Wake Me Up Before You...


I know many patients and friends who have tried intermittent fasting and been successful at losing some unwanted pounds. As someone who has always enjoyed eating a big breakfast, I’ve been hesitant to try… What the heck? Let’s see what this magical diet can do for me. Well to my dismay, I gained a few pounds after a week! I was so hungry by the time 10 am rolled around, I ate twice as much during the day!


It is clear that when it comes to sleeping, eating, and activity, that each of us has an individual preference for what “feels right”. Exploring our chronobiology maybe more important than you think. This may be the key to preventing many of the chronic diseases we are seeing today.


Circadian system helps control our metabolism over a 24-hour cycle, which is then repeated. This is influenced by sleep, eating, activity, and light exposure schedules. Human studies show that circadian rhythms also exist for glucose, glucose tolerance, insulin release, insulin sensitivity, lipid use and expenditure, energy expenditure, and appetite. The gut microbiome and the digestive system also plays a role and interfaces with other organs in regulating metabolism and establishing the circadian rhythms of the body. This is exemplified by our hunger at noon, when our body knows it will get lunch!


Shift workers who eat, sleep, and conduct activity at irregular hours in a 24-hour period, have higher glucose intolerance and insulin resistance. Furthermore, research shows obese individuals have altered or reduced rhythms for glucose, insulin, and insulin insensitivity. These rhythms can be absent in diabetic patients. This is why intermittent fasting may not work for all of us, it is dependent on the innate circadian system and the behavioral circumstances for the that individual.


More than ever, it is important for individuals to assess their personal rhythms, to determine if their schedule is impacting their health and putting them at risk for chronic diseases like diabetes and hypertension. This can simply be done by altering schedules and writing down results in terms of symptoms to determine what is optimal. A new term for this is “biohacking”. Though biohacking has various meanings, in my mind this term comes from a need to personalize health care and schedules. With many of us at home due to the COVID pandemic, I’m sure many of you have realized waking up at 6 am is just not your natural time and sleeping 6 hours doesn't cut it!


Obviously conventional medicine’s one-size-fits-all and medication heavy approach, has given very few tools for patients to prevent disease and improve wellness. Looking at circadian rhythms and behaviors such as exposure to bright light, sleep schedules, eating times, activity, and medication timing should be evaluated and optimized. It is a great time to explore alternative schedules and optimize them during COVID shelter-in-place. Understanding one’s chronobiology, could be the key to improving health and preventing obesity, diabetes, and hypertension.


For more help, feel free to reach out to Dr. Milan for laboratory testing, individualized integrative health care, and learning more about chronobiology.


References

Ding L, Xiao XH. Gut microbiota: closely tied to the regulation of circadian clock in the development of type 2 diabetes mellitus. Chin Med J (Engl). 2020;133(7):817-825. doi:10.1097/CM9.0000000000000702

Eisenstein, M. Chronobiology: Stepping out of time. Nature 497, S10–S12 (2013). https://doi.org/10.1038/497S10a

Poggiogalle E, Jamshed H, Peterson CM. Circadian regulation of glucose, lipid, and energy metabolism in humans. Metabolism. 2018;84:11-27. doi:10.1016/j.metabol.2017.11.017

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