caffeine

Snooze yourself to health

According to a report published by The Sleep Council in March 2013 the number of Britons getting just five to six hours sleep per night has risen dramatically: 40% of us are not getting the six to nine hours recommended by the NHS. Why is that? In the majority of cases health conditions, such as depression and anxiety or chronic pain are keeping us awake at night. Many are unable to sleep due to worry, but a great many of us are just not going to bed on time to get the rest we need. Some see sleep as a waste of time, which would be better spent working. Others don’t like going to bed early, because the only me-time they can get is in the evenings, when at last they get home after a long and stressful day at work or when the kids are finally tucked up and asleep. Understandable. But is it wise?

The fact that sleep is something our body just demands is a strong clue that we need it and that it is in fact good for something. If we are prevented from sleeping – and remember: sleep deprivation is a form of torture! – we will die. But even without this drastic outcome, sleep deprivation seriously affects our health.

Photo: Ambro, FreeDigitalPhotos.net

While we sleep, the body is very busy repairing and maintaining muscles, bones and organs. The brain needs sleep-time for clean-up, not just of “mind clutter”, but also of the chemical waste of brain cell metabolism that accumulated in the course of the day.

In the short term, sleep deprivation affects our memory and creativity, slows reaction time, and leads to micro-sleeps and drowsiness during the day, impatience and moodiness. Tiredness also shows on your face, and you won’t be looking your best. Apart from the fact that most of us really want to look good, research has found that people can easily spot a tired person and we instinctively know not to expect much from them, a fact that can affect your career and business.

Prolonged sleep deprivation, however, has much more serious consequences as it can lead to hormonal and neurological changes and even depression. With 40% of us not getting enough sleep, it is no wonder that symptoms are so common that they are easily mistaken as normal.

Sleep deprivation impairs insulin sensitivity, which promotes weight gain and contributes to diabetes II over time. It also affects weight by messing with the hormones ghrelin and leptin: Ghrelin is the "hunger hormone", which makes you feel peckish and slows down your metabolism, i.e. you'll burn energy more slowly. Leptin is the "satiety hormone", which makes you feel full, tells you when to stop eating and speeds up metabolism. If you are not getting enough sleep, leptin production is suppressed, while ghrelin production goes up. You'll want to eat more and the calories thus consumed will stick.

As if that wasn't bad enough, sleep deprivation is also pro-inflammatory. Continuous low-grade inflammation is known to promote degenerative diseases such as heart disease, diabetes II, Alzheimer's disease and multiple sclerosis.

If you need an alarm, use the snooze button, tend to fall asleep when you’re not in bed – for example on the train, a plane or in a meeting, the theatre or cinema – and feel the need to catch up on sleep on weekends or on holiday, you are not getting enough sleep. When we do, we wake up naturally, without needing an alarm. We should be able to get through the day without copious amounts of caffeine, and remain alert until it is time to go to bed at night. Yet for many of us that is not the case.

If you suffer from insomnia, whether you have trouble falling asleep (sleep-onset insomnia) or staying asleep (sleep-maintenance insomnia), you should go and see your doctor, especially if you suspect that you might suffer from depression and/or anxiety. Insomnia can be a side effect of medication, most commonly thyroid drugs or oral contraceptives. Ask your GP whether there is an alternative drug that you might tolerate better.

If there is no obvious medical reason, you could look at your diet:

Are you eating late and/or having heavy dinners?

If you need to digest during the night, your sleep will almost certainly be disturbed. Eat no later than 3 hours before bedtime if at all possible. Ideally, you should have your main meal at lunchtime and a lighter meal in the evening. If you have a business dinner, ask if it can be arranged a little earlier – perhaps at 18:30. This will get you all home earlier, too (more sleep time – bonus!). Choose light meals for dinner and avoid refined carbohydrates and sugar to balance blood sugar.

Balance Blood Sugar

Keeping blood sugar levels balanced throughout the day is the best way to ensure a steady supply of energy without mid-afternoon slumps and to get a good night’s sleep. If your evening meal is rich in refined carbohydrates, e. g. from white rice, white pasta, or sugar, this can cause a blood sugar spike which is soon followed by a steep drop. If this drop occurs during the night, stress hormones are released to increase blood sugar, and they are likely to wake you up (cortisol is in fact what gets you out of bed in the morning). A blood sugar drop can also happen if you have eaten a very low-carb meal too early in the evening. If that is the case, a small (!) snack of complex carbohydrate paired with protein just before bed can help stabilise blood sugar to get you through the night. Think one oatcake with hummus, cottage cheese or a piece of smoked salmon; a piece of banana with peanut butter, a small tub of plain yoghurt with berries.

Are you having too much caffeine?

Different people detoxify caffeine at different rates. While some can drop off easily after a post-dinner espresso, others are kept awake by caffeine even if they had their last cup at lunchtime. To find out whether you are sensitive to caffeine, cut it out completely for 7 to 10 days and see what happens. Make sure to eliminate all caffeine during that time: tea, coffee (including decaff), green tea, chocolate, caffeine drugs and energy drinks all contain varying amounts of caffeine. If it turns out that you sleep better without it, you may want to stay off it or at least not drink coffee any later than lunchtime.

Are you using alcohol to help you sleep?

Using alcohol to help induce sleep is very common, and it does in fact do that. The problem is, however, that it can disturb sleep further into the night. Alcohol is known to suppress the rapid eye movement (REM) phase of sleep, when we would normally dream and when the brain tidies up our memory, discarding what we don’t need and consolidating what we do. Also, carbohydrates in alcohol can lead to blood sugar spikes followed by drops, which then encourage the release of stress hormones (see above). Moreover, alcoholic drinks – especially beer – act as diuretics and may encourage you to get up and use the toilet during the night.

Eat your greens!

The minerals calcium and magnesium are required for relaxation of both the mind and the muscles. You are more likely to be low in magnesium than in calcium: Magnesium-rich foods are nuts and seeds, green vegetables, wholegrains and seafood. Green vegetables, nuts and seeds, seafood, tofu and molasses are also great sources of calcium. Adequate B vitamins, too, are important for good sleep, but if you are taking a multi-vitamin or B-complex supplement make sure to take them earlier in the day as B vitamins are involved in energy production.

Eat lettuce at night: Apart from magnesium lettuce contains the natural sedative lactucarium, which encourages deeper sleep. Lettuce can also be eaten cooked in soups or stir-fries. Try it, you may be surprised. Foods that are high in the amino acid tryptophan, such as chicken, cheese, tuna, tofu, eggs, nuts, bananas, dates, seeds and milk can help improve sleep. For more on tryptophan, have a look at my blog on Seasonal Affective Disorder (SAD). Other foods associated with inducing sleep are celery, oats and kiwi fruit.

To learn more:

The Sleep Council’s website is a great resource for everything sleepy. From mattresses to jet lag, there’s great advice here.

Tomorrow’s Nutrilicious News will have more tips on how to get a good night’s sleep, a sleepy recipe and some links. There is still time to subscribe!

Well watered - you are probably not dehydrated

Have you always been told to drink at least 8 glasses of water a day? Everybody knows that that's what you must do, right? And do you find that you are struggling to meet that target? Well, you are not alone. Many of us do, and the more disciplined among us will force it down, while others don't, but then feel guilty about not reaching the target. Even though most health professionals keep repeating the "8 glasses rule", there doesn't seem to be any scientific evidence for that. picjumbo.com_IMG_7875

Photo: picjumbo

A 2002 review by Heinz Valtin, published in the American Journal of Physiology (full text here), looked at the "8 x 8" rule (8x8 ounces = 8x236 ml) and other misconceptions in connection with water intake. He could not find any solid evidence to justify the "8x8" rule, but then neither did he find proof that we do not need to drink that much. But, says Valtin, "the published data available to date strongly suggest that, with the exception of some diseases and special circumstances, such as strenuous physical activity, long airplane flights, and climate, we probably are currently drinking enough and possibly even more than enough."

Why we need water

Our bodies consist of about 60% water. It is a vital nutrient, and we would not last longer than three days without water. Water is required for temperature regulation, physical and cognitive performance, heart function and blood pressure regulation, gastro-intestinal and kidney function, detoxification, and lubrication of the joints. While good hydration appears to play a role in the prevention of urinary tract infections (e.g. cystitis), high blood pressure, fatal coronary heart disease and deep vein thrombosis, its role in the prevention of constipation, exercise asthma and even skin health may be overrated.

How do we keep hydrated?

We lose water through breathing, sweating, urination and bowel movements and this needs to be replaced, but as the right water level is critical, our body has feedback mechanisms in place to regulate it. It cannot just rely on us to do the right thing, can it? If we are over-hydrated, we will feel the urge to pee. If we are dehydrated, we will be thirsty. Simple. If we temporarily do not have access to a drink, kidney output can be reduced to retain water. This is regulated by hormones, which act very quickly and accurately, keeping our water balance in check.

Thirst is the most obvious reason for us to drink and top up our water levels, but not the only one. Think about it: Do you only drink because you are thirsty? No, we often drink, because we like the taste of what we are drinking, and that could be water or coffee or milk or a soft drink or herbal tea or beer. Now, I am not saying that all of those are equally healthy fluids (because they aren't), but they do all count towards your fluid intake.

Yes, even tea, coffee and beer: Although caffeine and alcohol have a diuretic effect (i.e. they make you pee and thus lose fluids), they are diluted in so much fluid that the net effect is still positive. Due to the higher alcohol content, however, this is not true for wine and spirits, and of course alcoholic drinks have their own health implications, not least addiction, so please don't rely on beer for hydration! Soft drinks and fruit juices may contain calories as well as sugar, sweeteners, preservatives, colourings, caffeine and more undesirable substances - good reasons not to drink them - but with regard to fluid intake, they are just fine. So, we drink a lot just for pleasure, long before we are even feeling thirsty.

In addition, food comes with water, too. This is not just true for soups or water-rich fruits and vegetables, such as oranges, watermelon, tomatoes and cucumbers, but pretty much everything else that hasn't been dehydrated, for example raisins, dried mushrooms and herbs. Food accounts for about 20% of our daily fluid intake, and this is a significant amount.

Can you drink too much?

As with everything, moderation is key, because it is indeed possible to drink too much, even if it is "just" water. Too much water can lead to hyponatraemia, a condition which occurs when too much water in the body dilutes the sodium content of the blood. Signs and symptoms of hyponatremia include frequent urination, cold hands and feet, nausea and vomiting, headache, short-term memory loss, confusion, lethargy, fatigue, loss of appetite, irritability, muscle weakness, spasms or cramps, seizures and decreased consciousness or coma.

So, if you thought you might not be drinking enough: Relax! You probably are. If anything, you may want to review your sources of fluids. Water, herbal teas, limited tea and coffee are fine, but soft drinks - including "flavoured water" - and fruit juices can be laden with sugar.

Don't like water? Tomorrow's Nutrilicious News will have a tip on how to make water more interesting. There's still time to subscribe now.

Further reading:

Water, Hydration and Health, Popkin, B., D’Anci, K., Rosenberg, I. Annual Review of Nutrition, 2010 August; 68(8): 439–458.

Heinz Valtin: "Drink at least 8 glasses of water a day." Really? Is there enough evidence for "8x8"?, Am J Physiol Regul Integr Comp Physiol 283: R993–R1004, 2002. First published August 8, 2002.

British Nutrition Foundation - Healthy Hydration Guide

More on Stress from the Inside

A few weeks ago, I wrote about the body’s stress response, or “fight-or-flight” response. The article described what happens inside the body in a situation of immediate danger – the alarm phase. The changes I described are mainly due to the stress hormone adrenaline. It triggers a cascade of mechanisms designed to save our life. The effects of adrenaline are very short lived.

Another stress hormone, cortisol, kicks in right after adrenaline. It is produced in order to continue fighting the effects of a stressor long after adrenaline has worn off. Cortisol stimulates the conversion of protein into glucose to ensure that the body has a sufficient supply of energy even after the emergency stores of glucose have been depleted. For the same reason, it also continues to inhibit the functioning of insulin and sustains the changes to the cardiovascular system – among others elevated blood pressure and a fast beating heart – that are designed to transport oxygen and glucose to those cells that need them most in an emergency situation. Cortisol also helps us deal with emotional crisis, performing strenuous task and fighting pain and infection.

This is all extremely useful in an actual dangerous situation. Although physical danger is undesirable, it doesn’t normally go on forever. When it is over we can start recovery – again with the help of cortisol, which stimulates appetite and has anti-inflammatory properties. Eventually, all is well again and we move on.

Yet, today’s stressors are different. We are – luckily! – rarely under physical threat these days, but most of us are stressed, some of us often, some of us all the time. What this means is that our adrenal glands, where stress hormones are made, have to continuously churn out those hormones, with hardly any break, and in the long run, this can have serious consequences. If cortisol is constantly or very frequently present in the blood stream:

  • Blood pressure is high.
  • Insulin function is impaired, which over time can lead to diabetes II.
  • The heart beats fast and works overtime.
  • We are on high alert, which interferes with concentration and can contribute to anxiety.
  • Digestion is erratic at best.
  • Fertility is on hold, because as far as the body can tell this is not a good time to procreate.

This is clearly not good! Prolonged stress really is not just tiring, unpleasant and a matter of the mind. It affects the whole body and can be at the root or at least a contributing factor to a whole host of chronic illnesses.

Stress is often seen as “busyness to an unpleasant degree”, but having to rush around all day long is not the only and not the worst stressor by far. Technically, almost any change in our environment is a stressor: hot or cold, physical trauma such as illness or injury, stimulants such as caffeine, alcohol, cigarettes and sugar, environmental toxins (including exhaust fumes, pesticides, chemical exposure from furniture, cosmetics etc.), even exercise, if excessive. Then there are emotional stressors, like bereavement, divorce, bullying, job loss, debt and more.

Apart from the effects continuous stress hormone secretion has on the body, it also affects the adrenal glands, where they are made. For one, these little glands that sit on top of each of your kidneys, have other jobs as well. They make a wide range of other hormones besides stress hormones, too. If the adrenal glands are busy making stress hormones for a long time, this takes up most of their capacity and other hormones fall by the wayside. Remember: acute stress is meant to be a priority (and short-lived), so all efforts are diverted to them.

Stress hormones also hog the “raw materials” other hormones need: Cortisol and ultimately the sex hormones progesterone, oestrogen and testosterone are made from a hormone called pregnenolone, which in turn is made from cholesterol. If all the pregnenolone is diverted towards the production of cortisol, this will have a knock-on effect on sex hormone levels: think premenstrual syndrome (PMS), polycystic ovary syndrome (PCOS), fertility, libido and more.

Co-factors required for other hormones, too, are going towards the production of stress hormones. Stress uses up vital vitamins and minerals that will be missing elsewhere.

If stress persists over years and years, the adrenal glands can wear out and struggle to produce any hormones at all. You’d feel very tired and exhausted to the extent where even sleep does not refresh you enough, struggle to concentrate, and might even experience depression. It is possible to recover, but it may take a long time. After all, it took a long time to get to this stage, too.

So, what to do? Watch this space! While you wait, you may want to subscribe to Nutrilicious News. Tomorrow's contains a yummy stress-busting recipe, which is easy to make, as always. There'll also be a breakdown of what it is that combats stress in this particular recipe.

If you suffer from stress and its physical manifestations, if you are suffering from stress-related illness, why not book a personal health and nutrition programme with me at The Body Matters in Leigh-on-Sea, Essex?

Coffee - It's not black and white

Do you love your coffee? And if you do, do you feel guilty about it? After all, coffee seems to be bad for you and many health experts discourage its consumption. But as with most things concerning health and nutrition: It’s not black and white. We all know people who can guzzle a “venti” (20 fl oz = 600 ml) and still have a nap afterwards, when others only so much as sniff an espresso and are wired all day long. That’s because how you respond to caffeine - coffee’s most predominant active compound - is governed by your genes, some of which affect the way your liver processes caffeine, others influence how the brain reacts.

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Coffee and Blood Sugar Levels If you are stressed - and who isn’t these days - or are struggling with your weight, you should learn how to control blood sugar levels. You need to avoid sudden spikes, because high blood sugar levels stimulate the release of insulin, which in turn contributes to weight gain. Caffeine, a stimulant, does raise blood sugar levels. However, a Finnish study found that coffee increases insulin sensitivity (that’s a good thing) and lowers the risk for diabetes II. This is effect is attributed not to caffeine, but chlorogenic acid, an antioxidant in coffee. Chlorogenic acid is also responsible for many of the other beneficial properties of coffee.

So, coffee does raise blood sugar levels to some extent. We all love a biscuit or even a slice of cake alongside a cup of coffee, but combining coffee with sugar triples it's effect on blood sugar. Bad news, I know. So on to the good news …

Coffee and cardio-vascular disease Coffee is often thought to adversely affect the heart. However, according to an article published in Current Vascular Pharmacology in 2014, it is actually beneficial when consumed in moderation. Coffee lowers the risk for stroke and it does not even affect blood pressure to any great degree, but patients suffering from arrhythmia should avoid it. A word of warning though: Some people’s genetic make-up causes them to metabolise caffeine more slowly, and for them, there is indeed an increased risk of non-fatal heart attacks. (Fast caffeine metabolisers, on the other hand, actually lowered their risk of heart attack through coffee consumption.) Also, even if blood pressure is not greatly affected in healthy people, you should exercise caution and steer clear of coffee if you know that you suffer from hypertension.

But coffee does hurt the stomach. Doesn't it? It appears that even the most stubborn rumours about the ill effects of coffee are being overturned. A 2013 cross-sectional study in Japan found no correlation between coffee consumption and stomach ulcers, upper intestinal ulcers, or heartburn.

More good news Coffee has been found to protect from Alzheimer’s and Parkinson’s disease, depression, liver cirrhosis and liver cancer. Moreover, higher coffee consumption was found to significantly reduce the risk of recurrence of colon cancer, and reduces the overall risk of mortality meaning: Coffee makes you live longer - at least as long as you do not overdo it.

Who should avoid coffee? If your genes have not equipped you to tolerate coffee well, you very likely already noticed. If it makes you feel jittery, wired, causes tremors and gives you palpitations - avoid. You won’t need me to tell you that. Also, coffee is undoubtedly an addictive substance, as anyone who has ever gone through withdrawal will know, and that in itself will put a lot of people off who would rather not go there.

Pregnant and breastfeeding women and those trying for a baby should avoid coffee as it has been linked to miscarriage, stillbirth, premature delivery and lower birth weight. If you can’t live without the stuff, do not have ore than one cup a day.

If you are not sure whether or not you are a slow metaboliser - whose risk for heart disease, if you remember, is increased when they drink coffee - and would like to find out, you could do a gene test, which have recently become available at very affordable prices. (Note: The tests look at a number of health genes, not just the way you metabolise coffee.)

How to make your coffee The way you make coffee can change its properties: Boiled and unfiltered coffee may raise cholesterol and triglycerides, and paper-filtered coffee appears to contribute to inflammation. A possible reason for this is that with this method, the beneficial polyphenols in coffee are filtered out.

Consider what you’re adding Much of what gives coffee a bad reputation is not so much the coffee itself, but ingredients we like to add to it: Coffee as such has 0 calories. It may contribute to weight gain by raising blood sugar levels, but all by itself, it won’t do much damage. Consider, however, what you add to it: sugar, including syrups, lead to much greater blood sugar spikes and thus greater insulin excretion. Sugar also has powerful pro-inflammatory properties, and avoiding it is generally a good idea. Milk and cream (and sugar) all increase the calorie content of your coffee. And need I even mention marshmallows?

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On the other hand, you can improve on the properties of coffee by adding either cinnamon or ginger to it. Both substances have been tested in combination with coffee - albeit only in vitro - and were found to have enhanced anti-radical and anti-inflammatory properties. Other spices that go well with coffee are cardamom, cloves, or saffron.

Is decaf a good alternative? No, is the short answer.

First of all, be aware that “decaffeinated” does not mean that the caffeine content is zero. Processing usually removes 97% of the caffeine. Most commercial brands use chemical solvents to remove caffeine from the green coffee beans, and although the industry ensures us that there will be no residues when we drink it, I personally just don’t like the thought, and it will still impact on the environment.

How much coffee is ok? It appears that coffee consumption “in moderation” is not only harmless, but even healthy for most people. But how much is “moderate”? I’ve seen recommendations that say up to 600 mg of caffeine daily is ok, but most are lower, 400 - 500 mg. Translated into cups of coffee this is approx. 4 - 5 cups. That amount of coffee is also associated with the lowest risk of death (meaning: people drinking less than that are at a higher risk of death!).

So, that’s the lowdown on coffee. If you would like to read more on coffee, click here. Or - better still - sign up to my newsletter. Tomorrow morning's edition has more on antioxidants and a recipe for cinnamon almond latte.