoid generating an emotional response to psychological stress.  Many companies have begun mindfulness meditation programs as a way to help reduce stress for their employees and top executives tout it's benefits in helping them deal with stress.  How does this relate to Type 2 diabetes?  People with Type 2 diabetes have increased sympathetic nervous system activity(13).  This basically means that their stress response is activated more often and more easily than a normal person.  This flood of stress hormones and blood glucose is not good when it isn't needed.  Just to get a firm grasp on how important the stress response is in Type 2 diabetes, one of the ways that the stress response increases blood glucose is by causing the liver to produce more of it.  One of the primary pharmaceuticals used in Type 2 diabetes is metformin and it's mode of action is...It causes the liver to make less glucose.

Developing good stress management tools is key to helping prevent or reverse Type 2 diabetes.  Mindfulness is probably the best tool out there and can provide a one-two punch combined with proper sleep to help manage stress and help prevent or reverse Type 2 diabetes.  Add in a little physical activity to make you tired, and you have a pretty good jump start on living a healthier, Type 2 diabetes-free life.

Conclusion

There is tons of research on the aspects of lifestyle that will negatively impact blood glucose regulation and increase your risk for Type 2 diabetes.  Getting enough sleep, partaking in  regular physical activity, and managing stress are all important in preventing Type 2 diabetes as well as managing your blood glucose if you have it.  Making an effort to get 8 hours of sleep every night, getting at least 10,000 steps a day, spending as little time as possible being seated/sedentary, and utilizing stress management strategies such as yoga and practicing mindfulness should be on your to-do list if you want to live a long, healthy, happy life free of Type 2 diabetes.

Part 1-Overview
Part 2-Diet

How to lose weight the Synergy Wellness way. Part 6-Stress and sleep

When trying to lose weight, absolutely nothing has a greater impact than stress and for good reason.  Every other variable we have talked about including diet, exercise, and physical activity all use the stress response in some way to produce their effects on your ability to lose weight.  In addition, optimal health requires a properly operating stress response.  In this blog we will discuss how sleep and understanding the stress response teach you how to lose weight.

How proper sleep helps you to lose weight

Sleep restriction has multiple effects on your ability to lose weight.  Poor and/or restricted sleep duration leads to an approximate 20% decrease in leptin levels(1).  Leptin is a hormone secreted by fat cells that tells you when to stop eating.  A drop in leptin levels will cause you to eat more food than you normally would because your brain doesn't get the signal that you are full.  In theory, a 20% drop in leptin levels should lead to an increased consumption of between 350-500 cals per day for an average male(1); this approximates a 30-45lbs weight gain per year.  Since most of the studies are done with calories held constant under laboratory conditions, we can only guesstimate as to the amount of weight these levels of leptin could generate.

People with insulin resistance and type 2 diabetes tend to have leptin resistance, a situation where leptin levels are high, but the brain doesn't respond to it.  Leptin signaling is affected by insulin resistance and cells that are constantly bombarded by both of these hormones tend to downregulate receptors to them on their cell membrane.  This leads to constantly high circulating levels of both insulin and leptin which is highly inflammatory and compounds the problem of systemic inflammation even further.  Since the cells in the hypothalamus that regulate appetite are not listening to the signal from leptin, these people get the same effect as sleep deprived people do.  It's not that they are always hungry, it's that they don't know when to stop eating because the communication system that sends that signal is malfunctioning.

Sleep also affects many other aspects of your health that impact your ability to lose weight.  A single night of sleep deprivation has been shown to induce insulin resistance in multiple pathways (2).  Other studies have shown reduced insulin sensitivity(3, 4) as well as significant increases in the stress hormones epinepherine and norepinepherine (3) during periods of sleep deprivation ranging from 7 to 14 days.  In the shorter study, researchers looked at what happened at a genetic level during 7 days of sleep restriction.  The researchers designed the study in a way that would emulate real world conditions in the Western world.  During the sleep restricted portion of the study participants slept an average of 5.7 hours per night for a week while in the sleep sufficient portion of the study the participants slept an average of 8.5 hours per night for a week.  The sleep deprivation duration is highly comparable to real world conditions as 30% of American workers indicate they sleep 6 hours or less per night and many night shift workers get less(5).

In this study, there were 711 genes expressed differently during sleep restriction compared to sufficient sleep(4).  These genes were involved in sleep regulation and circadian rhythm, immune system/inflammatory response, metabolism, and the stress response.  In addition, oxidative stress increased in the sleep deprived state as did insulin resistance.  In the sleep deprived state, all of these genes were differentially expressed in a way that would negatively impact health and your ability to lose weight, including increased triglyceride levels.  Recall from the last bog that triglyceride levels are important as high triglyceride levels in the blood are indicative of a reduced ability to break down fat for energy, your primary goal when trying to lose weight.  So how does stress play in to this and how can understanding the stress response help you lose weight?

The Autonomic Nervous System

Your stress response is handled by a part of your nervous system called the Autonomic Nervous System (ANS).  Your ANS has 2 branches, the sympathetic and the parasympathetic.  The sympathetic branch of the ANS is responsible for the fight or flight response while the parasympathetic branch is responsible for rest and digest.  Your ANS basically partitions your resources to the more needed processes based on how you perceive your situation.  When you perceive a situation as stressful or you send signals to your body that indicate stress, the autonomic nervous system increases sympathetic activity which causes blood to flow away from organs of digestion and to your muscles so that you can respond to the stressor.  In addition, heart rate and blood pressure increase as well as respiration rate.  When a stressor is resolved or you begin to send signals to your body that the stressor is over, parasympathetic activity increases and heat rate, blood pressure, and breathing rate decline back to normal and blood flows back to the organs of digestion so you can recover from the stress.

Unfortunately, we are in a society that is stressful 24/7/365.  The stress doesn't need to be physical either, how you perceive the situation is just as important.  Worrying about bills, getting a job, passing finals, and breaking up with a significant other may not warrant a physiological change that partitions resources to fighting or fleeing, but that's precisely what happens whether the stress is real or perceived.  This is because the amygdala, the emotional center of your brain, has a direct connection to the hypothalamus.   In addition to regulating most every process in your body including appetite, the hypothalamus initiates the stress response by increasing sympathetic nervous system activity.  Over time, chronic activation of the sympathetic nervous system can lead to digestive issues as well as depressed immune function as the body constantly tries to respond to a stress that is never there.  This can lead to big problems because if you cannot digest or absorb your food properly, the vital nutrients your body needs to function properly will not get to your cells.

In addition, a chronically activated stress response prevents you from relaxing and falling asleep, which further impairs you ability to enter a parasympathetic state.  Forget trying to lose weight, at this point your health is probably deteriorating pretty rapidly and you need to hold on to everything you've got to make sure you survive.  Your body doesn't know that the late rent check isn't going to kill you, it perceives it as a life or death situation regardless.  A body under this kind of stress will not budge if you are trying to lose weight.

The question now becomes, "What activities will get me in to this situation and which activities will get me out?"  To answer the first question, the biggest contributor is probably poor stress management.  Not dealing with stress is a terrible way of trying to deal with it as it never goes away and that is the tack most people take.  Other frequent contributors to this state are poor sleep, binge drinking, high caffeine consumption, over-exercising, having a job where you have little control and high or low demand, a long commute to work, and poor nutrient quality in the diet.  Things that help you get out of this situation include dealing with stress, getting 8 hours of quality sleep a night, meditation, tai chi, yoga, stretching, massage, getting proper nutrition, laughing often, and trying not to put yourself in to stressful situations.  One thing I've found to be very helpful for people who have long commutes to work is to listen to stand up comedy on the way to work.

In our program we utilize a stress bank account where you have withdrawals (Stressors) and deposits (De-stressors).  Finding a balance that works for you is key in helping you learn how to lose weight.  Making sure every withdrawal is matched with a deposit will go a long way in helping you achieve your weight loss goals.

Conclusion

All of the variables we have discussed up to this point that are important in teaching you how to lose weight will impact your body's stress response system in some way.  One of the best ways to make sure your body is recovering from stress and not tipping toward too much sympathetic nervous system activity is to get adequate, high quality sleep.  Doing this will help regulate your appetite, allow you to deal with the stressors you encounter every day, and provide the optimal internal environment to help you lose weight.

In the part 7 of this series found here, I will discuss exercise and it's role in how to lose weight.

Epigenetics:Why you should care about sleep, physical activity, and what you eat.

Suppose you are sitting on a train, on a bus, on a plane, or on a park bench in between 2 other people.  Look to your left…Look to you right…Look in to your own hands…Now, realize a harsh reality…Two of you are going to die of cancer, diabetes, or heart disease; largely preventable diseases that have a deeper root in the way you live your life than in the genetic hand you were dealt. 

It may come as a surprise to you that you have a hand in preventing these diseases.  Twenty years ago it was thought that you were dealt your “hand” and you had to live with it.  The human genome project was undertaken to identify these genes so that pharmaceutical companies could target them and provide us with personalized therapies for what ailed us.  It was theorized that human complexity was determined by a large number of genes and once we mapped this genome we would be able to use the power of pharmaceutical medicine to completely revolutionize the way we practice medicine.  The fruit fly has about 12,000 genes, a piece of rice…40,000.  With such simple organisms having such a large number of genes, it was assumed that humans would have in excess of 100,000.

When the human genome project finished mapping the human genome, there was a bit of disappointment.  Not only do humans not have more than 100,000 genes, it turns out we barely have 20,000.  In addition, we share about 60% of our genes with the fruit fly.  To add insult to injury, we share 50% with a banana.  So, in the grand scheme of things, we really aren’t that exceptional.  That is, until, you look in to a little part of the DNA sequence that was once referred to as junk DNA.

The human genome project looked at what are called protein-coding genes.  Protein-coding genes make proteins in the body that ultimately make up you.  At the time, it was thought that the rest of the DNA outside of the protein-coding genes was junk and performed no real purpose.  Once it was found that the amount of our protein-coding genes was so low, scientists realized human complexity couldn’t be explained by protein-coding genes.  They decided to take a second look at the junk DNA and, lo and behold, they found something.

The original line of thinking that lead scientists to name this portion of DNA junk was that if a gene doesn’t make anything, it couldn’t have any relevance to human complexity or health.  When they realized the solution couldn’t come from the protein-coding genes, they needed to change their line of thinking.  By looking deeper in to the “junk DNA”, they realized that it wasn’t junk at all.  In fact, the junk DNA is running the show.  While the junk DNA doesn’t make anything, it basically gives the orders to the protein-coding genes to, “Make it happen!”  Rather than making insulin, or cortisol, or forming muscle tissue; the junk DNA acts as a switch and causes a number of genes to be expressed, calling in to action the appropriate gene sequence based on what you tell it to do.  But how do you tell it what to do and how does that impact your health?

There are 3 primary modifiable ways your body communicates with the environment; your diet, your lifestyle, and physical activity.  It is this communication with the environment that tells your body what to do.  In other words, this communication drives evolution by natural selection.  It does this via the hormones you produce in response to this communication.

It is well known that a lack of sleep will cause excess cortisol secretion, one of the primary hormones of your stress response.  Excess cortisol in the long term negatively impacts blood glucose, both by causing your blood glucose to rise directly as well as increasing your appetite for carbohydrate containing foods. This in turn may eventually lead to a malfunction in the hormone insulin, leading to constantly elevated blood glucose and Type 2 Diabetes (T2D).  Type 2 Diabetes is a major factor for many chronic diseases such as heart disease, Alzheimer’s disease, and cancer. 

Most of the recent research on Alzheimer’s disease has identified insulin resistance as a major predisposing factor.  In fact, this relationship is so strong that most researchers are referring to Alzheimer’s disease as Type 3 Diabetes, or insulin resistance of the brain.  Furthermore, a relationship has been established between Alzheimer’s/Dementia and lack of sleep, with sleep troubles being an indicator of future disease progression.  Given the relationship between sleep and cortisol as well as cortisol and insulin resistance it would seem that the answer to a cure for this disease may reside in the switches, not the coding DNA.  In other words your destiny isn’t written for you, a significant amount of it lies in your hands.

When you look at the cellular changes that occur in cancer, insulin and glucose are front and center.  Not only do most cancer cells primarily use glucose for fuel, cancer cells have 6 times more insulin receptors on their cell membranes than healthy cells.  This sounds like a pretty good adaptation to an environment that is high in both glucose and insulin.  Even better, the research on junk DNA identified that most of the thousands of changes seen in cancer don’t happen in the coding DNA, they happen in the switches.  Since they are happening in the switches, we have some control over them.  If you flip the switch on you get problems, if the switch stays off the problems are kept at bay.  This isn’t to say that once you have established cancer that you can reverse or remove it by changing your lifestyle, only that having the gene isn’t necessarily a death sentence provided you do your best to provide the proper information to the switches.  To the best of our knowledge, the best way to do that is get 8 hours of sleep a day, get regular physical activity, and eat a mostly whole foods diet while avoiding processed foods.