(audience applauds) - Thank you so much. So for thousands of years, for most of our human history, the biggest threat to human
health were these diseases. And what is amazing now is nearly half of you may not even recognize
the names of these diseases, or may not even know anyone who have had these diseases in their life. So what happened? What is the magic? What is the common glue that
helped us to fight these diseases? I think almost 200 years ago, there was a simple theory called
the germ theory of disease, that essentially, had a very simple idea that these diseases
are caused by pathogens who live outside our body,
and somehow they get into us and then cause disease and kill us. That simple idea drove three foundations of modern healthcare, and that's sanitation,
vaccination and antibiotics. And this revolution started
almost 110 years ago when the life expectancy for a baby born in this country was around 42 to 45 years. And every single year
of biomedical research in the last 100 years
has added three months to human health, human lifespan. So now, in 2018, if a baby is born, he or she is expected to
live up to the age of 80. And that is the miracle
of a simple theory. But now, although we
live a very long life, half of our life is
spent fighting with a lot of these different diseases. So although we live long,
we don't live healthy. And these are very
diverse types of diseases, so then the question is, can we think of a very simple idea, just like the germ theory of disease, to fight and effectively manage, reverse or even cure some of these diseases? And so in that context, I want to give you a very revolutionary and profound idea that many
of these diseases may be due to disruption of what we
call circadian rhythm. So the word circadian comes from two Latin words,
circa, nearly, and time. It's 24 hours, so that means
these are 24-hour rhythms. So then the question is, why
do we have these rhythms? And the reason is ever since
life has thrived on this planet, all life forms on this
planet have to adapt to this very predictable
change in light and darkness, every single day, in every 24 hours. So that's why every life form has evolved to have these rhythms
encoded in their DNA, and it's so intrinsic
to all the life forms that if we take human plants
or animals from our planet and transport to another planet that has the same identical ecosystem, but if the day-night cycle
is other than 24 hours, then we cannot survive and thrive. In recognition of this
foundational, fundamental impact of circadian rhythm in health and life, last year's Nobel Prize was given to three leading scientists in this field. So then the question is, how do we know that we have a clock that
gives 24-hours rhythm. A very simple experiment you
can do is you can lock me in this room with enough access to a bed, maybe, and some food, and what will happen is
although I won't have access to timing, I would go to sleep
around 10 o'clock at night. My deepest sleep will
happen around 2 o'clock. Even without an alarm clock,
my body temperature will begin to rise two hours before the sunrise time. And then as soon as I
wake up, open my eyes, my sleep hormone, melatonin,
will begin to plummet, and my stress hormone,
cortisol, will begin to rise. And bowel movement will be most likely in the first half of the day. My body will be most
effective in digesting food, better insulin sensitivity,
in the first half of the day. Then as the day goes on, my brain will be at its peak performance around noon, and then right around this time, my muscle will be at peak performance. And then as the evening rolls in, just like clockwork,
melatonin will begin to rise, body will cool down, and
I will go back to sleep. And this will happen every single day. Even if you lock me
here for a year or two, this will continue to happen. And this happens, because
almost every single hormone, every brain chemical and
even every single gene in our genome is
programmed to rise and fall at a predictable time. And all of these give rise
to one simple phenomenon. That is, we know that there are
three foundations of health, sleep, nutrition and physical activity. In fact, all of these are directly or indirectly regulated
by this timing system. And I think this is the
most complicated slide, because what I meant to say
is these clocks regulate when we sleep, when our
body is most effective in digesting and observing nutrition and then when our muscle is most effective in doing exercise. At the same time, these three
are under its own regulation. So although the clock tells us that our body is most effective
in eating at a certain time, if we don't have access to
food, then we'll feel hungry. So similarly, these three
systems are regulated within themselves, and
they affect each other. And then this whole system is linked to the outside light-dark cycle, and that causes a rhythm in
internal body temperature. So in a nutshell, our physiology
and metabolism, everything, is very strong rhythmic and
is tied to the outside world. So what has changed in the last 120 years? What is the fundamental
thing that has changed that make us more prone to disease? Definitely, our genetic
clock hasn't changed, because it's too short
of a time to change. What I think is our ancestral
rhythms are very different. When our ancestors were
hunter-gatherers or farmers, they had 12 good hours
of complete darkness. And they could sleep for nine hours. And then during the daytime,
there was plenty of light. There were plenty of physical activity. And the access to food
was actually very limited to only 12 hours, because after nightfall, it was dangerous to stay awake or to eat. So people used to eat maybe two, or maximum, three meals a day. And after the Industrial Revolution, we have electrical lighting that tells us to stay awake, late into the night. There is excess food production
and easy access to food. And finally, infrastructure development, what does it have to do with health? Infrastructure is the way
to move people, product, information and waste from
one place to another place with minimum human physical activity. So that means as infrastructure develops, we are less likely to
be physically active. So now our modern rhythm
is something like this. We are in a dimly lit room
like this, for 24 hours. We have sufficient access to light. We have very little sleep,
very little opportunity for physical activity. And then as long as our eyes are open-- (audience laughs) As long as our eyes are
open, our mouth is open. (audience laughs)
And in fact, we are told that, in
every two to three hours, we have to eat. So as a result, there is
this complete disruption of circadian rhythm that
happens, for most of us. And when this disruption
happens, for example, if you take a newborn baby or a premature-born baby, preemie, and there is strong
circadian rhythm disruption, there'll be lifelong impaired
growth and development. But just imagine, just one or two nights of staying awake late, to
take care of a loved one or to finish an assignment will
cause a lot of inconvenience, for example, these ones. And in fact, these may not be disease, but if somebody has an underlying disease, autoimmune disease or something
else, that may flare up. And if it continues for weeks or months, then we get closer and closer to a lot of different diseases. And these are not only restricted to young adults or middle-aged adults, and these diseases keep
on going as we get older. And in fact, what you
are seeing is the summary of nearly 2,000 publications,
over the last 25 to 30 years, showing how circadian rhythm disruption, either in real-life situation,
among shift workers, or in clinical control conditions or in animal models can
lead to these diseases. And what is scary is the ones
that are in red affect more than 10% of the population. So that means for these diseases, there are at least 30
million people in the US. Or if it affects only women,
15 million people, on average, that are affected by this disease. And more than 90% of our
healthcare costs go towards it. And at the age of
retirement, at the age of 65, 85% of adults in this
country have two or more of these diseases, and the cost
of living with that disease, one of them, is at least $3,000. So now you can do the math. So what the field of circadian
rhythm does is to figure out whether we can train our clock, we can maintain a healthy clock, and prevent or reverse our disease, or we can time the drug,
and then the third, and most amazing aspect, is
can we really drug the clock so that with a simple drug,
we can drive a healthy clock. And that's a little bit futuristic. But at the same time,
right now, let's talk about what are these clocks. So just like a brain has a
clock that we all experience that make us go to bed at a certain time and make us wake up at another
time, almost every organ in our body has its own clock. And the brain clock just
tells all these other clocks to be in sync. So brain clock acts almost
like a master conductor. And then the other clocks obey these rules. And as a result, every day, we have this daily rhythm
in sleep, mood, metabolism, and even our gut microbiome
also goes to 24-hour rhythms. And the question is, how is this connected to the outside world? So we know that when we go
from one place to another, across different time zones, or somebody does shift
work for a few days, then they can still retrain
their internal clock. And that happens because of
light going through the eye to the master clock. But this signal, one of that
light signal was very curious. We are very curious about it, because there are many
blind people who cannot see, but they can reset their clock. So almost 15 years ago,
when I was a postdoc, three different labs, including mine, we made a big discovery in this field. We discovered that there is
a blue-light-sensing protein that's present in only
5,000 squiggly neurons in each of our human eye. And that's called melanopsin. And this melanopsin
protein senses blue light and is directly connected to
the master clock in the brain. But there was some interesting
properties of this. These light-sensing neurons are
not that sensitive to light. They sense only blue light,
but if it is candlelight or orange light or fireside light, then they cannot actually sense and tell the brain that there is light. So as a result, for thousands of years, when we did not have access
to bright light at night, these melanopsin cells were
sleeping in the evening. Our brain was getting the
signal that it's evening time. Melatonin was rising. The sleep hormone was rising. And it was making us fall asleep. And we're getting a good night of sleep. At the same time, during daytime, as we get out of the bed and go outside, the bright light would
activate this melanopsin and would activate all the
alerting function of the brain, synchronize the brain clock. It raises alertness and reduce depression. So this was going on
for thousands of years. And in the modern days, as we stay indoors with bright lights and bright screens at night, then the blue light from those light sources
confuses melanopsin and confuses the brain,
and brain cannot figure out when it is evening. So your sleep hormone,
melatonin, doesn't rise. And we have difficulty falling asleep, or we wake up too many times at night, or even in the morning, when we wake up, we feel very tired. We have foggy brain during the daytime. And then throughout the day,
we spend most of our day in dimly lit rooms like this. That's not bright enough
to reset our clock. So as a result, we go from
sleepless night and foggy brain during daytime, and if it
continues for several weeks and months, then again,
scientists have shown, that we get closer to
many mental diseases. So as a result, there is
a new idea that lighting, there is a new lighting revolution that essentially says light
for vision is not the same as lighting for health. And in fact, a few years ago, The Economist magazine wrote
a very provocative article called The Light Therapeutic, the idea is if light affects our mood,
hormones, reproduction, and alertness, depression,
then light is a drug. And if we can control lighting,
then we can improve health. Then the question is, who
should regulate light, and who should listen to it? So that discussion is still going on, but at the same time,
scientists are still trying to figure out how much
light is good for us. And we haven't come to a consensus, but there is a rule of
thumb, that lighting to treat depression,
seasonal affective disorders, winter blues or ADHD, one
should get at least 10,000 lux of light for 15 to 60 minutes. What is 10,000 lux of light? So that is, if you go outside, even without directly standing
under the bright sunlight, if you were in a shaded area, you get 10,000 to 20,000 lux of light. So just going outdoor, gives
you the best anti-depression in this world, and it's free. We just have to set our foot outside. And then average person, for others who don't have
depression or something, then we need 1,000 lux of light,
500 to 1,000 lux of light, for 30 minutes in a day. So that is having your breakfast
right next to a window, not even looking at the sun. And just before going to bed,
at least dim down your light and have less than 20 lux
for two to three hours before going to bed. That will help us to build
up our melatonin level. And we have been working with
various national institute, building code specifiers,
for example, ASHRAE. And at Salk, we also have what we call Academy of
Neuroscience for Architecture, where neuroscientists and
architects have a joint dialogue to figure out how to
incorporate the knowledge from neuroscience into architecture. And our lab also has a iPhone
app called myLuxrecorder, which is free, and you can just download and then look around, and then it will show you
how much light you have. So it's a very simple app,
and you can click and save, so you can go back and see how
much light is in which place. And this simple idea has
revolutionized so much that now there are nearly two
billion smartphones and PCs that change their screen color from blue to maybe orange color,
around 10 o'clock at night. It's really gratifying to see that this basic science
discovery that happened in a little mouse, 15 years
ago, has already made it to two billion devices so
that people can become curious about the effect of light, and in fact, there are many other apps and wearables that are coming into the market. At the same time, if we think about light, and if we look at this
nighttime image of the US, then you see all these bright
spots, and if you zoom in, and then you see this kind of kitchen. So that means
(audience laughs) we don't stay awake late into the night, just reading books or something. We actually have entertainment and food. So then we got curious about
what are the effects of food on our circadian clock. And to make a long story
short, what we figured out is if food is presented at the wrong time, it just disturbs the entire circuit, and then food takes over all the clocks. So that means as we continue to eat late into the night, or randomly
eat one day or the other, then it's almost like our
body goes through jet lag. Although our brain doesn't
feel it, our body feels it. So a very simple experiment that is done 10,000 times or more, we latched on to that
experiment to figure out, to find the relevance of this simple idea. So the idea is this. If you take two identical sets of mice that are born to the same
mom in the same room, fed the same diet, had
the same microbiome, it divided them to two different groups. One group gets to eat a
balanced, healthy diet. The other group gets to eat a high-fat diet, high-sucrose diet, or any unhealthy diet. Then after a few weeks,
we know that the mouse that eats the unhealthy diet becomes fat. And that leads to obesity, diabetes and all these other
disease, and that's the idea that has been driving biomedical research into metabolic disease for
the last several decades. What is interesting is
if we look carefully into how these mice
eat, mice are nocturnal. They should be eating at nighttime. But if they have access to yummy food, then they will eat
throughout the day and night. And that breaks down their rhythms, so the genes that are supposed to turn on, the hormones that are supposed
to go up at a certain time, the hormones that are supposed
to go down at other time, they don't do that. So it's almost like all the traffic lights in a city being stuck in yellow or orange. Then the traffic doesn't flow well. So we thought, what is the impact of food versus timing on mouse health? So this is where the basic
science and basic imagination about what might be happening about metabolism comes into play. The idea is very simple. Nutrition science has told us that as long as we keep eating, in the morning, when
we start our breakfast, then we have the right
enzyme, the right hormone and the right microbiome, and
our body is primed to digest that food, take some of that
food and burn carbohydrates to fuel our body, and at the same time, store a little bit of fat. And it continues as long as
we eat throughout the day. And then after our last bite, the burning sugar part goes down, because there is not
enough available sugar, and then the fat begins to start burning. So in the last few hours
of our overnight fast, our body is actually burning fat, and at the same time,
repairing many organs. So the next day, when
we eat our breakfast, the cycle changes again. So now imagine if we spread this food over 15, 16 hours,
without changing calories, then our body will not
have enough time to switch from sugar-burning to fat-burning. It will also not have enough time to repair our gut lining and skin. So in the absence of that
repair, this is causing bacteria or even allergy-causing
chemicals can enter our body and can even cause more diseases. So with this idea, we
thought, well, that means if a mouse eats for 10 hours, then the mouse can have a healthy clock, can bond fat and be healthy, whereas if the same food
is given over 15 hours, or 24 hours, then the
mouse may become unhealthy. We took two identical set of mice. One group got to eat whenever they wanted, the high-fat food. The other group got to eat the same food, but they were trained to eat for eight hours, in the first experiment. And we did this experiment for 18 weeks. And there was a very surprising finding, that after 18 weeks,
although these two groups of mice ate the same exact calories, and the same identical food, every week, one group of mice was obese, and then the other group was lean. It was so surprising and
against everything else that we have learned in nutrition science that I had to get this experiment
done four different times by four different postdocs, so that's why this paper
has four co-first authors. And what is interesting
is the next experiment that Amandine, who is
actually in the audience, sitting in the very back, did
was a very heroic experiment. She actually took this fat mouse, and then put them back on eight
hours and nine hours eating and could reverse this disease. That was the most surprising fact. Although the mouse
already had the disease, you could reverse it, just by
changing what time they eat. And another thing that is most profound is there is no single medicine, that we know, that can reverse all of this disease, even in a mouse, in 10 weeks. So that's just this eight hours and nine hours eating
was the most powerful drug that we know, so far, if
you can call it a drug. So then we thought well,
it's nice and gratifying to cure a lab mouse,
but what about humans? So the first pushback we got was no, humans don't eat like mice. We are very different. We eat three meals. We wanted to see whether that's true. So we developed an app
called myCircadianClock. And anybody now can go to this website and sign up for this study. But what we do is we ask
people to take a picture of their food, because with a picture, we get what, when and how much people eat. And people love taking
pictures of their food, so it is very easy.
(audience laughs) And we ask them to take
pictures for three weeks, because we know that your weekday and weekend eating patterns
are very different. And we put them on a
timeline to make it easy for us to see when people eat. And this is what you see, every time a calorie-containing
picture comes in, or sometimes when they
forget, they just write it. Then we put it on a
timeline, and if it continues for three to four weeks, then
you can see how regularly or irregularly this person eats. And you can see that there is no rhyme, and there is really no pattern to it. And in fact, if we look at
the weekday and weekend, they also look very random,
and if we combine them, then we can see that it
appears as if this person was in San Diego in the weekday and
went to New York in weekend, (audience laughs) because we delay our
breakfast time in the weekend. But even if we combine all this data and then put it around the clock, then it looks like this
person was eating almost throughout the 24 hours, or
at least for 18-19 hours. This person was not an outlier. He was not a shift worker. And he was actually a nine-to-five job guy from around here. And in fact, in our first
study, we had 156 people. And all of them, nearly all of them, had this same eating pattern. And as expected, we saw that
people do eat around noon, for their lunch, and then
dinner around seven or eight. But at the same time, they
keep continue munching these small meals throughout nighttime. Then we asked how much calorie is present in each of these pictures. And what we find is the midnight snacks are actually very calorie-dense. People are not getting up just to have half an apple or something. (audience laughs)
They're actually having a big bowl of cereal with milk. So then we asked okay, so for how many hours
people are actually eating, just going back to mouse,
because we know in mice, if they eat eight, 10 or
12 hours, they're healthy. If they cross 12, then
they become unhealthy, even if they are given healthy food. What we find is 50% of adults
eat for 15 hours or longer. And think about it. If the first calorie starts
with the coffee and cream at 6 a.m. in the morning,
and the last calorie from your glass of wine or
beer is at 9 o'clock at night, that's already 15 hours, and
if you do it two to three times in a week, then that's almost
like disrupting the clock and going to East Coast and
West Coast a couple of times. And then we asked a very simple question. We know that our clock, our
body clock, is most effective in digesting food in the first
half of the day, but by noon, people consume less than 1/4 of their all daily calorie intake. In fact, by evening, we
still have 1/3 food to go. And in the evening,
two hours, three hours, we consume more food than
in the first eight hours. So that simply tells us that
we are actually eating opposite to what our body is designed to do. We even gave our participants
the watch that I'm wearing that collects sleeping time, eating time, and then we combined that
with the food pictures. We can see what time the person wakes up and what time they have
their first calorie. And to make a long story short, what we found is within
an hour of waking up, nearly 80% of people
have their first calorie. And then two to three
hours before going to bed, nearly 50% of people have something, some calories, before going to bed, and we know that these two are unhealthy. So the bottom line is, as I predicted, as long as our eyes are
open, our mouth is open. (audience laughs) So then the question was,
can we take some overweight and obese people, who are
eating for 14 or 15 hours, and then ask them to do only one change? The only one change they
have to do in their life is to figure out a 10-hour
window, and then try to eat whatever they want to eat,
without changing drastically what they're eating, within that 10 hours. So we have done this experiment now, quite a few times, and other people around the world have
been reproducing this, and the good news is
within 10 to 12 weeks, people actually lose a
modest amount of body weight. Their health, overall
health, actually improves. And I'll go over some of those. Then the practical question
is okay, so people ask me, "How should I organize my day?" And here is the very simple
and straightforward answer. The American Society
of Sleep Physiologists and all the sleep scientists,
they agree on one thing, that we should spend at least eight hours, every night, in bed. So that includes if you
are reading something or anything else, so eight hours in bed. So if you go to bed at 10
o'clock, wake up at six, then between after we wake
up, at least for an hour, our hormones are going
through change of guard. So the night hormones are going down. And the day hormones are going up. So it's kind of not very
healthy to eat something when these hormones are changing. So try to avoid food for
about an hour after waking up. And then if you try, if
you are really brave, and you want to start right away, then you can start a eight-hour window and stop eating at 4 o'clock. Or what we advise to
most of our participants, actually try to select a 10-hour window, because that's a little
bit easier to adopt. Some people go up to 11, just like me. I kind of slip towards 11 hours but never beyond 12 hours. So now you have four different choices, eight, 10, 11, 12, or
even you can do nine. And then give yourself two
to three hours without food and also without bright
light, before going to bed. So that makes it your full circadian day. Then what about light and exercise? We know that exercise has
undisputable benefits on health, so at least, 30 minutes
of physical activity, and if you can do it, even during daytime, walking under not midday sun,
but even with some daylight, that's good enough. So that's what we aim for
among our participants. But then the big question comes. What about coffee (laughs)? (audience laughs) So we said that you can have coffee from your start time
until about, say, lunch or maybe 2 o'clock but not beyond that, because coffee has a
half-life of around six hours for most of us, so that means if you drink a cup of coffee now, then your body still has half a cup of coffee six hours from now. So to have a good night's sleep, avoid coffee from 2 o'clock onwards. But I think most people are worried about, or ask us, "What about coffee here?" (audience laughs) So we have three answers. One is just about any food that we eat, our gut has to digest it
and send it to the liver. And the liver sends it out, and that's how coffee gets to your brain. So when all this process
happens, it's almost like trying to knock on the door of a sleepy person. Even if you knock slowly,
the person is waking up. So if you want to do a clean TRE, then coffee may not be okay. But life gets into the way. So if you have to keep your job, by having coffee,
(audience laughs) so that you can get to your job, have it. Second is safety. In the morning, 1/3 of
drivers are sleep deprived, are driving sleepy, so it's better to be caffeinated than to drive sleepy. And then third one is if
you cannot live without it, we don't want to take the last joy of life from your life.
(audience laughs) Then the second thing that
we are often asked is, "Well, I want to do eight
hours, and how can I time it?" As I said, yes, you can start
from one hour after waking up, and then you can also
sleep, say, seven hours. But some people want to start
at 10 o'clock in the morning. Some people even skip their breakfast and go straight to lunch. And we call it the early
TRE or the late TRE. And the bottom line is all the studies that are coming out, they're
showing that any eight to 10 hours time
restriction is always better than eating randomly, but if you want to have much better benefit,
if you want to go 100%, then try to do an early TRE. So that may be the ideal,
but at the same time, even if somebody is doing this late TRE, time-restricted eating, that will still give us a lot of benefit. Almost 80 to 90% of
benefits are still there, except for a few things. One is what we're finding
slowly is maybe the heart health or maybe people who have mild
predisposition to diabetes, it may be slightly better
if they adopt a early TRE. So now many of you might ask, "Okay, so what can you do now?" So we still have the
mycircadianclock.org website where anyone from anywhere
in the world can sign up. It's a IRB-approved study, so that means all your
information is very secure under a secure server, and
people do get feedback, and it's a guided study
for almost 12 to 14 weeks. So you can see what is your rhythm, and you can try to adopt
eight, 10 or 12 hours and see what benefits you'll see. So then the question is,
how is this so important? I mean, it's just eating eight, 10 hours. Is that it? So what we really see is this. After people start doing
this time-restricted eating, their nutrition quantity
goes down, of course, because the late-night
snacks and the wine and beer, those are going down. So you are losing some calories. You are reducing some
calories, and in fact, you are reducing some
calories that are unhealthy. So your nutrition quality goes up. And for some reason, we do
not understand correctly, but that might be something to do with gut and other physiology, when people do this
time-restricted eating, they get into deeper sleep at night. So they don't wake up that many times. So their sleep quality goes up. It happens two to four weeks after starting this
time-restricted eating. And then they also have
a much easier time getting into sleep. So sleep onset is much better, because you're also avoiding
light as part of it. And then your sleep duration
may improve, for some of us. So sleep improves. Nutrition quality improves. Then what happens? So we see reduced inflammation. So those who have little joint pain, that seems to go down
after six to eight weeks. In some cases, it takes up to 10 weeks. So once your joint pain goes down, then you can do better physical activity. Instead of taking the elevator, you can actually start to take the stairs. And then since everything is so timed, you actually can set aside a chunk of time for your physical activity. And then another surprising
thing that we find is people who do eight to 10 hours
time-restricted eating, they see a profound
improvement in their endurance. So those of you who are into
biking or staying on treadmill, then you'll see that you're
less tired at the end of your biking or treadmill. So then going back to
this particular chart, because what matters at the
end of the day is this chart. Can we reduce some of the disease burdens? Because even if we delay the
onset of one single disease, for one year, that's
$2,000 to $3,000 of savings in productivity loss and
also in healthcare costs. And if we can prevent that in
a million people for one year, so that's a $2 billion savings. So we and others around the world are now doing many
controlled clinical studies where we are measuring many
different broad parameters and also different things
invasively and non-invasively. And what is really
gratifying to see is some of these diseases that you
see, for example, obesity, pre-diabetes or type II
diabetes, this is acid reflux, some of these, we are beginning to see, are actually prevented or, in
many cases, can be reversed by sticking to this time-restricted eating for at least a few weeks, 10 to 12 weeks. And then the field is
getting really rich and rich, almost every month. There are new papers coming out in very high-profile journals. So for the general public and even for many of the scientists in the
field, it's really hard to keep up with the literature. So that's why a few years
ago, some of my colleagues at Salk Institute inspired
me to write this book. And I must say that all of
this, while actually possible, this research is possible,
because I was in Salk. They told me it would be
impossible to do somewhere else, because at Salk Institute, many donors, they gave us unrestricted
funds, and for example, for all of these experiments,
that I described, I had applied to federal
agencies 18 times and I did not get funding. Only on my 19th trial, finally, last year, I got funded, and until that time, all of this was done
with unrestricted gifts and targeted gifts from donors like you. So the book is divided
into three major parts. The first part deals
with the circadian clock. And it begins with the idea
that we are all shift workers. When you think of circadian
rhythm disruption, you might be thinking the guy who works in the assembly plant or the firefighter or the ambulance driver. They are the shift workers. Their clock is disrupted. But in fact, in this
chapter, I go into saying what is considered a
circadian rhythm disruption that causes disease, and in
fact, almost all of us go through this kind of disruption, at least a few years in our life, whether you are a mom,
whether you're a student. For example, in my lab,
for the last two weeks, almost everybody in our lab, 10 of us, we are going through
six to seven hours of, actually, nine hours of work,
in the middle of the night, every three or four days, and
we are going through this. And then the second chapter
is How Circadian Rhythms Work. So I go a little bit into
the molecular mechanisms and where are the cells,
which cells have clock and how they work, and then the
third one is Track and Test: Is Your Circadian Rhythm Okay? So these are very simple questions and then a few other ideas. Then part two goes into A Circadian Code for
the Best Night's Sleep, because sleep is one foundation of health. And then nutrition, to lose some weight and improve your health. And then to improve your
learning and working of brain health, and that
chapter goes into lighting and how to manage light. Then finally, how to exercise so that your circadian clock is in sync. And then I give some tips about lighting. Then finally is Optimizing
Circadian Health. What happens, or how can
you manage your clock if you have a gut disease
or digestive concern? And circadian code for
addressing metabolic disease, this is the crux of the book, because obesity, diabetes
and heart disease affect more than 70% of older adults in this country, and we can reverse or
prevent many of them. And then finally,
Enhancing the Immune System and Treating Cancer, because
40% of us, at one point in our life, will be
diagnosed with cancer. And if we can reduce our
inflammation right now, then we can delay, or we can even prevent. Second, during cancer treatment,
the new studies are showing that if we time the
drug to the right time, then we can improve efficacy,
and we can get a cure. Then the third, even
after cancer treatment, if we stay on time-restricted eating, then we can reduce the
risk of getting relapse. And that's now beginning to show up, because epidemiological
studies are showing that women with breast cancer, if
they eat for only 11 hours, then their chance of getting another bout of breast cancer goes down significantly. And those studies are being
repeated throughout the world, and in fact, now we
are seeing new research in prostate cancer. And then finally, how to
optimize circadian code for preventing dementia
and improving brain health. And finally, a perfect circadian day, where I give a few examples. And in fact, this book ends with somebody who has been living a
very healthy, long life and has been very productive in his life. And he is here, Roger Guillemin,
who is a Nobel Laureate, who is a faculty at Salk,
still drives his car every day. And his lifestyle goes with the clockwork. We interviewed him, a few years ago, and the book ends with his interview. So with that, I'll leave you
with this very simple idea, that our optimum health is
driven by having a strong clock. And when we have an erratic lifestyle, then that disrupts the cogs in this wheel, and we get all this disease. And it's almost like
taking 10 different cars and going off-roading. It's not that all 10 different cars will have the same
problem after two miles. So the same thing happens. Depending on our gene,
one may get heart disease. One may get cancer. But the bottom line is if we have a better circadian lifestyle, we can prevent or reverse many of them. And thank you. (audience applauds) - Well, I've heard Satchin many times, and I always learn something new. And it's wonderful to have
somebody doing something that we can actually apply to our lives. And it's positive and hopeful,
and we need a lot more of that in today's world. Well, we have about 10 to
15 minutes for questions. I know we won't get to everybody today. We've been live streaming on Facebook, so we've got questions from the audience and potentially online. My colleague Jane and I
will be wandering around with microphones, so Jane,
there's a question right here, the gentleman in the hat. And then afterwards, before
you ask your question, we have a book signing with Satchin. He will be at a table in the reception. So please don't come down here
to try to ask him questions, 'cause he has lots of people who are going to want his signature. So we will have him in the
foyer with food, reception, all of you, books, and if
you haven't gotten them, he's had so many write-ups in the press. We have one printout
from The New York Times. But just Google his name if you want to see what's out there. - Thank you.
- It's pretty impressive. So go ahead with the first question. - Thank you very much for such a comprehensive presentation. I'm very interested in
your comments and ideas and maybe past experiments or future ones regarding
the factor of aging with all the complex
variation that you address. - Yeah, so right now,
when we talk about aging, most of us have diseases of the aging. So our immune system deteriorates. Our motor coordinate system deteriorates so that we cannot walk properly. We cannot run properly. So those are the signs of aging. And this time-restricted eating can delay or even reverse some of those signs. So we think that this will ultimately lengthen, increase, the healthy lifespan so that we'll live a few years longer. In fact, just the first experiment in rodents, little mice,
just came out, last week, from the National Institute of Aging, showing that mice that eat
for 12 to even 13 hours, they live longer than mice
that eat the same number of calories, every single
day, in their entire life, but the first group was eating them only, and this 12 to 13 hours group live longer. They did not live as long as some of the old calorie restriction studies, where you have to reduce
calories by 30, 40%, every single day, but
it's very amazing to see that without counting calories, mice could live longer and healthier. - [Host] We are going to actually take a Facebook live stream
right now from Emily. She's actually in Satchin's
lab, and she's been helping out. - In fact, Emily will be
around after the talk. So if you have questions, she's the one who answers more questions
in my lab than I do. - [Host] All right, so you
have a question from John on Facebook asking if children should eat within a 10-hour eating window as well. (child babbles) (audience laughs)
- Okay. (Satchin laughs) Okay! So let's answer it slightly differently. I'll actually pose the question to you. So according to sleep
physiologists and pediatricians, children should be getting
around nine to 10 hours of sleep. When I'm talking about children,
I'm talking about children after the age of, say, 10. So if they're sleeping for nine hours, then they should not be eating for a couple of hours before going to bed. That's already 11 hours,
because even among children, not having food will help
them to go to sleep better. And then after they wake up, they will take half an hour
to an hour to get ready before they go to have their breakfast. So you can do the math. Even children can
actually eat for 12 hours. So that's why I say if you're
thinking about 10 to 12 hours, at least 12 hours, a five-year-old to a 100-year-old can try
to eat within 12 hours, sleep, for children, nine hours, for adults, seven to eight hours. And this is normal. Yes. - [Woman] I noticed Alzheimer's
on your list of diseases that could be impacted
by a circadian lifestyle, but not Parkinson's. I'm curious, why? - So we haven't actually looked carefully, because it's such a new area of study. Hopefully, what we
expect is in a few years, people will start experiments with mouse models of this disease. And then we'll see results. So far, we have seen from
Huntington's disease model. And mice who have the same mutation that causes Huntington's
disease in humans, if they eat within eight hours, then their disease severity is reduced. They sleep much better, and
their physical performance and activities were much better. So that initial experiment result from Huntington's
disease is giving us hope that hopefully we can replicate this in a few other disease models. Thank you. - A simple question--
- Sure. Right here, in the front. - [Host] In the front? - [Woman] Okay, this is a simple question. What does water intake-- - Oh yeah. - [Woman] Should you limit
water during the rest periods? - Yeah, so actually, I forgot to say. So you can drink plenty of water
outside this eating window. And in fact, many of the
medications are also fine. So you should consult your
physician about medications. But most medications are fine. Unless you are eating
those gummy bear vitamins, five of them,
(audience laughs) in the middle of the night. So you got to be careful
about that (laughs). Oh here. - This is fantastic work.
- Thank you. - I've been studying this material for about seven years now, since. I had insomnia back in 2011. It's phenomenal. I know that a lot of my
studies, the material that I've learned about
circadian rhythm are coming from the Ayurvedic and Indian culture, and I'm wondering what influence
that had on your studies and the work that you're coming up with. - Actually, some of the influence came from my research in
plants, because in plants, it's a very simple,
straightforward experiment. You take a little plant
and you give them light for eight hours, which is like food. Then the plant will take a long time before it produces flower
and fruit and dies. So that's a long life. Whereas you take a plant and expose it to 14 to 16 hours of light. That's food. Then the plant will flower
and fruit earlier and dies. So that was kind of in
the back of my mind, that if you eat for less number of hours, then you can live longer. Thank you. - [Woman] In military personnel, especially special operations,
they go through selection and assessment in numerous
schools in which they're put through circadian disruption,
energy deprivation, over and over and over again, over the course of their entire career. And would this suggest that
maybe we are aging them early? I can tell you from having studied them, they'll have significant
endocrine dysfunction. But if you look at their
values, oftentimes, the lipids, hemoglobin a1c, are normal
before and after these schools. So what would you say this
has in terms of impact for something like that? - Well, we're actually starting to study not really military personnel but San Diego firefighters, and they also go through
the same lifestyle. And in fact, Emily bravely
went and tried to experience what a typical San Diego
firefighter goes through, and she did quite a few
24-hour ride-alongs. And just imagine getting woken
up 10 to 12 times every night at random times, and you have to go through every single wake-up
and do the run and come back. And after one or two rides, she said, "I don't understand how these
people are still alive." (audience laughs) But what we know from
firefighters is they say that when they retire,
and within three months or four months, they come back, and they feel like they have
become 10 years younger, just not having that disturbance so much. And a very simple thing, when you look at any news
about a 100-year-old, you'll never find military personnel, a firefighter, a pilot, very
rarely even a scientist, living up to 100 years.
(audience laughs) And one of the common theme of our centenarians is they
live a very simple lifestyle, and they eat everything within set period, and they do enough exercise
and are exposed to light. So at the same time, we are
interested in these extreme ones who go through repeated
circadian rhythm disruption and yet they're healthy,
because we want their DNA, to study.
(audience laughs) If you know somebody, I'm serious. We'd like to study them. - [Woman] When people are eating, their mouths are opened. And have you found any correlation between improved nasal breathing
and better airway function in your research, or
are you looking at that? - Yeah, so this is so new, because our first human study
was only three years ago. And so these are some of the conditions we are looking at now. We just got funding from the
National Institute of Health, and literally the funding
letter came two days ago. That means we'll start recruiting
maybe December, January, and one of the questionnaires and one of the assessments will be
OSA, obstructed sleep apnea. So we'll get to that. - [Host] Up there, with Jane. - [Man] Yes, thank you, Dr.
Panda, great presentation. You did one back, a number of years, in the Rancho Santa Fe Rotary Club. - Yeah. - [Man] And people still talk about it. - Thank you. - [Man] My question relates to coffee, and I assume that relates to caffeine. We have a lot of other
drinks that have caffeine. So is the limitation the same on those? - Yeah, so I must, we actually spend, 80% of our questions are about caffeine and non-calorie-containing drinks. So when it comes to, say, sodas that have sugar substitute, we know that that sugar substitute does
affect our gut microbiome, so there are many other
reasons why to avoid them. But few drinks, for
example, carbonated soda, just seltzer water or sparkling
water is perfectly fine. And in fact, you can put
a little piece of lime and act as if you are having gin and tonic, vodka.
(audience laughs) And many of us do that (laughs). So it's fine. About other drinks, being a scientist, I
always wanted to go back and do the experiment, at least in mouse, and it's very hard to give
them these kind of drinks. (audience laughs) But what we tend to do is
try to do as much as you can with calorie-containing
food within eight to 10, or maximum, even 12
hours, and then outside, hot water, cold water,
sparkling water is fine. - [Host] Okay, this is the last question, and then he will be having to go out. - [Man] Thank you for an excellent talk. I'm wondering what happens to animals that are naturally nocturnal
feeders, like owls. Do they reset a different
sort of circadian rhythm? - Yeah, so actually, owls
are extremely interesting, because some of the owls go back and forth between nocturnal and diurnal, the owls that live in northern latitude. So the field of circadian
rhythm is very wide and diverse, because we also study, some
of us, study the switching between nocturnal and diurnality, and for birds, even migration
from one place to another. So we don't understand too much of it, because we have a lot of observation. We don't understand
the molecular mechanism that helps us switch. So before we end, those
of you who have books, of course, I'll sign, and
those who have already bought, and if you like it, then
please go to Amazon, or wherever you bought the
book, and then leave a rating. That will help other people
to appreciate the work and spread the word. - Thank you, Dr. Panda.
- Thank you. (audience applauds) Thank you, thank you.
(audience applauds)
