Intuitive Eating

Intuitive eating – which is best described as eating what you want, when you want, because you feel like eating it (with or without a “damnit!”) – is a great concept. Sure, it has limitations. One is that superstimuli such as artificial sweeteners, flavor enhancers, and pornographically-delightful foods like chocolate, cupcakes, Mountain Dew, and potato chips often induce us to eat, not for hunger’s sake, but out of an empty pleasure-seeking compulsion (sort of that “just one more” feeling you get when flipping through channels at the end of an unsatisfying day, or hopping around from site to site on the internet with that subtle whisper for gratification in the back of your mind).

But it’s worth recognizing how much more intelligent our bodies are than our minds when it comes to our physiological needs. A very simple example of this occurred the other day and really made me think. I hadn’t thought about it much before because it is so truly automatic, intuitive, and instinctual.

That simple example is how thirsty you get when you eat salty food. At first glance this seems like nothing. Like no big deal. But truly, the vast system of regulatory mechanisms in our body involved in this simple impulse is humbling.

The human body has a very tight range when it comes to the ratio of fluid to sodium. It wants to maintain that level for optimum health. If you consume salty food, you need more water. If you consume food without salt, you need less water to dilute the small amount of natural sodium found in the food. But our thirst really does a fantastic job of regulating this for us. Thirst is a manifestation of dozens of biochemical communications that result in a little lightbulb going off in our brains that says, “Damn an ice cold glass of “x” would really hit the spot right now.”

But even something so simple as sodium regulation is highly dependent on you being attuned to the cues your body gives you to drink. The danger arises when we have an external idea about whether water is good or bad for us, or salt is good or bad for us, or whether or not we should drink water with meals, or being told that we could die from dehydration if we don’t drink 6 quarts of water a day while working out in the hot sun (A safety handbook given to Forest Service employees, for example, suggests that one quart of water needs to be consumed every hour when engaged in hard physical labor. My supervisor just about died from doing this once, from inducing severe hyponatremia – dangerously low sodium levels, out in the middle of frickin’ nowhere).

All of this junk is mental interference that clogs up an otherwise well-oiled and sophisticated system. But even the smallest idea can do it, such as thinking that sugar will cause "insidious weight gain" and drinking water instead of Gatorade during intense physical labor/exercise.

It’s also a great example of how something simple and pure, like water, can save your life or be deadly depending on the context. Context is everything, and even water has a long list of “contraindications” depending on the circumstance. Our bodies are always in flux with changing demands, situations, and a constantly-transforming physiology dependent on something as simple as the time of day. A study mentioned in a book Rob A. sent to me actually showed that the prime determinant in whether a person developed side effects from chemotherapy (such as hair loss) was the time of day that the chemotherapy was given!

As it pertains to water, many people could benefit from drinking more water I’m sure, but give too much water to an infant and it can trigger seizures from low sodium levels, as this study shows.

That study is actually what got me so intrigued by this simple salt and thirst regulation system, as supposedly it is very difficult for those with a low metabolism to retain salt, and low sodium levels can induce seizures. The person I know who has problems with seizures hates water and loves salty food – and thinks it would be healthier to drink more water and avoid foods with a high sodium content. I think her body probably knows best on this one, and it is no accident that these are her preferences.

Speaking of which, I have made mention several times already of allowing this person’s daughter to eat absolutely everything she wanted starting two months ago. Back then she had severe sleep problems and was wetting the bed 3-4 nights per week. She has not had these problems at all in about six consecutive weeks since she was allowed to turn up her nose at dinner when it didn’t look good and eat massive gobs of ice cream instead. No longer is she forced to clean her plate or eat her vegetables, or meat, or starch, or whatever. And her tastes and cravings have become very well-rounded – with no more tension and anxiety and battle over eating time either. Intuitive eating can be a great thing.

And you never really know what your body might need to rebalance itself. I just received an email yesterday about many health benefits a person experienced after ditching coconut oil and eating a bunch of mayonnaise instead.

Think about all the mental interference you put up between your body and its natural cravings, impulses, and preferences. Many people notice health improvements when they just step out of the way. And this goes not just for eating, but for everything in life – certainly the type, duration, and time of day you get some exercise and movement, or the time you wake up, or whether or not you lay down and take a nap in the afternoon.

Stay tuned for a follow-up post to this, as intuitive “living” is only one tool in the toolbox. As you know, information can help, and investigation (of how you respond to certain foods, drinks, exercises, bedtimes, supplements, etc.) can help even more. Each by itself is limited in its usefulness, but taken together could be a pretty sophisticated way for figuring out how to get and keep your body in a harmonious balance.

Sleep Cycle: Review of iPhone Alarm App

I've spent the last week playing around with a 99 cent iPhone/i Pod Touch application called Sleep Cycle.  This is one of the innovate ways to incorporate the device accelerometer to monitor motion during sleep.  Motion during sleep is a proxy for sleep stage:  the more motion you are creating suggests being awake or in a light stage of sleep.  Deep sleep (or stage 3 or 4 sleep) typically involves limited movement.  REM (rapid eye movement) sleep that typically includes dream sleep also involves very limited physical body movement.  


Sleep cycle is a software app that uses movement during sleep to time your iPhone alarm.  It is designed to reduce the likelihood that your alarm will go off during a period of deep sleep or REM sleep.  If you have some movement around the time your alarm is set to go off, the alarm will be set off.  So say you want to wake up no later than 7 am.  Beginning at 630 am, sleep cycle with monitor physical movement.  If you begin to move during that 30 minute window, the alarm will sound.  I found the app easy to use and the primary function worked well--each time the alarm went off I was easily able to hear it and didn't feel like I had been awakened from a deep sleep or during dreaming.


But what I found even more fascinating than the alarm function with this app is the plot function that allows you to look at the entire night pattern of physical motion plotted to estimated sleep stage status.  The top screen shot shows a plot from my trial with the app.  It shows I fell asleep quickly to a deep sleep state.  I was awake at around 2 am for a brief period of time (elderly men will know what this was about) and then fell asleep with a gradual increase in sleep movement until being awakened by the alarm.  This pattern is pretty typical for normal patterns seen with more advanced sleep studies using EEG and polysomnograpy.

All right, so then last week I went on my annual ski trip to Lake Tahoe.  By history, I know that I sleep less well during travel and high altitude can influence sleep causing difficulty with onset insomnia and less deep sleep.  So I took the Sleep Cycle app along to Lake Tahoe and the figure at the left shows one of my night sleep plots.  I awoke in the morning with the alarm feeling like I had not slept well and that I had not had much good quality deep sleep.  The plot shows this to be the case.  I had 3 or 4 periods of being awake during the night.  One period of being awake around 430 am appeared to last at least 30 minutes.  There is less deep sleep and my total sleep time is less, as I was getting up earlier than my typical morning wake time.  


So this showed that Sleep Cycle was doing a reasonable assessment of my sleep pattern as the time in deep sleep approximated my sense of sleep quality.

So the next step in looking at Sleep Cycle was to see if it could monitor the potential therapeutic effect of taking a medication for sleep.  So after a night of poor sleep, I took a well-known sleep aid and started the Sleep Cycle app hoping for a good night's sleep and the sleep plot data to prove it.


The 27-28 January sleep plot shows the effect of the use of the sleeping pill.  There was a quick transition to a deep sleep that persisted through the first 6 hours of sleep.  After six hours of sleep there were two periods of being awake including one period shortly before the window for the alarm to sound went off.  


The sleep plot was consistent with what my subjective experience felt like.  I felt like I had slept well and in the morning I felt like I had a good night of sleep.  So the Sleep Cycle app confirmed my impression of the night.


Professional sleep study centers commonly use a technique called actigraphy.  Actigraphy typically involves wearing a motion sensing wrist watch like device.  It monitors activity through the night and estimates sleep based on the motion---very similar in principle to the Sleep Cycle app.  The Sleep Cycle app requires you to place your iPhone or i Pod Touch near your pillow.  I knocked if off the bed one night but other nights it was not a problem and seemed to do a good job monitoring sleep.


So I see the Sleep Cycle as the first iteration in the development of low-cost good quality actigraphy.  It seems to have excellent clinical potential.  For example, physicians might like to see 2 or 3 nights of Sleep Cycle data in the assessment of insomnia complaints.  They might also like to use it for monitoring response to treatment.  I certainly enjoyed this app and plan to continue to use it.  


Disclosure:  I have no financial interest in the Sleep Cycle app and have not been paid to write this review. 

Resetting Your Circadian Clock

Your typical health geek knows very little about Circadian rhythms, but real researchers know that there is a tremendous significance behind our daily biochemical rhythms. For those that don’t know, the circadian rhythms are basically just secretions of various chemicals and enzymes that take place during the 24-hour cycle that are set like a clock.

For example, during the evening it is natural for humans, a diurnal creature, to see a drop in cortisol and a rise in serotonin. This kills your appetite and makes you calm, sleepy, and ready to hit the hay after the sun goes down.

In the morning you see cortisol peaking in a normal, healthy human with ideal circadian rhythms. This helps to promote hunger, whereas having low cortisol levels throughout the night lends itself to a lack of hunger, helping you sleep soundly without needing to go on a midnight cupboard rampage. Anyway, you get the idea.

I first came across the importance of circadian rhythmicity when reading T.S. Wiley’s Lights Out: Sleep, Sugar, and Survival (2001) many years ago. In the book, Wiley makes a strong argument for the importance of sleep in avoiding metabolic syndrome due to the sleep cycles impact on circadian rhythms – cortisol in particular. And yes, it’s true, humans are sleeping increasingly less as the decades pass. Shawn Talbott, in the Cortisol Connection, mentions how the average night’s sleep has decreased from nearly nine hours of ZZZ’s to a measly seven over the past century. More and more studies seem to be emerging lately showing that lack of sleep is synonymous with metabolic syndrome.

During that same time, you see people drifting away from eating traditional breakfast classics like steak and eggs and moving to smoothies, Nutri-Grain bars, bagels, pastries, and Special K - the choice of a new, and pretty pathetic, generation. Being in New York City this morning, the white flour capitol of the world, and passing 2,784 bakeries and smoothie shops trying to find a place that serves something besides coffee, bagels, pastries, and smoothies was a great reminder of just how pervasive this poor excuse of a breakfast has become.

Keep in mind that these are the business establishments designed to serve those who DIDN’T wake up to sugary breakfast cereal or a smoothie they made themselves.

Anyway, that’s a separate tangent. What I’d really like to focus on is something that is a simple well-known fact that my own personal observations have reinforced over the years…

People with various signs and symptoms of metabolic syndrome seem to almost always have circadian rhythms that are totally out of whack.

To describe what I mean, I’ll explain what I believe to be a day in the life of someone with proper circadian rhythms…

1) Wake up in the morning spontaneously without an alarm clock at dawn no matter what time you fell asleep, full of energy and in a good mood with a strong appetite – like the family dog when he was in his prime

2) Eat a large and substantial breakfast

3) Desire to exercise early in the day, or at least get some kind of physical activity. Jittery and hyper if exercise is not possible

4) Have energy throughout the day without fatigue, drowsiness, irritability, feelings of depression or elation, mental fog, etc.

5) Good strong appetite at lunch but no panicked need to eat. Could skip lunch if he/she had to

6) Decreasing hunger levels throughout the day

7) Eat a normal-sized early dinner with no cravings or hunger afterward

8) Become sleepy early in the evening but not exhausted

9) Have no trouble falling asleep or nighttime hunger or cravings

10) Sleep soundly without hunger, without waking in the middle of the night, no need to urinate during the night

This is generally what a day in the life of a person with ideal circadian rhythmicity is like.

A short summary would be to simply say that most of the hunger and energy levels occur early in the day, while hunger and energy levels both decrease later, which results in no nighttime cravings for sugar or alcohol, no restless tossing and turning with your mind churning a million miles an hour or restless legs when you’re trying to fall asleep, and a solid night of deep sleep that you pop right out of early in the morning with no grog, fog, or zombie foot shuffling across the floor to get to the coffee maker. The day starts with bright-eyed energy, enthusiasm, and optimism with sort of a clean slate feeling.

Your typical obese person, or someone with the classic metabolic syndrome profile, often describes himself or herself as “not a breakfast eater” and “a late-night snacker.” Every morning is like having a hangover with no desire to eat and an unshakable feeling of drowsiness, fog, irritability, and fatigue. Hence the need for coffee at the very least, and something sugary and “light” if anything is eaten at all before noon.

At night things are equally screwed up, and even more annoying. Instead of winding down for a good night’s sleep, your typical metabolic syndromer starts winding up, and would love to go to sleep but hunger, cravings, and a feeling of restlessness seep in and get in the way – not to mention the normal chemicals that are supposed to be secreted in the evening that reduce the need to urinate aren’t secreted. What otherwise could have been complete sleep cycles is interrupted by a mega urge to whizzle if nagging hunger and cravings doesn’t get ‘em first.

Anyway, this is not meant to be a deeply revelatory blog post or anything like that. Rather, I want to put the importance of normal daily rhythms in the forefront of everyone’s mind.

In an evening of nonstop chatter and good times here in New York with Chek-certified trainer and health specialist/author Antonio Valladares, I mentioned that Circadian rhythms were something I was hoping to address in the near future. Valladares, who has spent years testing hundreds of clients with saliva tests taken at 4 times throughout the day to get a sense of such rhythms, responded to this by saying that “just knowing about Circadian rhythms puts you ahead of 99.9% of health and nutrition authorities out there.” I also asked him just how prevalent abnormal adrenal tests are, to which he said – “dude, it’s EVERYBODY.” And keep in mind this is just the saliva test, which says exactly NOTHING about the activity of the 11-HSD-1 enzyme that regulates corticosteroid activity in fat cells which I believe to be far more significant than levels detected in blood and saliva of adrenal hormones such as cortisol.

Coming up later we’ll definitely be focusing on some tricks to reset the biological clock. But in my experiences with resetting my clock and becoming more or less a new man years ago when I started really geeking out hardcore on all this health stuff, the most prominent keys to resetting the circadian rhythms go something like this…

1) Establish a regular bedtime. It’s better to go to sleep as close to sunset as possible, going to bed early. However, more important than the actual time you go to sleep is the regularity and consistency. Going to bed at almost the exact same time daily is a huge tool if you are seeking to better regulate your circadian rhythms.

2) Eat almost all of your calories within the first 8 hours of waking up. Eating an early breakfast that is pretty high in meat (and monstrous) is a great tool. If you are not a morning person and would like to become one, eating a big slab of something good in the morning is a powerful tool. An ideal day for me consists of about 80% of my calories being consumed during a very early breakfast and a midday lunch (interestingly, THIS STUDY that Riles passed along shows big differences in intermittent fasting when it comes to giving the food during daylight hours vs. giving the food at night. Our official 180 IF guinea pig, Collden, has also noticed much better circadian rhythms when eating food earlier in the day).

3) Stagger exercise towards the morning hours vs. the evening hours. This is still the hardest for me, but people that wake up to yoga, or a good workout, or a morning walk almost always notice a re-calibration of circadian rhythms (they shift to have more energy in the morning and be spontaneous “morning persons”).

4) Don’t watch too much late night tv, drink too much alcohol in the evening, or stuff yourself with a dessert after a full meal in the evening.

More on this to come as I delve deeper into this. But in general, the idea is to raise stress hormones in the morning with protein-rich foods and physical activity and keep them low at night. The carbohydrate to protein ratio discussed in the last post as well as the concepts here address that very simple fundamental.