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Thank You for Your Patience

May 2, 2013 in 2013

The Paleo Approach by Sarah BallantyneUgh.  Writing a book while being a full-time stay-at-home mom with young kids, an active blogger and podcaster, and while being focused on healing from an autoimmune disease is hard work!  Especially because this book is rapidly entering encyclopedia territory in terms of size and scope.

Not familiar with my book?  Click here for more information.

I want to thank all of you for being so patient with me while I frantically try to finish my book.  I know I haven’t been posting as frequently on the blog as I did pre-book (and the frequency has been even lower in recent weeks).   And it will probably remain low for a couple more months.  And for the next two weeks, you might not be hearing from me much at all!   Although, I won’t be completely dropping off the face of the planet — I do have some great guest posts, some great recipes of my own, some product reviews, and more teaser excerpts from the book coming soon.

I have about 2 weeks left to finish all of the writing (ack!) and draw sketches of all the medical illustrations, and then two weeks after that to type up the well over 100 recipes (haven’t counted lately, but there’s more than I had initially planned… I think about 120 with about 20 still in development that I may or may not finish on time) and go through all of the recipe photos (huge job).  Frankly, I’m not sure how I’m going to finish (but, I will).   And when I do finish the writing and recipes, I will be going immediately into the editing phase.  Normally, authors get a bit of a break between when they turn in material and start getting edits back from the publisher.  I won’t because the first half of the book is already being edited and graphics elements are already being created.

I hear that editing is even more demanding than writing, although frankly, I can’t even imagine how that is possible.  I don’t even have a good idea of what this process involves.  I know my book will go through at least two editors (and I think it might be three).  I know that there will be a lot of back and forth in terms of design elements, the medical illustrations,  other graphics and actual edits to the text.  I’m hoping that the experience of writing 14 peer-reviewed scientific papers during my time as a medical researcher, as well as writing a PhD thesis, will have helped prepare me for this.  After all, how can editing a book possibly be worse than editing a paper published in a top tier journal?  Don’t answer that.

This book has taken a toll on my health and on my family.  I am stressed.  I am not getting enough sleep.  I’m not experiencing a flare or anything (phewf!), but I have been very emotional and tend to lose my patience uncharacteristically easily.  My kids miss my attention.   I miss paying attention to my kids!   My husband and I joke that we’ll have to start dating when the book is over so we can get to know each other again.  Frankly, I am greatly looking forward to being done with it.

So, where am I at?  I have three written chapters left to write (although bits and pieces of two of them are done) and two weeks to write them in (just to compare, Chapters 2 and 3 each took me over two months to write).  Two of these chapters should be fairly straight forward (I tackled this book with the hardest parts first, and boy am I ever glad I did!!!).   The other will require some research on my part, which means it will be a fair amount of work to finish.  I’m at 180K words (granted 15K of that is references and 5K is instructions for illustrations and graphics elements)–not including recipes which are all still just written in notebooks–and we are starting to push the boundaries of what we can physically bind (the backup plan is to go with a slightly lighter weight paper rather than cut out any important information or go with a small font, which I am adamantly against doing).  It is unfortunately too late to switch to a hardcover binding… maybe for the revised edition.

I greatly appreciate that so many of you have expressed such excitement over this book.   I know you will not be disappointed!   The Paleo Approach going to be a tremendous resource and guide and it is definitely a project that I am immensely proud of.  Thank you so much to everyone who has pre-ordered (your pre-orders help boost book store orders, so they are very important!).  And, thank you so much to everyone who has shared my blog , podcast, and my book with your friends and families.  Thank you to everyone following me on facebook, twitter and pinterest.  And a VERY BIG thank you to everyone who has donated through PayPal and supported me by linking to amazon from my blog (remember, you don’ t need to buy the item you link from!).   This makes such a huge difference for me, I can’t even begin to thank you enough.  Every little bit counts.

And, thank you for your patience.  I hope that by mid-summer, I will be back to my prolific self on the blog.  And hopefully, sooner rather than later, I will back to my normal self at home!  And hopefully I will someday look back on this time and feel that it was all worth it.

Once again, thank you for your support.

Pre-Order The Paleo Approach!



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“How Do I Know When It’s Working?” A Quick Troubleshooting Guide to Paleo

April 15, 2013 in FAQ, FAQ, How To Get Started

yoga1It’s a question that many people new to paleolithic nutrition ask either while they are going through that initial adjustment period (especially when jumping into paleo with both feet but also with gradual transitions) or as the months wear on and the difference is not as magical as anticipated.  How do I know when it’s working?  When will I start to lose tons of weight and have lots of energy?  When will my health conditions miraculously disappear?

Well, the answer is “it depends”.

How different did you eat before committing to paleolithic nutrition?  Generally, the more different you are eating now to before you discovered paleo, the harder and longer your adjustment period.  This is especially true if you ate a lot of carbohydrates before.  It can take up to a month for your body to switch over to a metabolism that runs better on fat and in the meantime, you may feel tired, lethargic, have headaches, and generally feel pretty terrible.  But, this isn’t true for everyone.  And of course, the opposite can also be true:  some people are made so sick by the foods they were eating before that they notice an instant improvement to their health.

What health issues are you challenged with?  In my personal experience, most gut health issues will improve dramatically the first couple of weeks on paleo and then continue to improve slowly over the next six months as your gut continues to heal (for more posts on gut health, see here and here).  Issues relating to inflammation typically take longer to show significant improvement depending on how well you are sleeping and managing your stress (typically another month or two).  Remember that for many health issues, you need to address all of the tenants of a paleolithic lifestyle (get good sleep, manage stress, get outside).

Are you in autoimmune denial?  I was.  While out-of-the-box paleo tackled most of my health issues, I still had unresolved autoimmune issues even after four months of strict paleolithic nutrition.  I had to do the autoimmune protocol (I’ve written about the autoimmune protocol extensively and this is also the topic of my book), in which you also exclude all the gray area foods.  If you have been eating a strict paleolithic diet for two months and are still dealing with health issues, you might have to do this too.  The good news is that after a few months of no eggs, no nuts, no seeds, no nightshades, no alcohol, no NSAIDs, low caffeine and no cheating, with a concurrent focus on eating extremely nutrient-dense foods (lots of vegetables, grass-fed meat, organ meat, fish and bone broth), most people can add at least some of those things back in.

Is your gut in REALLY bad shape?  It is possible that your gut was very leaky before you started paleo, so healing is just plain ol’ going to take a while.  Especially, if you suspect that you have Small Intestinal Bacterial Overgrowth or extensive gut damage, you’ll need to focus on Repairing The Gut, which can take 6 months to 2 years (although you should see continuous gradual improvement).  For all of the posts I’ve written on gut health, click here.

stomach acidHow is your digestion?  You might need to add some digestive support supplements for a little while to help your body heal.  These include digestive enzymes, ox bile, and stomach acid supplements (which are contraindicated for those with ulcers, blood clotting disorders, or taking NSAIDs).  Digestive enzymes and ox bile, while they can be expensive, are generally very safe to take as directed on the bottle (just make sure you actually eat once you take digestive enzymes because taking them and then not eating can cause damage to your gut).  If you are interested in a stomach acid supplement, check out my post on stomach acid here and this post by Steve Wright.

Do you have unknown food sensitivities?  If you’ve had a leaky gut for some time, you may have food sensitivities that you are unaware of.  Many alternative health care practitioners will order an IgG and/or IgA antibody screen which tests for food sensitivities.  The good news is that if you leave those foods out of your diet for a while, you can usually add them back in after your gut has fully healed.  If you have symptoms of Irritable Bowel Syndrome (like diarrhea, constipation, gas, bloating, acid reflux), another possibility is a FODMAP sensitivity.  Other potential culprits include salicylate sensitivity and food allergies (such as latex allergies, citrus, fish and shellfish, tree nuts, eggs, and dairy).

Do you need liver detox support? If you had/have an overgrowth of bacteria or yeast in your gut that are now dying off in great numbers, your liver might be working in overdrive.  B-vitamins (rich in red meat and organ meat), sulfur (rich in cruciferous vegetables and vegetables from the allium family), selenium (rich in seafood and organ meat) molybdenum (rich in organ meat) are important to support the liver.  Milk thistle (extract or tea) may also be helpful.  Choosing foods rich in these substances (or supplements) to help support liver detox is also useful for anyone losing weight, especially if the weight is coming off quickly.  This is because the body uses the fat tissues to store some toxins and excess hormones like estrogen (which gets them safely out of the body’s circulation) and rapid weigh loss has the potential to release these putting an additional strain on the liver.

Are you sleeping enough?  Yes, this has nothing to do with diet.  But sleep has a profound effect on every system in your body and if you are not getting enough of it, you can’t heal properly.  Aim for 8-10 hours per night in a pitch black room (see this post if you’re having trouble getting good sleep).  You can read more about the importance of sleep on the immune system in this teaser excerpt from The Paleo Approach.

Are you stressed? If you are not taking adequate measures to manage your stress (like getting activity but avoiding excessively strenuous exercise, spending time outside, having fun, getting enough sleep and developing strategies to manage psychological stressors), then your stress hormones might be out of whack.  If you have been under high stress for a long time and have trouble sleeping, you may have adrenal fatigue.  Both www.RobbWolf.com and www.BalancedBites.com have lots of great suggestions for healing from adrenal fatigue.

Did you go too low carb? What types of carbs (fruit versus starchy vegetables versus both versus neither) and how many carbs we should eat (varying from ketogenic diets and 20g per day to plenty of “safe starches” and upwards of 300g per day) is probably the most hotly debated topic within the paleo community.  One of the reasons for there being no clear answer as to what is best is that the carb intake of historically-studied and modern hunter-gatherer populations varies wildly.  On one end of the extreme are the Eskimos, who consume a diet composed approximately of 50% fat, 35% protein and 15% carbohydrate.  On the other end of the extreme are the Kitavans, who consume a diet composed approximately of 20% fat, 10% protein and 70% carbohydrate.  And of course, everything in between.  This probably reflects the fact that macronutrient ratios are not as important as food quality and nutrient density.  So, if your introduction to the concept of paleo was through a resource that expounded on the benefits of low carb, it is important to understand that this view is not representative of the entire paleo community and no consensus exists.  It’s also important to understand, that while blood sugar regulation is extremely important, going too low carb can be tough on your thyroid and can decrease leptin sensitivity (see this post and this post).  Also, eating adequate carbohydrates and especially insoluble fiber is important for proper regulation of ghrelin levels (see this post).  So, what is a good carbohydrate intake?  That’s actually highly individual (you can read this series of posts about optimizing your carb intake here, here and here), but if you are not feeling very good on a standard paleo diet, adding a little fruit or starchy vegetables is a good idea to try.

Are you inappropriately IFing? There are many enthusiastic supporters of Intermittent Fasting, but it’s important to understand that this is only appropriate for very healthy people.  If your sleep is not great, if your stress in not managed, if you are substantially overweight or if you have any kind of chronic disease, skipping breakfast (or breakfast and lunch) can cause dysregulated cortisol and undermine your other efforts.  This is not something to experiment with early on in your paleo journey.

What are your goals and how far away from them are you?  If you have a lot of weight to lose, you will probably notice a big drop in weight fairly quickly.  This will be mostly water weight, but don’t worry, fat is also being burned and you should eventually settle down into some nice steady weight loss (slow and steady wins the race, so there is no reason to be frustrated with weight loss if you are “only” losing a half pound per week-that’s actually very healthy!).  When your body seems resistant to weight loss, try addressing sleep quality and stress levels, but also be aware of the impact of female hormones and hunger hormones (levels and sensitivity).  For more tips and tricks for losing weight, see this post.

gray foodsAre you truly complying with paleolithic nutrition?  There are few things worse than being “almost paleo” (depending on your health challenges and what “almost” actually means for you).  While many people can successfully navigate the murky waters of cheats and occasional gluten consumption, if you are asking the question “when will I feel fabulous” while not actually following a paleo diet as strictly as you can, then you might be a person who just can’t cheat or tolerate occasional gluten exposure.  And from a metabolism, hormone and taste-bud adaptation standpoint, allowing yourself the occasional slice of pizza or pie a la mode can really derail your efforts to get healthy and perpetuate cravings, food addictions, and feelings of deprivation.  I advise eating very strict paleo for at least a month before you play with eating small amounts of dairy or legumes or allowing yourself cheat meals (and I recommend a lifelong avoidance of gluten for most people).  If strict paleo isn’t enough to make you feel great, look at the gray area foods in your diet (eggs, nuts, seeds, nightshades, alcohol, caffeine).  Maybe one of them is the culprit (nightshades are my number one suspect).  But if you are truly sticking to it, my guess is you are already feeling much, much better!

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Guest Post from Alison Golden: 4 Steps To Doing Nothing To Manage Your Stress

April 6, 2013 in Stress and Sleep

paleo stressImagine.

The kids are whining. The dishwasher needs emptying. Dinner not only isn’t on the table, it’s still a solid block in your freezer. You’ve been on the go since dawn, and will carry on until well beyond dusk.

The list of responsibilities we have to complete in a single day seems, many times, to require feats of superhuman endurance and scheduling.

Time management gurus tell us to write our to-do lists, prioritize our items and work on those that generate the biggest payback.

Our list of responsibilities appears never-ending: The must-dos, the have-tos and the absolutely essential. Thing is, it’s all important. And often essential.

It’s all essential

Making dinner for the family is essential, going to work is essential, keeping the bathroom and the kitchen from being visited by the Board of Sanitation is essential. It’s all essential. Sigh.

There is simply too much going on in our twenty-first century lives. And it can lead to being on the go from morning to night. Add a sick child or a sleepless night to the equation and it can tip us into despair.

The result is we get irritable, resentful and start snapping at others. Our family members pick up on our irritability and tiredness and start their own little dramas. All manner of challenging behavior can begin to appear. Things are set up for a negative cycle of events.

And then…

Our endeavors to manage our stress, our sleep and healthy food go down the drain. We compound the problem by sabotaging ourselves with food. We don’t leave enough time to cook, we eat a quick, but unhealthy, pick-me-up to keep ourselves going, we eat for a treat. Or we eat to calm ourselves down.

Too late.

By the time we’ve got to this point, all reasonable and rational thinking has gone out the door. The time for prevention has passed. Or it certainly requires powers of superhuman intervention.

We need to avoid getting to this point. We need to stay calm, centered and avoid becoming frazzled. We need to start before it begins.

In my book, The Modern, No-Nonsense Guide to Paleo, I talk about how stress and sleep are the first building blocks to address when adopting a paleo lifestyle. Start with these two elements, build up your skills here, because if your stress and your sleep aren’t handled sufficiently, food behaviors are far more difficult to handle.

One inexpensive, easy-to-organize technique for handling your stress, keeping you calm and simply more happy is to set up regular “Don’t-Have-To-Days”. Judicious use of “Don’t-Have-To Days” is a technique to prevent the well of stress from building up and overflowing into a cascade of family drama.

What is a “Don’t-Have-To-Day”?

Good question. They are something that most women, all mothers and some men need to incorporate into their schedule. They are days, or hours if you can’t make a whole day, that you take off to spend how you please. Here’s how to set one up and reap the benefits of a easy, cost-effective chillax.

Step 1. Schedule a day, or half a day if you don’t have a whole day and certainly at least an hour to spend at home, alone.

Step2. Relieve yourself of children, work or other demands on your time for the period you’ve set aside.

Step 3. Turn off the computer, TV, phone and any other device likely to be a call on your attention.

Step 4. Do nothing you don’t want to. Nothing. At. All. For the whole time. This includes getting dressed, washing dishes, brushing your hair, etc. Let’s rephrase that. Especially not getting dressed, washing dishes, brushing your hair, etc.

Bonus Step. Plan to eat out for dinner or have someone take over bath night (or skip it entirely!) that day – unless these items are so pleasurable for you, they make you happy.

The “don’t have to” part comes in because this is time when you don’t have to do anything you don’t want to. The idea is to relieve yourself of the burden of the sense of obligation and responsibility for a small period of time.

They are mini-vacations from your regular life and they allow you to rest. You schedule them in your calendar. Organize your time so that you are free of work commitments, children or any other responsibilities. Preferably take them at home when no-one else is around.

You don’t have to take a full day or even half a day but make sure you take at least a whole hour. During this time don’t do anything you don’t want to – get dressed, answer the phone, do the dishes, workout. Avoid social media and any and all guilt. Just do what you like for the time you’ve allotted – anything that makes you happy or relaxed.

Benefits ensue even before you start – you’ll anticipate and look forward to your time – and afterward, you’ll feel more relaxed, and happier. Schedule these times regularly to keep your stress levels lowered before they get to screaming point.

Whenever I take this time, I find that I let chores pile up. Dishes aren’t done, teeth aren’t cleaned, I don’t even contemplate working out. I spend time in the house where I can’t see the mess and do whatever takes my fancy. (I usually have to sit and think about it, it is so rare to have such a slice of time.) Usually I journal, read, listen to podcasts I otherwise never listen to, sit in the sun, nap, drink tea and stare out the window.

You may find that, given enough time, you’ll eventually stop vegging, and spontaneously and willingly start completing the minor chores you neglected earlier but now your feelings of being put upon, over-burdened or just plain ennui have evaporated. When I do this, I have more emotional and physical energy, I’m more relaxed, happier, perfectly chilled and enthusiastic about life. And I’m planning my next “Don’t Have To Day”!

Permission to be permissive

Give yourself permission to spend this time how you please because it’s my guess that you rarely do. And it’s amazing how just being relieved of the need to clean our teeth one in a while can make such a difference.

So when the world and his mother is calling upon you, you have the whole civilization to save and everything to do, instead, as counterintuitive as it sounds, do nothing. Notice how your perspective changes, life gets lighter, a spring enters your step. Schedule your next “Don’t Have To Day” right then before it gets away from you and the kids come banging through the door.

And the best part?

Everyone benefits. Not just you but your kids, your spouse, even the mailman. Everyone. Focus on you. Everything starts here.

So now you know what to do, go do it! Protect this time, it is for you, you need to keep your awesomeness shining through.

AG_crop75Alison Golden is a writer, blogger, coach and mother of two. She has been an avid advocate of healthy eating for years and paleo since 2010. She is the author of The Modern, No-Nonsense Guide to Paleo, a book described by Mark Sisson as “one of the best tools I’ve seen yet to get you started and keep you motivated throughout your paleo journey” and blogs at Paleo/NonPaleo about living paleo in a non-paleo world.

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Teaser Excerpt from The Paleo Approach–The Importance of Sleep

April 4, 2013 in Practical Tips, Stress and Sleep, The Paleo Approach Excerpts

The Paleo Approach by Sarah BallantyneThere are many topics that I am researching and writing about for the book that I’ve been meaning to write about for the blog for ages (the book just gives me a firm deadline). I have decided take some of these topics (especially the more blog-sized ones) and publish them as teaser excerpts for the book (also because I think this information should be here too).

The book also contains a detailed (yet easy-to-follow) description of the components of the immune system, including a great quick reference guide to help you as you read through the book.  So, when you read this section in the book, you’ll already know why modulating Th1, Th2 and Th17 cells is important and you’ll already understand the essential role that regulatory T-cells play in the immune system.  

For a quick primer: Th1, Th2 and Th17 cells are subtypes of lymphocytes (white blood cells) that can be over-activated in autoimmune disease and cause damage. Regulatory T-cells are another subtype of lymphocyte that are supposed to keep all the other immune cells in check and suppress both over-activation of the  immune system and autoimmunity (they tend to be deficient in autoimmune disease). Cytokines are chemical messengers of inflammation. Monocytes and neutrophils are types of white blood cell responsible for generalized inflammation (part of the innate immune system whereas B-cells and T-cells are part of the adaptive immune system).  B-cells are the type of lymphocyte that produce antibodies.

So, forgive the references to Chapter 7 and page numbers with no number. While you’ll have to wait until the book is out in September to read those sections, in the meantime, please enjoy this part of Chapter 4:  Lifestyle Factors That Contribute to Autoimmune Disease.

Excited to read The Paleo Approach?

Pre-Order Your Copy Now!

Want to help spread the word about my book?  Please share this post and other teaser excerpts.  Thank you!

“A good laugh and a long sleep are the best cures in the doctor’s book.”

–Irish Proverb

In the last 50 years, the average amount of time that Americans sleep each night has decreased by 1.5–2 hours.  That’s a staggering amount of sleep—equivalent to a full month of continuous sleep every year—that we need but are not getting.  Epidemiological studies show a strong correlation between short or disturbed sleep and obesity, diabetes and cardiovascular disease.  In fact, lack of adequate sleep has been associated of increased morbidity and mortality from all causes.  This means that if you consistently don’t get enough sleep, you have a much higher risk of getting sick and/or dying.  Period.  Studies have also evaluated the role that sleep plays in healing from specific diseases, like breast cancer, and show that the less you sleep, the less likely you are to survive.

Frankly, scientists still don’t really understand why we need sleep, why we need as much as we do, and what our bodies are actually doing while we sleep.  But, it is obvious that sleep is important for human health.  Studies that evaluate the physiological changes caused by not sleeping or not getting enough sleep can be very instructive in understanding just how critically important sleep is.  For those with autoimmune disease, it is especially important to understand the role that sleep has in inflammation, stimulating the immune system, and regulating hormones (which themselves modulate the immune system).

Just plain old not getting enough sleep causes inflammation even in young, healthy people.  A variety of studies evaluating the effects of acute sleep deprivation (typically by restricting sleep to 4 hours per night) for several consecutive days (typically 3 to 5) have shown increases in markers of inflammation and the numbers of white blood cells in the blood.  Specifically, even just three consecutive nights of not enough sleep can cause increased monocytes, neutrophils and B-cells in the blood, increased proinflammatory cytokines (including cytokines known to stimulate maturation of naïve T-cells into Th1, Th2, and Th17 cells), increased C-reactive protein (a marker of inflammation), increased total cholesterol and increased low density lipoprotein cholesterol (LDL).

Even just one night of lost sleep (40 hours without sleep) causes inflammation in young, healthy people.  Just pulling a single all-nighter dramatically increases markers of inflammation in the blood, including C-reactive protein and proinflammatory cytokines.  Studies that evaluated not just sleep deprivation but also recovery after sleep restriction (with the idea of simulating a typical workweek where someone might get less sleep for 4 or 5 nights straight and then try to make up for it on the weekend) have also shown that the proinflammatory cytokine known to stimulate Th17 cell development persists for at least two days after increasing sleep to 8 hours per night, even though other markers of inflammation have recovered.  This means that even if you try and “catch up” on your sleep during the weekend, the stimulation to the immune system keeps going.  If you follow this stereotypical pattern of not getting enough sleep during the week and sleeping in on the weekend, you still run the risk of cumulatively causing detrimental changes in the immune system.  Certainly, you can recover from lack of sleep, but it takes persistence, consistency and commitment—even during the week.

Sleep deprivation is also associated with increased susceptibility to infection.  In fact, the less sleep you get, the more likely you are to catch the common cold.  Getting adequate sleep can also protect you from infection.  One study even showed that the longer the sleep duration, the lower the incidence of parasitic infections in mammals.

Inadequate sleep also has profound effects on hunger hormones and metabolism (recall that hunger hormones such as insulin, leptin, ghrelin, and cortisol are important modulators of the immune system, see page ##, ## and ##).  For example, when food intake is measured following sleep deprivation (5 consecutive days of 4 hours sleep), people tend to eat substantially (20%!) more than normal.  However, it doesn’t take five full days of inadequate sleep to see dramatic effects on insulin, cortisol, and leptin.  One study showed that even a single night of partial sleep (4 hours) causes insulin resistance in healthy people.  Another study showed that a single night of partial sleep (3 hours, in this case) caused reduced morning cortisol levels (when cortisol should be its highest) and elevated afternoon/evening cortisol (when cortisol should be gradually decreasing) and elevated morning leptin levels.  This means that one night of three or four hours sleep causes insulin resistance, dysregulated cortisol and increased leptin.  One late bedtime because you went to a late night movie or a party at the boss’ house.  One.

Inadequate sleep has also been investigated as a possible cause of autoimmune disease. In an animal model of psoriasis, sleep deprivation caused significant increases in proinflammatory cytokines, cortisol levels, and increases in specific proteins in the skin associated with symptoms of psoriasis (like the flaking, dry, scaly skin).  In an animal model of multiple sclerosis, mice subjected to sleep deprivation developed the disease earlier than mice that slept normally.  Once the mice developed multiple sclerosis, sleep deprivation caused increased disease activity and pain sensitivity.  Furthermore, sleep disturbances are commonly reported by people with chronic inflammatory conditions (such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease and asthma).  Whether the sleep disturbances cause the disease or the disease causes the sleep disturbances is not well understood.  However, such sleep disturbances are known to worsen the course of the disease, aggravate disease symptoms such as pain and fatigue, increase disease activity and lower quality of life.  Yes, sleep is important.

So, how much sleep do you need?  There is no clear answer to this.  Consensus is that healthy adults need 7-10 hours of sleep per night.  If you are trying to heal from an autoimmune disease, don’t be surprised if what your body needs is on the longer end of that range (say 9 to 10 hours) or even exceeding that range (some people with autoimmune disease report needing 12 hours of sleep every night to heal).

Getting enough sleep isn’t just about preventing inflammation; it’s also about repairing the body and modulating the immune system.  Certainly, the process of tissue repair in the body is predominantly performed during sleep.  However, an important study showed that regulatory T-cell activities follow a circadian rhythm, meaning that, just like many functions within the human body, they increase and decrease throughout the day.  In healthy people, regulatory T-cells are highest in the blood at night with lowest numbers in the morning (similar to melatonin production and the opposite of cortisol). The activity of the regulatory T-cells also follows a circadian rhythm, having the highest suppressive activity during sleep and lowest in the morning.  When volunteers were subjected to sleep deprivation, the suppressive activity of their regulatory T-cells was decreased (even though the actual numbers of T-cells remained the same).  This implies that sleep is required for the suppressive activity of regulatory T-cells, meaning that if you want to modulate your immune system and reverse your autoimmune disease, sleep is critical.

If you have an autoimmune disease (I generally assume you do if you are reading this book) and aren’t getting 8 hours of good sleep every night, I cannot emphasize enough the importance of putting sleep on the top of your priority list.  You need sleep.  Now.  Tonight.  Every night.  Seriously, stop reading and go to bed.  Strategies for prioritizing sleep and what to do if you are trying to get more sleep but just can’t are discussed in Chapter 7.

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Bosy-Westphal, A., et al., Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women, Obes Facts. 2008;1(5):266-73

Boudjeltia KZ, et al., Sleep restriction increases white blood cells, mainly neutrophil count, in young healthy men: a pilot study, Vasc Health Risk Manag. 2008;4(6):1467-70.

Donga, E., et al., A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects, J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8.

Frey, D.J., et al., The effects of 40 hours of total sleep deprivation on inflammatory markers in healthy young adults, Brain Behav Immun. 2007 Nov;21(8):1050-7

Heslop, P., et al., Sleep duration and mortality: The effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women, Sleep Med. 2002 Jul;3(4):305-14.

Hirotsu, C., et al., Sleep loss and cytokines levels in an experimental model of psoriasis, PLoS One. 2012;7(11)

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Lucassen EA, et al., Interacting epidemics? Sleep curtailment, insulin resistance, and obesity, Ann N Y Acad Sci. 2012 Aug;1264(1):110-34

Meier-Ewert HK, et al., Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk, J Am Coll Cardiol. 2004 Feb 18;43(4):678-83.

Palma, B.D., et al., Effects of sleep deprivation on the development of autoimmune disease in an experimental model of systemic lupus erythematosus, Am J Physiol Regul Integr Comp Physiol. 2006 Nov;291(5):R1527-32.

Palma, B.D. & Tufik, S., Increased disease activity is associated with altered sleep architecture in an experimental model of systemic lupus erythematosus, Sleep. 2010 Sep;33(9):1244-8.

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