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Dr. Satchin Panda

Appearances

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10030.021

Actually, this is a politically very sensitive issue. Okay. And since we don't have objective data, it's really hard to say. Got it. If you had to guess? I mean, there are challenges with each of them. So, for example, you know, we talk about a lot of issues with cops and other stuff, but we never ask a simple question. How long that cop was awake before he or she made that bad decision? Mm-hmm.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10060.178

And, you know, we always think that, okay, so this cop should have been more careful and all that stuff. But sometimes they have been, it's not only that one work, even though they may be in night shift, we are assuming that they might have slept during daytime, but they have a regular family. They have to take the kids for parent teachers or something else.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10081.537

So sometimes it's very difficult for them to actually get that restorative sleep. Even though they are in night shift for three months, but their lifestyle has changed so much that they end to stay awake throughout the night. And they have to be vigilant. They may be consuming three or four heavily caffeinated drinks. Right.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10104.258

So that even though they go home, even though they put all the curtains to make the room dark, they cannot sleep. And it does. We see that. But this is, again, anecdotal. So this is where we have to come up with more objective study to see what will help. We have done one study with San Diego firefighters. And firefighters, 70% of firefighters in this country, they work 24-hour shift.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10133.496

So that means they will come in at, say, in San Diego, they come in at 8 o'clock in the morning, and their shift ends the next morning at 8 o'clock. Wow.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10143.147

But at the same time, firefighters, particularly the firefighting community and the carrier firefighters, because there are 250,000, roughly 250,000 carrier firefighters in the U.S., 700,000 to 800,000 part-time firefighters or volunteer firefighters, but the full-time carrier firefighters. The number one cause of death or disability on work is heart disease or stroke.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10169.603

It's not getting injured from fire. It's heart disease and stroke. In California right now, the number one health issue is actually cancer because they're exposed to so much of toxins, chemicals, and so much of stress that maybe their body is not ready enough to fight all that assault, all that stress.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10192.055

So we did this study where we asked a very simple question that can the firefighters adopt a 10-hour time-restricted eating? And, you know, we always, when people hear intermittent fasting, they think, 16, 8, 16 hours of fasting and 8 hours of eating.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10210.072

And that gets back to our 2012 study where we showed mice that eat within 8 hours, even though ate very bad food, junk food, that had high fat, high sucrose, all this diet, they were resistant to many diseases.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10245.376

It's mice. But that formed the basis. That formed the concept. Yeah. That formed the concept because we published it in May. And by December, there are books published on eight-hour diet, intermittent fasting, people talking about it. And I was scared because I used to go to conferences and people used to ask me. Should we do it?

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10265.897

And I said, only if you have a pet mouse and you love your pet mouse, maybe you can do it because I don't want to go and tell people to do it. And then there is adverse effect. But the bottom line is the reason why we did eight hours was, you know, that time, Christopher Balmers, who is who actually he and I started this experiment ourselves. So in the weekdays,

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10289.09

He would go feed the mice for eight hours, and in the weekend I would come and feed the mice for eight hours. We reversed the light-dark cycle because mice are nocturnal, they're supposed to eat at night, so when it was day for us, the mouse room was night. And we would change cages. So tens of cages.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10308.249

And you have to take out every mouse gently and transfer them to feeding cage, to fasting cage, and fasting cage, to feeding cage. And there was a lot of manual work. We still do it the same way because we actually get to see the mice, how they're doing. If they're injured or they're not eating, they will know. But the reason why we did eight hours was two.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10331.245

One was when we fed the mice for eight hours, we realized that they were eating the same number of calories as our control mice who had access to food 24-7. So that means these mice were eating the same food. Same number of calories. The only difference was this eight hours. The window. The window. If we reduce it to six hours, four hours or seven hours, then they would eat less.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10355.303

And if any health outcome comes out, then we cannot figure out whether it's due to narrow eating window or eating less because we know reducing calories also have benefits. The second reason why it was eight hours was pure convenience. You have, since you are supposed to be in work for nine to 10 hours, so eight hours is a good spot.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

1036.01

No, that's true. I mean, a lot of people, we think that we can get away with occasional late night eating. And this is where the circadian rhythm, again, some of the concepts of circadian rhythm kicks in. When we think about what are the adverse effects of disrupting our rhythm, we always think of people who do night shift work, evening shift work, or morning shift work.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10377.882

And people thought, even now people believe that intermittent fasting means you have to stick to eight hours. But in subsequent papers, we have actually gone back and systematically tested eight, nine, 10, 11, 12, up to 15 hours. And in mice, what we have seen is 8, 9 and 10 have very similar health benefits.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10399.958

So that means mice can eat for 9 or 10 hours every single day or 9 hours, 10 hours for 5 days and 2 hours cheat day. They get a lot of benefits. And in humans, although people talk about eight hours intermittent fasting, in some studies where we started telling people you should be eating for eight hours, they'll start with eight hours. And after six or seven weeks, they'll drift towards 10 hours.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10427.459

So we realized that 10 hours is a sweet spot where a lot of people can do it because in that way they can at least accommodate having a breakfast with their spouse, maybe late breakfast or an early dinner with their family members. So they can comply or adhere to this habit for a long time. So that's why we did this 10 hours. And that's why we asked firefighters.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10453.144

And this was a very high-risk project. Because, first thing, the city was skeptical that if you ask firefighters to wait only for 10 hours, will they have energy at nighttime to respond to calls? Because, you know, when firefighters show up, even 30 seconds late to an incident, that's life and death. Millions of dollars in property value vanishing. So it's a high-risk project.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10485.789

And second, the firefighter union is also mindful about their members' health. I said, well, does it have any adverse effect? Because if it has, for example, if the firefighter's immune system deteriorates or if they are more prone to injury because people think that if you're not eating, Well, you may not have strength. You cannot climb the ladder. You cannot fight.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10510.564

So there was also that kind of risk. So that's why this study was actually done with a lot of, you know, risk from the city, from the fire chief, from the union leaders. And also we had an oversight committee from Federal Emergency Management Agency, or FEMA, And they want to make sure that what we are doing is not going to harm the firefighters.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10540.038

And what we found was very interesting because this was a study where anyone, any firefighter could enlist. They don't have to have a bad health condition. They didn't have to have diabetes, obesity or cardiovascular disease. So we had a mix of healthy and also not so healthy firefighters metabolically.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10561.515

But, you know, the bottom line is all firefighters have to have to meet some physical activity criteria. And they were all in that way. They were all able bodied firefighters were fighting that really the superheroes of the society.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10575.072

so that's why we called it the healthy hero study and other 150 firefighters and this is an example where we also learned a lot about uh the stressful life of firefighters yeah we actually embedded ourselves in the busiest fire station we did many of my teammates particularly emily manugian who is the first author in this study

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

1058.907

And there is a rich literature from over the last 100 years. People have gathered a lot of literature saying that many people who work late at night or night shift workers, they are actually at a very high risk for metabolic disease, cardiovascular disease, heart disease, etc. Cancer as well. Cancer also.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10600.918

She went and spent 24 hours in the busiest fire station in San Diego and she experienced 10 calls that night. Just imagine, even though she had access to, she was assigned a bed so that she could sleep there. Just like any other firefighter, she had to get up when she heard the beep and put on her shoes and a jacket and helmet. And she had to run.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10627.27

She was assigned a specific fire engine and a seat. She had to get into that seat and sit there, just like other firefighters. And to go to the incident site, she has to get out of the truck and stand there. Of course, she was not fighting fire, but stand there and then come back. That happened 10 times that night. Wow. And then the next day, she came back.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10648.547

She said, I don't know how these guys are actually still alive. And I don't think our study will be helpful because there's so much stress. I don't think that they can actually cope with it.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10665.901

Yeah. And then she said that, well, when they're getting out at eight o'clock and I see also she also got out at eight o'clock, she said, well, You know, in the beginning, I was also at events that, well, you should not drink coffee outside your eating window.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10681.292

And then she said, there is no way I can ask the firefighters not to drink coffee, at least for public safety, because I don't want these firefighters to drive home sleepy. Totally, totally. So that also helped us a lot about the stressful life they have because a typical firefighter sees really bad things in a single day than what we see in our entire lifetime.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10705.986

And although she did not go to the site, she heard what happened. And so amidst all that stress, we know that we are always told and we always think that when we are stressful, then we cannot adopt healthy lifestyle. So she was very skeptical, and we are skeptical.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10725.777

Even my clinical collaborator, Pam Taub, who oversaw the whole project, and she was really crucial in making sure that all the clinical blood tests and everything is done well. Initially, we thought that we are destined to fail. And we also tapped onto something the firefighters actually have. They have a very strong sense of community, strong sense of sisterhood and brotherhood.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10753.937

And they realized that this is not a regular study because In clinicaltrial.gov, this is a website that lists all the clinical trials ever done. There are 420,000 clinical trials ever done in 110 countries and less than 100 of them are actually clinical trials to improve the health of shift workers. So one in five adult works in shift. And shift work increases the risk for many of the disease.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10789.205

So they have the they carry disproportionately large burden of disease, but less than 1% of studies as looking into how to improve their lives. Yeah. So when the firefighters actually heard about it, they realized that whatever we find First thing is, this is almost once in their lifetime study.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10811.101

And second, whatever we find that might help their brothers and sisters, 250,000 active duty firefighters in this country alone and internationally, maybe a few million firefighters in figuring out whether this 10 hours time receiving gives them any help.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10834.63

Yeah. So that's something that we really appreciated because many times people who are part of the clinical trial, they may or may not know that whatever they are doing is going to affect the health of millions of people.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10852.899

The greater role that they play. So that's why I am always very respectful. I have huge regard for people who actually volunteer their time to be part of any study. And You know, what did you guys find? So what we found was, yes, it is feasible.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10870.315

And firefighters who actually did this 10 hours time restricting, we had 75 firefighters doing 10 hours, 75 could do whatever the regular standard of life they're living in. And so one thing is it's feasible. So it did not reduce the quality of their work.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10890.17

Yeah. So that performance was perfectly fine. And this study was done during COVID. So majority of the participants actually signed up after March 2020. And this is also the time when in California we had two serious fire seasons. Yes. And that means many of these firefighters were actually called in to fight fires for two or three weeks.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10915.603

And when they're fighting fires, of course, we asked them, don't think about this study. Just eat whenever you want to energize yourself. So there was a lot of stress. And they're responding to COVID-19 calls because they were at the forefront. And what we also found was the time-restricted eating group. We had a battery of tests. One was the brain health or mental health.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

1094.346

But I think what is actually disconnected, what we don't understand in real life is, if we ask, what is shift work? Yeah, I've heard you talk about this.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10942.32

And what we found, those who did 10 hours time-restricted eating, their brain health, their ability to absorb this emotional stress at work, sustained throughout this study. Whereas this control group who are also exposed to this COVID-19 and related stress, their brain health deteriorated during that study. So this is a huge thing for firefighters because...

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10973.826

A big chunk of firefighters actually deal with stress and almost like PTSD kind of stress because just imagine when we drive to work at every intersection or every time we think about, oh, this is the store where we get this candy or that donut, this food and all that stuff.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

10994.939

When a firefighter drives to work or anywhere in the city, since they live in that community, they serve that community, there's a constant reminder, oh, at this intersection, there was this terrible vehicle accident. That house, somebody committed suicide. I could not save. I was late. That house burned down, and I could not help.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11016.869

So that stress is always every single hour of their wakeful hours on the outside. They are getting that stress. And this is something that we don't talk about because we think that, okay, so firefighters, they go and come back. So this is another thing that we learned, how much stress they go through.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11034.718

And for them to adopt this 10 hours time ratio routine was a miracle because we thought that they did it.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11044.804

And then when we looked at the firefighters who started healthy, they stayed healthy. Because many times we think that, even nowadays I hear, okay, if you're healthy, maybe if you eat within 10 hours, you lose your muscle mass, many bad things will happen and all that stuff. No. Actually, these people stayed healthy. Their performance did not decrease.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

1106.713

Yeah. It's not that somebody has to have a job like in police department or firefighter or nurses. Of course, they are shift workers. Right. But then if we think about metabolically for our health, for our body, how our body is thinking, whether you're doing shift work or not, because our body is actually not checking whether you checked into your shift work or not. It's only checking two things.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11067.719

And of course, firefighters are very mindful of their food. We also give this advice that everybody should follow a Mediterranean diet because the control group, you just cannot say that. You just go and do whatever you do. We give them Mediterranean diet cookbook and then they actually improve their diet because they also used our MyCircadianClock app.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11090.117

So they took pictures or they logged what they were eating. We actually saw there was a significant increase in their fruits and vegetables intake. And to our surprise, this was not intended. We saw that the time-restricted eating group reduced their alcohol intake.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11107.572

And this is, again, a big thing for nighttime shift workers, particularly firefighters, because they have so much stress that they actually go find relaxation in alcohol and, in fact, reducing alcohol intake. is an active area of research for firefighters and even active duty military or those who recently retired.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11130.827

And now in retrospect, it makes sense because if they're eating only for 10 hours, they don't have much opportunity because the bar closes at 7 or 8. And this is another benefit we saw for everybody, those who were drinking at baseline. And then those who had high blood pressure that reduced,

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11148.53

including systolic and diastolic, because diastolic blood pressure, the smaller number in your blood pressure reading, that's actually difficult to reduce with even blood pressure medication, and we are pleasantly surprised that that reduced. Then those with high cholesterol, we also saw the cholesterol levels decreased significantly, those who started high.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11170.049

And then high sensitivity CRP, which reflects inflammation because firefighters, they're exposed to so many bad things. I mean, what I also learned is less than 25% of the calls are for fire. 75 plus percent calls are for medical emergencies. So that means they're actually taking sick patients who may have infectious disease and Sometimes they sneeze. Sometimes there is.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11203.172

So one firefighter said, yeah, when you are on duty, if something falls on your skin, it's wet. Yeah, that's some bacteria or bug or something that's really nasty or virus. And then if you smell something that's odd. That's cancer because most of the things that burn, also that fume has a lot of toxin.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11223.807

So to see that the CRP level also significantly decreased is a very nice sign that maybe the inflammation is also reduced.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11235.439

so for these firefighters these were specifically shift working yeah 24 hours so typically what time was their eating window yeah so this is this is also another thing we asked them to self-select self-select 10 hours window and what we found is most people selected a time window that starts somewhere between 8 and 11 o'clock in the morning okay So they were not skipping breakfast.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11261.538

This is very important. They were actually eating a very healthy breakfast, either at 8, very few at 7.30 or 7 o'clock, but the median was somewhere around 9 o'clock or something. And they would eat their breakfast and then they would have actually a lunch because another thing with firefighting community, at least in San Diego, is they tend to cook at fire station.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11286.148

And sometimes they can eat during lunch and sometimes if there is a call, they will go and come back. And then they would have a little bit food for dinner around six o'clock. So in that way, what I found was surprisingly, when they were at work, they were more disciplined about their food versus when they're at home.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

1131.054

Are you staying awake for two or more hours between 10 p.m. and 5 a.m.? Because that's when your body is designed to sleep. So are you up for two or more hours between 10 p.m. and 5 a.m.? And being engaged in some kind of work. Engaged in some sort of work. Some sort of work. You're not just lying in bed with your eyes open.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11310.036

Right. And this is where the social aspect of doing it is also important. And particularly what we find is, and this relates to household, if the person who is making food and serving food, whether it's the male member or the female member of the household, if that person adopts a healthy lifestyle, then that creates a culture within the family.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11335.465

And here within the firehouse, we started a culture and that actually propagated very nicely to the extent that some of our control group actually towards the end, they were doing time-restricted eating, which might have reduced some of the difference in effect because we also saw many of them benefited.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11352.419

So this is one example where, you know, we did this study and even till now, many firefighters contact me and saying, well, How can we help you to disseminate this to all the firefighters within the union and also through international firefighters association international Association of firefighters and Luckily few years ago.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11377.621

I was on a podcast with Rhonda Patrick and Another another philanthropist actually reached out to me saying that okay, so I'll help you to disseminate this Wow and And with that funding, we actually, luckily, I've been extremely lucky to be in Salk Institute because we had a videographer, Mike Jeffs.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11400.203

And that time, he wanted to do something interesting because he wanted to go to film school, get his degree. And they said, hey, can I follow your firefighters? I said, yeah, you can follow, but you cannot tell me which firefighters you are following because that would influence the study teams monitoring of those firefighters.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11420.88

So he followed four or five firefighters throughout this time-restricted journey. And he took various video footages, interviewed them, and then he came up with 19, 20 minutes of a short documentary about And then we showed it to firefighters and then they said, wow, this is really cool. Can you expand it so that you can have more stuff about firefighters?

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11450.419

Yeah. So I went around and then, um, at the beginning of the pandemic, I went interviewed a few firefighters in other parts of the countries, and then we put it together. So now there is a documentary called healthy heroes. We are now can we bring it up?

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11467.914

And so far, we haven't released it. It's going through various film festivals. And luckily, we have quite a few healthy heroes. And luckily, we have a few awards so far. Oh, that's great. That's great. So it'll be nice to release it later this year.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

11490.48

Yeah, I'll post it on Twitter. You'll post it on Twitter. Yeah. And also the Institute will also post it.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

1155.084

Of course, if your eyes are open and you're watching TV, that's also... Sure.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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Yes. Yeah, that's powerful. That's something that's very, I was skeptical from the beginning and now. Yeah, no, that's really beautiful. And then the nice thing is, you know, we always respect the firefighters and we also understand their life is stressful. Yes. If they can do it, you can do it. If they can do it, you can do it. Yes.

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Because your body is not resting. And if you do that, on an average, once or twice a week, that is shift work. Because your habitual sleep time, suppose, is 11 o'clock every night. And once or twice, you are staying awake either till 1 o'clock in the morning. Or you're waking up at three or four o'clock in the morning to get to work or do something.

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Yeah, I mean, whatever we are learning from the research app, that's my circadian clock, what we learned is a lot of people can... follow very simple things about the 24 hours schedule. One is self-select, beginning with, say, maybe 10 hours of eating.

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Yeah, what works best for you. And you can try it for a few days to figure out, okay, what are the barriers? Is it your health condition? Because sometimes some people might have type 1 diabetes. Or they may be on a drug that actually makes it worse to be fasting. So for example, type 2 diabetics who are on sulfonylurea, they may find it difficult because their blood glucose level can go down.

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So what we're finding is... 12 hours to begin with those who have those conditions is relatively safe because there is we haven't seen any adverse effect with 12 hours but at the same time 12 hours may not be optimum for many things and then after one or two weeks you can reduce it to 10 hours to see which 10 hours works.

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And then maybe for some people, you can still go down to eight or nine hours, at least for a few days or a few weeks. One thing is you have to have consistent breakfast. Your first meal should be consistent because that first meal, changing that first meal is sending a signal to your circadian rhythm that it's a different day.

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The day is starting at a different time, what I call that causes this metabolic jet lag.

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Yeah. It's breaking your fast. It's not the fast meal that you have to eat after waking up. Yeah. Get confused because the thing that, okay, so as soon as I get up, I have to eat something that's my breakfast. No, it's the breaking of the fast. So you should have fasted for at least 14 hours to break your fast.

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Yeah, so usually I finish my breakfast at home and then these days I come to love and then I have my coffee because I realized that, yes, if I can have coffee with somebody during my meeting with them, then we achieve two things. One is I've already done my breakfast and then that's an optimum time. So that's one. So that we incorporated into the app, how many hours you're eating.

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Second is, as we discussed, brain health is so much important. Even those who don't have depression, anxiety or anything, just for your nighttime sleep, getting outdoor, getting an hour of daylight. And this is not looking at the sun, just daylight, even if it's cloudy, even if it's snowing, put on the right protective clothes and then get out. And then just get outside. Get outside.

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And then the afternoon exercise or 30 minutes of exercise, even if it is brisk walking. I mean, Getting 150 minutes is not that difficult. I mean, many people can do that.

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Yeah. So that will add up. And then avoiding light for two to three hours before bedtime. That's a huge thing because a lot of people actually don't think about light. And in fact, a lot of people that think that their room should be lighted because the reason is daytime. They have closed their windows, put their curtains for privacy or other issues that they brighten up their day daytime light.

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Right to bed. So this is another thing that one can do. Very simple stuff.

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And now if we think about it, almost 70, 80% of us are shift worker or we are living the life of a shift worker. So if you look at the average person who's listening a day.

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Yeah, just like you need an alarm clock to wake up. You need little nuts to go to bed. And since we are also on all digital devices, another thing people can do is to switch on the night shift or nightlight feature in your Android phone or iPhone or your laptop. Even my laptop has the same feature. All laptops, all computers have that feature.

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And you just turn that on so that around, I do it around 8.30 p.m. So 8.30 p.m. my devices are dimming down and they're also red shifted or orange shifted. So then I know, oh. It's time. Because sometimes, you know, we don't keep track of what time it is. So this is like a nudge. Hey, this is time to wind up.

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Yeah, so what I've heard is a lot of people actually find it helpful, but the blue light blockers, typically the good blue light blockers are funky looking. They're either yellow or red.

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Well, it may be blocking 5% or 10% because there is no clear definition. There is no standard saying that this glass will reduce blue light by X percentage. Since we don't have that standard, then anyone can reduce blue light by 10%. And say, this is helping. Yeah, this is helping.

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So, for example, you can go to the, you know, to protect yourself from skin cancer, you can always say, I have SPF 1. Right, right, right.

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They are a shift worker. And if you think about now, let's become more granular. So who are at a high risk for this kind of disruption? All the high school students. Because over the last few years of the pandemic, what has happened is there is a lot of remote learning, and then the default time to submit your homework is now midnight. Yeah.

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Yeah. And also, you know, if those who use it, even though they can wear blue light blocker and watch a little bit of TV, of course, the TV is still going to be stimulated. No, no. The TV images will be a little bit weird because you are taking away blue. But they report that they can still feel sleepy much better.

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And this is particular, you know, there are a lot of people who send feedback through the app or they talk to me. And this is where I, what I hear is older people, particularly, they find the blue light blocker much more useful than younger people.

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Yeah. So that's why there are four or five things that people have to check every day. So in that way, it's just a reminder. Sure. Even the small things, what we are seeing is a lot of people, even me when I started, it's not that every day will be a perfect day. Right. But at least what happens is when we cannot sleep, then we can go back to sleep. huh, I actually ate late.

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And this is one that I know perfectly for me. What will happen is if I eat after 8 p.m., my usual dinner time is around six. And then if I have to go for dinner or some- Or like we're recording a podcast, it's six o'clock now, you're going to probably eat later.

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Then I know that that night my sleep will be bad. Yes. And I have to take some extra precautions. So for example, I'll take a shower before sleep, bedtime. Sure. To further cool down. So these things actually help us to really look at ourselves, how our habit influences our health. Just like having a mirror in the bathroom helps us to figure out, okay, so do I have to shave? Do I have to...

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Cut my hair, all that stuff. So similarly, these five simple habits, whether we did that or not, reminds us what to focus on. That's powerful.

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And then the same thing applies to all the college students. So starting from teeners, now we have literally institutionalized circadian disruption by making your homework submission time as midnight. Right. Then let's think about after young adults go and get a job. In many jobs, of course, they're staying up late or they're traveling. But let's think about women.

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And you mentioned time-restricted eating, intermittent fasting. That's kind of one aspect of this circadian rhythm biology. But this is actually one way to get into the science because once we understand why we should be eating in less than 12 hours and why that has to be consistent for the science behind it, then we can dissect a little more into the interrelated parts of fasting, sleep,

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Yeah, so they can follow me on Twitter. That's where you're most active. I try to be active. And that's where whenever I see an interesting paper or something I want to share that wisdom, then that's where I share. Which I really appreciate.

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Thank you. And for making a donation, actually, there will be a link. Hopefully you can share. So I think it's panda.sog.edu giving. And again, these donations actually help us to do this very three things. One is. Think outside the box, do very simple experiment that can be done with three months, six months in the lab. Then second, start small human study.

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So, for example, I hear a lot of feedback from people saying, hey. I know somebody who has PCOS, and they tried time-restricted eating, and they improved their health. But it's anecdata. Going from that anecdata to a small study, 12 people, 24 people, that needs these small donations. So then the third one is, for example, I talked to you about the firefighter study.

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We collected blood samples from firefighters at baseline, after intervention. And we reported few things in the first set of papers, but we have the invaluable blood samples. Now the question is, can we go back? Because now technology is advancing so fast. Now we can actually look at 7,000 proteins, including hormones and different things in the blood samples.

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And these kind of donations actually help us to analyze that blood sample for these different hormones, different proteins, or metabolites. So for example, one thing, again, this is out of these donations that came out, was we took a small set of samples and then we sent this for metabolomics.

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So that means we can look at 1,000 different molecules, whether it's glucose, whether it's amino acids, whether it's toxic chemicals produced by the gut and sent to the plasma, sent to the blood. And what we found, surprisingly, was people who do time-restricted eating, even though they did not change their diet drastically,

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The toxic chemicals that are made by the gut microbiome and sent to the blood called TMAO, I will not go into detail, but that is now linked to different kinds of cancer. The TMAO levels went down. And now we are thinking, okay, so there must be a link with gut microbiome or how the chemicals are processed in the gut.

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So these kind of donations actually help us to go and even use some of the samples that are left from studies that are funded by the federal grant to explore new frontiers.

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In this country, in the U.S., every year, 3.8 million women are becoming new moms. When they're becoming new mom, they're actually signing up for shift work because they have to wake up many times in the night and they have to take care of the babies. Right. Breast feed, bottle feed, change diapers, everything. What is worse is shift workers actually get days off. But new moms don't get this.

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They don't, right. And then we have to also think about caregivers. There are a lot of us who actually give care to parents or somebody who is sick at home. Sometimes there are people living with chronic disease with us. And those caregivers also have to stay awake.

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So in a way, that's why I'm saying like more than 70, 80% of us live the life of a shift worker for at least one to two years in our lifetime. And we can all relate that whenever we live that lifestyle, we are not actually living with our peak performance. We are not living with our peak physical, emotional, and intellectual performance.

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Sleep is a crucial part of it. And also sleep, when you disrupt sleep, it's not like we are actually not sleeping and not eating because when we don't sleep, we also tend to eat more. So as you mentioned, when we don't sleep, actually sleep has many functions. And one function is to

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Make sure that our literally our mind is clear because when we sleep, our brain actually gets rid of a lot of toxic products. Yes. And literally sleeping is decluttering or detoxifying. Our brain so that our mind is clear. And why this is important is different parts of our brain has to, they have to interact with each other. And they have to be clear communication between brain parts.

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And why that is important is our brain essentially does few things. One is it takes information. Correctly. Second, it processes that information. And third, it takes action. So just now, as we're talking, our brain, our listener's brain is taking that information and sometimes it's processing it and then that may be converting to action.

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But in real life, in every day, we are also making a lot of decisions. So, for example, you walk into a store to pick up your coffee, and you're seeing a lot of food choices in front of you. And your brain has to take that information and process and decide what you're going to order or what you're going to eat. You are walking into your kitchen.

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Should I get the donuts or should I eat the vegetables? Yeah. And even if you had promised last night that you will eat healthy, because of sleep deprivation, now the brain is making a lot of bad decisions. I'll say, oh, maybe just one day, just this time.

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We justify things to ourselves. So that's why you get into this vicious cycle that your sleep is disrupted and you make bad food choices. And then bad food choices will also perpetuate that habit because this highly processed food also gives you a glucose spike and then you go into the low and then you have to

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compensated for that by drinking coffee to come back to full energy and then when this continues throughout the day then you have late night coffee intake and that disrupts again another night of sleep and it continues right so now the point is you know we

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we designed this anthropogenic world or the man-made world over the last 150 years of post-industrial era without knowing how important is this circadian rhythm. So it's almost like building all our buildings with lead and asbestos that we did up to 1970s without knowing what are the harmful effects of those bad things. And now we are trying to clean up that.

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what time we should be exposed to light, when we should exercise, and that will give us kind of a nice toolbox for each one of us to adopt.

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So similarly, this is a point only in the last 20, 25 years We have begun to understand what is the role of this circadian rhythm, 24 hours rhythm. And when we disrupt these rhythms, what happens? So I think this is, we are just at the beginning of understanding how these rhythms affect so that we can redesign our world.

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It's not that we have to switch off our light at 8 o'clock in the evening and then go to bed every night at 10 o'clock and wake up at 5 o'clock. But the challenge is how do we understand circadian rhythm in a way that we can still continue to perform at our peak physical, emotional, intellectual performance at any age and at any health condition and still continue to be healthy.

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Circadian rhythm essentially relates to almost a daily timetable of things that has to happen in our body, whether it is fighting infection, metabolic balance, brain health. or even repair and rejuvenation for injuries. And when we think about circadian rhythm, then since it's a big new concept, it's also a little bit difficult to understand.

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Yeah. I mean, when we think about lifestyle, when we say, what is your lifestyle? We always talk about how lifestyle affects health. And what I say, lifestyle is what, when, and how much we eat, sleep, and move around or physically active. So out of these three, for eating and for moving, you have to actually make a conscious effort and you have to invest.

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For example, for eating, you have to invest in good food and all that stuff. And then for exercise, also you invest. Sleep is the simplest one. You don't have to do anything. You just have to go have a set time when you have to go to bed and just lie down. And that's the simplest thing out of all these three that one has to do.

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And it's just mind-boggling why so many people just can't get that one correct. Because once you get seven hours of restorative sleep, then everything else falls into place.

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Yeah. I mean, this is, there's also another twist to that because after the, we humans are the only species that can control fire. That's the differentiator, means no other species can control fire. So that means we also control light. We also control warmth. And if you look at last 150 years of human history, human civilization,

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Our civilization actually flourished by being active late into the night. Right. So that means when we are active late into the night, sacrificing some amount of sleep, then we can create wealth. We can be more creative. We can make a career. And that's what has percolated down to...

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students, high school students, college students, and we always demand that they, even for many families, they say sleep is not that important. Just get four to five hours of sleep and then get back, do your homework and all that stuff. But then the question is, can we show benefit, tangible benefit, by letting students or teenagers sleep? And this is where science comes into play.

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So, for example, a few years ago, Horacio de la Iglesia, who is a professor in UW, University of Washington, did a very fundamental study. What he found was, well, most people, most parents who have high schoolers, they know that the high school students, they wake up just before the class begins and then you have to drag them to school.

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They're sleepy and then for the rest of the day, it means they wake up after midday. So then the question is, if you delay the high school start time, hopefully you can give them opportunity to sleep a little bit more. So this is a study that Farashio took great pain in convincing a couple of schools and then also the Seattle School District.

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to experimentally delay high school start time by just an hour. And has he reported the findings? Yeah, so that was actually published in 2017, 2018. So there are two different schools.

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And this is where we talk a lot about scientific results and how the lifestyle and everything is built on scientific evidence, but it takes a lot of pain and a lot of organizational skill to get this simple study done. And there was also a lot of opposition because the parents said, well, if you delay the high school start time, then maybe we cannot drop them in the right time. Right.

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Yeah. And then the school buses, the driver said, no, it kind of breaks our schedule. So it took a huge amount of planning to do this study. And this is only two different schools. And also he had to make sure that you just can't do it in one school because every school has a different demographic. People, students of different socioeconomic status also come in.

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So he had to do it in two different schools, one relatively rich neighborhood and one not so rich neighborhood. And for one year, the students actually delayed their school start time and then he had to follow them. So he had to collect, actually objectively collect information. how much activity, how much sleep these kids had by putting an active watch or FDA-approved Fitbit kind of device.

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Yeah. So let's start with what we do every day. Eat. So when we eat, our digestive system digests the food, absorbs the nutrients, sensitive blood, and then... Our pancreas does its duty to control blood glucose. So now if we start with the digestion process itself, the first stage of digestion is that happens in our mouth.

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And that also collected their light exposure, their physical activity, their sleep. And then not only that, he had to also collect how they were doing at school. So then he had to get access to grades and tardiness, whether the students were actually getting late to school or early to school.

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The bottom line is what we found was by delaying high school start time by an hour, these two school students got to sleep 34 minutes extra. And what do you think about? So what, 34 minutes? Actually, the best sleeping pill gives you only 15 to 20 minutes extra sleep. This was the outcome was actually much better than the best sleeping pill. Which is what Ambien is where people take something?

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On an average, I'm saying. On average. Then second thing is sleeping pill will not improve grades. These kids actually improved their grades by 4.5 percent. In both schools? In both schools. That's incredible. Then the third one, actually reduced their tardiness. And when they're not getting late to the school and they're on time, it also improved their self-confidence.

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And for many high school kids, it's a big thing how to feel confident, to have that self-image that they're worth it. And those things actually improved. So those were published. And then there are many other studies similar to that. Those are repeated in different parts of the US and Europe. And that finally led to the California legislature to pass this delay school start time bill.

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And so that now all California schools, middle schools and high schools cannot start before 830 in the morning. So this is another example where, you know, circadian rhythm research can actually lead to public policy changes. And this is one example where we did not know what is the impact of circadian rhythm on sleep. on students' performance.

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And we designed school start time without paying attention to the importance of sleep and circadian rhythm. And now that we know what is the impact and we change school start time, now we are letting students sleep much more than what they could have slept with a sleeping pill. No, that's powerful. This is powerful.

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Horacio de la Iglesia. Amazing, amazing. And actually, I was fortunate enough to be a co-author because we analyzed a lot of the data from that study. And then we have continued to collaborate on many other aspects. So this is, again, some of the studies that are not easily federally funded. Sure.

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And these are the studies that are mostly done by initial, like a little bit of contribution from private philanthropies, private philanthropy. And when you think about private philanthropy, we always think of Bill Gates and, you know, we're putting billions of dollars into it.

Dhru Purohit Show

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Yeah. But actually, some of the studies are done with small contributions from people. So that's why, just think about it. If a million people just donate their one cup of coffee worth of money to a lab, we're talking about two to three million dollars. Absolutely. Just a million people, one coffee cup. Right.

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And that will do a huge amount of research because a typical large federal grant is about that size. And there's also a reason why we should not play with honest taxpayers or federal money on random ideas, because sometimes these ideas are very out of the box. They're bold ideas.

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As we salivate, there are many enzymes in our saliva that breaks down some of the food components. And there is a circadian rhythm to this whole process of salivating. And we are more likely to produce a lot of saliva during our wakeful hours or during the daytime. And the saliva production actually goes down, way down, right around when you go to bed.

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Yeah. So that's why the research enterprise also works in a very systematic way. First, we try to do small studies in, say, animals. And whereas where we work with, say, fruit flies or a little bit of cells in a disc. And then we play with that idea to see whether it actually has some benefit.

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Also, whether it has some risk, because sometimes some ideas can actually kill fruit flies, and it's okay. But we should not play with that idea on humans. So we produce that initial idea testing, and for that we need this philanthropy money, private donations, because this is where we... I personally don't want to use... honest taxpayers' money.

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When we think about federal money, we are thinking about, okay, some federal government writing a check. No, actually that money comes from people who are- Taxpayers.

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Yeah, we do. Actually, we'll have the link to our labs donation phase. And this is where even small donations actually help because sometimes the trainees, the PhD students and then postdocs who have finished their PhDs who could have gone to make big bucks in pharma or in other places. They're actually passionate about research.

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They're working and then sometimes they want to go to a conference to present their results. Sometimes they want to just have subscription to a journal that's only a few hundred dollars. So these are really some of the key contributions.

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As I said, a long time ago when we started this time-restricted feeding or time-restricted eating, which is now famous as intermittent fasting, that was all funded by small philanthropic grants. And if we think about, okay, what is the return on investment on those philanthropic grants? It's 100 times, 200 times.

Dhru Purohit Show

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Yeah, so a lot of us actually, we wake up to an alarm clock. The reason is our body is not prepared to wake up and we are forcing our body to wake up. And the reason why our body is not prepared to wake up is we may not be getting the amount of sleep that our body needs. So for example, most people say that, okay, so you should get seven hours of sleep.

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But in fact, if we look at teenagers, teenagers need eight to nine hours of sleep. And as we get older, we think that we actually need less sleep because our grandparents or our parents may be sleeping less. But it's not that. They need less sleep. They just can't sleep because their sleep debt will get to that. Sleep debt doesn't add up. So their body doesn't feel. Sleep debt. Yeah, got it.

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And I'll get to that point why this plays a role. So now the next step is digestion and that happens in the stomach and a lot of the enzymes that break down food that are produced in what we call the pancreas, it has two different roles. We always hear about the insulin production part, but pancreas also produces a lot of stuff to digest our food. And then what we now know is that

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yeah so so now let's see why we wake up to alarm clock and what happens so approximately one to two hours before we wake up the many things that happen in our body and brain to prepare us to wake up one of the things is our melatonin production goes down because melatonin helps us sleep and it has to go down so that we can wake up and we'll feel a lot

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then our blood pressure slightly increases, our heart rate also slightly increases, our breathing increases so that we can, when we wake up, we have breathing enough oxygen, our heart is pumping enough so that we can actually move around without feeling drowsy and our brain is also waking up.

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So when we set that alarm clock and we wake up, yes, we dragged ourselves out of the bed, but our circadian rhythm hasn't prepared our body to wake up. So the hormones of the day, nighttime, they haven't gone down. So for example, cortisone, sorry, melatonin levels haven't gone down.

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Our heart hasn't started pumping at its usual morning rate and our breathing may be slow and all these things happen. So that's why if you can, the first thing that you can do for the day is go to bed at a consistent time and stay in bed for at least eight hours so that you can get seven to seven and a half hours of sleep.

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And when you wake up with little bit of nudge from alarm clocks, just a reminder, sometimes some people actually use the alarm clock just to remind them that, hey, this is usual wake up time and they can get out of bed. But most people actually put an alarm clock so that they can drag themselves. Right.

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And second thing is you have to acknowledge that if you have to wake up to an alarm clock because you are sleep deprived, you just cannot get enough sleep. Because, you know, there are many people who are morning shift workers or they have long commute hours, so they have to get up. then you have to be mindful that our body is not ready for a few things.

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One is your body is not actually ready to eat after you wake up because your nightly hormone melatonin is still high and your stomach and digestive system has not become ready to digest and process that food. So in those cases, you definitely should not be eating right away after waking up.

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And then another thing that I think is not well researched is whether you should actually do strenuous exercise in the morning if you're waking up to an alarm clock, if you didn't have enough sleep. Suppose, say, you had only four or five hours of sleep, but your routine is go to the gym in the morning. Should you actually go to the gym?

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And if you go to the gym, what kind of exercise you should be doing? Because your heart is not running at its peak performance. So what people have seen, and this is, again, this is an experiment that has been going on for 100 years.

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And the experiment is the standard time and the daylight saving time. Right. And light bulbs. No, particularly when we fall back. Right, right, right. Daylight savings. Daylight savings. And then when it ends, everybody has to wake up an hour early. Right.

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And what we have seen is that's an experiment where millions of people have to essentially set an alarm clock and wake up an hour earlier than they're supposed to. And then what happens? That's the morning when there is a spike in heart attack and stroke. And that essentially says that what happens when you wake up an hour earlier and then go do your regular stuff.

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And of course, it's not that all healthy people, if they wake up to an alarm clock, they will get a heart attack. But it says that, okay, so... For a lot of people whose heart is not ready or who may have a weaker heart or there might be an underlying condition, then just waking up to an alarm clock can put a lot of stress.

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And you should be mindful of that stress by not engaging in strong, strenuous physical activity, resistance training, lifting a lot of weight. So this is another example why how circadian rhythm knowledge can help us optimize by adjusting our morning routine when you have to wake up to an alarm clock.

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That process producing acid to break down food and these enzymes to break down the food, all those are also circadian. So that means during the daytime there is strong production of these enzymes and increased acidity to break down food. And then there is a weird thing that happens around sleep time or late at night. Our stomach is more sensitive.

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That's there. If you're getting enough sleep. That's a big challenge for a lot of us.

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Yeah. And particularly, you know, when you're talking about sleep, we're always thinking about metabolic health and age. But we should start that practice when, you know, our kids are going to middle school and high school, because that's the time when disruption, sleep disruption begins at that stage. Because that's the time when we put a lot of pressure on our kids.

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And also the kids are also feeling pressured by their peer to stay up late into the night and and they lose sleep. And when they lose sleep, then that increases the risk for anxiety, depression, bipolar, and all these brain health issues that we are witnessing.

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And this has become a pandemic because, you know, some of the surveys that you see, we see that one in five high school students are so depressed that they thought about suicide. Those kind of numbers are what fraction of college students are actually seeking mental health

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But we don't talk about how to structure high school, college, and then in a way that kids can actually get sleep that they really deserve. Means if we want to invest in kids' future, One investment, one thing that we can do is let them sleep for at least seven hours.

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If we think about, if we look at high school students, 90 plus percent of high school students do not get the amount of sleep the body needs. The same thing applies to college students. And when they don't sleep, They can counter it with, so one thing is there is mental health issues and sometimes there is also substance abuse issues that come from reduced sleep.

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So we have to think about the whole spectrum from high school kids, all the middle school kids, all the way to older adults. You mentioned sleep debt.

Dhru Purohit Show

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Well, sleep debt is a body needs, for example, seven hours of sleep because a lot of studies around the world, when they look at what is the average number of hours people sleep and what are the comorbidities or diseases or even longevity, what they find is Six and a half to seven and a half hours in adults, older adults.

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We're not talking about college students or high school students, older adults. That seems to be the sweet spot. People who sleep less, they have more comorbidities and people who also sleep more, maybe they have underlying conditions. That's why they're sleeping more. They also have other comorbidities. Right.

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So that means even a little amount of food can hyper... It's almost like the stomach is sleeping and all of a sudden somebody comes and knocks on the door. And not only you wake up, you actually wake up with increased vigilance. You may pick up a stick or something thinking that somebody is in bedding. So stomach actually... hyper reacts by producing too much acid.

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So a lot of people who sleep less in the weekdays, say five to six hours or five hours, then they experience it, that their body actually keeps track of how many hours of sleep you have lost. So that by Friday or Saturday, you are so sleepy that you just want to catch up. When people say I'm catching up on my sleep, that's exactly what they're doing.

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Their body has calculated and then it's telling them that, okay, so on Saturday you got to sleep another four hours or five hours and they're catching up. And what happens is, so that's kind of what we say sleep debt. You have taken that debt against your regular sleep and you have to pay it back, pay it back to your body by sleeping extra.

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When we get older, then what happens is our bodies, the sleep debt calculator doesn't work very well. It actually doesn't remember how much debt we are accumulating. So that means you can go with less sleep four or five days, but your brain is not remembering, so you'll still end up sleeping less. And you think you're fine. And you think you're fine. So that's why this is...

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This is some instances where you should not be listening to your body. If you know, if your smartwatch or smartphone is telling you you have been sleeping for five hours and you know that you are sleeping for five hours every night. And then you got to work on it. Another reason why we also forget our body forget sleep date is when we over consume caffeine.

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And this is something I have personally felt because there are many times when I have to consume excess caffeine or maybe late afternoon coffee just to get through a grant deadline or a manuscript deadline or something else.

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and then if i continue that habit in the weekend and also have a lot of caffeine then of course i'm sleeping less six or less hours and my brain doesn't remember that that i'm having sleep debt but the other way it shows up is i'm more hungry i'm more irritable i know that i cannot think clearly And my overall productivity goes down. And I'm kind of struggling. And then I kind of blame myself.

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I blame people around me. And I'm thinking that, okay, so for all of my problems, somebody else is responsible. I beat myself. Why I cannot get these things done. So a few years ago, I did a simple experiment. I kind of do all types of experiments on myself. One is, I said, okay, so between Thanksgiving and New Year, I will stop caffeine, all kind of caffeine-containing drinks.

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Coffee, green tea, et cetera. Coffee, green tea, Diet Coke, anything that has coffee or caffeine, including dark chocolate, also has many flavonoids that can keep us awake. Sure. And to my surprise, almost every night, the first few days, I felt like I haven't slept for a month or so. My sleep just kicked back in. And then I would fall so sleepy. I'd feel so sleepy by 9 o'clock.

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It was really hard to stay awake past 9.30. And so that goes on for at least 15 days to three weeks that I'm just sleeping like eight, nine hours.

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Yeah, my body actually has remembered my sleep debt and it's just saying, no, you got to pay. You have a huge debt and you haven't paid for a long time. And then after two to three weeks, then I come to the equilibrium that I can actually sleep. sleep for seven hours and that's when I realized okay so this is my normal circadian rhythm. This is your baseline. This is my baseline.

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To reestablish and also to know what my body needs. And essentially what my body needs is I should be going to bed between 10 and 11 and should be waking up between six and seven. That's what I figured out. So this is the kind of stuff that everybody can do once in a while, do an experiment. You're not going to die if you stay away from caffeine for maybe in the weekend or for a week.

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And now too much acid is actually not that bad, but what happens is too much acid can go up our esophagus and can cause acid reflux. And I told you that how at nighttime our mouth actually reduces saliva production. The reason is in our sleep we should not be drowning in our saliva. So saliva neutralizes a lot of acid.

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And we always talk about personalized health, personalized precision health, and all these fancy terms that we say. Whenever there is the word personalized, we have to keep in mind that more than half of that responsibility is on us to try something, a new lifestyle. Try to figure out whether you can change the quality, quantity, or timing of your food, exercise, or sleep.

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And this is where one can actually try. And for older adults, it's difficult because, as I said, even in experimental models, like for example, we can take little fruit flies, and this is not experiment in my lab, but other people have shown it.

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And the young fruit fly, if you keep them awake by putting them in a rotating drum so that they cannot sleep, then the next day when you give them an opportunity, they will sleep. But you take the older fruit flies and keep them awake, and next day they actually don't fully compensate their sleep loss. So this is a phenomena that's already known happens in humans.

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So then the question is, can we model it in flies or drosophila, fruit flies or in mice? Then we can go back and see, okay, so what part of the brain is involved? What can we do for the fruit fly or the mice to remember they're sleep dead so that they can go back to sleep and recover? And then what happens when they have this sleep dead, when they cannot sleep enough?

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So, for example, now many labs have shown that in experimental condition, if you take a mouse or a fruit fly that is prone to neurodegenerative disease or dementia and you disturb their sleep for a few days, then that can accelerate the progression to dementia or that can exacerbate the symptoms of dementia. And so that's one part of the story.

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And then the other part of the story, which relates to timing of food, is if you now put these fruit flies or mice that are more prone to dementia, and people, we never connect how timing of food connects with dementia, but this is something that, Actually, one of the earliest experiment was, in fact, done in LA, in Los Angeles, in UCLA. At the Buck Institute? No, actually UCLA. UCLA. UCLA, yeah.

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And what they did was they took a few mouse strains that are more prone to Huntington disease, and they did eight hours time restricted feeding. So that means these mice have to eat only for eight hours and fast for 16 hours. And what they found was, surprisingly, the sleep quality of these mice actually improved.

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And I remember that experiment because the researcher and their team actually asked me, hey, do you think there will be an effect? You know, those are the early days, 10 years ago, nine years ago. And I was thinking, huh, this will be an interesting experiment to do. Let's try it. He tried it and we found that.

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And then now there are a lot of studies on how time-restricted feeding or intermittent fasting actually helps brain health by improving sleep. And this is something that we had never thought.

Dhru Purohit Show

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Yeah. So this also relates to another question that I often get. People say, well,

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I'm healthy I already have the perfect body composition and why should I pay attention to when I eat and my answer is well we know there are few things one is even though you are healthy one thing is it can actually keep your brain health much better and in fact when we did our first study on humans and this was eight years ago 2015 the people came out

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So then we have increased acid production at night and less saliva to neutralize it. And that's one reason why people eat too late at night. Not all, some might actually experience more acid reflux than others. Right. So now in the next step in digestion is after the stomach is digesting food, it goes to the intestine and the intestine kind of has a peristaltic motion.

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And there are only eight participants in their study. And this was very early days. We asked, is it feasible for people who have been eating for a long time throughout their life, last 15, 20, 30, 40 years? Can they change that habit? Because this is a big issue in behavior change. Sure. Because we are so married to our old habit.

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Imagine, even for coffee, a lot of people, they cannot give up coffee. It's not that they're born with a coffee in their sippy cup. We picked it up along the way. But we got so used to coffee that we cannot leave it. So similarly, people who are used to snacking over a long period of time, the question is, can they change behavior? And in that study, there were only eight people.

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And again, this was funded by an innovation grant from the Salk Institute by a philanthropist. And when these eight people, they stuck to a 10-hour time restricting. So that means they were allowed to eat for 10 hours. They self-selected that 10-hours window so that that fits with their lifestyle. And they had to do it only for 18 weeks.

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That was the advice that, okay, so we'll do this study for 18 weeks. At the end of 18 weeks, we'll collect some data, and then you are free to go. And so they were free to go after 18 weeks. They were not even obese people. They were mostly overweight, BMI somewhere between 25 and 30, and the average BMI was 27. And they lost a modest amount of weight, 3.5% body weight.

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We didn't actually measure at that time body composition, whether that is fat loss or muscle loss, because it was a pilot feasibility study. But what was interesting was after a year, We were curious because in many behavior intervention, people actually can't change their behavior forever. It's not sustained. It's not sustained.

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And in fact, people who do weight loss trial means they try to reduce calories, change a different diet plan or get on a diet regularly. They actually gained back a lot of body weight that they lost. Many of the benefits actually disappeared. So that's why we are curious. We asked them to come back after one year, and then we realized that, to our surprise, they actually kept that weight loss.

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Even though it was a small weight loss, we thought that they would gain back that weight. They kept that weight loss. And we are curious. So we had a very standard questionnaire about their daily habit and other stuff. And what we were surprised to see was they said, all of them, they said it improved their sleep. They were less hungry at bedtime. and they're more energetic in the morning.

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And they said the reason why they continued with the habit was not because of weight. It was because how they felt, how they were feeling, that they were working at a higher performance level throughout the day. And that's the first time.

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This is where human studies are so important because when we're studying fruit flies and mice, we cannot ask the mice and fruit flies, how are you feeling this morning? The mouse is not giving me a high five.

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Yeah. And another thing, the difference between human and mice is actually we did an experiment where the mice had to eat nine hours, Monday through Friday. And then we gave them a cheat day. Weekends were cheat days, so they were allowed to eat whenever they wanted because the food was given 24-7 on the food hopper. And they actually don't learn the habit.

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So that means they continue to eat 24-7 in those two days. They're over it. The good thing is they still had a lot of health benefits, almost 80% of health benefits. From practicing the time-restricted eating. Just for five days. For five days. In mice. And that was actually eye-opening for me because I thought that all these benefits will go away if they cheat for two days.

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So that means it beats and sends that food slowly while the intestine is also absorbing nutrient. And that process almost shuts down during our sleep or late at night. So that means even if you have eaten food, it actually doesn't get digested, the nutrient doesn't get absorbed late at night. So this is a clear example how even very basic step of digestion has a strong circadian rhythm.

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And because, you know, when these mice are eating randomly, then they're also disrupting their circadian rhythm and other stuff. And that gave me hope that even humans, hopefully, if they try to do time-restricted eating, even for five to six days, that can have health benefits. So that key experiment in mice gave us hope. But in humans, it's very different.

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When we talk to people who have been trying, and most of our studies are 10 hours time-restricted. I'll get back to why 10, not 8, not 9, not 6, etc. They say that they get food hangover if they eat late. And this is something that our mice never told me. And then again, a lot of people, they actually, when I think of hangover, it's mostly alcohol.

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But then I came to understand this from people's point of view because they said, well, Food hangover is when you eat late and when you wake up in the morning you feel like the food is still there it's not digested and you feel groggy and you don't have appetite to eat and your whole morning is spoiled and it's almost like a hangover from alcohol but it's from food.

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And we realize that a lot of people who actually try this, if they eat late into the night, their body revolts and it reminds them, hey, these are the immediate bad things that you'll face. So that's something that we realize that in the human studies, that time-restricted eating has an impact on sleep.

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again we don't know why because sleep researchers essentially study sleep right nutrition researchers don't ask questions about sleep sure and this is a challenge for people like me because when we want to do a

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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experiment and most listeners when we think about health we are not thinking about only how to improve sleep or how to improve exercise or how to improve food in a day we have to we always think about all three aspects And it's very challenging to objectively measure all this stuff, even in mice. Forget about humans. We are not talking about humans. Totally. Yeah.

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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So this is where combining mouse research and human research actually helps us to go back. Now we know that, okay, so it improves sleep. Then we're going back and asking, okay, so what happens? Now, people who do time-restricted eating or mice that do time-restricted eating, Does their brain remember that sleep date when they get older?

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And that's a very fundamental question that we're trying to figure out in basic research. And then we go back and ask the same question in humans.

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This is where actually we don't know. My humble answer is we don't know. And this is where there is scope for research because Even when we do research on mice or fruit flies, we rarely study older mice or older fruit fly. The reason is very simple. Let's do the simple math. You know, a mouse is pregnant for 19 days and then gives birth. And then after seven weeks, the mouse is adult.

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And you can study this mice. These, you know, 10 weeks old mice are almost like a 19 year old human. Right. And the simple economics is a 10-week-old mouse will cost me maybe $50 to purchase from a reputed source that kept all the health records. And I get a mouse that is perfectly healthy with no disease, no infection, nothing. And then I can do some experiments.

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Now imagine a 24-month-old mouse is equivalent to 50 to 60-year-old humans. And that 24-month-old mouse will cost me at least $700 to $800 after factoring in how many mice I can purchase from a reputed source and how many of them will be healthy without any confounding disease that I can use in study.

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And that helps to make sure that our food is digested the right way. And the reason why everything shuts down in the digestion at night is during the daytime or when we eat. Just imagine, it takes a lot of energy, a lot of acid to break down food. Imagine that. kind of digesting that piece of sushi that you ate.

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Yeah. So that's the challenge. And so over the last 50 years of biomedical research, everything that we know comes from studying disease or disease models in young mice. We haven't actually invested that much to study what is aging. Very simple idea, why we age or when we age.

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If we think about a specific milestone, because we have to first think about what is the milestone that defines we have aged. For men, it's a little bit difficult to define. For women, it's very simple to define. Menopause is a very well-defined milestone. And menopause will happen somewhere between the age of 45 and 55. And the question is, why that happens? We still have no answer.

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Similarly, for most people, insulin sensitivity will begin to decline, say, after the age of 50. And the question is, why is that? What happens to our insulin producing cell? Is it the sensing mechanism? Is it the processing part? Or is it the production part? Or simply these cells, we use the word exhausted, but what is the definition of exhaustion?

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Can we figure out what is the molecular mark there that says these cells are exhausted? So very simple thing that we take for granted. We think that, oh, scientists must have figured this out. No, we haven't figured it out. We are flying in the dark. We are just trying different things.

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So I guess the next 50 to 100 years of biomedical research hopefully will be to figure out why we age, because age itself is the biggest risk factor for all kinds of disease. When we get older, we are more prone to infectious disease. When we get older, we are more prone to metabolic disease.

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Just 65 years of age, if we look at the stats, in this country, 90% of people above the age of 65 have at least one metabolic disorder. Either they have too much fat or too little muscle, or they are diabetic or pre-diabetic, or they have high blood pressure, high cholesterol, all these factors. And so age itself is the biggest risk factor, and we don't know why that happens.

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Even when it comes back to circadian rhythm, because we're talking about circadian rhythm, As I mentioned, our sleep quality degrades so that it becomes very difficult to sleep as we get older. And when we don't sleep, we are more prone to eating late at night and getting exposed to light that itself puts us into a vicious cycle. So I guess the simple way to think about our

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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journey through life is when you are young, you are almost like on a self-driving mode in Tesla because your circadian rhythm is robust. Just think about kids. You cannot keep kids sleep deprived from and keep them sleep deprived for five hours. Because when a five-year-old gets only five hours of sleep, then there are consequences for the entire family next day. Yeah, absolutely.

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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But just imagine that in our life, daily life, we organize our life around time. We think of the whole day, what time I have to get up, what time I have to go to school or send kids to school, and then what time I go to work, what do I do, and then in the evening, what time I have to meet friends or get back to home, what time we sleep.

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So if your stomach is digesting that piece of sushi, at the same time, it must be damaging some stomach lining. And that actually happens. So that stomach lining has to be repaired at night. So there is a different circadian rhythm starting from the brain. that produces growth hormone in the first couple of hours of our sleep.

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They will let you know. Yeah. So that's, I call it, that's in the self-driving mode. And then in the middle age, like from 20s to 50s, we're kind of going on cruise control, means we can, body can still manage to some extent if we take a little bit of care. But after 50, we're almost like in a manual drive mode.

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We have to pay attention to all these things because our body is not keeping track of when we should be sleeping, how long we should be sleeping, when we should feel hungry and eat, when we should stop eating. And this very fundamental question, why our circadian rhythm breaks down

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and cannot guide our body throughout 24 hours as we get older, that's also a big fundamental question that we don't understand.

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And although we are not growing after reaching adulthood in size or height, but actually we are replacing many of our stomach lining and many other cells throughout the body. And that happens only at nighttime. So again, there is another clock that kind of works with the digestion clock to make sure that during daytime we digest and at nighttime we repair. So these are just very few examples.

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Well, you brought up a bigger question. I mean, see, you brought up a huge challenge. One is, you know, if you want to create a culture of health, then of course, you got to tell that if you don't do this, what is going to happen? What are the consequences? What are the consequences? So if you do this, what are the good things that is happening?

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Because that drives us every day when you're thinking about our decisions. Our decisions are driven by, mostly by what are the bad things that are going to happen, right? Sure. Like the reason why I did not smoke was I knew if I smoked. Right, the negativity bias. The negativity bias actually drives a lot of... So that information has to go out so that people know.

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So just simple facts that how we have reduced so much of infectious disease is if you don't wash your hand... Here's all the consequences. All these consequences. And then the second thing is you offer information and then we have to offer... opportunity to sleep in this case. So how they can create opportunity to sleep.

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So this is where people can get all types of tips, including how to prepare to go to bed by not having bright light or food for two to three hours before going to bed. And then once you get into the bed, you brought up the temperature issue. And that's huge because our body actually cools down during night so that we can sleep. And when our core body temperature goes up, then we wake up.

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And sometimes, as you mentioned, the room temperature may be high or sometimes the bed itself can reflect back a lot of heat and we wake up. Then the question is, okay, so if you wake up, then what can you do? Yeah, if you wake up, what can you do?

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Well, the first thing is, if you're just waking up to go to the bathroom and coming back, Or if you're waking up in California, it's very dry. Some people wake up, they're breathing through their mouth. They wake up, take a sip of water, and then they're going back to sleep. So the bottom line is if you're waking up and staying awake for less than 15 minutes, then you should not worry.

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Then you're fine. Then you're fine. Just don't worry too much about that. You're in a good group of people who can... Only when you wake up and cannot go back to sleep for an hour, then it can be a little bit of worry, but at the same time, there is some context. Like, for example, people who take a nap during daytime, they're more likely to wake up because Their sleep debt is not there.

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They have already got a little sleep and then they're sleeping and then they're more likely to have less deeper sleep. But then if you wake up, then it's pay attention to what is going on, why you woke up. As you mentioned, sometimes it's the warm bed. And when I travel, there are many hotels where they actually don't have the perfect bed. So I always go for two queen beds.

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If one bed is warm, I wake up, I just go to the other bed. That's a good hack. Or you just roll over to the other side and sleep. A cooler bed. To cooler side of the bed. Yeah, cooler side. And as you mentioned, don't open to see your text or emails or anything. Your phone.

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That's the worst time to kind of do sensory stimulation because whatever you see, whether it's a good news or bad news, either thing will keep you awake. So they can wait. The world is not going to crash because you did not check your email or something. So I actually make it a point that I don't touch my phone until after I'm out of bed.

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But if we drill down, almost every single cell has its own clock and it has implications for how we should live, how we should organize our day.

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No, I just have it on do not disturb mode so that only if somebody calls me, it vibrates and I know that the only person who would call me during that time maybe in case is My sister, my mother who lives in India, and I know that if that phone call comes, then something serious has happened. Sure, sure. That never came. Yeah.

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But other than that, there is no... So then the question is, if you wake up... Vince, I must say that there are many times I also wake up and I cannot easily go back to sleep, so I have come up with my own hack. Yeah, what is it? What is your hack? Well, sometimes it's just...

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And a lot of the time we cannot go back to sleep because our mind is wandering and kind of we're thinking about different stuff.

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Yeah. But in those cases, you have to come up with your own coping mechanism. And my mechanism is to kind of, you can say, it's a silent meditation kind of stuff. I pay attention to my breathing and then I kind of count backward from 500. Every breath I take, I just count once, 500. 499. It's very slow. But then what I have experienced is I have barely, I have really gone down from 500 to 300.

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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You already fall asleep. Yeah. So, and you know, since one breath, one count, it's around 12 to 15 counts per minute. So by a few minutes, I'm... I lose count first, and then I realize, okay, so then I'm falling asleep. So that's one. And then in most cases, what I've found is there are cases, there are some time when I was allergic or maybe I was not coping with certain type of food. Okay.

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And I would wake up, and then I would realize that, yes, my... my digestive system may not be okay. My core body temperature is playing because my digestion is not right. So in that way, I have gone back to changing food and that actually helps.

Dhru Purohit Show

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Yeah. So sleep is a perfect example where the personalized precision health comes into play. Whatever works for you may not work for me. And then whatever. So this is where people this is a place where a lot of information about what helps, what doesn't help different people will actually help individuals to figure out their own way to sleep. I know we have the app called My CKDN Clock.

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Yeah, talk a little bit about that. And hundreds of thousands of people have downloaded the app. This is a research app. We don't sell any information. We don't sell any products. And we follow HIPAA compliance. So that means that all the data is de-identified. Yeah, anybody can download it. It's at MyCircadianHealth.com? MyCircadianClock.org. Let's bring that up, Tessa.

Dhru Purohit Show

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Yeah. So you were saying? And then people who are sharing, voluntarily sharing data, because this is, again, another thing. I'll go back to a little bit of how clinical research and how it actually impacts health.

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If you go back to, say, intermittent fasting or time-restricted eating, all the studies that were done, and you combine how many people were in those studies, it'll be less than 2,000 people. Wow. Okay? Out of those, maybe three or four studies, which are a randomized controlled trial, well done, they have less than 500 people. So just imagine that.

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all the scientists and all the podcasters and thought leaders like you, we are talking about results from 500 people. And most of them, would you say, is men? Young men? Yeah, in many cases, it means that it's mixed. Sometimes it's only female also. There are many, many studies. But the point is they're

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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very small number of small population who participate in clinical trials because it involves a lot of trips to the um clinical center and also it involves giving blood following a lot of instruction so we thought how can we capture more data from people there are a lot of people who are

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willing to share some of their lifestyle data, what they ate, how much they ate, when they ate, or what type of, what they're facing in sleep, how much they're sleeping.

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So we made this app where people can download and then for the first two weeks, we asked them to just log your regular habit, food, sleep, if you want exercise or pair your device or your phone with the app so that we can get your step counts. So now from there, we have a few hundred thousand people who have shared their data.

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And then what we think about, okay, so we ask every day, how was your sleep? And they have to rate whether it's good or bad. And then if they say bad, then we ask them, what are the three? There are three causes of sleep disruption or three major complaints. One is difficulty falling asleep. So you go to bed, but you cannot fall asleep within 30 minutes.

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Most people fall asleep within 30 minutes, some people cannot, and that's worrisome. When you cannot fall asleep within 30 minutes of going to bed, then you got to start thinking about some strategy. The second is fragmented sleep. You wake up too many times, or maybe one time, but you are staying awake for a long time, you cannot fall asleep. You cannot fall back asleep again.

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Third one is insufficient sleep. Maybe you are sleeping only five hours or six hours. It was perfectly fine. You went to bed. You went through all five hours of sleep. But in the morning, you had to wake up for commute or work or something else. So you're putting the alarm clock and you're waking up. So these are the three major complaints about sleep. And then we ask anything else.

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What caused it? What we find is surprising that's never discussed. One is a lot of people actually have a pet who sleeps with them. And the pet can wake them up. Yeah, dogs wake up so many times or roll around at night, have dreams, have nightmares. Or the cats, they actually, cats are crepuscular. So that means they are more active in the evening and also more active in the morning.

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So before you wake up, cats want to have their food. So we're also seeing that a lot of people have pets in the room and they feel like they're babies. And I respect, yes, pets actually give us a lot of emotional comfort and all that stuff. Right, they feel like a family member. They are family members and actually many pet, they describe themselves as pet parents.

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So that's fine, but you got to also keep in mind that for your health, better health, and also your pet's better health. You should also just like you have to train your baby to sleep through the night and put your baby in a crib. Most people do. Similarly, have your love for your pet outside your sleeping hours. That also helps.

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And you also mentioned like if you're sharing a bed with somebody and then the other person is having sleep issue or snoring, that can also affect your sleep. And pay attention to that. I mean, I also have some little bit of interest in architecture. So I go to many old houses of people and there are quite a few very nice, well-preserved houses in India.

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LA, Los Angeles area from turn of the 20th century. And if you go to those houses, what was interesting, what struck me really was how in those houses, the couple slept in separate small beds. They slept in different rooms, yeah. either in separate rooms or in separate beds in the same room.

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And going back, actually, I realized that even my grandparents, they had two separate beds in their room to sleep. So this is really interesting to sleep in the same bed. Of course, it's very difficult nowadays with the rental price so high and a lot of people cannot even afford to have a one-bedroom apartment. It's a challenge, but this is something if you can do, think about it.

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to see whether you can sleep in a separate bed. It's not taking away a lot of your love for your partner, but actually it's a lot of respect for the other person's sleep need.

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And when people sleep well, one thing that we have to also acknowledge is a lot of family stress comes from someone not sleeping enough and not coping with the stress that comes with raising kids, having a job, and coping with your partner.

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Yeah, exercise does improve sleep. People who exercise regularly, they always report better sleep than those who don't. Or people who have never exercised and they start exercising, they also report that they are sleeping better. And a lot of the time we think that by exercising you are just tired and you can sleep. That explains why people who exercise can sleep.

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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But what is the molecular definition of being tired? So that's what we are thinking. So right now what we know from basic circadian rhythm biology is these are these type of experiments we can do in small animals in laboratory. So this is, again, another really nice experiment well done by another researcher who is at UCLA, Katema Paul. What their group did was we have what we call clock genes.

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So just like genes give you eye color, hair color, skin color, et cetera, there are also genes that we all have that help us to tick this 24-hour clock. So that means if we have a mutation or if we don't have that gene, actually, I don't know anyone in living human who doesn't have a complete set of clock genes.

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They might have a slight tweak so that they may be designed to go to bed early or wake up a little early, but there is no human that we know of that has completely lost all the clock genes. But to understand the impact of this clock in laboratory, we can make mice that don't have a clock gene. And these mice sleep like babies.

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That means they sleep for one or two hours, wake up, eat, and then go back to sleep. So they don't have any circadian rhythm of sleep or wakefulness. So now this group did a very interesting experiment. What they did was they made a mouse that did not have any clock genes. So the mice were waking and sleeping at random time. But then they made a trick in that way.

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Only in the muscle, they had a clock. Not in the brain, not anywhere else. Only muscle clock. And to their surprise, what they found was these mice now could go to sleep and wake up like a regular mouse. There is no difference between a regular mouse that has circadian clock everywhere in the brain, muscle, gut, everywhere, versus a mouse that has clock only in the muscle.

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It's as if the muscle clock is in control of sleep-wake cycle. And again, this is a crazy experiment that they did, and we still don't understand what is the signal from muscle that's actually telling our brain to sleep. So we started a new set of experiments, a new line of research essentially in my lab.

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We're looking at what are the signals from muscle, tendons, ligaments, all the conductive tissue in response to exercise that affect our gut microbiome, our digestion, our metabolic health, brain health, even depression, anxiety, etc.

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What you're finding is when mice exercise, we can take specific muscle type, what we're finding, there are at least 400 or 500 gene products, like proteins, hormone-like molecules that are secreted from muscle. And that may explain, and maybe in those 400 to 500 things that we have now found, one or two of them may be involved in the sleep regulation.

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And why this is so exciting is, in the past, we had no idea that muscle plays a role in sleep. And second, just like any cell, muscle cells also have 25,000 genes. Out of 25,000 genes, which ones are good? Which ones may be the candidate? We didn't know. With this simple experiment and doing very molecular studies, now we have narrowed down from 25,000 to 200 to 300.

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And out of those, now we can go back and figure out which one or two may be important, and then go back and see whether those ones respond to exercise and whether they mediate the effect of exercise on sleep.

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Then now, to close the loop, we can go back to older mice and ask, if old mice exercise a little bit, can they also improve their sleep and the brain's capacity to calculate how much sleep they have, and can they go to sleep?

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And if we find those specific hormone-like molecules, then it's also possible that in future we'll have a new type of medication or drug that is more specific for the sleep effect than Ambien or anything else that we have. So this is, again, an exciting field.

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And going back to your original question, yes, muscles, activities during afternoon, again, we'll go back to why afternoon exercise, but that seems to improve sleep. The other thing that also improves sleep, again, this is a surprising finding. It's a collaboration, again, with Horacio de la Iglesia from U-Dub.

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What we found is people who have exposure to outdoor light, daytime bright light being outdoor, somehow, we don't understand why, their nighttime melatonin goes up and they can sleep better. And this is something that he did with three living people outside. But I went back to literature and I figured out that no, actually people knew this for almost...

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Some scientists had done this experiment almost 20 years ago where they had people inside the lab. This is where the lab research is also important because one might say, well, we don't know outside what happened. These people are walking around. Maybe they had some food, something else that boosted up their nighttime melatonin.

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So this research, which was done in Japan, where they brought healthy volunteers, and then the same volunteers got either dim light during daytime or bright light. That is 5,000 locks of light. We'll get to that. And those volunteers who got 5,000 locks of light during daytime, they had higher melatonin at nighttime.

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We still don't understand why, but at least we know that daytime bright light improves your nighttime melatonin and indirectly might improve your sleep.

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So this one was anytime of the day. Anytime during the day. Anytime during the day.

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No, the skin is not that important for circadian rhythm. It's actually the light that goes through the eye that impacts our brain health and circadian health. And you don't have to look at the sun. That's very important because going back to when I said 5,000 lux or 10,000 lux, One lux is very dim light. One lux is roughly in a very dark room at nighttime.

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If you have one candle light and you're sitting roughly two feet away from the candle, the amount of light at your eye level or your face level, that's one lux of light, roughly. Mm-hmm. And right now in this studio, I would estimate there is somewhere between 500 to 800 lux of light. Okay.

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Now, if you open that large window and if we sit right next to the window, that'll be also 1000 lux of light. Now the regular people who are going to different stores and buying, almost all of us, we go to stores and buy grocery, buy medicines. If you walk into a regular grocery store these days in the evening, that's somewhere between 1,000 to 1,500 lux a flight. Mm-hmm.

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And if you walk inside a 7-Eleven corner store or Walmart, then that's also 1,500 lux of light. And then on a cloudy day in L.A. or cloudy day in London, outside there is 5,000 lux of light. Right. Just imagine, even when you walk into that grocery store, you might be feeling this is so bright, but in a cloudy day, we have four times more light outdoor. Sure.

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So that's why getting outdoor, even on a cloudy day, or if you are even sitting on your porch or maybe outdoor under a tree, that itself is enough light.

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Yeah. But another big effect of light is light is the best antidepressant because light also suppresses many brain functions that are linked to depression. And in fact, this is well known for more than a couple of hundred years because all the people who live in the Nordic countries, so that's Sweden, Switzerland, and all this, Norway,

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They know that in wintertime, when it's so dark outside, when it's almost 24-7 dark for a few days, they barely get two to three hours of daylight, that not having enough light, because it's also cold in winter. Not many people are going outdoor. That causes depression. So that's why there is this term of winter blue.

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That means in wintertime, when people don't get enough light, this is what happens. And we think that we are getting enough light. But actually, unfortunately, there are not too many smartwatches that can measure light and tell you how much light you're exposed to. I wish there were even eyeglasses.

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Yeah. So we do put these watches that are FDA approved for measuring light. And of course, these are on wrist watches also on the wrist. So that means we're not measuring how much light is at the eye level. Sure. But what we're finding is even in San Diego area, which is considered- Where your lab is and everything. Where my lab is.

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And people always think sunny San Diego, sunny California, people are all happy and all that stuff and people are outdoor. But what we find is a lot of people, I would say more than 75% of our participants in our studies who wear these watches, they get less than one hour of bright light outdoor. And me included in some cases.

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One hour at least. One hour at least. So 75% are not even getting an hour. Getting an hour. Because just imagine, we are mostly indoor. Most of us actually, you know, in California, we don't even walk to the next bus stop. We walk from our kitchen to the garage and then get in the car, drive over. And when you're driving, we also, a lot of us, we have sunglasses. Sure.

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And sunglasses can reduce light by sometimes by 80 to 100 volts, depending on which kind of sunglass. And, you know, I'm a light fanatic, so I had light sensors with me all the time. So I realized that inside my car, I get maximum 5,000 to 10,000 lux of light because you're not getting direct sunlight. Most of the time the sun is above.

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And on top of that, if I'm wearing sunglasses, then the light at my eye level is less than 500 lux. It's almost like staying indoor in a closed office room. And then I reach my work and then I'm walking from there to the building. That may be the time when- You have some exposure. Some exposure because the outdoor light, if it is sunny in San Diego, then it's 100,000 lux of light.

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Even if you take 95% of that, I still get 5,000 lux. So I realized that, yes, that was what I was getting. And there was a time when I actually, I was on a safari outside Nairobi. And that's the time when my watch clocked eight plus hours of bright light throughout the day because I was outdoor in a safari vehicle with all the open doors and windows. Sure. That's the one time.

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And then when I travel, like for example, when I'm in India visiting my folks or I'm outdoor, that's the time when I get two to three hours of bright light. But back in San Diego, that was what was happening. And then I said, okay, so I'm not wearing sunglasses anymore. So I stopped wearing sunglasses only except when I had to go to the beach.

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So when my daughter was young and I had to go to the beach for a couple of hours or something, then of course you have to wear sunglasses. To protect your eyes, right. Or if I'm driving a long distance and there is a chance that there will be horizontal sunlight like at morning or evening. But other than that, for daily commute, I'm sorry, this is bad for sunglass industry, but...

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Still, you should have a pair of sunglasses, I'm not saying. Right, right.

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It is worth it. And this is also another time when people are talking about flexible working hours or hybrid, and they're staying all day in their home. And one thing they should be doing at least is in the morning. Another thing is in the morning, you talked about morning light. And in fact, the morning light is the biggest synchronizer of our internal clock and outside time, because

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A body has to learn. One is the morning time. Of course, it is anticipating, it's knowing, but it needs that reinforcement. So, you know, sometimes, particularly kids, college kids, during COVID time, they were always indoor. They were doing everything over Zoom. And a lot of people who used to go to office, they were working on Zoom.

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So similarly, every single cell in our body has its own 24-hour timetable. That means the cell has to decide, okay, this is the time I have to make energy. This is the time when I have to recycle. This is the time to divide and rejuvenate.

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And they always complained about this solitude, feeling lonely, and very poor brain health. So I always wondered how much time they were actually spending outdoor, because there was a time when we kind of built the habit that you have to be indoor because everything is... bad outside dangerous outside and infrastructure change so that we can be just working in our PJ all day.

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And there was really that was and we are now talking about the lingering effect of COVID And we're thinking about some virus or long COVID. Of course, that may be some part of it. But the point is, we changed our habit to stay indoors. So even now, my daughter is in college and I always tell her that, okay, so after you wake up, just make an effort to go outside and walk for 10 minutes.

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It's not one hour of walking or 30 minutes, just go. She's a resident advisor, RA. So I said, yeah, so in the morning you take the round, like you go around your building and come back and see. And she says, wow. I love this fresh air. I love this fresh air.

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And it's almost like a switch because, you know, so once you go outside, and even I have experienced, I also experienced this because I wake up and go outside just to check the plants or, you know, to... One weird thing that means these days, everybody is reading everything on digital, but I still love the feeling of having a physical newspaper because there is no distraction.

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There is no advertisement on the side. There's nothing popping up. I wake up, open my garage door, go outdoor to pick up my newspaper and that itself, just going outdoor, getting that fresh air, seeing what is the temperature, sensing the temperature outside and seeing that light.

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It's almost like a trigger point that just tells my body and brain that and even though I'm tired or something and that five or ten minutes outdoor, It does magic. Makes a huge difference. Huge difference. So these are the small things that people can. You don't have to get a gym membership. You don't have to buy extra food. So that's why I'm saying light is the best antidepressant.

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It's a mood switch. It's plentiful. You can still have in your PJ. You can go outside, just open the sliding door and step outside or go to the balcony and Stand there, drink your coffee outside, drink your hot tea or read your newspaper, whatever you want to do.

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Yeah, so light any time of the day is very important. Because it's always just syncing your circadian clock. Yeah, yeah. So that's one aspect. And second is the mood also improves because we also know that people who are more depressed or those who experience anxiety, they also have sleep problem. Either they tend to sleep too much or they sleep less because of the anxiety and depression.

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They cannot fall asleep easily at night. So it has an indirect effect. And this is also important because in our lifetime, I'm not talking about at any given time, in our lifetime, almost 80 plus percent of us will experience some kind of depression or low mood.

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It may be, it's not that clinical depression, but, you know, anytime there is a bereavement, whether it's your pet, whether it's someone you love, or whether it's Your friend, somebody is having an accident or somebody is struggling with cancer or some kind of bereavement will cause us to feel a little depressed. And a lot of us will actually have clinical symptoms of depression.

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15% to 20% will have in our lifetime some clinical symptoms of depression. And this is where being outdoor, having that daylight, and as you said, layering different habits. This is where, okay, so the first thing is to get outdoor. Second will be, can you combine it with exercise? Walking. And then the third one, can you walk with your friend or somebody else?

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That also combines this societal, social support system, social network. And all of these things can be layered. And these are free. These are some habits that people can build.

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Yeah, so just like every cell has clock, our muscle cells do have clocks. And that means our muscle cells might have a peak time when they should perform. But at the same time, we have to also think of movement or exercise as what we call the emergent property or a combination of many things working together.

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So for exercise, our lungs have to work much better so that we have better oxygen inhalation and use of that oxygen to oxygenize the body. Our heart should be also pumping blood well without getting stressed. And there are many other factors that have to kick in. Similarly, our joint or the muscle temperature has to be a little bit warm so that there is better flexibility

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Many of us, we experience that our joints are a little stiff in the morning, but they get much more flexible towards late afternoon. So these are many different things that actually change in a way that our body is more likely. So there are two things. One is our body is more ready for exercise.

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joints are more flexible, our heart is pumping much better, our lungs are functioning at a higher capacity, and finally our muscle strength and coordination are also much better in the late afternoon. So if you combine all of these, then it makes sense that the late afternoon exercise is better than morning exercise of the same quality and quantity of exercise.

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Yeah, so, you know, acid reflux and indigestion, another thing that we talked about. And again, going back to the same digestion process, one more thing is, you know, when we eat something, most of our food does have some carbohydrate, unless you are just eating ketogenic diet, which is very difficult to do for long term. But for every regular person, we consume some carbohydrate.

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Then there is another reason of late afternoon exercise having benefits. That is its impact on blood pressure and blood sugar. And why this is important is in this country right now, in the U.S., almost 50% of adults are either pre-diabetic or type 2 diabetic. And in California, definitely more than 50% of adults are pre-diabetic or type 2 diabetic.

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That means their blood sugar level remains high. Fasting blood sugar level and also post-prandial blood sugar level may be high. That reflects in hemoglobin A1c being higher than 5.6, 5.7. And then we also know that more than 50% of adults in this country also have either mild or more serious blood pressure, higher blood pressure.

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And what is interesting is there are a lot of papers dating back to 70s, 80s, 90s, showing that we know that exercise benefits blood pressure and blood sugar, no doubt about it. But what is interesting is late afternoon, early evening exercise is much more potent in reducing and normalizing blood pressure than morning exercise.

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And research in the last five to seven years have also shown that the same high-intensity interval training, if done in the morning or afternoon, on the same individual, this is very important, this is a crossover trial, the same individuals who are type 2 diabetic and who are wearing continuous glucose monitors so that we can see results,

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Glucose level 24-7, when they exercised in the morning, their blood glucose level, 24 hours blood glucose level, either remained the same or actually worsened. They raised a little bit higher. And the same individuals, when they exercised in the afternoon, their 24 hours blood glucose actually reduced significantly.

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This was done on a small number of individuals, and now this study that came out of Karolinska Institute in Sweden, they're planning a bigger study. But now we are seeing it makes sense for a few reasons. One is, let's go back to what I mentioned at the very beginning, that how our pancreas, is much more efficient in producing insulin for the first half of the day.

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And that means for the second half of the day, for the same amount of food, it's actually producing less amount of insulin. And that means there is All this food that we're eating late in the afternoon or early evening needs a little bit of extra boost for that glucose to be absorbed in muscle because our muscles are the biggest organ in the body and they also consume a lot of energy.

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So what is interesting is late afternoon, early evening exercise or any time exercise actually helps our muscle to absorb a lot of glucose and use them with no or minimum help from insulin. So that means when our insulin levels are low in late afternoon, then physical activity can make good of that low insulin production or low insulin sensitivity.

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So that's why I would say almost everybody should think about, even if you're going to gym in the morning, that's fine. But in late afternoon, early evening, if you have pre-diabetic or type 2 diabetic, and I'm sure many of the listeners either they themselves or they know someone in their household.

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That means that's broken down and that increases blood sugar level and the pancreas has to adjust that sugar by producing insulin. And pancreas does have a circadian clock. So that means it actually doesn't produce enough insulin late at night. So that's one. And then the second thing is the sleep hormone melatonin.

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who is fighting this pre-diabetes or type 2 diabetes, they may start thinking about switching that exercise either before dinner or after dinner. And it doesn't have to be intense exercise. And what we have seen, even people who are just taking a brisk walk for 10 to 15 minutes before their dinner or after their dinner, they also see some benefit. So start from there. Yeah.

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Is that a fair assessment? Just get some exercise. Just get some exercise. Some exercise and then you can tweak long term. Yeah. Great. I love it. Yeah. You know, you talked about performance and actually the history of afternoon exercise or circadian rhythm dates back to 80s when...

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Some researchers actually had the curiosity to see what happens in the late afternoon when West Coast team flies to East Coast and plays Monday night football. Interesting. So these guys, they may be... They are playing too many games in a season, so they don't have the luxury of flying to East Coast and waiting for seven days before their game.

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So they play, suppose, a Sunday, and then Monday, if they're playing, most of the time the games are going until 9 or 10 at night. And 9 o'clock or 10 o'clock at night in the East Coast for the jet-lagged West Coast team is actually 6 or 7 in the evening, which is at their peak performance time. Peak performance.

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that goes up at night, and that's why people who have sleep problems, they think that they can sleep well by taking extra melatonin, and I'll get to that, but melatonin actually has another brick on insulin production, because melatonin makes the pancreas less sensitive to glucose level in our blood, so the pancreas cannot sense accurately how much glucose is in the blood, so it cannot produce or release enough insulin.

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So somebody went back to getting the travel record and game records of 25 years of NFL, and they figured out that the chance of West Coast team winning against the East Coast home team

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Home court advantage. If they flew on Sunday and played on Monday, West Coast team has an advantage, has a higher chance of winning. So all the sports battles outside. Listen. Everybody's going to Vegas. If you can figure out when your team is traveling and when they're playing, from which time zone to time zone, actually that particular paper compared that against Las Vegas odd score.

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And they found that if you know the travel date, And when your team is performing, you can beat Vegas. I love it. That's great. And this has been now repeated again and again in NBA and other games. And that has led to many elite athletes planning their travel, when they should travel or when they should practice.

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So for example, if you're competing in Olympics, it's actually a huge challenge because sometimes, The your qualifying hits in the morning, whereas your final or semifinal is in the afternoon. Right. And this becomes very tricky when they should practice and when they should shift their security because. You know, for you and I, it doesn't matter.

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One day I can be slow for maybe by five or 10 seconds and it doesn't matter. But for those athletes, even fraction of a second actually matters. So this is a clear example where actually the timing when you trend, when you travel and when you're competing has a huge impact on whether you get the gold medal or you're out.

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Yeah. This graphic essentially says that if you exercise, then you risk for many types of cancer, starting from breast cancer, colorectal cancer, endometrial cancer, gallbladder, kidney, multiple myeloma, ovarian, pancreatic, all this cancer risk goes down. Yeah. And now let's think For a second, on this graph, there is no cancer of the muscle. You actually never see cancer of the muscle.

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Interesting. Muscle constitutes the biggest part of our body, but yet it's immune against cancer. And we don't understand why, for some reason, muscle cells are very effective in defending themselves against cancer. Then the question is, Why is that? Are there some intrinsic factor inside the cells or they actually secrete some anti-cancer molecule that protect themselves?

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And I guess we still don't understand why. My guess is it's the combination of both. Right. And so that's why there are a lot of people who are actually interested in seeing when we exercise, what are the factors that are produced from the muscle? And if we take those factors and screen them against cancer cells, maybe we'll find a factor that is protecting against cancer. So that's why.

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The idea is, yes, when you exercise just in regular, without exercise, even in sedentary people, we never see muscle cancer.

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So now you combine these two, what happens is when we eat late at night or very close to bedtime, then there are at least two or maybe even more things that are playing against digesting and absorbing that glucose correctly. One is insulin production itself has slowed down.

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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Yeah, it's the biggest user of glucose. It's the biggest producer of reactive oxygen species because mitochondria have to work.

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And this is a conundrum because, and they also have multinucleators. So the cells have multiple nuclei, which again is a no-no for any other cell types. And at the same time, somehow the muscle cells Even the sarcopenic old person is not getting muscle cancer. So even people who have a gene mutation that causes cancer, that gene is mutated in all cells.

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That should cause cancer in any type of cells. But even in those cases, even if in mice we pump up the activity of cancer-causing genes, we never see cancer of the muscle. And actually, there are two kinds of cancer of the muscle, and also there is some few exceptions, but mostly in fat cells also we don't see cancer of the fat. Very few cases that are called lipoma. So...

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I think these are the two organs and the resistance to cancer gives us hope that we can understand a lot about what protects these cells and when we exercise what muscle cells produce that reduce the risk for cancer. And, you know, there might be multiple direct and indirect mechanisms. One is, as we said, people who exercise, they also have much better sleep.

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And we know sleep disruption alone increases risk for cancer. So that's an indirect mechanism. It has nothing to do with what is secreted from muscle that is acting on cancer cells. But at the same time, I think there has to be a lot of research on understanding why muscle cells are resistant to cancer. Yeah. And why physical activity increases resilience against cancer.

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And this is something that we have seen again and again. Cancer is terrible. You don't know what is the outcome. You don't know what will be life one month or one year. And then the chemo itself causes chemo fog. Many cancer medications have very serious adverse effect.

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But what is now becoming very clear is people who are going through chemotherapy or cancer treatment, if they can exercise, that accelerates their prognosis. So that means they can get better sooner. And it can also reduce the adverse side effects of many of the cancer drugs.

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So this is a very new concept in science, and this has the potential to impact our daily habits, and it has the potential to increase efficacy of medications that we take or supplements that we take on a daily basis.

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And second, if there is melatonin that's rising, and actually two hours to three hours before our habitual bedtime, our pineal gland starts to produce melatonin. So that means within two to three hours before bedtime, if we eat, then that melatonin can inhibit, can desensitize the pancreas so that it's not producing enough insulin.

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Because on a day-to-day basis, what you really want is reduced chemo fog or reduced stress from just going through the treatment. And then the second thing that you want is your treatment should be more effective and it should give you much better outcome. And the third one is actually coming back to play. So return to play.

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So for example, right now in the US, there are nearly 16 million people who are cancer survivors. They survived cancer, but we know that many cancer survivors also face other problems.

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Because during the cancer treatment itself, either due to the direct effect of the drug or something else, the disrupted lifestyle that they have to go through, unfortunately, that causes many changes to their cardiovascular system, their insulin regulation system, brain health, and they're at a higher risk for cardiovascular disease. They're also at a higher risk for type 2 diabetes.

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So in those cases, again, cancer survivors benefit a lot by exercise and also time-restricted eating or intermittent fasting.

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Yeah, so there are two things here I want to highlight. One is, what is our personal risk for cancer? And what is the likelihood that if we take 100 people and follow them throughout their life, how many people are more likely to get diagnosed with cancer? And that number is pretty high. It's 42%. Yeah. So close to 42% of us will get at least one cancer diagnosis in our lifetime.

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And in that context, always what we want to do is reduce that risk. And if we get cancer, then we should accelerate that cure. And in that context, when we talk about 30 minutes of exercise, people may be thinking, well, do I have to exercise every single day? If I miss one day, then what happens? Is that an exercise debt? Can I pay that debt in the weekend?

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Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And the answer, again, there was another meta-analysis. Of course, it was not connecting with cancer risk, but what it essentially showed was the metabolic health benefits are still there if you are a weekend athlete. So that means if you're getting that 150 minutes of exercise over Saturday and Sunday, you're still getting most of the benefits of exercise.

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So these two can work together to first thing that will happen is you might have higher level of blood glucose level. And this is something that has been observed since 1970s. Even, in fact, endocrinologist would take healthy people and fast them for 10 to 12 hours and then give them a bolus of glucose either in the morning or after 10 to 12 hours of fasting.

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very early childhood or even newborn babies. So one thing that has happened is, you know, there is a lot of light in our home and that light also, although babies don't have, we think that babies don't have circadian rhythm because they wake up and cry and every two to three hours they do actually have a circadian rhythm. Every cell in their body has circadian rhythm. They do something else.

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They actually help babies grow. and be healthy. And the biggest impact of that circadian rhythm disruption unfortunately is among preterm babies. Babies who are born before they are mature enough to be born naturally or after full term. And we know that preterm babies stay in the NICU, neonatal ICU, for several weeks. And that's a huge stress on the parents and everybody.

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And we also know that many preterm babies don't fully develop. Sometimes they live the rest of their lives with some issues, whether it's the vision issues, whether it's the brain maturity, metabolic health, etc.,

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So what is interesting is since we did not know the impact of circadian rhythm or how light and darkness affects our circadian rhythm, almost all NICUs all over the world were actually lighted 24-7. Yeah. And that constant light, although the babies are closing their eyes and they're not looking at the light 24-7, still they open their eyes and get that light.

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So there was a very simple study done in Mexico City. Again, these are some of the really outside-the-box experiments. Somebody read about our blue light sensing protein melanopsin that we discovered more than 20 years ago and how it regulates circadian rhythm. And one key aspect of this light sensor that senses light and resets our clock is is it's actually less sensitive to dim light.

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So that means people might have experienced when they have candlelight dinner, they feel sleepy. Or if you have dim light at night, or for example, if you went camping trip and you have a little bit of light, you fall asleep. There's still some light, but it's dim enough that you start to feel a little sleepy.

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Yeah, because that dim light is not bright enough to activate this melanopsin system, this blue light sensing system that resets or disturbs our circadian clock. So this researcher, he came up with a very simple idea that what if I don't have to actually switch off light in NICU, but dim the light?

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And still he got a lot of resistance from doctors and nurses because there has to be bright light to see everything. We're going to make mistakes. Something bad is going to happen. And that's a genuine concern. So that's why he came up with a very simple idea that he would just partially cover the creams with a blanket so that at least on the head level, because again...

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The idea is all the light that disturbs our circadian clock actually goes through the eye, not through our skin. And in fact, many preterm babies need enough light shining on their skin to break down bile acids and many other things so that they can be healthy.

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So the compromise is he just put a kind of a semi-helmet-like cover on top of the head so that at the eye level, the light is around 20 lux. So like having 20 candles in a room. Still relatively bright, but it's not enough to disturb. And during daytime, they had the regular light that was in the NICU.

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We did this study on 50 or 60 preterm babies, and what we found was babies who went through this simulated dim light and bright light, those babies were released from NICU because they grew much faster. They achieved their milestones 13 days before the control or standard of care. Wow. One day of NICU care in this country, I'm sure, must be more than $15,000 a day. It's expensive.

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the same bolus of glucose or sugar in the evening. What they found was the same healthy person may be diagnosed healthy in the morning, but may be diagnosed as diabetic because this person's blood glucose goes pretty high and doesn't come down easily.

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It's very expensive. So we are talking about at least 10 days of NICU care that is saved by doing this simple light-dark cycle, right? Light and dim light, not even dark. And in this country now, in 2022, 2023, one in 10 live births is a preterm baby. So that means 385,000 babies are born preterm. In fact, anyone who is listening, they must know someone who had a preterm baby.

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And this is some practice that can be implemented. In fact, I hear that in Mexico City now this has become a standard of care in many of the NICUs. So they implement this day and night or bright and dim light cycle. And just imagine, if we can delay, if we can reduce hospital stay in 385,000 preterm babies in this country in one year, so that's 3.8 million NICU days.

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That's a saving that will pay for all circadian rhythm research ever done. in this country.

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Also, the parents are much more happier. So this is one simple... So many of the security and rhythm research implementation is either... free of drugs, free of pharmacotherapy, or it needs very simple change in our standard of care. So now, if you think about the next step, since we are in the NICU, let's go to ICUs.

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Almost all ICUs have continuous light, and also in ICU, since we did not know the importance of circadian rhythm or sleep, An average ICU patient in this country gets less than five hours of total sleep in 24 hours.

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So this is another example where people who are thinking that they can get away with food at night, although we are not walking around with continuous glucose monitor, all of us, but some of them, And this is a common theme that we are finding.

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In fact, if you take everything that's done in ICU, constant light and constant frequent poking and taking blood samples, if you do that to a healthy person in the normal setting, that will actually meet the definition of criminal torture. Yeah, that's crazy.

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And if you go to International Criminal Court, those things that all countries have signed, that if they capture a prisoner of war, they cannot torture them that way. What we do to our ICU patients.

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Pretty much we're doing everything else. Everything else. And still, we haven't implemented a better care in ICU. And what is the impact? Because we know that one in three ICU admitted patients will develop delirium. They'll have no sense of time, no sense of where they are, no sense of context. And a lot of patients actually want to get out of ICU.

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They will say that, well, I am ready to live with all this pain, but please take me out of ICU. And so that's one challenge, that we can improve the health of ICU patients by implementing some kind of circadian lifestyle. And there is context to it. So for example, in the early days of COVID, when we had the first COVID drug,

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If you look carefully about the clinical outcome, it actually did not reduce death. What it reduced was ICU stay by five days.

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So at that time, since ICU beds were so scarce and we wanted those ICU beds to be free so that we can treat more patients, even reducing four to five days of ICU stay, literally if you think about the monetary value, that was almost $70,000 to $80,000 of savings, and then the drug was costing only $5,000, so it made sense.

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So in that context, now if we think about, can we implement circadian lifestyle in ICUs? That can be done in this country, globally, everywhere. How many lives we can save? And now if we think about who are the patients who are likely to end up in ICU, these are mostly patients with sepsis, patients with very serious accidents and other conditions.

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In the US alone, there are 15 to 17 million people who get diagnosed with sepsis and have to be admitted to the ICU. And of course, the data is not very clear because the cause of death may be for many different reasons and there might be underlying conditions. But most people will agree that nearly 20% of people who get sepsis, they're likely to die within two months.

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And then those who survive, they also have a lot of comorbidities for the next one year or so. Now the question is, okay, so can we make a dent by implementing circadian lifestyle, lighting, darkness, or even practice in ICU? And also once they're released from ICU,

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Can we implement some kind of circadian sense, whether it's time-restricted eating, but I'm not saying that they have to eat for eight hours, but even if they eat for 12 hours among post-ICU patients, and if their sleep is taken care of, because when they come out of ICU, it takes them many weeks to actually get back to a regular sleep schedule. Sure.

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And so this is where this is another place where we can have bigger bang for the buck for the attempt. So now you came up, you also asked what about, you know, for school start time, for example, since 1950s, every year, US high school students were losing somewhere between 10 seconds to 30 seconds of sleep.

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So when they sleep 34 minutes more by extending or delaying school start time, we're essentially making our kids sleep as their grandparents were sleeping in the 1950s. So this is another big... Big win. Big win. The other thing you brought up is workplace. In any organization, less than 5% of people actually have a window.

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So a lot of people actually work indoor without having access to daylight. And then the question is, can we change architectural design to bring light into the house? And again, this is another area where I go around and put light sensors in different houses, buildings, dorms, etc. And what we find is a lot of the buildings are actually not designed to bring light. But

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the good thing is glass is the best way to bring light indoor because if you have large windows then you can bring light and glass manufacturing has gone through tremendous progress so now glass has become a load bearing factor in new buildings so that's why you see a lot of big high-rise buildings you still see glass big glass walls outside because Of course, they're not as strong as concrete.

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You cannot build a house with glass, but still it has become so strong that you can afford to actually have bigger windows.

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Yeah. So this is another area where we can actually go back to our ancestral living in the sense that although we cannot go outdoor, can we bring daylight into our workplace? And we are seeing a lot of work in that area. There are many large architectural firms in this country who are paying attention.

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And in fact, at Salk Institute, we do have an organization called Academy of Neuroscience for Architecture. The idea is whatever we have learned from neuroscience, can we bring that to architecture? Because our brain resides inside built environment. And whatever affects our brain can be, some of them can be designed into our built environment to improve brain health. The idea is very simple.

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So for example, we all like high ceiling. We don't know why. But our brain likes high ceiling, and that's a very simple thing that can be implemented. Similarly, the sense of light actually gives us a sense of time and sense of direction. So, for example, if you close all the windows in this office and you sit here,

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And not only you lose the sense of direction, because now looking outside, I know which side is east, west, where the sun is coming, but it's also giving me a sense of time. If we close all the windows, then I won't get the sense of time.

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And why this is important is if you look at many new apartment buildings and, you know, nowadays it's very hard for new, the Gen G or the young people to actually buy a single family detached house. Most people are buying or renting or living in a high-rise building with apartments and they have very little light coming through. And on top of that, they put heavy curtains and blinds.

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So there is no sense of light. There is no sense of time. And that is also driving why we tend to stay awake late into the night. Just imagine, if you go to Vegas, most of the hotels, most of the casinos, they don't have windows. Right. They don't want you to know. And once you are there, you won't know the sense of time. You can stay awake throughout the night if the lights are on.

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They will bring you food and other things. So that's why it's very important to understand how sense of light, sense of time are interconnected that affect our circadian rhythm. And this is when new building architecture, new building design, which might suggest that you should bring X number of locks into the building for X number of hours will help.

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In fact, we are also working with various organizations that are involved in building design and also well-building code to now bring up this idea of circadian lifestyle encoded in building design so that there is a sense of light. People should have access to light, period. Right. And we know that a lot of people may stay indoor because of injuries or because of old days they cannot go out.

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Yeah. And also since it's the time when insulin production, it's not that insulin production has shut down. It's actually there is a trickle of insulin that comes out and it continues for a long time because it has to work hard to get the glucose absorbed. So then your insulin level remains high in the blood for a long time.

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And can we implement building codes so that they have access to light? Even though, you know, we have so many things that are controlled by remote. And I always wonder, how can you not build a very simple curtain? that can be remote controlled so that somebody who has an injury and is bedridden at least press a button.

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Yeah. And also come up with better ways to, when we fall sick, another thing that we haven't discussed is the timing of medication, timing of surgery, even timing of vaccination. All of these are linked to our circadian rhythm. So there are studies showing that those who have at least one week of good sleep before getting a vaccination, has much better response to vaccine.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And this is important because as we get older, almost everybody should take the flu vaccine. At least I take flu vaccine every year because I used to get, I used to fall sick. I travel a lot and then I fall sick. And I tend to, I have become a true believer of flu vaccine because when I Take the vaccine, and if I get cold or flu, it's not that severe. I used to be knocked out for a week.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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So I make sure that at least at Salk Institute, they used to give us flu vaccine at work. and we had to schedule that.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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I remember I used to schedule it so that for the past 15 days I was not traveling and I take the vaccine of course in the morning because there are also studies showing vaccination in the first half of the day is much more effective in kicking in faster and with a higher titer than the same vaccine taken in the late afternoon or evening.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And you know, there are many old people who have to be vaccinated against flu. There are a lot of people who are going to travel in three to four weeks. And the country they're going to travel to that may need vaccination against yellow fever, all types of bad things, parasitic disease. And in that case, everybody needs to figure out what is the best time, what is the best lifestyle.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And that has a lot of other effects because insulin also promotes fat making. So our cells actually make more fat also in response to insulin. So that's another reason why late night eating can cause weight gain. Chronic late night eating. Chronic late night eating.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And this is where having a good night of sleep for the last five or seven days and then scheduling your vaccine in the morning is something everybody can do. And this is where, you know, it's not that it may give you a superpower, but at population level, when you're vaccinating a million people and 10,000 of them may get sick, we can reduce that number to 5,000 or 4,000 or 1,000.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And those who are falling sick may not get that severe disease. So this is one area where, again, something can be implemented much faster. The other area is chemotherapy. So there is a vast literature dating back to 80s showing, particularly for breast cancer, certain chemos work better in the morning and other chemos work better in the afternoon.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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But those studies were done on a small number of patients. And they have not been done on a large number of patients in multiple clinical centers, which is essential. And this is where some funding bodies should come in and then say, okay, let's go figure out when is the best time to schedule your chemo relative to your past sleep-wake cycle.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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But what is also known is women who have breast cancer, if they sleep regularly, get sufficient sleep, then they respond to chemo much better and also their prognosis is much better. So this is another case where people can pay attention to their current habit of sleep-wake cycle, at least from patient perspective, that can be implemented right now.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And in future, we can look into the optimum timing of chemo relative to your sleep-wake cycle or eating-fasting cycle. Because as we know now, these days, your eating-fasting cycle has much bigger impact on circadian rhythm in all these tissues than even light-dark cycle.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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Yeah, I completely agree because you said succinctly that these days it's not our genetic code that determines our health. It's the zip code where we live. Because unfortunately, if you live in a zip code that doesn't have access to

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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Yeah. So this is something that has to come from clinical studies, but at least in mice or in laboratory animals, where we can accurately control what time they're eating, how much they're eating, what quality of food they're eating. There we can see that when they eat randomly or eat when they're supposed to sleep, then they gain excess body weight.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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healthy food and you are also likely to be engaged in shift work because there are some zip codes where the socioeconomic conditions are so bad that people have to commute an hour each way and then they are mostly working in shifts or they are doing gig works and that type of work is disrupting this very foundational balance in their sleep-wake cycle, eating-fasting cycle and

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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So in that way, circadian rhythm research or its applications also address one of the fundamental issues with health care, that is the inequity. So it'll actually, since the same, if you're poor or rich, it doesn't matter. You can benefit from sleeping for seven and a half hours. Yeah. So that's one thing. And second thing is, can you create that opportunity for health?

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And this is where public policies get into play. We have not even touched shift work. People who work day and night shift or night shift and day shift. All those shift work schedules are built around convenience of the manager or few people who decide that this should be our shift. And, for example, I live in San Diego. It's kind of interesting to see.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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San Diego city government has different departments or different arms. They have different shift schedule, and it happens in every city. And one department may, for example, police department, maybe they are adopting day shift, sorry, swing shift, morning shift and night shift. And the cops have to stay in one shift for three months before they go to a new shift.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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Whereas in the same city, you might actually find healthcare workers are actually going back and forth between day and night shift in the same week. For three days, they may have to work in day shift, and for one or two days, they may be working in night shift. or the, you know, ambulance drivers. So they are also on different, their shift is actually changing very frequently.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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So when we think about modern lifestyle, it is made possible because of shift workers. Absolutely, we owe them so much. But we haven't standardized their work hours. We talk a lot about 40 hours work week, 30 hours work week, whether we should start at 9 o'clock or 8 o'clock, what time we should end. We never talk about shift work.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And also what we're seeing now, there are also new drugs that are based on circadian rhythm to essentially based on the idea that as we get older or in many diseases, our circadian clocks are disrupted. And the question is, if we can fix our clock with a new drug, can we also fix a disease? So these are the three big principles that are coming into play.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And this is one thing where it actually affects a lot more people than we think, because in the US, one in five people are shift workers. And then there is secondhand shift work, because The spouses and family members of shift workers, they are also affected by shift work because they're trying to be more caring, loving, inclusive. So they want to give company to this person.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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They'll stay up for the partner. They'll wake up early, go to bed late. Yeah. And those things affect everybody in the house. It also creates a culture of bad health because when the kids think, see, it means I remember when I grew up with my maternal grandfather who used to occasionally do night shift work. And I used to think, oh, my God, he's a superhero. He can stay up all night. Yeah.

Dhru Purohit Show

Supercharge Your Sleep and Improve Your Longevity Using the Power of Intermittent Fasting & Circadian Biology (Rebroadcast)

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And then later on, later in life, he actually had dementia and passed away much earlier than my paternal grandfather who lived in the farm and did not have much access to modern day health care. But he kind of had a strong circadian rhythm. I don't remember him staying awake till midnight any single day. So this is one area where if you're thinking of global change, standardizing.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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But I think what is actually disconnected, what we don't understand in real life is if we ask, what is shift work? Yeah, I've heard you talk about this.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Yeah, it's not that somebody has to have a job like in police department or firefighter or nurses. Of course, they are shift workers. Right. But then if we think about metabolically for our health, for our body, how our body is thinking, whether you're doing shift work or not, because our body is actually not checking whether you checked in to your shift work or not. It's only checking two things.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Are you staying awake for two or more hours between 10 p.m. and 5 a.m.? Because that's when your body is designed to sleep. So are you up for two or more hours between 10 p.m. ? And 5 a.m. And 5 a.m. And being engaged in some kind of work.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Some sort of work. You're not just lying in bed with your eyes open. Of course, if your eyes are open and you're watching TV, that's also... Sure.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Because your body is not resting. And if you do that, on an average, once or twice a week, that is shift work. Because your habitual sleep time, suppose, say, is 11 o'clock every night. And once or twice, you are staying awake either till one o'clock in the morning, or you're waking up at three or four o'clock in the morning to get to work or do something.

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The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And now if we think about it, almost 70, 80% of us are shift worker, or we are living the life of a shift worker.

Dhru Purohit Show

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Circadian rhythm essentially relates to almost a daily timetable of things that has to happen in our body, whether it is fighting infection, metabolic balance, brain health, or even repair and rejuvenation for injuries. And when we think about circadian rhythm, then since it's a big new concept, it's also a little bit difficult to understand. But just imagine that in our life, daily life,

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Well, sleep debt is, our body needs, for example, seven hours of sleep because a lot of studies around the world, when they look at what is the average number of hours people sleep and what are the comorbidities or diseases or even longevity, what they find is six and a half to seven and a half hours in adults, older adults.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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We're not talking about college students or high school students, older adults. That seems to be the sweet spot. People who sleep less, they have more comorbidities. And people who also sleep more, maybe they have underlying conditions. That's why they're sleeping more. They also have other comorbidities. Right.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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So a lot of people who sleep less in the weekdays, say five to six hours or five hours, then they experience it, that their body actually keeps track of how many hours of sleep you have lost. So that by Friday or Saturday, you are so sleepy that you just want to catch up. When people say, I'm catching up on my sleep, that's exactly what they're doing.

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The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Their body has calculated and then it's telling them that, okay, so on Saturday, you got to sleep another four hours or five hours. And they're catching up. And what happens is, so that's kind of what we say sleep debt. You have taken that debt against your regular sleep and you have to pay it back, pay it back to your body by sleeping extra.

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When we get older, then what happens is our bodies, the sleep debt calculator doesn't work very well. It actually doesn't remember how much debt we are accumulating. So that means you can go with less sleep four or five days, but your brain is not remembering, so you'll still end up sleeping less. And you think you're fine. And you think you're fine. So that's why this is...

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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This is some instances where you should not be listening to your body. If you know, if your smartwatch or smartphone is telling you you have been sleeping for five hours, and you know that you are sleeping for five hours every night, And then you got to work on it. Another reason why we also forget our body forget sleep date is when we over consume caffeine.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And this is something I have personally felt because there are many times when I have to consume excess caffeine or maybe late afternoon coffee just to get through a grant deadline or a manuscript deadline or something else. And then if I continue that habit in the weekend and also have a lot of caffeine, then of course I'm sleeping less, six or less hours.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And my brain doesn't remember that, that I'm having sleep debt. But the other way it shows up is I'm more hangry, I'm more irritable, I know that I cannot think clearly. And my overall productivity goes down. And I'm kind of struggling. And then I kind of blame myself. I blame people around me. And I'm thinking that, okay, so for all of my problems, somebody else is responsible. I beat myself.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Why I cannot get these things done. So a few years ago, I did a simple experiment. I kind of do all types of experiments on myself. One is... I said, okay, so between Thanksgiving and New Year, I will stop caffeine, all kind of caffeine-containing drinks. Coffee, green tea, etc.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Coffee, green tea, Diet Coke, Coke, anything that has coffee or caffeine, including dark chocolate, also has many flavonoids that can keep us awake. And to my surprise, almost every night, the first few days, I felt like I haven't slept for a month or so. My sleep just kicked back in. And then I would fall so sleepy. I would feel so sleepy by 9 o'clock. It was really hard to stay awake past 9.30.

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The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And so that goes on for at least 15 days to three weeks that I'm just sleeping like eight, nine hours.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Yeah, my body actually has remembered my sleep debt and it's just saying, no, you got to pay. You have a huge debt and you haven't paid for a long time. And then after two to three weeks, then I come to the equilibrium that I can actually sleep for seven hours. And that's when I realized, okay, so this is my normal circadian rhythm.

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The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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we organize our life around time we think of the whole day what time I have to get up what time I have to go to school or send kids to school and then what time I go to work what we do and then in the evening what time I have to meet friends or get back to home what time we sleep so similarly every single cell in our body has its own 24 hours timetable

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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To reestablish and also to know what my body needs. And essentially what my body needs is I should be going to bed between 10 and 11 and should be waking up between six and seven. That's what I figured out. So this is the kind of stuff that everybody can do once in a while, do an experiment. You are not going to die if you stay away from caffeine for maybe in the weekend or for a week.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And we always talk about personalized health, personalized precision health, and all these fancy terms that we say. Whenever there is the word personalized, we have to keep in mind that more than half of that responsibility is on us to try something, a new lifestyle. Try to figure out whether you can change the quality, quantity, or timing of your food, exercise, or sleep.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And this is where one can actually try. And for older adults, it's difficult because as I said, even in experimental models, like for example, we can take little fruit flies, and this is not experiment in my lab, but other people have shown it.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And the young fruit fly, if you keep them awake by putting them in a rotating drum so that they cannot sleep, then the next day when you give them an opportunity, they will sleep. But you take the older fruit flies and keep them awake and next day they actually don't fully compensate their sleep loss. So this is a phenomena that's already known happens in humans.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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So then the question is, can we model it in flies or drosophila, fruit flies or in mice? Then we can go back and see, okay, so what part of the brain is involved? What can we do for the fruit fly or the mice to remember they're sleep dead so that they can go back to sleep and recover? And then what happens when they have this sleep dead, when they cannot sleep enough?

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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So for example, now many labs have shown that in experimental condition, if you take a mouse or a fruit fly, that is prone to neurodegenerative disease or dementia, and you disturb their sleep for a few days, then that can accelerate the progression to dementia, or that can exacerbate the symptoms of dementia. And so that's one part of the story.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And then the other part of the story, which relates to timing of food, is if you now put these fruit flies or mice that are more prone to dementia, and people, we never connect how timing of food connects with dementia, but this is something that actually one of the earliest experiment was in fact done in LA, in Los Angeles, in UCLA. At the Buck Institute? No, actually UCLA. UCLA. UCLA, yeah.

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The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And what they did was they took a few mouse strains that are more prone to Huntington's disease and they did eight hours time restricted feeding. So that means these mice have to eat only for eight hours and fast for 16 hours. And what they found was, surprisingly, the sleep quality of these mice actually improved.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And I remember that experiment because the researcher and their team actually asked me, hey, do you think there'll be an effect? And those are the early days, 10 years ago, nine years ago. And I was thinking, huh, this will be an interesting experiment to do. Let's try it. He tried it and we found that. And then now there are a lot of studies on how

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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time-restricted feeding or intermittent fasting actually helps brain health by improving sleep. And this is something that we had never thought.

Dhru Purohit Show

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that means the cell has to decide okay this is the time i have to make energy this is the time when i have to recycle this is the time to divide and rejuvenate so this is a very new concept of in science and this has the potential to impact our daily habits and it has the potential to increase efficacy of medications that we take or supplements that we take on a daily basis

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Yeah. So this also relates to another question that I often get. People say, well, I'm healthy. I already have the perfect body composition. And why should I pay attention to when I eat? And my answer is, well, we know there are a few things. One is, even though you are healthy, one thing is it can actually keep your brain health much better. And in fact,

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When we did our first study on humans, and this was eight years ago, 2015, the paper came out, and there are only eight participants in their study. And this was very early days. We asked, is it feasible for people who have been eating for a long time throughout their life, last 15, 20, 30, 40 years, can they change that habit? Because this is a big issue in behavior change. Sure.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Because we are so married to our old habit. Imagine, even for coffee, a lot of people, they cannot give up coffee. It's not that they're born with a coffee in their sippy cup. We picked it up along the way. But we got so used to coffee that we cannot leave it. So similarly, people who are used to snacking, over a long period of time, the question is, can they change behavior?

Dhru Purohit Show

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And in that study, there are only eight people. And again, this was funded by an innovation grant from the Salk Institute by a philanthropist. And when these eight people, they're stuck with 10-hour time-restricted eating. So that means they were allowed to eat for 10 hours. They self-selected that 10-hours window so that that fits with their lifestyle. And they had to do it only for 18 weeks.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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That was the advice that, okay, so we'll do this study for 18 weeks. At the end of 18 weeks, we'll collect some data, and then you are free to go. And so they were free to go after 18 weeks. They were not even obese people. They were mostly overweight, BMI somewhere between 25 and 30, and the average BMI was 27. And they lost a modest amount of weight, 3.5% body weight.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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We didn't actually measure at that time body composition, whether that is fat loss or muscle loss, because it was a pilot feasibility study. But what was interesting was after a year, we were curious, because in many behavior interventions, people actually can't change their behavior forever. It's not sustained. It's not sustained.

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And also what we're seeing now, there are also new drugs that are based on circadian rhythm to essentially based on the idea that as we get older or in many diseases, our circadian clocks are disrupted. And the question is, if we can fix our clock with a new drug, can we also fix a disease? So these are the three big principles that are coming into play.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And in fact, people who do weight loss trials, they try to reduce calories, change a different diet plan, or get on a diet, they actually gain back a lot of body weight that they lost. Many of the benefits actually disappear. So that's why we are curious. We asked them to come back after one year, and then we realized that, to our surprise, they actually kept that weight loss.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Even though it was a small weight loss, we thought that they would gain back that weight. They kept that weight loss. And we are curious. So we asked, we had a very standard questionnaire about their daily habit and other stuff. And what we were surprised to see was they said, all of them, they said it improved their sleep. They're less hungry at bedtime and they're more energetic in the morning.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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And they said the reason why they continued with the habit was not because of weight. It was because how they felt, how they were feeling, that they were working at a higher performance level throughout the day. And that's the first time.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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This is where human studies are so important because when we are studying fruit flies and mice, we cannot ask the mice and fruit flies, how are you feeling this morning? And the mouse is not giving me a high five.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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Yeah. And another thing, the difference between human and mice is actually we did an experiment where the mice had to eat nine hours, Monday through Friday, and then we gave them a cheat day. Weekends were cheat days, so they were allowed to eat whenever they wanted because the food was given 24-7 on the food hopper. And they actually don't learn the habit.

Dhru Purohit Show

The Science Behind When To Eat and Other Top Lessons On Circadian Biology

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So that means they continue to eat 24-7 in those two days. They're over it. The good thing is they still had a lot of health benefits, almost 80% of health benefits. From practicing the time-restricted eating. just for five days. For five days. In mice. And that was actually eye-opening for me because I thought that all these benefits will go away if they cheat for two days.

Dhru Purohit Show

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And because, you know, when these mice are eating randomly, then they're also disrupting their circadian rhythm and other stuff. And that gave me hope that even humans, hopefully, if they try to do time-restricted eating, even for five to six days, that can have health benefits. So that key experiment in mice gave us hope. But in humans, it's very different.

Dhru Purohit Show

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When we talk to people who have been trying, and most of our studies are 10 hours time-restricted. I'll get back to why 10, not eight, not nine, not six, et cetera. They say that they get food hangover if they eat late. And this is something that our mice never told me. And then again, a lot of people, they actually, when I think of hangover, it's mostly alcohol.

Dhru Purohit Show

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But then I came to understand this from people's point of view because they said, well, food hangover is when you eat late and when you wake up in the morning, you feel like the food is still there. It's not digested and you feel groggy. and you don't have appetite to eat, and your whole morning is spoiled. And it's almost like a hangover from alcohol, but it's from food.

Dhru Purohit Show

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And we realize there are a lot of people who actually try this. If they eat late into the night, their body revolts and it reminds them, hey, these are the immediate bad things that you'll face. So that's something that we realize that in the human studies, that time-restricted eating has an impact on sleep. Again, we don't know why, because sleep researchers essentially study sleep.

Dhru Purohit Show

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And you mentioned time-restricted eating, intermittent fasting. that's kind of one aspect of this circadian rhythm biology but this is actually one way to get into the science because once we understand why we should be eating in less than 12 hours and why that has to be consistent what is the science behind it then we can dissect a little more into the interrelated parts of fasting sleep

Dhru Purohit Show

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Nutrition researchers don't ask questions about sleep. And this is a challenge for people like me because when we want to do an experiment, and most listeners, when we think about health, we are not thinking about only how to improve sleep or how to improve exercise or how to improve food. In a day, we always think about all three aspects.

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And it's very challenging to objectively measure all this stuff, even in mice. Forget about humans. We are not talking about humans. Totally. Yeah. So this is where combining mouse research and human research actually helps us to go back. Now we know that, okay, so it improves sleep. Then we're going back and asking, okay, so what happens?

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Now, people who do time-restricted eating or mice that do time-restricted eating, Does their brain remember that sleep date when they get older? And that's a very fundamental question that we're trying to figure out in basic research. And then we go back and ask the same question in humans.

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what time we should be exposed to light, when we should exercise. And that will give strong production of these enzymes and increased acidity to break down food. And then there is a weird thing that happens around sleep time or late at night. Our stomach is more sensitive. So that means even a little amount of food can hyper, it's almost like

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The stomach is sleeping and all of a sudden somebody comes and knocks on the door and not only you wake up, you actually wake up with increased vigilance. You may pick up a stick or something thinking that somebody is invading. So stomach actually hyper reacts by producing too much acid.

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And now, too much acid is actually not that bad, but what happens is too much acid can go up our esophagus and can cause acid reflux. And I told you that how at nighttime, Our mouth actually reduces saliva production. The reason is in our sleep we should not be drowning in our saliva. So saliva neutralizes a lot of acid.

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So then we have increased acid production at night and less saliva to neutralize it.

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and that's one reason why people eat too late at night not all some might actually experience more acid reflux than other right so now in the next step in digestion is after this stomach is digesting food it goes to the intestine and the intestine kind of has a peristaltic motion so that means it beats and sends that food slowly while the intestine is also absorbing nutrient

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And that process almost shuts down during our sleep or late at night. So that means even if you have eaten food, it actually doesn't get digested, the nutrient doesn't get absorbed late at night. So this is a clear example how even very basic step of digestion has a strong circadian rhythm, and that helps to make sure that our food is digested the right way.

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And the reason why everything shuts down in the digestion at night is during the daytime or when we eat, just imagine, it takes a lot of energy, a lot of acid to break down food. Imagine kind of digesting that piece of sushi that you ate. So if your stomach is digesting that piece of sushi, At the same time, it must be damaging some stomach lining, and that actually happens.

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So that stomach lining has to be repaired at night. So there is a different circadian rhythm starting from the brain that produces growth hormone in the first couple of hours of our sleep. And although we are not growing after reaching adulthood,

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in size or height but actually we are replacing many of our stomach lining and many other cells throughout the body and that happens only at night time so again there is another clock that kind of works with the digestion clock to make sure that during daytime we digest and at night time we repair so these are just

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There is few examples, but if we drill down, almost every single cell has its own clock and it has implications for how we should live, how we should organize our day around these clocks.

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Yeah, so acid reflux and indigestion, another thing that we talked about. And again, going back to the same digestion process, one more thing is when we eat something, most of our food does have some carbohydrate, unless you are just eating ketogenic diet, which is very difficult to do for long term. But for every regular person, we consume some carbohydrate.

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That means that's broken down and that increases blood sugar level and the pancreas has to adjust that sugar by producing insulin. And pancreas does have a circadian clock. So that means it actually doesn't produce enough insulin late at night. So that's one. And then the second thing is the sleep hormone melatonin that goes up at night.

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And that's why people who have sleep problems, they think that they can sleep well by taking extra melatonin. And I'll get to that. But the melatonin actually has another break on insulin production.

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because melatonin makes the pancreas less sensitive to glucose level in our blood, so the pancreas cannot sense accurately how much glucose is in the blood, so it cannot produce or release enough insulin. So now you combine these two, what happens is when

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we eat late at night or very close to bedtime then there are at least two or maybe even more things that are playing against digesting and absorbing that glucose correctly one is insulin production itself has slowed down and second if there is melatonin that's rising and actually two hours to three hours before our habitual bedtime our pineal gland starts to produce melatonin.

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So that means within two to three hours before bedtime, if we eat, then that melatonin can inhibit, can desensitize the pancreas so that it's not producing enough insulin. So these two can work together to first thing that will happen is you might have higher level of blood glucose level. And this is something that has been observed since 1970s.

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In fact, endocrinologist would take healthy people and fast them for 10 to 12 hours and then give them a bolus of glucose either in the morning or after 10 to 12 hours of fasting, the same bolus of glucose or sugar in the evening.

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What they found was the same healthy person may be diagnosed healthy in the morning, but may be diagnosed as diabetic because this person's blood glucose goes pretty high and doesn't come down easily. So this is another example where people who are thinking that they can get away with food at night, although we are not walking around with continuous glucose monitor, all of us, but some of them,

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and this is a common theme that we are finding.

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Yeah, and also since it's the time when insulin production, it's not that insulin production has shut down. It's actually there is a trickle of insulin that comes out and it continues for a long time because it has to work hard to get the glucose absorbed. So then your insulin level remains high in the blood for a long time.

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And that has a lot of other effects because insulin also promotes fat making. So our cells actually make more fat also in response to insulin. So that's another reason why late night eating can cause weight gain. Chronic late night eating. Chronic late night eating.

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Yeah, so this is something that has to come from clinical studies, but at least in mice or in laboratory animals, where we can accurately control what time they're eating, how much they're eating, what quality of food they're eating. There we can see that when they eat,

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No, that's true. I mean, a lot of people, we think that we can get away with occasional late night eating. And this is where the circadian rhythm, again, some of the concepts of circadian rhythm kicks in. When we think about what are the adverse effects of disrupting our rhythm, we always think of people who do night shift work, evening shift work, or morning shift work.

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And there is a rich literature from over the last 100 years. People have gathered a lot of literature saying that many people who work late at night or night shift workers, they are actually at a very high risk for metabolic disease. cardiovascular disease, heart disease, etc.