1- Insomnia & Sleep-Wake Cycle Disorder

What is Insomnia?

Insomnia refers to a difficulty in achieving or maintaining normal sleep. There are two basic forms of insomnia. In sleep-onset insomnia a person has a difficult time falling asleep. In sleep-maintenance insomnia a person suffers from frequent or early awakening.

What causes Insomnia?

The most common causes of insomnia are psychological: depression, anxiety, and tension. If psychological factors do not seem to be the cause, various foods, drinks, and medications may be responsible. There are numerous compounds in food and drink (most notably caffeine) that can interfere with normal sleep. There are also over three hundred drugs that interfere with normal sleep.

What dietary factors are important in Insomnia?

Eliminate caffeine. It is essential that the diet be free of natural stimulants such as caffeine and related compounds. Coffee, as well as less obvious caffeine sources such as soft drinks, chocolate, coffee-flavored ice cream, hot cocoa, and tea, must all be eliminated. Even small amounts of caffeine such as those found in decaffeinated coffee or chocolate, may be enough to cause insomnia in some people.

Other food compounds that can act as stimulants include some food colorings. Adverse food reactions such as food sensitivities and allergies can also cause insomnia. Although not considered a stimulant, sugar and refined carbohydrates can interfere with sleep. Eating a diet high in sugar and refined carbohydrate and eating irregularly can cause a reaction in the body that triggers the “fight or flight” part of the nervous system, causing wakefulness.

Eliminate alcohol. Alcohol causes the release of adrenaline and disrupts the production of serotonin (an important brain chemical that initiates sleep).

Avoid nocturnal hypoglycemia. In my clinical experience I have found nocturnal hypoglycemia (low nighttime blood glucose level) is an important cause of sleep-maintenance insomnia. When there is a drop in the blood glucose level, it causes the release of hormones that regulate glucose levels, such as adrenaline, glucagon, cortisol, and growth hormone. These compounds stimulate the brain. They are a natural signal that it is time to eat. Good bedtime snacks to keep blood sugar levels steady throughout the night are oatmeal and other whole grain cereals, whole grain breads and muffins, and other complex carbohydrates. These foods will not only help maintain blood sugar levels, they actually can help promote sleep by increasing the level of serotonin within the brain.

Foods high in the amino acid tryptophan, such as turkey, milk, cottage cheese, chicken, eggs, and nuts, especially almonds, may help to promote sleep. In the brain, tryptophan is converted to serotonin and melatonin, which are natural sleep-inducing compounds.

2- Obesity

 What is Obesity?

Obesity is defined as a state of being more than twenty percent above “normal” weight, or having a body-fat percentage greater than thirty percent for women and twenty-five percent for men. Another measurement of obesity is having a body mass index greater than 30.

What causes Obesity?

Theories of the underlying causes of obesity are tied to genetics, low brain serotonin levels, impaired diet-induced thermogenesis (heat production), and the inner workings of fat cells. All of these models support the notion that obesity is not just a matter of overeating. They explain why some people can eat large quantities of food and not increase their weight substantially, while for others, just the reverse is true. For example, a certain amount of the food we consume is converted immediately to heat, which is known as diet-induced thermogenesis. Diet-induced thermogenesis is the method by which the body “wastes” calories. There is evidence that the level of diet-induced thermogenesis is what determines whether an individual is likely to be overweight. In lean individuals, a meal may stimulate up to a 40% increase in heat production. In contrast, overweight individuals often display only a 10% or less increase in heat production. The food energy is stored as fat instead of being converted to heat.

What dietary factors are important in Obesity?

There are literally hundreds of diets and diet programs that claim to be the answer to obesity. However, the basic equation for losing weight never changes. In order for an individual to lose weight, energy intake must be less than energy expenditure. This goal can be achieved by decreasing caloric intake (dieting), and/or by increasing the rate at which calories are burned (exercising). Most individuals will begin to lose weight if they decrease their caloric intake below 1,500 calories per day and do aerobic exercise for 15-to-20 minutes 3-to-4 times per week. Starvation and crash diets usually result in rapid weight loss (largely muscle and water), but cause rebound weight gain. The most successful approach to weight loss is gradual weight reduction (0.5 to 1 lb per week) through adopting long-term dietary and lifestyle modifications.