Dr. Satchin Panda: When to eat, sleep, and exercise to achieve peak performance

hi everyone and thank you for coming today to learn about circadian rhythms and how they can influence your day-to-day um with none other than dr sachin panda and amir so i'll give a quick introduction to a little bit about the studies that they have done and who they are and then we'll get right into their conversation followed by a q a um so without further ado i'll give an introduction to amir so dr zarin parr is a basic and translational science researcher in the gut microbiome and circadian rhythms as well as a gastroenterologist at ucsd and the san diego va focused on treating obesity and its related complications such as non-alcoholic fatty liver disease and type 2 diabetes um in addition he completed a postdoc at salk where he worked on circadian rhythms and metabolism with such and panda sachin hannah is professor at the salk institute california and author of the book circadian code and after completing a ms in biotechnology he moved to the us to start researching at the salge institute in which he primarily focused on circadian rhythms which he is here to talk about with all of you today so without further ado let's introduce our speakers thank you avery it's a pleasure for me to start this conversation with dr panda my former mentor who i had the privilege of working on time restricted feeding with um uh welcome uh sachin and um how's it going how's uh kova treating you thank you amir this is really a big pleasure for me because this is a unique day to see you and i talking about the research that you essentially spearheaded in my lab um about almost eight nine years ago and what is also more important is many ucsd undergrads and master students have participated in that research so this is really a unique and interesting moment that you and i are speaking on a ucsd event um where all this research originated and uh yes kobit is uh something that is affecting all of us in fact in the human history modern human history this will turn out to be one very important event that affected almost every single person around the globe so i guess 10 to 15 years down the road when our children will look at us i think the first thing they will ask us is what did he do during coffee um so we are living through a historical moment and it's suffice to say that we are all trying to adjust to the new reality so sachin let's talk a little bit about the pre-covet days so how did you first get interested in circadian rhythms yes you know my primary interest is biology of time because most of the biology that i was learning in college and university uh dealt with um how biological systems work most of the principles are based on how gene a for example affects gene b or protein a affects protein b but we know that there is a timing component to it and in fact if we think about health a lot of the diseases that we see is disease of time for example cell subject is divided in say in every 18 hours or 24 hours and when they divide much faster then we get to tumor or cancer similarly a blood glucose should rise and fall after a meal within couple of hours and if it takes longer time to fall then we get diagnosed with diabetes so in that context i was interested in the biology of time and there is one universal principle of timing that is 24 hours timing or circadian rhythm and the beauty of circadian rhythm is it's conserved from single cells like in bonds karma cyanobacteria all the way to humans so you have much broader species to learn biological principles from and then apply that to your system of interest so that's how i got drawn into circadian rhythm almost 20 25 years ago you know when i first heard about your lab i actually heard from my graduate school advisor at callaway and he seemed to be more familiar with the work that you had done in the super chiasmatic nucleus and um he had heard that you had started to work in metabolism and at the time i had become interested in metabolism so um and he recommended that i look into into the work that you were doing so how did you um how did you become interested in how circadian rhythms and its relationship with metabolism in general well if we think about uh why we live on this planet we live to eat and we eat to live and throughout 24 hours if you look at circadian rhythm and what those circadian rhythm genes or the genes that are regulated by circadian rhythms too most of them are involved in metabolism so that means a big function of circadian rhythm is actually to maintain metabolic homeostasis and in fact the review that you wrote few years ago that included different mutant mice that have mutations in different circadian clock genes one common theme that comes out of all those mutations is almost every single mutant mouse that has a disrupted circadian rhythm also has disruption in glucose regulation either they are hypoglycemic or hyperglycemic either they are too lean or they are too fat so it almost looks like the ultimate function of circadian rhythm is to maintain body weight and to maintain blood glucose level and if you fast forward and now imagine what happens when our blood glucose level goes too low or too high then we can connect them to a variety of big range of diseases starting from gi diseases to liver disease diabetes of course and then even dementia and certain kind of cancer so i think although the idea is security under them when we think about it it's synonymous with sleep wake cycle but ultimately it its function is to maintain our blood glucose level and metabolite level within a very narrow range and sleeping is turns out to be a proxy for fasting so in that way i think circadian rhythm is more intimately tied to metabolism and you know when when people think of circadian rhythms um at least before the time of the work from your lab people think of light and um you know what was really remarkable about time restricted feeding was how powerful of an entraining agent feeding really is in terms of metabolism um when when did you have this first clue that feeding could be just as powerful as light in affecting so many aspects of what's going on internally yeah so i think when we did our first gene expression profiling from liver that was back in 2001 2002 and we looked at which genes are security and regulated or 24 hours rhythm in liver we saw quite a few genes that are involved with metabolism but during that time when i would look for what do these genes do because i would find a gene that's cycling and then go and pubmed look for them and most of the very frequently i would find genes was discovery went back to uh people looking for food induced genes or fasting induced genes so then it became very clear that many of the genes or transcripts that cycle with a 24-hour rhythm are induced or modulated by food and in turn they also participate in metabolizing glucose protein fat or secondary metabolites such as cholesterol and other stuff so that led to the idea that maybe um feeding and fasting might act downstream of the clock so that was the initial idea so that's why we did a simple experiment and that was published in 2008 when we fared mice during the day when they're not supposed to eat and our idea was maybe the circadian clock control genes would continue to cycle as if the mice aren't eating at night time and the treating fasting genes should cycle and they will follow food but surprisingly what we found was almost every single gene that cycled in liver they simply followed food so there was no they were not following the brain signal so i think that was the aha moment and then the question was how do we use this information to improve health i think that's where um we kind of often forget what kind of world we live in because if we dial back to 150 years ago or so when there was no electrical lighting people used to and also food was less than people used to eat only two or three meals mostly before nine nine o'clock at night because fire was very expensive and people could not afford to store food and only in the modern days right now we have access to food around the clock so then the question was are we disrupting our metabolic cycle because if we make it very simple just like our brain needs six to eight hours of sleep or downtime at night maybe our gut our liver and all of our organs also need eight to ten hours of down time at night and by randomly eating at night time we may be disrupting the sleep of our organs so that led to the idea that maybe time yesterday eating will bring back that ancestral rhythms and our guts and organs will get to sleep at night so that was the very simplistic way to put it i know i know you guys have looked at how often people eat during the day and you guys have continued to look at that since i've left the lab even more closely at people of different cultures and different ages um have you been surprised by what you found uh did uh do people still eat at all all over the time in all different cultures yeah so this is the study that we started in 2015 when we wanted to know when people eat and i think uh that was that started from a discussion in the lab where you were there and we thought it would be very simple idea to let people take a picture of their food and that's when subrose gill who was a grad student at that time in ucsd biology program he self taught himself how to write code for a smartphone app and the idea was very simple you open the app one click take a picture second click and press save third click and instead of the picture being saved on the phone it was coming to our server and from there we figured out that nearly 50 percent of adults eat for 15 hours or longer and these were not shipped workers these were irregular people that means if they had their first calorie at 6 a.m in the morning the last calorie was happening at 9 00 pm at night or even later and that was eye opening because until that time [Music] we all assumed that we all eat within 10 or 12 hours and in fact these people when we ask them when you eat your first and last meal they also thought that they were eating within 12 hours but the fact was very different and then we have repeated this in different countries and we find the similar trend less than 10 percent of people actually eat within 12 hours or less and consistently we find somewhere between 40 to 50 heat for 15 hours or longer did you notice whether people who are younger like in college or people of certain cultures did you notice any variations or is this something that was consistent between all peoples yeah so uh now we have data from more and more people so we can look at this fine granularity of eating habit and what we see is younger people that tend to wake up later in the morning so they start their day a little later so they are likely to start eating at 10 or 11 in the morning they also tend to eat very late into the night um then older people as we know they wake up a little bit earlier so they're more likely to start their day eat their breakfast very early maybe between seven and eight and but the problem is they are also late into the night watching movies and socializing so they also tend to eat later into the night until even up to midnight or so then we also find other places so for example people who tend to cook their food you might think that cooking is healthy and yeah you should be eating healthy food but at the same time since our before kobe since people used to spend a lot of time commuting people who cook their food they are more likely to eat later in the diet than people who took take out so that was an interesting aspect that we learned from this study so um have you learned anything that um you know i know that you you guys have done studies where you've done interventions um and and there have been some success in terms in terms of how these intervention interventions affects health uh could you summarize some of these findings for us yeah so these interventions i must say those are pilot studies because those are small in numbers and they also lasted up to 12 weeks maximum 16 weeks they didn't have too much diversity because when you have small number of persons they're more likely to be um within very narrow range so with all these caveats what we find is um it's relatively easy i won't say it's super easy but relatively easy for people to stick to a 10 hours window of eating and then counting calories and when they do that there are some of the the first one or two weeks a little bit difficult because they're trying to adapt to this eating habit and then after two to three weeks uh the first benefits that they observe is their sleep quality goes up their gut health is much better so they have less bloating acid reflux etc then slowly we do say modest reduction in body weight um some people who pay too much attention are very strict about the eating time they may also reduce some of the calories and that's where we see five to seven percent weight loss but it's typical to see say three to four percent weight loss over three to four months and then people who are pre-diabetic they're more likely to improve their blood glucose regulations they may become more normal and people who are early stage diabetic they may also see some improvement in blood sugar we haven't put too many type 2 or type 1 diabetics through timeless eating so far so we'll see what happens but another thing that's universal in all time distributing studies is we see improvement in blood pressure and this is important because currently nearly 102 million people adults in the us have hypertension and only 24 of them take the blood pressure medication regularly so that means by time rating if we can reduce blood pressure in even 10 percent of those 100 billion that's a big number so i think that's an immediate and achievable target and some of the studies done in collaboration with dr pam top of ucsd we also find people who have metabolic syndrome and they're already taking medications to control their blood pressure they still see additional improvement from time to eating so that means in addition to taking the medication they can add time restorating as an adjuvant therapy or adjunct therapy to further improve their blood pressure so these are some of the early indications and but there are many clinical trials around the world if you go to clinicaltrial.gov there are nearly 40 plus time ratio eating studies around the world aiming at improvement in fatty liver disease reduction in sorry controlling type 2 diabetes controlling gi diseases and for cancer survivors reducing cancer fatigue and recover accelerating recovery so there are a lot of studies that are going on so it'll be interesting to see um how the results will pan up i was actually just noticing that uh one of the national cancer institute's provocative questions about circadian rhythms and cancer uh explicitly mentions i think uh intermittent fasting or time restricted feeding and how it could be affecting cancer as well so it's it's affecting um that as well do you think uh we know everything about time restricted feeding in health uh what else do you think it's out there what else do we like you know um we haven't explicitly mentioned inflammation but you mentioned sleep what do you think is um some of the things that we have yet to find out um are there some things that are going to be more long-term benefits about time-restricted feeding that's going to take us a while to find out yeah so you know i mean when we published that study back in 2012 and then again in 2014 when you published the other two studies what was interesting was it um produced a lot of phenotype so we were surprised at the extent of benefits so for example we saw improvement in endurance even in mice that are eating this unhealthy high fat high sucrose diet it still boggles our mind why even unhealthy diet eating within eight hours or nine hours improved the endurance of mice and they overtook the mice that were eating healthy diet and we also saw in your study the mice had better motor coordination and motor coordination is a very complex task because it involves the brain the neuromuscular junction and the muscle so it leaves open what is the impact of time distributing on the entire circuit similarly you remember that the biggest phenotype that we found was the fatty liver disease and nearly one in three adults in the u.s at the risk of developing fatty liver disease and fatty liver disease is the precursor to many can hepatocellular carcinoma liver cancer so we still don't understand how time ratio eating can reduce uh fatty liver disease incidence and whether it's only to mice or whether it also happens in humans the impact of on sleep is also very interesting because we never thought that metabolism would affect sleep that much because people who do time-restricted eating they always self-report that they sleep much better the quality of sleep is much better and we are beginning to see in both drosophila and mouse that sleep improves so that opens a completely new avenue about how peripheral metabolism affects sleep then there are also papers that are published in the demanding year showing mouse model of huntington disease benefit from time distributing again we don't know whether the benefit is straight from improved sleep and water coordination or there is direct impact on huntington disease pathway so i think we are surprised almost in every month about phenotype you know every phenotype takes at least five people five years to try to understand the mechanism so i think what you started in 2012 i started a completely new new area in science you can say new cult and in fact now intermittent fasting can be called as a new car because people strongly believe in this and it will take a few decades and to give you some context for example almost 70 80 years ago scientists first described how caloric restriction improved health of rats and we still are trying to figure out how caloric restriction works in multiple organs so i guess what you started in 2012 um what we are seeing is just at the beginning of the timeless waiting studies we'll have another 40 50 years to see the mechanism and how we can implement in different diseases and combinations of the drugs without drugs in different conditions in different days etc uh yeah actually what you're saying is very exciting because we originally did that experiment in the hopes to prevent badness from occurring right prevent diabetes prevent obesity but now the idea that we're actually seeing things get better than normal um that the exercise improving um the the uh the enhancement aspects of this are definitely things that you you you you know we didn't even imagine are things that that could be improving so that's very exciting um so i think that you know uh people in the audience want to know um how do we use this information to lead better lives um like uh do we um do we have enough information from the the work that we've gathered from humans actually before we get into that um i should say that you know one of the projects that you've been working on or that i know that um you were successful in at least initiating before kovid was the fireman study um i i know that uh you just got that started before covet i don't know how klovit has affected that but um is there additional information that's coming out from that that you can share with us yeah that's a very interesting study five factor study because um you know nearly 20 percent of the working adults in the us they do shift work just like firefighters nurses long-car truck drivers and they experience chronic circadian rhythm disruption and what is interesting is if you look at these people who people who become fat people who become airline pilot are people who are getting into healthcare profession they are among the healthiest bunch among their peers when they sign up for the job but then 10 to 15 years down the road there are the they have the highest risk for many of the chronic diseases so just 10 to 15 years of doing shift work seriously affects their health and what was what was really heart-wrenching for me to see was you know if you go to clinicaltrial.gov you see that there are nearly 350 000 studies listed and less than one percent of those studies have to look at the effect health of shift workers so just imagine 20 of the working population bears unreasonably disproportionately heavier burden of disease and we spend less than one percent of our clinical trials to study them and not only that most of our clinical trials have shift work as a exclusion criteria so that's why i got super excited because you know [Music] i mean you and i we got into this biomedical research because a very basic foundational reason that is irrespective of age gender sex and nationality every single human has a basic human right and aspiration to live a healthy life from birth to death and the goal of biomedical research is to come up with solutions that are agnostic to all these uh differences and they should create healthy quality so to see that shift workers are disproportionately bearing a heavier burden of disease and we are paying very little attention to caring for them um prompted me to look into this so we started this study and through this study the idea is very simple can firefighters who do 24-hour shift in san diego can they adopt a 10-hour hitting interval and if they do then what are the benefits and we're extremely grateful to city of san diego and san diego fire and rescue because the goal was to recruit 150 firefighters and san diego health and rescue san diego fire and rescue has 800 firefighters so that means we're recruiting one in five firefighters into the study and what if there is adversely adverse effect and they cannot do their job they cannot get into the fire truck and they are delayed by even a minute that will cause a lot of harm but we are grateful that they participated and we haven't seen any adverse effect of time restorating they can actually adopt it pretty well because they tend to eat they can eat between 8 am and 6 pm for example some people before 9 to 7 etc and so far um we have seen great progress another thing what we found is firefighters are extremely dedicated to the study so during this study we had two major california fires we also had kobe 19 and irrespective of all these hurdles they continued their interventions they continued to come for their clinic visits we continue to gather data and send us data through the my circadian clock up so i'm super excited so out of 750 clinic visits from 155 fighters we have only nine clinic visits remaining we are hopeful that we can finish them by middle of january and then the final data analysis but the good news is that we did not see any adverse effect we have seen excellent compliance and we hope to see better health outcomes that that is amazing um yeah the you know i had the privilege of meeting some of the firefighters at one of the events that you and i were at at one of the ccb events i think it was and and just their uh dedication to the study and um that's just really amazing that they were able to do this given all the terrible things that have happened the last half year or or so um that's fantastic also that that you were able to get this study going so successfully that's definitely a testament to you and your team um yeah there's also another point i must bring up that is when we recruited these firefighters they realized that although the study will be done on 150 firefighters the results that will come out will apply to 1.2 million firefighters who are in this country so they have that burden they feel that personal responsibility that they have to be a good participant because the results from one firefighter might affect the health of 10 000 firefighters only in the us and then if you expand it to worldwide so i guess that's something that in many clinical trials there are patient advocacy groups and if we can present that picture that look you what you're doing is extremely noble and what we get out of the study will impact for example in a blood pressure trial 100 million people in this country so if we give that context and the participants are more likely to comply and you will have much better results sorry for the interest no no that's that's great i think it it speaks to you know these are already individuals who are very selfless to begin with so this is uh this is uh further confirms that uh that character that characteristic of theirs um so uh so going to the question of how do we use this information to lead better better lives um i think most people who are at this webinar are coming here for for the title of um how do we you know is there a optimal time to be to use or is there a way that we can use this information to enhance our diet or exercise or sleep um [Music] is there is there enough information to make these kind of recommendations yet or or do we only have these informations for people like shift workers or do we only have these kind of recommendations for people who have um who are pre-diabetic or who have a high blood pressure or or do we have enough information where we can start making more broad recommendations what do you think i think um we can incorporate some of the advice that comes from sleep research society or american college of um sports medicine or right now even american heart association has recognized the importance of daily fasting so you can bring all of this together now the question is um what is in it for people who do not have chronic disease i think this is where we have to emphasize that uh human performance is a function of our physical metabolic and mental health and irrespective of which days of the life you are we know that just one day of sleeping less or not exercising for five or six days or eating too much food or eating late into the night will affect that human performance and productivity and particularly for students and younger adults who are actually going through the peak phase of human performance they want to be physically fit they have to be they also want to be mentally fit and they also want to be emotionally fit and what we know is exercise food and sleep affect all these aspects of our life and in fact if we think of lifestyle and how do we define lifestyle we know that good lifestyle improves health irrespective of what condition you have and lifestyle is what when and how much we eat sleep and move on a daily basis and then if we think uh almost all of us are shift workers because the definition of shift work by world health organization or international actually um international labor organization is someone who stays awake for two or more hours between 10 pm and 5 am for at least once a week is living the life of a ship worker so i guess now that qualifies you and i have shift worker and almost 60 to 70 percent of audience uh students who are listening now they're also living the life of a shift worker um so in that context i think i'm sure that almost everybody will benefit from optimizing our circadian rhythm so it's beyond um timeless rating so in that context i would like to share this slide to summarize what we can do so we must we can accept that sleep specialist and american sleep society sorry sleep research society and sleep professionals have advised us that we should be in bed for at least eight hours if we give ourselves eight hours in bed we make cats six to seven and a half hours of sleep and there have been studies on millions of people showing somewhere between six and a half to seven and a half hours of study is sorry sleep is best for you then next after waking up i've heard at least one hour after waking up about food for one hour after waking up because that's when a melatonin or sleep hormone goes down and our stress someone cortisol begins to rise and both of them are known to affect insulin response so it's better to avert food for an hour or two and then you can select to eat within eight nine ten eleven or maximum twelve hours and that's what we call eight hours time just to eating ten hours eleven or twelve hours time yesterday but at the same time we also can agree from [Music] the rich history of gastroenterology and physiology that it's not a good idea to eat two to three hours before going to bed because your stomach is still working for four to five hours to digest that food and pass on to intestine also there is new data showing evening melatonin might affect your insulin secretion and function then bringing light into the equation we can also agree that there should not be any bright light couple of hours before going to bed because that can disrupt our sleep so now what about exercise it's um we also agree that 150 to 200 minutes of physical activity in a week that boils down to 30 minutes of activity is good for us so that means brisk walking and if you're doing it it's better to walk outside when you have daylight because daylight again during day time it enters our circadian clock but what is much more important is it acts as a anti-depressant and we know that a lot of us nearly 10 percent of the adult population in the u.s see their doctor for depression whereas we know that daylight is the best anti-depressant it's plentiful and it's free you just have to walk outside so in this way now we can put this together to to so that we can follow our circadian lifestyle to support our circadian rhythm because when we support our circadian rhythm it takes care of our health and in fact if we boil down everything that you have seen amir in your mouse paper and what we have seen in the last eight years from mouse and human studies is time restorating or having a good circadian rhythm is a multi-solving approach to health because it can reduce your risk or reduce the severity of disease from your gi tract liver brain health glucose hypertension etc and when we have this multi-solving approach then why not to adopt it because it's free no thank you for sharing that that's it's very cool i think uh everyone wants to have a copy of that slide um you know um just looking at that slide and uh thinking about the mice and thinking about real world um you know i was thinking that the mice don't really the mice become or adopt a unhealthy habit of eating when we give them high fat diet and i and you know um you mentioned that 150 years ago uh we didn't really have a light and uh you know light at night like we do now um and also nowadays we have a lot of screens and a lot of nutrient-rich food [Music] do you think that um do you think that it's because we have a lot more of these material do you think that it's basically a lot of these societal factors that have contributed to the disruption of circadian rhythms in this manner or like do you think this in other words do you think it's societal the the availability of the societal factors that have contributed to the destruction of circadian rhythms or are there other factors that we're not thinking of i think a big of a very important point and in this context i would like to go back again to 100 years ago you know um discovered 19 is shocking us because it has high mortality but we must also should not forget that there are a lot of deadly diseases that used to affect us just imagine the type of vaccines we take almost everybody who is listening must have taken at least one vaccine and many of us have taken at least five or six vaccines because all those diseases were fit and what happened at the turn of last century was we figured out that many of the infectious diseases are caused by pathogen so that led to the germ theory of disease and john theory of disease actually helped us create a different world the first effect is sanitation the reason why we sanitize our home outside and there is a huge sanitation industry out there is based entirely on germ theory of disease so we created an anthropogenic world that is entirely based on this germ theory of disease so that we could increase lifespan by saving people from infectious disease and then came vaccination and antibiotics so now the same line although we have been living with circadian rhythm for last 200 000 years since humans evolved on this planet we did not know about the importance of circadian rhythm in our health in fact only in 1970 people thought that circadian rhythm may be something real and maybe encoded by genes so what it implies is we built an anthropogenic world without the knowledge of circadian rhythm so as a result we never thought about how to automatically switch off the light how to brighten up the room in the day time and similarly when we should have access to food when we should be taking our medication all of these things so now i would say that this is an inflection point in human civilization because just like germ theory of disease i would say there is a circadian theory of health and the circadian theory of health will say that if we entrain and nurture our circadian rhythm by regulating light regulating when we eat food and when we exercise that can increase our productive healthy lifespan then that will create a different economy and we are beginning to see that because the indoor lighting and led itself is a 27 billion dollar industry and they are paying attention just imagine 15 years ago no one would have thought that every smartphone would have a night shift feature now billions of smartphones billions of laptops and computer screens all the computers now come with night shift feature and it's interesting to see that san diego airport for example used to dim down at 10 o'clock at night so beginning to see circadian rhythm uh being adopted in rebuilding a new anthropogenic world and i'm super excited about uh this future but just like later in asbestos in seventies we discovered the bad effect of latin asbestos and it took us 50 years to rebuild our buildings similarly it will take another 50 years to rebuild our anthropogenic world to support security and algorithms so sachin i think it's time for us to take some questions from the uh from the audience and i'm gonna go a little bit out of order because someone asked a question that uh applies to a comment that you already made um samantha samantha i hope i said that correctly asked about how much um how much effect do you think daylight savings time change affects our circadian rhythms yeah so that's an event that's going on for a long time and i think this is the largest circadian experiment ever done in human history because for last almost hundred years uh we have been changing the light timing twice a year uh so i have come to call this daylight saving time or the time chance day as the international circadian day because that's the day everyone from newborn to 100 year old are given a one hour jet lag and the experiment result has been unanimous that it's a discomfort and also we do see a spike in accident spike in heart attack and many things in addition to that there are now more deeper studies looking at the impact of daylight saving time on productivity happiness wealth etc so the result of this long-standing experiment is it's not good to change timing and hopefully we'll see that many states in the us and many countries in europe will ebola's daylight saving time and we'll see what happens after that not too bad we'll not have the international circadian day that happens twice a year um so another question that i think is really interesting here is you know someone mentioned in an anonymous attendee asked the uh you know mentioned the you know there are people with a variety of chronotypes uh so you know um extreme morning larks or extreme night owls um do you think that um first of all do you think that is your is the advice of time restricted eating to these individuals the same or do you think that um time restricted eating is there going to be a time restricted eating from a type difference or variety in these individuals as well so i think whether it adheres to the same light chronotype or not it's a different question but yeah so i think since we live under artificial light um so that's why that slide i shared i did not put time on that slide because it all depends on whether you are consistently going to bed at the same time if you go to bed at eight o'clock in the evening then maybe you should stop eating at five and if you consistently go to bed at one o'clock in the morning then maybe you should stop eating at 10 or 11 at night and accordingly you can dial in and then see what time you're waking up when you should start eating and when you should stop eating but irrespective of all of that try to be outside for 30 minutes to do some exercise a physical activity and everybody can do that so i don't think it will impact or there will be different recommendations for different prototypes so um so i got to ask you this question because an nih reviewer asked me this question um so um so you know uh um circadian rhythms or light rhythms or even feeding rhythms are not the only biological rhythm you know in mice we tend to do research mainly in male mice however in in human research certainly and of course if you want to expand outside of metabolic research in female mice there are reproductive rhythms how how do we see do how do circadian rhythms and menstrual rhythms intersect with each other do you see one influencing the other in any specific way yeah so this is a great question because this affects of course half of the population and we have been ignoring and doing most of the studies in male mice um by the same time many of the circadian mutant mice do have the female mice who have menstrual cycle defect or they have defect in conceiving many of the female vice also have premature babies and all all these problems do happen so now the converse question is if you fix the circadian rhythm do you see improvement and this is an important question that is um this is an important uh clinical study to be done for example we know that many young adults women who are in universities and colleges they have circadian rhythm disruption because of staying late at night at the same time many of them also um complain about missing their period or irregular menstrual cycle so then the question is by timeless to eating or by consistently sleeping and working can they correct and i think this is an important area of research and somebody should test it but at least in mice we know circadian rhythm disruption leads to menstrual cyclic disruption so i'm going to try to combine three questions here so um for someone who's trying to start out the time restricted eating how would you recommend them starting out you kind of hinted at it with your slide um but do you have any additional recommendations and then what do you uh how do you think that so physiologically do you have some explanation of what's going on especially if they have pre-diabetes or obesity yeah so people who with obesity and pre-diabetes or diabetes their hormonal rhythms are also very different in the sense hunger satiety hormones are also very different so they may find it a little bit harder to apply timelessly because they are naturally programmed to feel more hungry so that's why they have to be mindful to expect that the first few days will be a little bit hard um it's uh difficult to jump straight into six hours eating or eight hours you think because the internet cult of intermittent fasting says that but first try to eat within 12 hours and then try to eat say if you can within 10 hours there are certain things that you can do so for example after overnight fasting or 12 14 hours of fasting you may feel more hungry in the morning and if so then try to eat a good size breakfast with a lot of complex carb protein etc so that you can go on without snacking until late afternoon for a small lunch and then maybe an early dinner it's also important that if you're trying this not to have too much simple carb at dinner time because you'll have a sugar high and then it will go down and you might feel hungry before your bedtime what we also see is people slowly change that taste so they cannot eat too much sweet food after two or three weeks some for some people four or five weeks so be prepared for that and ultimately you'll like it you'll like to enjoy the food because after so many hours of fasting your test birds are very different and you'll begin to enjoy the flavors and taste in food that you have never tested before so very mindful about this those who have a continuous glucose monitor access to that particularly type 2 diabetic or type 1 diabetic it's very important that if you're trying to start time restorating also pay attention to your glucose meter there's a small but significant chance that you may go hypoglycemic it also depends on what medications you take so i guess for people with type 2 diabetes or type 1 it's better to have a continuous glucose monitor to begin this um one of the questions uh is has there been a relationship between internet intermittent fasting and the rate of neural degeneration yeah so when we think of intermittent fasting or this time ratio eating [Music] we should also bring everything into context for example caloric restriction studies have shown that cr improves neural function because it increases bdnf and improves synaptic plasticity etc most of the caloric restriction studies and mice are combination of both reducing calorie and also time restriction or intermittent fasting so it lives up on the question whether the benefits of caloric restriction is entirely due to caloric restriction or partly due to time restriction since we do see i mean in your experiment you saw that mice improved motor coordination which comes which is partly neuronal improving at least the neuromuscular synapses then i'm hopeful that a time resorting or intermittent fasting will improve brain health reduce dementia so in that way i'm hopeful that it will have positive impact so um one of the questions is uh why isn't why isn't there more research on the relationship between certain rhythms and how it affects our health well as i said this is a relatively young field and there are relatively fewer number of researchers for example in every university you will find a department of cancer department for diabetes etc uh treating disease but there is no single circadian disease so that's why we have less manpower and there are also other disease priorities so i think this is a great time for students and young adults to consider circadian rhythm as a career choice because once they get in in circadian rhythm field you don't study about one aspect of earth this is really the true integrative aspect of health and when we have more people then we'll have more studies and we can improve the health of more and more people so sachin i know this is a question that you and i have debated in the past and i wonder if your if your answer to this question has changed over the last five years is it the length of feeding period that matters or is it the length of the fasting period i think the length of um these are interrelated because it's two sides of the coin if you reduce the length of fading period then ultimately you are automatically you are increasing the length of fasting period um i guess we still have five years from now i wonder if you did like a quick pulse of a of a food in the middle of the fasting period or something like that um yeah yeah i don't know how that entrains things differently but yeah and then if you take out the entrainment if you just follow your gi physiology for example in the middle so let's let's break it down to really the number of hours so after the last meal suppose i have my last meal at 6 pm then it could take almost five hours for the stomach to digest that food and spit it out into intestine right so that means if i had my dinner at 6 pm then until 11 pm at night my stomach is still working it's not into repair mode and then from 11 till next morning suppose i eat my breakfast at 8 o'clock i get 9 hours of rest time to repair my gut lining and replenish my digestive juice as said etc so now you are saying that in the middle of that supposedly at two o'clock in the morning i have only half a banana or half an apple what do you think will happen to my stomach will it take four hours to digest that and will it interrupt the repair process well what if you even had something simpler what if you only had like simple syrup or something like that so so the like you know you you don't even have fiber you you just have something where you can't even call it fasting but it's not even digestion at that point yeah so now let's take another example so you know i mean if you if you bleed me to death and take out all of my blood and measure how much sugar i have in my blood it will be 100 milligram per deciliter or 5 grams of sugar so you are saying that if i have just one teaspoon teaspoon of sugar in a cup of water and i drink that what will happen so that 5 gram additional 5 gram of sugar will bring up my blood glucose level to 200 milligram per deciliter so that's beyond diabetes so that is that will trigger my pancreas to wake up insulin wells turn on it will shut down glucagon and when they get depending on whether i'm sleeping how much growth hormone i have it will also interfere with growth hormone function and defense so a lot of things will happen so now you can imagine that even from the very basic biology of just glucose regulation even half a teaspoon would bring my blood sugar up to 175. so now you got your answer now i just remember at the time i used to think that the fasting was important and i remember you disagreed you said that the feeding was important and i remember this vehemently disagreeing with you and then thinking a year later that you were right it took me a year to to realize it but but i remember thinking that you were right about that but so avery it's six o'clock we didn't we weren't able to answer all these wonderful questions that people have had um uh we did get a lot of really good questions um i did answer one of them um by typing in the answer i don't know uh what would you like us to do yeah um we've reached the 6 pm in deadline so we do not want to hold you guys any longer we already appreciate this hour immensely so we just want to thank you all for um coming and answering all the questions that we had for everyone and i'm sure that you both have resources that maybe you could quickly point to for people who did not get their questions answered or something that you would recommend that they take a look at um now knowing that there are other questions that have yet to be answered yeah i mean as we mentioned during the discussion we have this my circadian clock app but then we also have the my circadian clock.rg website there are some blogs and other stuff that are there and links to some videos and news release and sites so they can learn more about that ccb itself it has a wealth of information both basic science and applied translational research and with my conflict of interest i do have a book so if you're interested then it's there it's now translated into seven or eight different languages so you can book in your hopefully in your favorite language um so i think this is uh interesting that you know the point is five years ago when people talked about circadian rhythm then i always used to get the question what is that is it about the insect that comes out in every seven years and things have changed and now we know what is circadian rhythm and i strongly suggest that people can go and read a little bit because if you want to create a culture of health then you got to learn about very basic thing about lifestyle or health and then you should have opportunity to practice it and circadian rhythm is very foundational there are very few simple things to learn and there are also easy things to implement so you can really implement and expand the culture of circadian health and be healthy awesome i think those are super important messages and once again thank you both for coming hope people check out the circadian code it is a very good book um do you recommend so yeah thank you all so much have a great tuesday um and yeah stay safe thank you amir stay safe everyone bye-bye thank you sachin thank you avery

Channel: The Loft UC San Diego

Views: 5,863

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Id: ESNOBbxCtmQ

Length: 64min 20sec (3860 seconds)

Published: Tue Dec 15 2020